The healthcare provider prescribes methylprednisolone 1 mg/kg IM every 12 hours for inflammation for a child who weighs 58 pounds.

The vial is labeled, "40 mg/mL.”. How many mL should the practical nurse (PN) administer with each dose? (Enter the numerical value only. If rounding is required round to the nearest tenth.)

Choice A rationale

Rho immune globulin (RhoGAM) is administered to Rh-negative mothers who have given birth to an Rh-positive baby. This injection prevents the mother's immune system from developing antibodies against Rh-positive red blood cells, which could otherwise harm future Rh-positive fetuses in subsequent pregnancies through hemolytic disease of the newborn.

Choice B rationale

If the mother is Rh positive and the baby is Rh negative, there is no risk of Rh incompatibility. The Rh-positive mother's immune system will not produce antibodies against the Rh-negative fetal red blood cells, as she already possesses the Rh antigen. Therefore, Rho immune globulin is not indicated in this scenario, as there is no sensitization risk.

Choice C rationale

When both the mother and the baby are Rh negative, there is no Rh incompatibility. Since neither the mother nor the baby has the Rh antigen, the mother's immune system will not be stimulated to produce anti-Rh antibodies. Consequently, Rho immune globulin administration is unnecessary in this situation, as no immune response will be triggered.

Choice D rationale

The Rh status of the father is relevant in determining the potential for Rh incompatibility, but it does not directly dictate the need for Rho immune globulin. The critical factor is the Rh status of the mother and the baby. If the mother is Rh positive, regardless of the father's Rh status, she will not produce Rh antibodies, and RhoGAM is not indicated.

Choice A rationale

Propping a bottle can lead to several adverse outcomes for an infant. It increases the risk of aspiration, as the infant may not be able to control the milk flow adequately. It can also contribute to otitis media due to milk pooling in the eustachian tubes and is associated with dental caries, particularly bottle mouth syndrome, and impaired bonding.

Choice B rationale

Sharing the observation with the charge nurse without first addressing the issue directly with the mother is not the most immediate or appropriate action. The PN should first attempt to educate and guide the mother, as this is within the scope of practice for direct client care and education.

Choice C rationale

Asking the mother if she is too tired is speculative and may be perceived as judgmental, potentially creating a barrier to effective communication and education. The PN's role is to provide health education and guidance regarding safe infant feeding practices, focusing on the behavior rather than the mother's perceived fatigue.

Choice D rationale

While observing the infant's behavior during feeding is important for a comprehensive assessment, the immediate and most critical action is to intervene with the unsafe practice of bottle propping. Observing further without addressing the identified risk delays necessary education and intervention to ensure infant safety.