A client arrives for her second prenatal visit and the provider is reviewing the results of her tests.The client’s blood type and Rh factor are B- (negative). What additional intervention is needed for this client?
Blood transfusion just after delivery.
Maternal serum alpha-fetoprotein (MSAFP) at 24 weeks gestation.
RhO(D) immune globulin at 28 weeks gestation.
Three-hour glucose tolerance test at 26 weeks gestation.
The Correct Answer is C
Choice A rationale
A blood transfusion just after delivery is not a standard intervention for a client with Rh-negative blood type. The primary concern for Rh-negative clients is the potential for Rh incompatibility with the fetus, which can lead to hemolytic disease of the newborn. This condition is prevented by administering RhO(D) immune globulin during pregnancy.
Choice B rationale
Maternal serum alpha-fetoprotein (MSAFP) testing is used to screen for certain fetal abnormalities, such as neural tube defects, but it is not specifically related to Rh incompatibility. The primary intervention for Rh-negative clients is the administration of RhO(D) immune globulin to prevent sensitization.
Choice C rationale
RhO(D) immune globulin is administered at around 28 weeks of gestation to prevent Rh sensitization in Rh-negative clients. This intervention is crucial for preventing the development of antibodies that could harm the fetus in current or future pregnancies.
Choice D rationale
A three-hour glucose tolerance test is used to screen for gestational diabetes, which is a separate concern from Rh incompatibility. The primary intervention for Rh-negative clients is the administration of RhO(D) immune globulin.
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Correct Answer is C
Explanation
Choice A rationale
Intimate partner violence (IPV) does not necessarily decrease during pregnancy. In fact, pregnancy can sometimes increase the risk of IPV due to various stressors and changes in the relationship dynamics.
Choice B rationale
IPV consists of more than just physical abuse. It can also include emotional, psychological, and sexual abuse. Emotional abuse can involve manipulation, threats, and controlling behavior, while sexual abuse includes any non-consensual sexual activity.
Choice C rationale
IPV can indeed include emotional, physical, and sexual abuse. This comprehensive understanding is crucial for recognizing and addressing all forms of IPV, as each type can have severe and lasting impacts on the victim’s health and well-being.
Choice D rationale
IPV is not rare; it is a common issue affecting millions of people worldwide. It can occur in any demographic and socioeconomic group, making it a significant public health concern.
Correct Answer is A
Explanation
Choice A rationale
The ductus venosus, foramen ovale, and ductus arteriosus are shunts in fetal circulation that bypass the lungs and liver, directing oxygenated blood to the brain and body. The foramen ovale allows blood to flow from the right atrium to the left atrium, bypassing the lungs. The ductus arteriosus connects the pulmonary artery to the aorta, allowing blood to bypass the lungs. The ductus venosus shunts blood from the umbilical vein to the inferior vena cava, bypassing the liver.
Choice B rationale
This choice is incorrect because the primary purpose of these shunts is not to ensure proper development of the fetal heart. While they do play a role in directing blood flow, their main function is to bypass the non-functional fetal lungs and liver.
Choice C rationale
This choice is incorrect because the shunts are not primarily involved in regulating blood pressure in the fetus. Their main function is to direct oxygenated blood to vital organs like the brain and heart.
Choice D rationale
This choice is incorrect because the shunts bypass the lungs, which are not yet functional in the fetus. Gas exchange occurs in the placenta, not the fetal lungs.