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A nurse is reinforcing postpartum discharge teaching to a client who had no immunity to varicella and was given the varicella vaccine.Which of the following statements by the client indicates understanding?

A.

I need a second vaccination at my postpartum visit.

B.

I will need to use contraception for 3 months before considering pregnancy.

C.

I was given the vaccine because my baby is O-positive.

D.

I will be tested in 3 months to see if I have developed immunity.

Answer and Explanation

The Correct Answer is A

Choice A rationale

 

The client needs a second varicella vaccination at her postpartum visit to ensure full immunity. The initial dose provides partial immunity, and the second dose completes the vaccination series.

 

Choice B rationale

 

The client needs to use contraception for 1 month, not 3 months, before considering pregnancy after receiving the varicella vaccine. This is to prevent potential harm to a developing fetus.

 

Choice C rationale

 

The varicella vaccine is not given based on the baby’s blood type. It is administered to protect the client from varicella infection.

 

Choice D rationale

 

There is no need for testing to see if the client has developed immunity after receiving the varicella vaccine. The second dose is given to ensure full immunity.


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Correct Answer is A

Explanation

Choice A rationale

At 1 cm above the umbilicus is the expected position of the uterine fundus 12 hours postpartum. After delivery, the fundus is typically at the level of the umbilicus and then descends approximately 1 cm per day. At 12 hours postpartum, it is normal for the fundus to be slightly above the umbilicus.

Choice B rationale

One fingerbreadth above the symphysis pubis is not the expected position of the fundus 12 hours postpartum. This position is more typical several days postpartum as the uterus continues to involute and return to its pre-pregnancy size.

Choice C rationale

To the right of the umbilicus is not a normal finding and may indicate a full bladder, which can displace the uterus. The nurse should assist the client to void and then reassess the fundal position.

Choice D rationale

Three fingerbreadths above the umbilicus is not expected 12 hours postpartum. This position may indicate uterine atony or subinvolution, which requires further assessment and intervention.

Correct Answer is D

Explanation

Choice A rationale

Rho(D) immune globulin is not indicated if both the client and the newborn are Rh positive. There is no risk of Rh incompatibility in this scenario.

Choice B rationale

Similarly, if both the client and the newborn are Rh positive, there is no need for Rho(D) immune globulin.

Choice C rationale

If both the client and the newborn are Rh negative, there is no risk of Rh incompatibility, and Rho(D) immune globulin is not needed.

Choice D rationale

Rho(D) immune globulin is indicated when the client is Rh negative and the newborn is Rh positive. This prevents the development of Rh antibodies in the client, which could affect future pregnancies.

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