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A nursery nurse is caring for a newborn who was born 2 hours ago. Upon review of the prenatal records, the nurse notes the following prenatal panel results:

 

A positive, Hepatitis B positive, RPR negative, Rubella immune, HIV negative, GBS positive. In addition to Vitamin K and Erythromycin ophthalmic ointment, what injection(s) should the newborn receive?

A.

Hepatitis B vaccine only, administered within 1 hour of birth.

B.

Hepatitis B vaccine and Hepatitis B immunoglobulin administered within 12 hours of delivery.

C.

Hepatitis B immunoglobulin (HBIG) only, administered within 12 hours of birth.

D.

Hepatitis B immunoglobulin (HBIG) within 12 hours, followed by hepatitis B vaccine monthly for 12 months.

Answer and Explanation

The Correct Answer is B

Choice A rationale

 

Administering only the Hepatitis B vaccine within 1 hour of birth is not sufficient for a newborn born to a Hepatitis B positive mother. The newborn also needs Hepatitis B immunoglobulin (HBIG) to provide immediate passive immunity.

 

Choice B rationale

 

Administering both the Hepatitis B vaccine and Hepatitis B immunoglobulin (HBIG) within 12 hours of delivery is the recommended practice for newborns born to Hepatitis B positive mothers. This provides both active and passive immunity.

 

Choice C rationale

 

Administering only Hepatitis B immunoglobulin (HBIG) within 12 hours of birth is not sufficient. The newborn also needs the Hepatitis B vaccine to develop long-term immunity.

 

Choice D rationale

 

Administering Hepatitis B immunoglobulin (HBIG) within 12 hours, followed by monthly Hepatitis B vaccines for 12 months, is not the standard practice. The newborn should receive the Hepatitis B vaccine series according to the recommended schedule. .


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View Related questions

Correct Answer is B

Explanation

Choice A rationale

Erythema toxicum is a common, benign rash in newborns but does not cause swelling that crosses suture lines.

Choice B rationale

A caput succedaneum is swelling of the scalp that crosses suture lines and is caused by prolonged pressure on the head during delivery.

Choice C rationale

Mongolian spots are benign, flat, congenital birthmarks with wavy borders and irregular shapes, typically found on the lower back and buttocks, not the head.

Choice D rationale

A cephalhematoma is a collection of blood between the skull bone and its periosteum that does not cross suture lines. .

Correct Answer is C

Explanation

Choice A rationale

Applying a 1-2 cm ribbon from outer to inner canthus is incorrect because it increases the risk of contamination and infection by moving from a less clean area to a more clean area.

Choice B rationale

Applying a 2-3 inch ribbon from inner to outer canthus is incorrect because the length of the ribbon is too long and the direction is not recommended for preventing contamination.

Choice C rationale

Applying a 1-2 cm ribbon from inner to outer canthus is correct as it minimizes the risk of contamination by moving from a cleaner area to a less clean area, ensuring proper application of the ointment.

Choice D rationale

Applying a 1-2 inch ribbon to the upper eyelid is incorrect because the upper eyelid is not the recommended site for application, and the length of the ribbon is too long.

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