A client who is 6 hours postpartum and Rh-negative has an Rh-positive newborn. The client asks why an indirect Coombs test was ordered. Which of the following is an appropriate response by the healthcare provider?

Correct Answer: C

Rationale: The correct answer is C because the indirect Coombs test is used to detect Rh-positive antibodies in the mother's blood. In this scenario, the mother is Rh-negative, so if she has been sensitized to Rh-positive blood during childbirth, her immune system may produce antibodies that could potentially harm future Rh-positive pregnancies. This test helps identify the presence of these antibodies early on so appropriate interventions can be initiated to prevent hemolytic disease of the newborn. Choices A, B, and D are incorrect: A: This test does not determine if kernicterus will occur in the newborn. Kernicterus is a severe complication of jaundice, which may result from hemolytic disease of the newborn if untreated. B: The indirect Coombs test does not detect Rh-negative antibodies in the newborn's blood. It specifically looks for Rh-positive antibodies in the mother's blood. D: The test does not determine the presence of maternal antibodies in the newborn's blood. It focuses on detecting antibodies in

Correct Answer: C

Rationale: The correct answer is C: Assess the odor of the amniotic fluid. This is the appropriate nursing action because the woman is at risk for chorioamnionitis due to the elevated temperature and ruptured membranes. Assessing the odor of the amniotic fluid can help in identifying signs of infection, as foul-smelling amniotic fluid may indicate chorioamnionitis. This can guide further interventions and management, such as initiating antibiotics. Choice A is incorrect as waiting 4 hours to recheck the temperature can delay necessary interventions for potential infection. Choice B is also incorrect as administering glucocorticoids is not the immediate priority in this situation. Choice D is incorrect as preparing for an emergency cesarean section is not warranted solely based on the client's temperature and ruptured membranes without further assessment for infection.

Correct Answer: A

Rationale: The correct answer is A. Rubella immunization should be given shortly after giving birth to prevent any potential harm to the fetus during pregnancy. Immunization during pregnancy is contraindicated to avoid any risk of harm to the developing baby. Option B is incorrect as immunization in the third trimester can still pose a risk to the fetus. Option C is incorrect as immediate immunization during pregnancy is not recommended. Option D is incorrect as waiting until the next attempt to get pregnant does not protect the current fetus.

Correct Answer: A

Rationale: The correct answer is A because the maternal serum alpha-fetoprotein test is specifically used to screen for neural tube defects and other developmental abnormalities in the fetus. Alpha-fetoprotein levels in the mother's blood can indicate the presence of such abnormalities. This test is typically done around 15-20 weeks of gestation. Choice B is incorrect because the maternal serum alpha-fetoprotein test is not used to assess various markers of fetal well-being. Choice C is incorrect because it does not identify Rh incompatibility, which is typically detected through other tests. Choice D is incorrect because the test is not primarily for spinal defects, but rather for neural tube defects and other developmental abnormalities.

Correct Answer: D

Rationale: The correct answer is D: Variable decelerations. Variable decelerations are abrupt decreases in the fetal heart rate that coincide with contractions, indicating umbilical cord compression. This pattern can lead to fetal hypoxia and distress. Early decelerations (A) are gradual decreases in heart rate that mirror contractions and are considered benign. Accelerations (B) are increases in heart rate and are a reassuring sign of fetal well-being. Late decelerations (C) are gradual decreases in heart rate that occur after the peak of a contraction, indicating uteroplacental insufficiency.