Fraternal twins are delivered by your Rh-negative patient. Twin A is Rh-positive and twin B is Rh-negative. Prior to administering Rho(D) immune globulin (RhoGAM), the nurse should determine the results of the

Correct Answer: C

Rationale: The correct answer is C, indirect Coombs test of the mother. This test is crucial to determine if the mother has developed antibodies against the Rh-positive blood of twin A. If the test is positive, it indicates sensitization has occurred, making RhoGAM necessary to prevent hemolytic disease in future pregnancies. Direct Coombs tests of the twins (choices A and B) are not relevant in this scenario as they assess for antibodies already attached to the red blood cells. Transcutaneous bilirubin levels (choice D) are used to monitor jaundice, not Rh incompatibility.

Correct Answer: A

Rationale: The correct answer is A because insulin needs vary during pregnancy due to hormonal changes affecting insulin sensitivity. In early pregnancy, insulin needs may decrease due to increased insulin sensitivity, but in late pregnancy, insulin needs may increase due to insulin resistance. Choice B is incorrect as insulin needs do not consistently increase throughout pregnancy and postpartum. Choice C is incorrect as insulin needs typically increase rather than decrease during pregnancy. Choice D is incorrect as the fetus does not produce its own insulin to regulate the mother's blood sugar levels.

Correct Answer: D

Rationale: The correct answer is D because the patient, having just given birth, is at a higher risk of complications from chickenpox. By staying away from her home until her children are no longer contagious, she reduces the risk of contracting the illness and potentially passing it on to her newborn. This is crucial for the safety of both the mother and the baby. Choice A is incorrect because treating the children with acyclovir does not prevent the mother from contracting chickenpox. Choice B is incorrect as immunity is not transferred from the children to the mother or newborn. Choice C is incorrect because even with gowns and masks, the risk of transmission is still present, especially for a postpartum mother and a newborn.

Correct Answer: B

Rationale: The correct answer is B because a postpartum patient with Class II heart disease complaining of frequent coughing requires further assessment due to the risk of exacerbating heart failure. Coughing can increase cardiac workload, leading to potential complications. Choice A may indicate excessive postpartum bleeding, which would require immediate intervention. Choice C has a slightly elevated blood sugar level but is not immediately concerning. Choice D may require monitoring and possibly treatment for active herpes lesions, but it is not as urgent as assessing a patient with heart disease and coughing.