# Review the postpartum record for an unsensitized Rh(D)-negative client. Which medication plan is best?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522644&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

Review the postpartum record for an unsensitized Rh(D)-negative client. Which medication plan is best?

History

Vitals

Labs

Orders

Notes

Unsensitized A-negative client received routine antepartum prophylaxis at 28 weeks

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1

Administer the postpartum Rh(D) immune globulin dose to the newborn only.

✕

2

Withhold prophylaxis because the routine antepartum dose prevents every later exposure.

✕

3

Administer the postpartum dose to the mother within 72 hours and determine whether the quantified fetomaternal hemorrhage requires additional dosing.

✕

4

Delay all prophylaxis until the 6-week postpartum visit regardless of newborn status.

✕

## Explanation

An unsensitized Rh(D)-negative mother who delivers an Rh(D)-positive newborn needs postpartum Rh(D) immune globulin within 72 hours. Exposure above 15 mL of Rh(D)-positive fetal red cells requires additional dose calculation.

## In-depth explanation

Quick answer
Give postpartum prophylaxis to the mother and account for the measured fetal-cell exposure.

Why this is correct
The antepartum dose does not replace postpartum prophylaxis after a new Rh(D)-positive exposure, and the product is not administered to the newborn for this indication.

Easy analogy or mental picture
Use a family-centered medication-safety loop: verify age or pregnancy context, identify the exposure and new cue, prevent further harm, stabilize the client, and confirm the response.

Memory hook
Population, indication, dose or route, contraindication, urgent cue, protective action, and reassessment.

NCLEX decision rule
Choose the action that protects the maternal, newborn, or pediatric client from the most immediate medication-related harm while preserving authorized treatment.

Why the other choices are wrong
Options that normalize a danger sign, substitute an unapproved route or dose, or delay reassessment leave the client exposed to preventable harm.References
1DailyMed: RHOPHYLAC (Rh[D] immune globulin)Antepartum and postpartum prophylaxis, maternal administration, timing within 72 hours, and additional dose for excessive fetomaternal hemorrhage

## Clinical scenario

Maternal, newborn, and pediatric medication safety review
Verify the client's age or pregnancy stage, indication, weight or laboratory context, route, interacting therapies, contraindications, caregiver teaching, and measurable follow-up.

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