Practice Quiz

CNM Certified Nurse Midwife

Category - Primary Care

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A female client asks a nurse midwife why a newborn is not immunized with MMR immediately after birth. The client was immunized with MMR about 5 months ago and is planning to get pregnant. Which of the following possible responses is the most appropriate?
  1. “IgM maternal antibodies cross the placenta into the fetus during the third trimester, giving the newborn temporary passive immunity during the first months of life.”
  2. “If the mother has been immunized within five months before the pregnancy, the newborn is temporarily protected from German measles during the first months of life. This is an example of active immunity.”
  3. “IgG maternal antibodies cross the placenta into the fetus during the third trimester, so temporary active immunity is attained during the newborn’s first months of life.”
  4. “IgG maternal antibodies cross the placenta during the third trimester, giving the newborn temporary passive immunity during the first months of life.”
Explanation
Answer: D - The nurse midwife should inform the client that a newborn is protected from infectious diseases, such as German measles, during the first months of life because IgG maternal bodies can cross the placenta during the third trimester, which is a form of passive immunity. IgG is the only group of antibodies that can cross the placenta barrier. The level of IgG peaks at birth and decreases over the next eight months. The transfer of maternal antibodies to the fetus through the placenta is an example of passive immunity.
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