Nokea
At what age is the first dose of the hepatitis A vaccine recommended to be started?
- A. 1 year
- B. 1 month
- C. 12 years
- D. It is not recommended at any age
Correct Answer: A
Rationale: The correct answer is A: 1 year. The hepatitis A vaccine is now recommended for all children starting at age 1 year (i.e., 12 to 23 months). This is due to the recognition of hepatitis A as a significant child health problem, especially in areas with high infection rates. The virus is primarily spread through fecal-oral transmission, person-to-person contact, ingestion of contaminated food or water, and rarely through blood transfusion. Administering the first dose at 1 year helps protect children from this infection. Choices B and C are incorrect as the vaccine is not recommended at 1 month or 12 years. Choice D is also incorrect as the hepatitis A vaccine is recommended at a specific age to prevent the infection.
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What is an important intervention in providing a neutral thermal environment for an LBW infant in an incubator?
- A. Use wool blankets.
- B. Avoid using disposable diapers.
- C. Prevent heat loss.
- D. Closely monitor both incubator and rectal temperatures.
Correct Answer: C
Rationale: Preventing heat loss in a low birth weight (LBW) infant is crucial in maintaining a neutral thermal environment. The use of cotton blankets is recommended over wool blankets. Avoiding disposable diapers is not directly related to maintaining a neutral thermal environment. While monitoring temperatures is important, the key intervention is preventing heat loss to ensure the infant's survival.
Which laboratory value at the time of diagnosis should the nurse anticipate would determine the worst prognosis for a child with leukemia?
- A. Slow response to chemotherapy
- B. Platelets of 150,000/mcL
- C. Leukocytes less than 10,000/mcL
- D. Leukocytes of 275,000/mcL
Correct Answer: D
Rationale: A high white blood cell count (leukocytes of 275,000/mcL) at diagnosis is associated with a worse prognosis in leukemia because it indicates a more aggressive disease with a higher tumor burden. Slow response to chemotherapy (choice A) is a consequence of the aggressive disease and not a determining factor at diagnosis. Platelets of 150,000/mcL (choice B) and leukocytes less than 10,000/mcL (choice C) are within normal ranges and not indicative of a worse prognosis in leukemia.
The nurse is using a bulb syringe to suction a neonate after delivery. What is an important consideration?
- A. Compress the bulb before insertion.
- B. Clear the mouth and pharynx before the nasal passages.
- C. Use two bulb syringes, one for the mouth and pharynx and one for the nasal passages.
- D. Continue using a bulb syringe until secretions are removed as mechanical suction is contraindicated.
Correct Answer: B
Rationale: The correct consideration when using a bulb syringe to suction a neonate after delivery is to clear the mouth and pharynx before the nasal passages to prevent aspiration of amniotic fluid. Compressing the bulb syringe before insertion is important to create suction. Using two bulb syringes is unnecessary, as one is sufficient for both the mouth/pharynx and nasal passages. It is not recommended to continue using a bulb syringe until all secretions are removed; instead, mechanical suction can be employed if more forceful removal of secretions is required.
Several types of seizures can occur in neonates. What is characteristic of clonic seizures?
- A. Apnea
- B. Tremors
- C. Extension of all four limbs
- D. Jerking that cannot be stopped by flexion of the affected limb
Correct Answer: D
Rationale: Clonic seizures are characterized by slow, rhythmic, jerking movements that cannot be stopped by flexion of the affected limb. Therefore, the correct characteristic of clonic seizures is option D. Option A, apnea, is not characteristic of clonic seizures. Option B, tremors, does not describe clonic seizures accurately. Option C, extension of all four limbs, is not a typical feature of clonic seizures but rather seen in tonic seizures.
When assessing a family, the nurse determines that the parents exert little or no control over their children. This style of parenting is called which?
- A. Permissive
- B. Dictatorial
- C. Democratic
- D. Authoritarian
Correct Answer: A
Rationale: Permissive parenting is characterized by parents exerting little or no control over their children, leading to a lack of boundaries and structure.