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A 24 month old comes into the clinic to get his first flu vaccination. The nurse notices what food allergy in the patient's chart that would make this vaccine contraindicated?
- A. Gelatin
- B. Peanuts
- C. Eggs
- D. Bee Venom
Correct Answer: C
Rationale: Gelatin: Gelatin is sometimes used as a stabilizer in vaccines, including some flu vaccines. Individuals with severe gelatin allergies may need to avoid vaccines containing gelatin. However, egg allergy is more common and directly relevant to the contraindication for flu vaccination. Peanuts: Peanuts are not typically used in the production of flu vaccines. Peanut allergies are not a contraindication for flu vaccination unless the person also has an egg allergy or another contraindication. Eggs: Flu vaccines are commonly produced using chicken eggs. Therefore, individuals with a severe egg allergy should avoid flu vaccines, as they may experience an allergic reaction. This is especially important for young children, as they may be more prone to severe allergic reactions. Bee Venom: Bee venom is not an ingredient in flu vaccines. While it's essential to consider allergies to various substances when administering vaccines, bee venom allergy does not impact the safety of flu vaccination.
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Bacterial infection caused by both staph and strept bacteria. Usually sign around mouth and nose, more common in children and the elderly.
- A. Eczema
- B. Vitiligo
- C. Angioedema
- D. Impetigo
Correct Answer: D
Rationale: Eczema: Eczema is a chronic skin condition characterized by inflammation, redness, and itching. It is not typically caused by bacterial infections and does not present with signs around the mouth and nose. Vitiligo: Vitiligo is a condition characterized by the loss of skin color in patches. It is not caused by bacterial infections and does not typically present with signs around the mouth and nose. Angioedema: Angioedema is swelling beneath the skin, often around the eyes and lips, and is commonly associated with allergic reactions or other triggers. It is not caused by bacterial infections. Impetigo: Impetigo is a bacterial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes bacteria. It commonly presents with red sores or blisters around the mouth and nose, especially in children and the elderly. Therefore, option D, Impetigo, is the correct answer.
A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following as an acceptable food choice for this child?
- A. Barley
- B. Rye
- C. Rice
- D. Wheat
Correct Answer: C
Rationale: Barley: Barley is a grain that contains gluten. Foods made from barley, such as barley flour or barley-based products like bread, cereal, or beer, should be avoided by individuals with celiac disease because gluten can trigger an immune response that damages the small intestine. Rye: Similar to barley, rye is another grain that contains gluten. Foods made from rye, such as rye bread or rye-based cereals, should also be avoided by individuals with celiac disease because they can trigger adverse reactions due to gluten. Rice: Rice is a gluten-free grain and is safe for individuals with celiac disease to consume. It does not contain gluten proteins that can cause intestinal damage or trigger immune responses in those with gluten sensitivity or celiac disease. Wheat: Wheat is a major source of gluten and should be strictly avoided by individuals with celiac disease. Foods made from wheat, such as wheat bread, pasta, or baked goods, can lead to symptoms and intestinal damage in individuals with gluten intolerance or celiac disease.
A nurse is caring for a child who has atopic dermatitis. Which of the following findings should the nurse expect?
- A. Maculopapular lesions between fingers and toes
- B. Inflamed area with white exudate
- C. Nonpruritic erythematous papule
- D. Rash with thick skin
Correct Answer: D
Rationale: Maculopapular lesions between fingers and toes: This finding is not typically associated with atopic dermatitis. Maculopapular lesions between the fingers and toes are more commonly seen in conditions like scabies or fungal infections. Inflamed area with white exudate: This finding is also not characteristic of atopic dermatitis. An inflamed area with white exudate may indicate a bacterial infection rather than atopic dermatitis. Nonpruritic erythematous papule: Atopic dermatitis often presents with erythematous (red) papules (small raised bumps) that are pruritic (itchy). However, the presence of nonpruritic lesions is less typical of atopic dermatitis. Rash with thick skin: This finding is consistent with atopic dermatitis. Chronic scratching and rubbing of the affected areas can lead to thickening of the skin (lichenification) in individuals with atopic dermatitis.
A nurse is caring for a toddler who has intussusception. Which of the following manifestations should the nurse expect?
- A. Drooling
- B. Increased appetite
- C. Mucus in stools
- D. Jaundice
Correct Answer: C
Rationale: Drooling - Drooling is not typically associated with intussusception. Intussusception is a condition where one portion of the intestine telescopes into another, leading to bowel obstruction and subsequent symptoms such as abdominal pain, vomiting, and 'currant jelly' stools. Increased appetite - Increased appetite is unlikely in a toddler with intussusception. Instead, affected toddlers may experience symptoms such as abdominal pain, vomiting, and lethargy, which can lead to decreased appetite. Mucus in stools - Mucus in stools is a characteristic finding in intussusception. As the telescoping of the intestine causes irritation and inflammation, mucus may be passed in the stool along with blood and, in some cases, a characteristic 'currant jelly' appearance. Jaundice - Jaundice is not a typical manifestation of intussusception. It may be present in conditions affecting the liver or bile ducts, such as biliary atresia or obstructive jaundice, but it is not a direct symptom of intussusception.
A nurse is caring for a 4-year-old child who had an incident of bedwetting during hospitalization. The child's parents expresses concern about the incident. Which of the following responses should the nurse make?
- A. I know this can be embarrassing. I have kids myself so I understand, and it doesn't bother me.
- B. Children who are hospitalized often regress. The toileting skills will return when your child is feeling better.
- C. I will discuss your child's loss of bladder control with the provider.
- D. Why is she wetting the bed in the hospital? She must wet the bed at home.
Correct Answer: B
Rationale: I know this can be embarrassing. I have kids myself so I understand, and it doesn't bother me.' This response acknowledges the child's feelings and reassures the parents that bedwetting is a common occurrence, especially during hospitalization. It also demonstrates empathy by sharing a personal experience. However, it may not address the parents' concerns about their child's bedwetting or provide information on how to manage it. 'Children who are hospitalized often regress. The toileting skills will return when your child is feeling better.' This response provides an explanation for the bedwetting incident, reassuring the parents that it is a common response to hospitalization and will likely resolve once the child feels better. It offers support and normalization of the behavior, which can help alleviate the parents' concerns. 'I will discuss your child's loss of bladder control with the provider.' This response indicates that the nurse will address the issue with the healthcare provider, which is appropriate if further evaluation or intervention is needed. However, it may not directly address the parents' concerns or provide immediate reassurance. 'Why is she wetting the bed in the hospital? She must wet the bed at home.' This response may come across as accusatory or judgmental, which can increase parental anxiety or guilt. It does not provide reassurance or support to the parents and does not address the child's immediate needs.