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A newborn infant receives the first dose of hepatitis B vaccine within 12 hours of birth. The nurse instructs the parent regarding the immunization schedule for this vaccine and should tell the parent that the second vaccine is administered at which time periods?
- A. 3 years of age and then during the adolescent years
- B. 8 months of age and then 1 year after the initial dose
- C. 6 months of age and then 8 months after the initial dose
- D. 1 to 2 months of age and then 6 months after the initial dose
Correct Answer: D
Rationale: The vaccination schedule for an infant whose mother tests negative for hepatitis B consists of a series of 3 immunizations given at 0 months (birth), 1 to 2 months of age, and then 6 months after the initial dose. An infant whose mother tests positive receives hepatitis B immune globulin along with the first dose of the hepatitis vaccine within 12 hours of birth.
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A mother is concerned about the amount of snacking her teenage boy is doing. She is concerned that this behavior could lead to obesity. Which of the following is an appropriate percentage of the daily diet to be obtained from snacks?
- A. 10%.
- B. 25%.
- C. 40%.
- D. 50%.
Correct Answer: B
Rationale: Snacks should contribute about 25% of daily caloric intake to balance nutrition without leading to excessive weight gain.
The nurse is caring for a client with a history of heart failure who is receiving furosemide (Lasix). Which laboratory value should the nurse monitor closely?
- A. Serum potassium
- B. Serum calcium
- C. Serum glucose
- D. Serum cholesterol
Correct Answer: A
Rationale: Furosemide, a loop diuretic, can cause hypokalemia due to potassium loss in urine. Monitoring serum potassium is critical to prevent arrhythmias or muscle weakness.
A client with the diagnosis of leukemia is receiving chemotherapy. When the registered nurse (RN) notes that the white blood cell (WBC) count is 4000 mm^3 (4 x 10^9/L), the new nurse caring for the client is informed about the results. Which intervention identified by the new nurse indicates a need for further teaching?
- A. Restricting visitors with colds or respiratory infections
- B. Removing all live plants, flowers, and stuffed animals in the client's room
- C. Placing the client on a low-bacteria diet that excludes raw foods and vegetables
- D. Padding the side rails and removing all hazardous and sharp objects from the room
Correct Answer: D
Rationale: Padding the side rails and removing all hazardous and sharp objects from the environment would be instituted if the client is at risk for bleeding. This client is at risk for infection. When the WBC count is less than 5000 mm^3 (5 x 10^9/L), visitors should be screened for the presence of infection, and any visitors or staff with colds or respiratory infections should not be allowed in the client's room. All live plants, flowers, and stuffed animals are removed from the client's room. The client is placed on a low-bacteria diet that excludes raw fruits and vegetables.
The nurse is caring for a client with a history of glaucoma who is prescribed timolol (Timoptic) eye drops. The nurse should instruct the client to report which of the following side effects?
- A. Blurred vision.
- B. Bradycardia.
- C. Eye redness.
- D. Dry eyes.
Correct Answer: B
Rationale: Timolol, a beta-blocker, can cause systemic effects like bradycardia, which should be reported immediately.
A client asks the nurse how long she has to take her medicine for hypothyroidism. The nurse's response is based on the knowledge that:
- A. Lifelong daily medicine is necessary.
- B. The medication is expensive, and the dose can be reduced in a few months.
- C. The medication can be gradually withdrawn in 1 to 2 years.
- D. The medication can be discontinued after the client's thyroid-stimulating hormone level is normal.
Correct Answer: A
Rationale: Hypothyroidism typically requires lifelong thyroid hormone replacement therapy, as the condition is usually permanent due to underlying thyroid dysfunction.