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A nurse is reviewing the medical record of a school-age child who is current on recommended immunizations. Which of the following immunizations should the nurse plan to administer at the 11-year-old well-child visit?
- A. Tetanus, diphtheria, acellular pertussis (Tdap)
- B. Haemophilus influenzae type b (Hib)
- C. Inactivated poliovirus (IPV)
- D. Rotavirus (RV)
Correct Answer: A
Rationale: Tdap is recommended at 11-12 years as a booster. Hib, IPV, and RV are given in infancy, not at this age.
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A nurse is caring for a child who is experiencing a seizure. Which of the following actions should the nurse take?
- A. Loosen restrictive clothing.
- B. Hyperextend the child's neck.
- C. Time the seizure episode.
- D. Place the child in a side-lying position.
- E. Restrain the child.
Correct Answer: A,C,D
Rationale: Loosening clothing, timing the seizure, and side-lying position ensure safety and documentation. Hyperextending the neck risks injury, and restraining is unsafe.
A nurse is caring for an adolescent who reports manifestations of an STI. Which of the following actions should the nurse take?
- A. Request that the adolescent sign a consent for treatment form prior to performing STI screening.
- B. Instruct the adolescent that a guardian must be present to provide consent for STI screening.
- C. Plan to notify the adolescent's guardian if the STI screening comes back positive.
- D. Obtain phone consent from the guardian of the adolescent prior to performing STI screening.
Correct Answer: A
Rationale: Adolescents can consent to STI screening in many jurisdictions, respecting their privacy. Guardian involvement may deter care, and notification breaches confidentiality unless required.
A nurse is assisting with the care of a hospitalized toddler who has congenital heart disease. The parent calls the nurse to the room to ask for fresh linens and states, 'My child never wets the bed at home. I am not sure why this is happening now.' Which of the following responses should the nurse make to the parent?
- A. I know this must be embarrassing for you. I have kids myself, and I would be concerned, too.
- B. Regression is a common reaction to stress when toddlers are hospitalized. This is temporary.
- C. Your child appears to be just fine. If they aren't worried about it, then you shouldn't be either.
- D. I will talk to the provider about this. It could indicate worsening of your child's condition.
Correct Answer: B
Rationale: Regression like bedwetting is common during hospitalization stress and is typically temporary. Other responses either dismiss concerns or unnecessarily escalate the issue.
A nurse is reinforcing teaching with the guardian of a 1-month-old infant who has colic. Which of the following instructions should the nurse include in the teaching?
- A. Offer a pacifier when your baby is fussy.
- B. You should offer water in between feedings.
- C. You should place a warm heating pad on your baby's abdomen.
- D. Allow your baby to cry for 5 minutes before responding.
Correct Answer: A
Rationale: A pacifier soothes colicky infants. Water risks intoxication, heating pads may burn, and delayed response increases distress in young infants.
A nurse is caring for a 4-year-old child who has pneumonia due to varicella zoster. The parent asks the nurse what types of activities are available for the child. Which of the following play activities should the nurse recommend?
- A. Watching cartoons in the unit activity room with peers
- B. Pulling a wagon of stuffed animals in the hallway
- C. Writing a short letter to send to a friend
- D. Playing an alphabet flash card game with the parent
Correct Answer: D
Rationale: Alphabet flashcards are safe, low-exertion, and avoid infection spread. Cartoons with peers, wagon pulling, or writing are riskier or too demanding.