Nokea
Pertussis vaccination should begin at which age?
- A. Birth
- B. 2 months
- C. 6 months
- D. 12 months
Correct Answer: B
Rationale: The acellular pertussis vaccine is recommended by the American Academy of Pediatrics beginning at age 6 weeks. Infants are at greater risk for complications of pertussis. The vaccine is not given after age 7 years, when the risks of the vaccine become greater than those of pertussis. The first dose is usually given at the 2-month well-child visit. Infants are highly susceptible to pertussis, which can be a life-threatening illness in this age group.
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Which muscle is contraindicated for the administration of immunizations in infants and young children?
- A. Deltoid
- B. Dorsogluteal
- C. Ventrogluteal
- D. Anterolateral thigh
Correct Answer: B
Rationale: The dorsogluteal site is avoided in children because of the location of nerves and veins. The deltoid is recommended for 12 months and older. The ventrogluteal and anterolateral thigh sites can safely be used for the administration of vaccines to infants.
Which serious reaction should the nurse be alert for when administering vaccines?
- A. Fever
- B. Skin irritation
- C. Allergic reaction
- D. Pain at injection site
Correct Answer: C
Rationale: Each vaccine administration carries the risk of an allergic reaction. The nurse must be prepared to intervene if the child demonstrates signs of a severe reaction. Mild febrile reactions do occur after administration. The nurse includes management of fever in the parent teaching. Local skin irritation may occur at the injection site after administration. Parents are informed that this is expected. The injection can be painful. The nurse can minimize the discomfort with topical analgesics and nonpharmacologic measures.
A 4-month-old infant comes to the clinic for a well-infant checkup. Immunizations she should receive are DTaP (diphtheria, tetanus, acellular pertussis) and IPV (inactivated poliovirus vaccine). She is recovering from a cold but is otherwise healthy and afebrile. Her older sister has cancer and is receiving chemotherapy. Nursing considerations should include which?
- A. DTaP and IPV can be safely given.
- B. DTaP and IPV are contraindicated because she has a cold.
- C. IPV is contraindicated because her sister is immunocompromised.
- D. DTaP and IPV are contraindicated because her sister is immunocompromised.
Correct Answer: A
Rationale: These immunizations can be given safely. Serious illness is a contraindication. A mild illness with or without fever is not a contraindication. These are not live vaccines, so they do not pose a risk to her sister.
Which is described as an elevated, circumscribed skin lesion that is less than 1 cm in diameter and filled with serous fluid?
- A. Cyst
- B. Papule
- C. Pustule
- D. Vesicle
Correct Answer: D
Rationale: A vesicle is elevated, circumscribed, superficial, smaller than 1 cm in diameter, and filled with serous fluid. A cyst is elevated, circumscribed, palpable, encapsulated, and filled with liquid or semisolid material. A papule is elevated; palpable; firm; circumscribed; smaller than 1 cm in diameter; and brown, red, pink, tan, or bluish red. A pustule is elevated, superficial, and similar to a vesicle but filled with purulent fluid.
Treatment for herpes simplex virus (type 1 or 2) includes which?
- A. Corticosteroids
- B. Oral griseofulvin
- C. Oral antiviral agent
- D. Topical or systemic antibiotic
Correct Answer: C
Rationale: Oral antiviral agents are effective for viral infections such as herpes simplex. Corticosteroids, antibiotics, and griseofulvin (an antifungal agent) are not effective for viral infections.