Nokea
Recommendations for hepatitis B (HBV) vaccine include which statement?
- A. First dose is given between birth and age 2 days.
- B. First dose is given between ages 12 and 15 months.
- C. It is not recommended for neonates who are at low risk for hepatitis B.
- D. It is not recommended for neonates whose mothers are positive for HBV surface antigen.
Correct Answer: B
Rationale: The current recommendations for hepatitis B (HBV) vaccine state that the first dose should be administered between ages 12 and 15 months. The vaccine series typically consists of three doses, with the second dose administered 1-2 months after the first dose, and the third dose given at least 8 weeks after the second dose. This schedule is recommended by the Centers for Disease Control and Prevention (CDC) to provide optimal protection against the hepatitis B virus. Starting the vaccine series at 12-15 months ensures that the child's immune system is mature enough to respond effectively to the vaccine and generate lasting immunity.
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The age of a child who can imitate construction of gate with 2-4 parts; draws longer lines; and draws a man with 5 cubes is
- A. 24 months
- B. 30 months
- C. 48 months
- D. 54 months
Correct Answer: B
Rationale: These milestones are typically achieved around 30 months.
Which of the following conditions is suspected?
- A. Anemia
- B. Rheumatic arthritis
- C. Leukemia
- D. Systematic Lupus Erythematosus (SLE)
Correct Answer: C
Rationale: Leukemia is a type of cancer that affects the blood and bone marrow, leading to an overproduction of abnormal white blood cells. The symptoms of leukemia can include fatigue, weakness, weight loss, frequent infections, fever, bruising or bleeding easily, and bone pain. Given the vague presenting symptoms and the potential involvement of multiple bodily systems, leukemia is a condition that should be suspected and investigated further. Anemia, rheumatic arthritis, and systematic lupus erythematosus can also present with some similar symptoms, but for the given scenario, leukemia is the most probable condition to suspect.
When the nurse interviews an adolescent, which is especially important?
- A. Focus the discussion on the peer group.
- B. Allow an opportunity to express feelings.
- C. Emphasize that confidentiality will always be maintained.
- D. Use the same type of language as the adolescent.
Correct Answer: B
Rationale: When the nurse interviews an adolescent, allowing an opportunity for the adolescent to express their feelings is especially important. Adolescents are at a stage in life where they are developing their own identity and dealing with a range of emotions. Providing a safe space for them to open up about their thoughts and feelings can help the nurse better understand and address their needs. This can also build a trustful relationship between the nurse and the adolescent, leading to more effective communication and care.
A client with thrombocytopenia secondary to leukemia develops epistaxis. The nurse should instruct the client to:
- A. Lie supine with his neck extended
- B. Sit upright, leaning slightly forward
- C. Blow his nose and then put lateral pressure on his nose
- D. Hold his nose while bending forward at the waist
Correct Answer: B
Rationale: The nurse should instruct the client to sit upright, leaning slightly forward when experiencing epistaxis (nosebleed). This position helps prevent blood from dripping down the back of the throat, reducing the risk of aspiration. In the case of a client with thrombocytopenia secondary to leukemia, the blood may have difficulty clotting due to low platelet counts. Therefore, it is important to minimize bleeding as much as possible. Lying supine with the neck extended may increase the risk of blood flowing down the throat, while blowing the nose or putting lateral pressure on it may aggravate the bleeding. Holding the nose while bending forward at the waist may also increase blood flow towards the head. Sitting upright, leaning slightly forward is the safest position to prevent complications associated with epistaxis in this case.
As the nurse collects data on a patient, which of the following is a symptom that may be found that the patient with anaphylaxis may be experiencing?
- A. Dermatitis
- B. Sinusitis
- C. Delirium
- D. Wheezing
Correct Answer: D
Rationale: Wheezing is a common symptom of anaphylaxis, along with other signs such as difficulty breathing, chest tightness, coughing, and throat swelling. Wheezing is caused by the constriction of the airways due to the body's extreme immune response to the allergen, leading to difficulty in breathing and wheezing sounds during respiration. It is important for healthcare professionals to recognize wheezing as a symptom of anaphylaxis and respond promptly with appropriate interventions, such as administering epinephrine and providing respiratory support.