Nokea
The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine?
- A. The hepatitis B vaccination series should be begun at birth
- B. All are applicable
- C. Any child not vaccinated at birth should receive two doses at least 4 months apart
- D. An unimmunized 10-year-old child should receive three doses administered 4 weeks apart
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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What time frame has the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists recommended that pregnant adolescents and women who are not protected against pertussis receive the tetanus, diphtheria, and pertussis (Tdap) vaccine?
- A. Between 27 and 36 weeks of gestation or postpartum before discharge from the hospital
- B. During the first prenatal visit when pregnancy is confirmed
- C. The vaccine should be administered 24 hours prior to delivery
- D. This vaccine is only recommended during the first trimester
Correct Answer: A
Rationale: The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists recommend that pregnant adolescents and women without protection against pertussis should receive the Tdap vaccine ideally between 27 and 36 weeks of gestation or postpartum before discharge from the hospital. This timeframe allows for the development of antibodies in the mother to protect her and provide passive immunity to the infant. Administering the vaccine during the first trimester (Choice D) is not recommended as the optimal time is between 27 and 36 weeks. Choice B, during the first prenatal visit, is too early for optimal protection, and Choice C, 24 hours prior to delivery, does not provide enough time for the vaccine to be effective before birth.
Which nursing intervention should be included in the postoperative care of a child following a tonsillectomy?
- A. Encourage the child to blow the nose gently
- B. Notify the physician if mucus is observed in the emesis
- C. Position the child supine in the immediate postoperative period
- D. Avoid giving citrus juice
Correct Answer: D
Rationale: The correct answer is D: 'Avoid giving citrus juice.' Citrus juice can irritate the throat after a tonsillectomy, so it should be avoided. Choice A is incorrect because blowing the nose gently is not a recommended intervention following a tonsillectomy. Choice B is incorrect as mucus in emesis is not uncommon postoperatively and does not necessarily require physician notification. Choice C is incorrect as positioning the child supine immediately postoperatively can increase the risk of airway obstruction and should be avoided.
The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby's formula faster. What should the nurse recommend?
- A. Heat only 8 oz or more.
- B. Do not heat a plastic bottle in a microwave oven.
- C. Leave the bottle top uncovered to allow heat to escape.
- D. Shake the bottle vigorously for at least 30 seconds after heating.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A breastfed infant is being seen in the clinic for a 6-month checkup. The mother tells the nurse that the infant recently began to suck her thumb. Which is the best nursing intervention?
- A. Reassure the mother that this is normal at this age
- B. Recommend the mother substitute a pacifier for her thumb
- C. Assess the infant for other signs of sensory deprivation
- D. Suggest the mother breastfeed the infant more often to satisfy her sucking needs
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is performing an assessment on a 10-week-old infant. The nurse understands that the developmental characteristic of hearing at this age is which?
- A. The infant responds to his own name.
- B. The infant localizes sounds by turning his head directly to the sound.
- C. The infant turns his head to the side when sound is made at the level of the ear.
- D. The infant locates sound by turning his head to the side and then looking up or down.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.