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The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine?
- A. The child has recently been exposed to an infectious disease
- B. The child has symptoms of a cold but no fever
- C. The child is having intermittent episodes of diarrhea
- D. The child has a disorder that causes a deficient immune system
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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At an 8-month-old well-baby visit, the parent tells the nurse that her infant falls asleep at night during the last bottle feeding but wakes up when moved to the infant's crib. What is the most appropriate response for the nurse to make?
- A. You should put your baby to sleep 1 hour earlier without the nighttime feeding but with a pacifier for soothing.
- B. You could place rice cereal in the last bottle feeding of the day to ensure a longer sleep pattern.
- C. You should have your partner give the last bottle of the day and observe whether your infant stays awake for your partner.
- D. You could increase daytime feeding intervals to every 4 hours and put your baby in the crib while the baby is still awake.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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.
The nurse is caring for a child with Neuroblastoma. Where is the tumor most commonly located?
- A. Bone
- B. Kidneys
- C. Cortex
- D. Abdomen
Correct Answer: D
Rationale: Neuroblastoma is a cancer that commonly originates in the adrenal glands located in the abdomen. It can also occur in nerve tissues along the spine, but it is most frequently found in the abdominal region. Therefore, the correct answer is D. Choices A, B, and C are incorrect as Neuroblastoma typically arises from neural crest cells in the adrenal glands or sympathetic ganglia, not in the bones, kidneys, or cortex.
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 an infant with a cleft palate ask the nurse, "What follow-up care will our infant need after the repair?" Which is an accurate response by the nurse?
- A. Your infant will not need any subsequent follow-up care
- B. Your infant will only need to be evaluated by an audiologist
- C. Your infant will only need follow-up with a speech pathologist
- D. Your infant will need follow-up with audiologists and orthodontists
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.