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Why is the infant scheduled to receive the intramuscular polio vaccine instead of the oral vaccine, as asked by the parents?
- A. The American Academy of Pediatrics recommends the intramuscular vaccine because it is safer.
- B. Both vaccines produce the same results and are equally safe, according to consensus.
- C. The intramuscular vaccine is preferred over the oral vaccine due to cost considerations, unless contraindicated.
- D. The U.S. Centers for Disease Control and Prevention recommends the intramuscular vaccine unless the infant or a family member is immunocompromised.
Correct Answer: A
Rationale: The American Academy of Pediatrics recommends the intramuscular polio vaccine over the oral vaccine due to its superior safety profile. Intramuscular administration ensures better immunogenicity and protection against poliovirus. Choice B is incorrect as the intramuscular vaccine is preferred for safety reasons. Choice C is incorrect because the recommendation is based on safety, not cost. Choice D is incorrect as the CDC recommendation is not solely based on immunocompromised status but rather on the overall safety and efficacy of the vaccine.
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A 4-year-old fell from a third-story window and landed on her head. She is semiconscious with slow, irregular breathing and bleeding from her mouth. After performing a jaw-thrust maneuver with simultaneous stabilization of her head, what should you do next?
- A. suction the oropharynx
- B. insert a nasopharyngeal airway
- C. initiate positive pressure ventilations
- D. place the patient in the recovery position
Correct Answer: A
Rationale: In this scenario, the 4-year-old is presenting with signs of airway compromise due to the fall. After performing a jaw-thrust maneuver to open the airway while stabilizing the head to prevent further injury, the next step should be to suction the oropharynx. Suctioning helps to clear any blood or secretions from the mouth and throat, ensuring a clear airway for proper breathing. Inserting a nasopharyngeal airway or initiating positive pressure ventilations would be premature without first ensuring the airway is clear. Placing the patient in the recovery position is not indicated at this point as the focus should be on managing the airway.
When teaching a class about trisomy 21, the instructor would identify the cause of this disorder as:
- A. nondisjunction.
- B. X-linked recessive inheritance.
- C. genomic imprinting.
- D. autosomal dominant inheritance.
Correct Answer: A
Rationale: Trisomy 21, also known as Down syndrome, is caused by nondisjunction, which is an error in cell division that leads to the presence of an extra chromosome 21. This additional chromosome alters the normal genetic makeup, resulting in the characteristics associated with Down syndrome. Therefore, the correct answer is nondisjunction (Choice A). Choices B, C, and D are incorrect because Trisomy 21 is not caused by X-linked recessive inheritance, genomic imprinting, or autosomal dominant inheritance. Understanding the specific genetic mechanism involved in Trisomy 21 is crucial for grasping the basis of this chromosomal disorder.
A 12-month-old infant has become immunosuppressed during a course of chemotherapy. When preparing the parents for the infant's discharge, what information should the nurse give concerning the measles, mumps, and rubella (MMR) immunization?
- A. It should not be given until the infant reaches 2 years of age.
- B. Infants who are receiving chemotherapy should not be given these vaccines.
- C. It should be given to protect the infant from contracting any of these diseases.
- D. The parents should discuss this with their health care provider at the next visit.
Correct Answer: B
Rationale: The correct answer is B. Live vaccines like MMR should not be given to immunosuppressed infants because their weakened immune systems may not handle the vaccine safely. Choice A is incorrect as delaying the MMR vaccine until the infant reaches 2 years of age does not address the issue of immunosuppression. Choice C is incorrect because administering live vaccines to an immunosuppressed individual could lead to serious complications. Choice D is incorrect as immediate action is required to prevent potential harm to the immunosuppressed infant.
A parent brings an 18-month-old toddler to the clinic. The parent states, 'My child is so difficult to please, has temper tantrums, and annoys me by throwing food from the table.' What is the nurse's best response?
- A. "Toddlers need discipline to prevent the development of antisocial behaviors."
- B. "Toddlers are learning to assert independence, and this behavior is expected at this age."
- C. "It is best to leave the toddler alone in the crib after calmly explaining why the behavior is unacceptable."
- D. "This is the way a toddler expresses needs, and this behavior is acceptable during the initiative stage of development."
Correct Answer: B
Rationale: The correct answer is B: "Toddlers are learning to assert independence, and this behavior is expected at this age." At 18 months, toddlers are in the stage of developing autonomy and independence. They may exhibit behaviors like temper tantrums and defiance as they assert their independence and test limits. It is crucial for parents and caregivers to understand that these behaviors are typical for toddlers at this age. Choice A is incorrect because discipline should be age-appropriate and focus on positive reinforcement rather than preventing antisocial behaviors. Choice C is inappropriate as leaving a toddler alone in a crib after explaining unacceptable behavior is not a recommended approach and can lead to feelings of abandonment. Choice D is inaccurate as the described behavior is more related to asserting independence rather than the initiative stage of development.
A child with sickle cell anemia develops severe chest pain, fever, a cough, and dyspnea. What should the nurse do first?
- A. Administer 100% oxygen to relieve hypoxia
- B. Administer pain medication to relieve symptoms
- C. Notify the practitioner because chest syndrome is suspected
- D. Notify the practitioner because the child may be having a stroke
Correct Answer: C
Rationale: The correct action to take first when a child with sickle cell anemia presents with severe chest pain, fever, cough, and dyspnea is to notify the practitioner because acute chest syndrome is suspected. This condition is a medical emergency requiring prompt intervention. Administering oxygen or pain medication may be necessary interventions but should not precede notifying the practitioner. Stroke is not typically associated with these symptoms in sickle cell anemia.