A hospice nurse is reinforcing teaching to a parent about how age affects how their child experiences a terminal illness. Which of the following statements should the nurse include?

"Adolescents may feel responsible for the illness."

"Adolescents may feel frustrated for being dependent on others."

"Children 3 to 5 years old are too young to understand the difference between life and death."

"Children around 5 or 6 years old may try to be brave and shield loved ones from distress."

Answer and Explanation

The Correct Answer is B

A. "Adolescents may feel responsible for the illness." While younger children may engage in magical thinking and believe they caused their illness, adolescents typically have a more developed understanding of disease processes and are less likely to blame themselves.

B. "Adolescents may feel frustrated for being dependent on others." Adolescents value independence and autonomy, so a terminal illness that forces them to rely on caregivers can lead to frustration, anger, and emotional distress. This struggle with dependency is a common psychosocial challenge in adolescent patients.

C. "Children 3 to 5 years old are too young to understand the difference between life and death." Preschool-aged children may not fully grasp the permanence of death, but they do have some awareness of it. They often see death as temporary or reversible, influenced by their limited cognitive development and exposure to media or stories.

D. "Children around 5 or 6 years old may try to be brave and shield loved ones from distress." While school-aged children may begin to understand the finality of death, the tendency to "be brave" and protect loved ones is more common in older children and adolescents, who have a stronger sense of emotional responsibility.

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Correct Answer is B

Explanation

A. The vaccine is administered subcutaneously, or just underneath the skin. The pneumococcal vaccine (PCV13) is given intramuscularly (IM), not subcutaneously. The preferred injection sites are the anterolateral thigh (for infants) or the deltoid muscle (for older children).

B. The first dose of the vaccine is administered at 2 months of age. This is correct. The pneumococcal conjugate vaccine (PCV13) is routinely given at 2, 4, 6, and 12–15 months of age to protect against Streptococcus pneumoniae, which can cause pneumonia, meningitis, and sepsis.

C. The vaccine is contraindicated in individuals who are allergic to gelatin. This is incorrect. The pneumococcal vaccine is not formulated with gelatin. Gelatin allergies are more relevant for vaccines like MMR and varicella. However, PCV13 should not be given to those with severe allergic reactions to any previous dose of the vaccine.

D. The vaccine is given in a series of six doses spread throughout the first 5 years of life. The PCV13 vaccine is given in a series of four doses, not six. While some high-risk children may require additional doses of PPSV23 (pneumococcal polysaccharide vaccine), the routine childhood schedule consists of four doses.

A. Complete a screening test for autism spectrum disorder (ASD). B. Ask the parent about recent immunizations C. Educate the parent that toddlers do not typically say their first word until 18-20 months of age. D. Ask the parent if the toddler has a history of hospitalizations or surgeries.

Correct Answer is A

Explanation

A. Complete a screening test for autism spectrum disorder (ASD). By 18 months, most toddlers have said their first word, and a lack of speech development can be an early sign of ASD or other developmental delays. The M-CHAT (Modified Checklist for Autism in Toddlers) is a common screening tool used at this age to assess for autism. Early identification allows for timely interventions.

B. Ask the parent about recent immunizations. While immunization history is important for overall health, there is no connection between vaccines and delayed speech development. This question does not directly address the developmental concern at hand.

C. Educate the parent that toddlers do not typically say their first word until 18-20 months of age. This is incorrect. Most toddlers say their first word around 12 months, and by 18 months, they typically have a vocabulary of several words. A lack of speech at this age warrants further assessment.

D. Ask the parent if the toddler has a history of hospitalizations or surgeries. While medical history is important, hospitalizations or surgeries are not the most common causes of delayed speech. Developmental screening is the most appropriate next step in evaluating speech delays.

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A hospice nurse is reinforcing teaching to a parent about how age affects how their child experiences a terminal illness. Which of the following statements should the nurse include?

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a parent about the pneumococcal vaccine. Which of the following should the nurse include?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

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