A newborn infant is prescribed an immunization prior to discharge. Which action should the practical nurse (PN) implement?

Ask the mother if she wants the infant immunized for Haemophilus influenzae.

Prepare the first dose for Diphtheria, tetanus toxoid and acellular pertussis (DTaP).

Give the first dose of the Rotavirus vaccine if any sibling have diarrhea now.

Obtain signed consent from the mother for administration of Hepatitis B vaccine.

Answer and Explanation

The Correct Answer is D

A. Ask the mother if she wants the infant immunized for Haemophilus influenzae: While parental involvement is important, the Hib vaccine is a standard immunization recommended for all infants.

B. Prepare the first dose for Diphtheria, tetanus toxoid and acellular pertussis (DTaP): DTaP is typically given at 2 months of age, not immediately at birth. Administering vaccines not indicated at the newborn stage could lead to scheduling errors or adverse outcomes.

C. Give the first dose of the Rotavirus vaccine if any sibling have diarrhea now: Rotavirus vaccination is contraindicated if there is active gastrointestinal illness. However, the immediate priority is obtaining consent for the vaccines appropriate for the newborn, rather than assessing sibling health.

D. Obtain signed consent from the mother for administration of Hepatitis B vaccine: Legal and ethical standards require informed consent before administering vaccines to a newborn. The Hepatitis B vaccine is recommended at birth, and obtaining consent ensures the PN can safely and appropriately proceed with administration.

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Correct Answer is D

Explanation

A. Would you like me to call another nurse to be here while I show you the wound?: Offering another nurse does not address the client’s emotional readiness. It may increase anxiety by implying pressure to view the incision before she is prepared to do so emotionally.

B. You will feel better when you see that the incision is not as bad as you may think: This minimizes the client’s feelings and attempts to reassure without validating her emotions. Clients coping with body image changes after mastectomy need empathetic support rather than persuasion.

C. Part of recovery is accepting your new body image, and you will need to look at your incision: Although acceptance is an important part of recovery, this response is too directive and lacks sensitivity. Forcing confrontation with the incision can hinder emotional healing.

D. It’s OK if you don’t want to look or talk about the mastectomy. I will be available when you’re ready: This response acknowledges the client’s current emotional state and gives her control over the timing of her coping process. It conveys empathy, patience, and readiness to provide support when she is emotionally prepared.

A. Encourage a low carbohydrate diet. B. Use a cushion when sitting. C. Perform range of motion exercises. D. Discuss a low sodium diet.

Correct Answer is D

Explanation

A. Encourage a low carbohydrate diet: Carbohydrate restriction does not address fluid retention, edema, or electrolyte imbalances associated with chronic kidney disease and is not the priority intervention in this scenario.

B. Use a cushion when sitting: This intervention may help prevent skin breakdown, but it does not address the underlying fluid overload or electrolyte imbalance.

C. Perform range of motion exercises: ROM exercises support joint mobility and circulation, but they do not directly manage fluid retention or prevent further complications from electrolyte disturbances.

D. Discuss a low sodium diet: Sodium restriction helps manage fluid retention, edema, and blood pressure in clients with chronic kidney disease. Implementing a low-sodium diet directly targets the cause of weight gain and generalized edema, making it the priority intervention.

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A newborn infant is prescribed an immunization prior to discharge. Which action should the practical nurse (PN) implement?

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Naxlex Comprehensive Predictor Exams

At the first dressing change, the practical nurse (PN) tells the client that her mastectomy incision is healing well, but the client refuses to look at the incision and refuses to talk about it. Which response by the PN to the client's silence is best?

Correct Answer is D

Explanation

The practical nurse (PN) identifies an electrolyte imbalance, a generalized edema, and a weight gain of 4.4 lbs (2 kg) in 24 hours for a client with chronic kidney disease. Which intervention in the plan of care should the PN implement?

Correct Answer is D

Explanation

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