A nurse in a pediatric clinic is performing a history and physical for a toddler who is scheduled to receive a measles, mumps, and rubella (MMR) immunization. Which of the following findings indicate that the immunization should be withheld?

Temperature of 38° C (100.4° F)

Family history of sudden unexpected infant death (SUID)

Taking an antihistamine for seasonal allergies

Receiving prednisone for nephrotic syndrome

Answer and Explanation

The Correct Answer is D

A. Temperature of 38°C (100.4°F): A mild fever is not a contraindication for the MMR vaccine. In fact, a low-grade fever is common after immunizations and does not warrant withholding the vaccine.

B. Family history of sudden unexpected infant death (SUID): While a family history of SUID may be concerning, it is not a contraindication for administering the MMR vaccine. This history would not directly impact the safety or effectiveness of the vaccine.

C. Taking an antihistamine for seasonal allergies: Taking an antihistamine for seasonal allergies does not typically contraindicate the administration of the MMR vaccine. Antihistamines are generally safe to use with vaccines, and they do not interfere with the immune response to the vaccine.

D. Receiving prednisone for nephrotic syndrome: Prednisone is an immunosuppressive medication. Children receiving high-dose corticosteroids (such as prednisone) should avoid live vaccines like MMR

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Correct Answer is C

Explanation

A. "What is your pain level right now?": This response doesn't directly address the child's question about mortality and may deflect the conversation away from the child's concerns. While assessing pain is important, it should not be the immediate response to a question about mortality.

B. "Your doctor will be able to answer your questions tomorrow.": This response delays addressing the child's concerns and may leave the child feeling anxious or unsupported in the meantime. It's important for the nurse to provide immediate support and reassurance when a child expresses fears or worries.

C. "It sounds like you are worried. Tell me what you have been told.": This response acknowledges the child's emotions and invites them to share their thoughts and concerns. It opens up a dialogue between the nurse and the child, allowing the nurse to provide appropriate support and information based on the child's understanding and perspective.

D. "It's natural to worry about death, but you should focus your energy on getting better.": While this response acknowledges the child's worry, it may come across as dismissive or minimizing of the child's concerns about mortality. It's important to validate the child's emotions and offer support rather than redirecting their focus away from their worries.

A. Thicken the infant's formula with cereal. B. Avoid giving the infant citrus juices. C. Position the child with their head elevated after meals. D. Place the infant's head on a soft pillow while sleeping. E. Administer an antiemetic to the infant.

Correct Answer is ["A","B","C"]

Explanation

A. Thicken the infant's formula with cereal: Thickening the infant's formula with cereal can help reduce the likelihood of regurgitation by increasing its viscosity and promoting better gastric emptying. This can help decrease the frequency and severity of gastroesophageal reflux episodes.

B. Avoid giving the infant citrus juices: Citrus juices are acidic and can exacerbate gastroesophageal reflux symptoms in infants. Avoiding citrus juices can help reduce the acidity of the stomach contents, potentially decreasing the likelihood of regurgitation.

C. Position the child with their head elevated after meals: Keeping the infant in an upright position with the head elevated after meals can help prevent regurgitation by reducing the likelihood of gastric contents flowing back into the esophagus. This position facilitates gravity-assisted digestion and minimizes pressure on the lower esophageal sphincter.

D. Place the infant's head on a soft pillow while sleeping: Placing the infant's head on a soft pillow while sleeping is not recommended as it increases the risk of suffocation and sudden infant death syndrome (SIDS). Infants should always be placed on their back to sleep in a flat, firm surface without pillows or soft bedding to reduce the risk of adverse events.

E. Administer an antiemetic to the infant: Administering an antiemetic to the infant is not typically indicated for the management of gastroesophageal reflux in infants, especially as a preventive measure. Antiemetics may have potential side effects and should only be used under the guidance of a healthcare provider for specific indications.

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A nurse in a pediatric clinic is performing a history and physical for a toddler who is scheduled to receive a measles, mumps, and rubella (MMR) immunization. Which of the following findings indicate that the immunization should be withheld?

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