A nurse in a provider's office is planning to administer immunizations to an 11-year-old child who is up to date with current recommendations. Which of the following immunizations should the nurse plan to administer?
Hepatitis B (Hep B).
Measles, mumps, rubella (MMR).
Tetanus, diphtheria, and pertussis (Tdap).
Pneumococcal (PCV).
The Correct Answer is C
Choice A reason:
Hep B is given at birth, 2 months, and 6 months of age not at 11 years old.
Choice B reason:
Measles, mumps, rubella (MMR) The rationale for not choosing Measles, mumps, rubella (MMR) is the same as for choice A. If the child has already received the required doses of the MMR vaccine, giving extra doses is not necessary and may not provide any additional benefit.
Choice C reason:
This vaccine is recommended for children at age 11-12 years to boost immunity against tetanus, diphtheria, and pertussis. This is a one-time dose, and it's important to ensure that children receive it on schedule.
Choice D reason:
Pneumococcal (PCV) The rationale for not choosing Pneumococcal (PCV) is that this vaccine is typically given in infancy and early childhood as part of the routine immunization schedule.
Since the child is 11 years old and up to date with current recommendations, they are unlikely to require another dose of PCV at this stage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
The nurse should not recommend drinking warm tea before bed for a pregnant client. Certain herbal teas might not be safe during pregnancy, and caffeine-containing teas should be limited due to their potential effects on the fetus. Therefore, it is best to avoid suggesting this option to the client.
Choice B reason:
This is the correct choice as relaxation exercises can be beneficial for pregnant clients who are experiencing difficulty sleeping. These exercises can help reduce stress, promote relaxation, and improve sleep quality without any adverse effects on the client or the baby.
Choice C reason:
The nurse should avoid recommending that the client sleep on their right side. While the left side is generally recommended during pregnancy to improve blood flow to the placenta and baby, sleeping on the right side is not harmful either. However, it is better to provide the most suitable option for promoting sleep, which is relaxation exercises as mentioned in Choice B.
Choice D reason:
Soaking in a hot tub for 60 minutes is not advisable during pregnancy. Prolonged exposure to high temperatures, such as in hot tubs or saunas, can raise the body's core temperature, potentially causing harm to the developing fetus. Pregnant individuals should avoid hot tubs to prevent overheating.
Correct Answer is B
Explanation
Choice A reason:
Obtaining vital signs is essential in assessing the child's overall condition, but it is not the first action the nurse should take in this situation. The priority is to address the immediate concern of difficulty breathing.
Choice B reason:
Stopping the IV infusion is the most critical action the nurse should take first. Difficulty breathing can be a sign of a severe allergic reaction, and if it is related to the IV cefuroxime, stopping the infusion will prevent further administration of the medication and possibly worsening the reaction.
Choice C reason:
Administering epinephrine IM is not the first-line action in this scenario. Epinephrine is used in severe anaphylactic reactions, but it should not be given without a proper evaluation of the situation and a clear indication for its use.
Choice D reason:
Monitoring intake and output is an important nursing intervention, but it is not the priority when the child is experiencing difficulty breathing. Addressing the respiratory distress should be the initial focus to ensure the child's safety and well-being.
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