A nurse is collecting a medication history from the parent of a preschooler who comes to the clinic for routine immunizations. For which of the following findings should the nurse withhold the varicella immunization?

A pregnant parent

Receiving treatment for leukemia

Taking acetaminophen for mild discomfort

An allergy to eggs

Answer and Explanation

The Correct Answer is B

A. A pregnant parent. A child can receive the varicella vaccine even if the parent is pregnant. While the varicella vaccine is a live attenuated vaccine, the vaccinated child does not pose a significant risk of transmission to others. The parent should avoid direct contact with the vaccinee's rash if one develops, but this is not a contraindication to immunization.

B. Receiving treatment for leukemia. Children undergoing treatment for leukemia often have weakened immune systems due to chemotherapy or radiation. The varicella vaccine is a live attenuated vaccine, meaning it contains a weakened form of the virus that could cause severe illness in immunocompromised individuals. These children should not receive live vaccines until their immune function improves and their healthcare provider approves vaccination.

C. Taking acetaminophen for mild discomfort. Acetaminophen is an over-the-counter pain reliever and fever reducer that does not interfere with the efficacy or safety of the varicella vaccine. There is no evidence that mild analgesic use before or after vaccination affects immune response, so it is not a reason to withhold the immunization.

D. An allergy to eggs. Unlike some influenza and yellow fever vaccines, the varicella vaccine is not produced using egg-based components. An egg allergy is not a contraindication to receiving the varicella vaccine, as it does not contain egg proteins.

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Correct Answer is D

Explanation

A. Meperidine. Meperidine is an opioid analgesic used for moderate to severe pain. It does not treat nausea and vomiting and can worsen these symptoms by delaying gastric emptying. Opioids also depress the central nervous system, which may cause dizziness and sedation.

B. Diazepam. Diazepam is a benzodiazepine used for anxiety, muscle spasms, and seizures. It has no antiemetic effects and does not relieve nausea or vomiting. Instead, it can cause dizziness and drowsiness, which may further discomfort the client.

C. Naloxone. Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression. Since the client’s nausea is not opioid-related, naloxone would not be beneficial. Its administration can also cause withdrawal symptoms in opioid-dependent clients.

D. Promethazine. Promethazine is an antiemetic that blocks histamine and dopamine receptors in the brain, reducing nausea and vomiting. It is commonly used for motion sickness, post-surgical nausea, and gastrointestinal illnesses, making it the appropriate choice for this client.

A. Deferoxamine B. Vitamin K C. Epinephrine D. Prednisone

Correct Answer is C

Explanation

A. Deferoxamine. Deferoxamine is a chelating agent used to treat iron overload or toxicity. It has no role in managing an acute allergic reaction or respiratory distress caused by nafcillin, a penicillin-type antibiotic.

B. Vitamin K. Vitamin K is used to reverse the effects of warfarin-induced anticoagulation and is not indicated for treating an allergic reaction. Anaphylaxis is not related to coagulation disturbances, making this an inappropriate intervention.

C. Epinephrine. Epinephrine is the first-line treatment for anaphylaxis, which can present with difficulty breathing, bronchospasm, and hypotension. It works by stimulating alpha- and beta-adrenergic receptors, leading to bronchodilation, increased cardiac output, and vasoconstriction to counteract severe allergic reactions. Immediate administration is necessary to prevent further airway compromise and circulatory collapse.

D. Prednisone. Prednisone is a corticosteroid used to reduce inflammation and prevent delayed allergic reactions. While it may be prescribed as part of long-term management, it does not provide the rapid bronchodilation and vasoconstriction needed for emergency treatment of anaphylaxis.

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A nurse is collecting a medication history from the parent of a preschooler who comes to the clinic for routine immunizations. For which of the following findings should the nurse withhold the varicella immunization?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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