A nurse is planning care for an adolescent who has sickle cell anemia.
Which of the following immunization should the nurse include in the plan?
pneumococcal conjugate (PCV13)
Respiratory syncytial virus (RSV).
Measles, Mumps, and rubella MMR
Rotavirus.
The Correct Answer is A
Choice A rationale
The pneumococcal conjugate vaccine (PCV13) is recommended for children with sickle cell anemia. This is because individuals with sickle cell disease are at an increased risk of infection, and the PCV13 vaccine can help protect against Streptococcus pneumoniae, a bacterium that can cause serious infections like pneumonia and meningitis.
Choice B rationale
The Respiratory syncytial virus (RSV) vaccine is not typically included in the immunization schedule for children with sickle cell anemia.
Choice C rationale
While the Measles, Mumps, and Rubella (MMR) vaccine is part of the standard immunization schedule for all children, it is not specifically indicated for children with sickle cell anemia.
Choice D rationale
The Rotavirus vaccine is part of the standard immunization schedule for all infants, but it is not specifically indicated for children with sickle cell anemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice c. Sunken anterior fontanel.
Choice A rationale:
A heart rate of 162/min in a 2-month-old infant can be within the upper range of normal, especially if the infant is crying or agitated. While it is important to monitor, it is not the most critical finding in this context.
Choice B rationale:
A negative doll’s eye reflex (oculocephalic reflex) can indicate neurological issues, but it is not directly related to heart failure or the administration of furosemide.
Choice C rationale:
A sunken anterior fontanel indicates dehydration, which is a critical concern for an infant receiving furosemide, a diuretic that can lead to significant fluid loss. Dehydration can exacerbate heart failure and lead to severe complications.
Choice D rationale:
A potassium level of 5.1 mEq/L is slightly elevated but not immediately life-threatening. It requires monitoring and potential intervention but is not the most urgent issue compared to dehydration.
Monitoring for dehydration is crucial in infants on diuretics like furosemide, making the sunken anterior fontanel the priority finding.
Correct Answer is D
Explanation
Choice A rationale
Having a vocabulary of 30 words is not a finding that should be reported to the provider for a 24-month-old toddler. By 24 months, most children can say 50 words or more.
Choice B rationale
Sleeping 11 to 12 hours per day is not a finding that should be reported to the provider for a 24-month-old toddler. This is a typical amount of sleep for a child this age.
Choice C rationale
Eating a large amount of food one day then very little the next is not a finding that should be reported to the provider for a 24-month-old toddler. Toddlers often have variable appetites, and it’s normal for them to eat more on some days and less on others.
Choice D rationale
Holding his breath when having a temper tantrum is a finding that should be reported to the provider for a 24-month-old toddler. While breath-holding spells can be a normal part of toddler behavior, they can also be a sign of an underlying medical condition. It’s important for the provider to evaluate this behavior to rule out any potential health concerns.
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