A nurse is planning to administer the influenza vaccine to a toddler. Which of the following actions should the nurse take?

Administer intramuscularly in the anterolateral thigh.

Divide the medication into two injections if necessary.

Use a 22-25 gauge needle.

Place the child in a comfortable position, preferably sitting upright.

Answer and Explanation

The Correct Answer is A

Choice A reason: The anterolateral thigh is the recommended site for intramuscular injections in toddlers due to the well-developed muscles and minimal risk of injury to nerves or blood vessels.

Choice B reason: Dividing the medication into two injections may be necessary for large volumes, but influenza vaccines typically do not require this.

Choice C reason: A 22-25 gauge needle is recommended for intramuscular injections in toddlers to minimize discomfort and tissue damage.

Choice D reason: While the supine position is not incorrect, a comfortable sitting position is preferable for toddlers to reduce anxiety and ensure a smooth vaccination process.

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Correct Answer is B

Explanation

Choice A reason: This choice is incorrect because a CD4+ T-cell count of less than 200 cells/µL and the presence of PCP are indicative of AIDS, not the chronic asymptomatic phase of HIV.

Choice B reason: This is the correct choice. A CD4+ T-cell count of less than 200 cells/µL and an opportunistic infection such as PCP meet the CDC criteria for an AIDS diagnosis.

Choice C reason: This choice is incorrect. A CD4+ T-cell count of less than 200 cells/µL is below the normal range and is one of the criteria for an AIDS diagnosis.

Choice D reason: This choice is incorrect because the acute HIV infection phase is characterized by a high viral load and a decrease in CD4+ T-cell count, but not necessarily below 200 cells/µL or the presence of opportunistic infections.

A. Apply lidocaine and prilocaine cream to three potential insertion sites. B. Explain the procedure using the child's favorite toy. C. Allow the child to make one choice regarding the procedure. D. Ask the parents to leave during the procedure. E. Perform the procedure with the child in his bed.

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

Explanation

Choice A reason: Applying lidocaine and prilocaine cream can help numb the area, reducing pain and discomfort during catheter insertion, which aligns with atraumatic care principles.

Choice B reason: Explaining procedures using familiar objects can help reduce anxiety and fear in children, making the experience less traumatic⁷.

Choice C reason: Allowing the child to make choices can provide a sense of control, which is important for reducing stress during medical procedures⁷.

Choice D reason: Asking parents to leave is not recommended as their presence can be comforting to the child and is part of atraumatic care.

Choice E reason: Performing the procedure in a familiar environment, such as the child's bed, can help minimize stress and fear.

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A nurse is planning to administer the influenza vaccine to a toddler. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

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

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