A nurse is reinforcing teaching with a parent about the pneumococcal vaccine. Which of the following should the nurse include?

The vaccine is administered subcutaneously, or just underneath the skin.

The first dose of the vaccine is administered at 2 months of age.

The vaccine is contraindicated in individuals who are allergic to gelatin.

The vaccine in given in a series of six doses spread throughout the first 5 years of life.

Answer and Explanation

The Correct Answer is B

A. The vaccine is administered subcutaneously, or just underneath the skin. The pneumococcal vaccine (PCV13) is given intramuscularly (IM), not subcutaneously. The preferred injection sites are the anterolateral thigh (for infants) or the deltoid muscle (for older children).

B. The first dose of the vaccine is administered at 2 months of age. This is correct. The pneumococcal conjugate vaccine (PCV13) is routinely given at 2, 4, 6, and 12–15 months of age to protect against Streptococcus pneumoniae, which can cause pneumonia, meningitis, and sepsis.

C. The vaccine is contraindicated in individuals who are allergic to gelatin. This is incorrect. The pneumococcal vaccine is not formulated with gelatin. Gelatin allergies are more relevant for vaccines like MMR and varicella. However, PCV13 should not be given to those with severe allergic reactions to any previous dose of the vaccine.

D. The vaccine is given in a series of six doses spread throughout the first 5 years of life. The PCV13 vaccine is given in a series of four doses, not six. While some high-risk children may require additional doses of PPSV23 (pneumococcal polysaccharide vaccine), the routine childhood schedule consists of four doses.

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Correct Answer is B

Explanation

A. Schedule the child for a follow-up blood test to monitor lead levels over the coming weeks. While ongoing monitoring is important, it is not the immediate priority in a child with extreme lead poisoning. Immediate intervention is needed to manage acute symptoms and prevent further complications.

B. Provide supportive care to manage common symptoms of nausea and pain. This is the correct first action. Severe lead poisoning can cause neurological and gastrointestinal symptoms, including abdominal pain, vomiting, and irritability. Supportive care addresses these symptoms while preparing for further interventions like chelation therapy.

C. Promote a balanced diet rich in calcium and iron to help mitigate lead absorption. Nutritional support is beneficial in mild to moderate cases, as calcium and iron reduce lead absorption, but it is not the first priority in extreme poisoning. Immediate medical treatment takes precedence.

D. Notify the health department to investigate potential lead exposure sources. Identifying the source of lead exposure is crucial for long-term prevention, but in cases of severe poisoning, immediate medical care is the priority before environmental interventions.

A. "The life expectancy for an individual who has this disorder is 25 years of age.” B. "This disorder is most common in individuals of Northern European descent.” C. "Heart failure will occur at some point during the progression of CF.” D. “This disorder occurs when the mother has a mutation of the 7th chromosome.”

Correct Answer is B

Explanation

A. "The life expectancy for an individual who has this disorder is 25 years of age." Advances in treatment, including improved respiratory therapies and medications like CFTR modulators, have significantly increased life expectancy. Many individuals with cystic fibrosis (CF) now live into their 40s or beyond, depending on disease severity and access to medical care.

B. "This disorder is most common in individuals of Northern European descent." CF is most prevalent in individuals of Northern European ancestry, affecting about 1 in 2,500 to 3,500 newborns in this population. It is much less common in individuals of African, Asian, or Hispanic descent.

C. "Heart failure will occur at some point during the progression of CF." CF primarily affects the lungs and digestive system due to thick mucus production, but heart failure is not a direct consequence of the disease. However, cor pulmonale (right-sided heart failure) can develop secondary to chronic lung disease and pulmonary hypertension in severe cases.

D. "This disorder occurs when the mother has a mutation of the 7th chromosome." CF is an autosomal recessive disorder, meaning a child must inherit mutated CFTR genes from both parents (not just the mother). The mutation affects the CFTR gene located on chromosome 7, leading to defective chloride transport and thick mucus production.

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A nurse is reinforcing teaching with a parent about the pneumococcal vaccine. Which of the following should the nurse include?

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