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. "Since ADHD is genetic, we need to know if other family members have been diagnosed to determine if your child has it." While ADHD has a genetic component, a family history alone is not sufficient to diagnose the condition. A proper diagnosis requires a comprehensive evaluation, not just genetic predisposition.

B. "Your child will need a comprehensive evaluation, based on specific criteria including a detailed history and behavior assessment." ADHD diagnosis is based on clinical criteria from the DSM-5, which includes a thorough history, observation of symptoms in multiple settings, and standardized behavior assessments. This ensures an accurate and well-supported diagnosis.

C. "If your child shows symptoms of ADHD at home but not at school, they can still be diagnosed with ADHD." ADHD symptoms must be present in at least two different settings, such as home and school, to meet diagnostic criteria. If symptoms are only seen in one setting, another cause may be responsible for the child’s behavior.

D. "ADHD can be confirmed with a blood test, so we should schedule one for your child." There is no laboratory test, imaging, or biomarker that can diagnose ADHD. Diagnosis is based on behavioral criteria and clinical evaluation rather than medical testing.

Correct Answer is ["3.8"]

Explanation

Convert the child's weight from pounds to kilograms:

Formula:

kg = lb / 2.2

= 22 lb / 2.2 lb/kg

= 10 kg

Calculate the total daily dose of dexamethasone:

Total daily dose (mg) = Dose (mg/kg/day) × Weight (kg)

= 1.5 mg/kg/day × 10 kg

= 15 mg/day

Calculate the dose to be administered every 6 hours:

Dose per interval (mg/dose) = Total daily dose (mg/day) / Number of doses per day

= 15 mg/day / 4 doses/day

= 3.75 mg/dose

Calculate the volume of dexamethasone oral solution to administer:

Volume (mL) = Dose (mg) / Concentration (mg/mL)

= 3.75 mg / 1 mg/mL

= 3.75 mL

Round to the nearest tenth:

3.75 mL rounded to the nearest tenth is 3.8 mL.

The nurse should administer 3.8 mL per dose.

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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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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching to the parent of a 7-year-old child who has manifestations consistent with attention deficit hyperactivity disorder (ADHD). Which of the following statements should the nurse make regarding the screening and diagnosis of ADHD?

Correct Answer is B

Explanation

A nurse is preparing to administer a dexamethasone 1.5 mg/kg/day PO to divide equally every 6 hr to a preschool-age child who weighs 22 lb. Available is dexamethasone oral solution 1 mg/mL. How many mL should the nurse administer per dose?

Correct Answer is ["3.8"]

Explanation

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