During a well-check for a 12-month-old, the nurse plans to administer the first dose of the varicella vaccine. What is an appropriate action for the nurse to take?

Delay the immunization if the child presents with nasopharyngitis.

Evaluate for presence of allergies to vaccine components.

Refrain from administering since the first dose is not given until 4 years of age.

Administer intramuscularly into the vastus lateralis.

Answer and Explanation

The Correct Answer is B

A. Mild illnesses like nasopharyngitis (a common cold) do not typically contraindicate vaccination, so there is no need to delay immunization.

B. It is essential to evaluate for allergies to vaccine components, such as gelatin or neomycin, which could contraindicate the administration of the varicella vaccine.

C. The first dose of the varicella vaccine is recommended at 12-15 months of age, not at 4 years of age, so it is appropriate to administer it during this well-check.

D. The varicella vaccine is administered subcutaneously, not intramuscularly, so this is not the correct route for administration.

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Correct Answer is A

Explanation

A. Projectile vomiting is a classic sign of pyloric stenosis, where the thickened pylorus muscle obstructs the passage of food from the stomach to the small intestine, causing forceful vomiting.

B. Large amounts of bilious emesis would suggest an obstruction beyond the pylorus, which is not characteristic of pyloric stenosis.

C. Watery diarrhea is not associated with pyloric stenosis, which typically causes dehydration and constipation.

D. Steatorrhea, or fatty stools, is not a feature of pyloric stenosis but rather is associated with malabsorption syndromes.

A. "My symptoms should subside within 7-10 days." B. "I won't share my drinks or utensils with anyone." C. "I will be on bedrest until I feel better." D. "A full course of antibiotics will treat this illness."

Correct Answer is B

Explanation

A. Symptoms of Epstein-Barr virus, also known as mononucleosis, can last for several weeks to months, not just 7-10 days.

B. Epstein-Barr virus is spread through saliva, so avoiding sharing drinks or utensils helps prevent transmission.

C. Bed rest is recommended, but it is not the only measure needed; monitoring and managing symptoms is also important.

D. Epstein-Barr virus is a viral infection, and antibiotics are not effective in treating viral illnesses.

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During a well-check for a 12-month-old, the nurse plans to administer the first dose of the varicella vaccine. What is an appropriate action for the nurse to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is reviewing the record of a pediatric client diagnosed with pyloric stenosis. Which assessment finding would the nurse expect to find in the electronic health record?

Correct Answer is A

Explanation

An adolescent presents to the clinic with extreme fatigue, fever, and body aches and is diagnosed with Epstein-Barr virus. What statement by the adolescent shows that discharge teaching was effective?

Correct Answer is B

Explanation

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