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 B

Explanation

. While pain management is important, the primary treatment for pyloric stenosis is surgical correction, not just analgesic medication.

B. Preparation for surgical correction, specifically a pyloromyotomy, is the standard treatment for pyloric stenosis to relieve the obstruction.

C. A barium enema is not used in the diagnosis or treatment of pyloric stenosis; it is typically used to diagnose other gastrointestinal conditions.

D. Thickened feedings with rice cereal are not indicated for pyloric stenosis and would not resolve the obstruction.

A. Blood pressure of 136/92 mg B. Heart rate of 100 bpm C. Decreased urine output D. Tea-colored urine

Correct Answer is A

Explanation

A. Hypertension (blood pressure of 136/92 mm Hg) in a child with acute pyelonephritis can indicate a severe condition that may lead to renal damage or worsening kidney function. Immediate intervention is necessary to manage high blood pressure and prevent complications.

B. A heart rate of 100 bpm is within normal limits for a 7-year-old and does not require immediate action.

C. Decreased urine output is concerning and needs monitoring, but hypertension is the more urgent issue.

D. Tea-colored urine suggests hematuria or concentrated urine, which is important but not as immediately life-threatening as high blood pressure.

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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

An infant has been admitted to the pediatric unit with a diagnosis of pyloric stenosis. What would the nurse expect in the plan of care for this client?

Correct Answer is B

Explanation

A nurse is assessing a 7-year-old who has been diagnosed with acute pyelonephritis, what assessment finding requires immediate action by the nurse?

Correct Answer is A

Explanation

A clinic nurse is caring for a 4-year-old client with acute diarrhea and mild dehydration who is afebrile, active, and alert. The nurse is providing instructions to the parent. Which statement by the parent indicates understanding?

The nurse is reviewing the treatment plan with the parents of a newborn with hypospadias. Which statement should the nurse include in the teaching when describing this disorder?

The nurse is reviewing the medical record of a pediatric client suspected to have acute glomerulonephritis. What finding should the nurse expect to note in a client with this diagnosis?

A 10-year-old client is experiencing acute renal failure from long-term kidney disease. The nurse is preparing to administer intravenous (IV) fluid. Which action is appropriate when caring for this client?

A newborn has been admitted to the intensive care unit with a diagnosis of myelomeningocele. The nurse could expect which of the following with the disorder?

A school-age client with asthma has been monitoring their daily peak expiratory flow rates(PEFR). The client's mother calls the clinic to report that the PEFR was at 45% of their personal best. Which guidance should the nurse provide to the mother?

A nurse is caring for an infant who has diaper dermatitis. What is an appropriate action for the nurse to take when caring for this client?