The mother of a child with mumps tells the nurse that she does not understand how her son could have gotten mumps since he was immunized according to her physician's recommendations.
What is the best response by the nurse.

Are you sure your child received an immunization for mumps.

I am wondering if your physician followed the immunization schedule correctly.

I am sure it must be frustrating. Where did you have the immunizations performed.

While immunizations are highly effective they aren't 100

Answer and Explanation

The Correct Answer is D

Choice A rationale

This response inappropriately questions the mother's recollection or honesty regarding her son's immunization status, potentially damaging the therapeutic relationship and trust. While verifying the immunization record is essential, the initial response should prioritize validating the parent's frustration and offering a scientifically sound explanation of vaccine efficacy. The focus should be on education and support, not interrogation, to ensure collaborative care and open communication with the family.

Choice B rationale

Questioning the physician's adherence to the standard immunization schedule is confrontational and unprofessional, potentially leading the parent to distrust the primary care provider. The nurse must maintain a professional stance, focusing on providing accurate, non-judgmental information about vaccine characteristics. It is highly unlikely a standard physician would knowingly deviate from well-established public health guidelines without cause.

Choice C rationale

Acknowledging the mother's frustration is good communication, but immediately asking where the immunizations were performed is irrelevant to the central question of why a vaccinated child contracted the disease. The location of vaccination does not typically affect the vaccine's efficacy. The priority is to educate the parent on the biological reality of vaccine effectiveness rates and the possibility of primary vaccine failure.

Choice D rationale

This response is the most therapeutic and accurate, validating the parent's concern while providing a correct scientific explanation. While highly effective, vaccines like the MMR (Measles, Mumps, Rubella) vaccine do not guarantee 100 percent immunity (primary vaccine failure) in all individuals, meaning a small percentage of fully vaccinated people may still contract the disease. This is due to individual variations in immune response.

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Correct Answer is B

Explanation

Choice A rationale

Arching the child's back using two hands is contraindicated in the secondary trauma assessment. This maneuver involves hyperextending or flexing the spine, which creates excessive, uncontrolled movement. In any child with multiple trauma, until cervical and spinal injuries are definitively ruled out,the spine must be maintained in a neutral, in-line position. Arching the back risks displacing an unstable fracture, leading to severe or permanent spinal cord injury.

Choice B rationale

Logrolling the child to the side is the most appropriate technique for inspecting the back while maintaining spinal immobilization. This maneuver requires at least three rescuers (one stabilizing the head and neck, two to roll the body as a unit) to turn the patient onto their side simultaneously, keeping the head, neck, and torso in rigid alignment. This safe procedure allows for the visual and tactile assessment of the posterior surfaces for injury without compromising spinal integrity.

Choice C rationale

Lifting the child off the stretcher to inspect the back is unsafe and inappropriate in a trauma setting. Lifting involves uneven force and movement, making it impossible to guarantee complete spinal immobilization. This technique dramatically increases the risk of inadvertent movement of the cervical, thoracic, or lumbar spine, which could lead to secondary spinal cord injury if a vertebral fracture or ligamentous instability is present.

Choice D rationale

Sitting the child upright is absolutely contraindicated during the secondary assessment of a multi-trauma patient. Positioning the child in any manner that flexes or extends the spine, such as sitting them up, compromises the goal of spinal immobilization. This action could result in catastrophic neurological deterioration if an unstable fracture is present, underscoring the necessity to maintain the child supine and immobilized until radiological clearance of the spine is achieved. —.

Correct Answer is ["780"]

Explanation

Step 1 is to calculate the total IV intake. The IV ran for 4 hours (from 0100 to 0500). 60 mL/hour × 4 hours = 240 mL.

Step 2 is to convert the apple juice container volume from ounces to milliliters. 1 ounce is approximately 30 milliliters. 3 ounces per container × 30 mL/ounce = 90 mL per container.

Step 3 is to calculate the total apple juice intake. 2 containers × 90 mL/container = 180 mL.

Step 4 is to calculate the total water intake (already in mL). Water intake = 360 mL.

Step 5 is to calculate the total oral intake. 180 mL (apple juice) + 360 mL (water) = 540 mL.

Step 6 is to calculate the total intake (IV and oral) in milliliters. 240 mL (IV) + 540 mL (oral) = 780 mL. The patient's total intake (IV and oral) from 0100 to 0500 was 780.

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The mother of a child with mumps tells the nurse that she does not understand how her son could have gotten mumps since he was immunized according to her physician's recommendations. What is the best response by the nurse.

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Naxlex Comprehensive Predictor Exams

A nurse is conducting a secondary assessment of a child who has experienced multiple trauma. When inspecting the child's back which of the following would be most appropriate to do.

Correct Answer is B

Explanation

Correct Answer is ["780"]

Explanation

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The mother of a child with mumps tells the nurse that she does not understand how her son could have gotten mumps since he was immunized according to her physician's recommendations.
What is the best response by the nurse.