The nurse is preparing to give a vaccination to a 2 1/2 year old child. Which I.M. site should be used?
Vastus medius muscle
Ventogluteal muscle
Deltoid muscle
Dorsogluteal muscle
The Correct Answer is A
Intramuscular vaccination in toddlers requires selection of a large, well-developed muscle with minimal risk of neurovascular injury. Pediatric pharmacologic administration prioritizes safe absorption, adequate muscle mass, reduced nerve injury risk, and predictable vaccine immunogenicity for effective immunization response.
Rationale:
A. The vastus lateralis (referred to here as vastus medius) is the preferred IM site in toddlers due to well-developed quadriceps muscle mass, minimal major neurovascular structures, and reliable absorption. It provides safe vaccine delivery with reduced risk of sciatic nerve injury.
B. The ventrogluteal muscle is anatomically safe but less commonly used in toddlers due to caregiver unfamiliarity and difficulty landmarking. Although it avoids major nerves and vessels, it is not typically first-line for routine immunization in young children.
C. The deltoid muscle is underdeveloped in children under 3 years. It has limited muscle mass, making it unsuitable for reliable vaccine absorption and increasing risk of local irritation or suboptimal immunogenic response in this age group.
D. The dorsogluteal muscle is contraindicated for injections in young children due to proximity to the sciatic nerve and gluteal vessels. It carries higher risk of nerve injury and variable absorption, making it unsafe for pediatric immunization practices.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Pain assessment in neonates relies on behavioral and physiological indicators due to inability to self-report. These include facial expression changes, crying patterns, oxygen saturation fluctuations, and motor responses during painful stimuli or invasive procedures.
Rationale:
A. Qualitative pain scale is inappropriate for neonates because it depends on subjective description of pain experience. A 3 week old infant cannot verbalize discomfort. This method lacks objective behavioral indicators, making it unreliable for clinical assessment in non-verbal populations.
B. NIPS (Neonatal Infant Pain Scale) is appropriate for infant pain assessment in neonates. It evaluates facial expression, cry, breathing patterns, arm and leg movements, and arousal state. It is validated for postoperative monitoring in infants unable to self-report pain.
C. Wong Baker Faces Scale requires cognitive ability to associate facial expressions with pain intensity. A 3 week old infant lacks cognitive development for interpretation. It is designed for older children typically above 3 years, making it invalid for neonatal assessment.
D. Numeric pain scale depends on self-reporting of pain intensity from 0 to 10. A 3 week old infant cannot perform self reporting due to developmental immaturity. This makes it unsuitable and unreliable for assessing pain in neonatal or infant populations.
Correct Answer is C
Explanation
School-age children (6–12 years) are in Erikson’s stage of industry vs inferiority, with increasing independence, curiosity, and peer-driven activity. Cognitive development often includes incomplete risk appraisal, leading to overconfidence, risk-taking behavior, and increased susceptibility to accidental injury.
Rationale:
A. Inability to read labels is not typical for school-age children. Basic literacy develops during this stage, and poisoning risk is more related to curiosity and improper supervision rather than reading inability alone.
B. Reduced interest in family opinions reflects adolescent psychosocial development, not school-age children. This stage is still strongly influenced by family guidance, so this option does not explain injury risk in this age group.
C. School-age children commonly overestimate physical abilities, leading to risky behaviors such as climbing, cycling, or sports activities beyond safe limits. This cognitive misjudgment increases exposure to trauma and accidental injury significantly.
D. School-age children are highly capable of safety education and learning rules. They are not too young to be taught hazard avoidance. Injury risk is not due to inability to understand danger but due to overconfidence and experimentation.
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