The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received one dose of the measles, mumps, rubella (MMR) vaccine. Which intervention should the nurse implement?

Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year.

Send notices home with the children on the first day of class advising that MMR vaccine series must be completed.

Note in student records that the second dose of the MMR vaccine should be administered prior to entering first grade.

Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children.

Answer and Explanation

The Correct Answer is A

A) Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year:
Directly contacting parents before the school year begins is the most effective intervention for ensuring that students receive the necessary immunizations. By reminding parents ahead of time, the school nurse can help ensure that the second dose of the MMR vaccine is administered before the start of kindergarten, which is crucial for meeting school entry requirements and protecting public health.

B) Send notices home with the children on the first day of class advising that MMR vaccine series must be completed:
Sending notices on the first day of class might be too late for many parents to act on promptly. Ensuring that children have received the second dose of the MMR vaccine before the school year starts is important for compliance and preventing potential outbreaks.

C) Note in student records that the second dose of the MMR vaccine should be administered prior to entering first grade:
While noting the requirement in student records is important for long-term tracking, it does not address the immediate need to ensure that students are up-to-date with their vaccinations before starting kindergarten. Immediate action is necessary to ensure compliance at the beginning of the school year.

D) Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children:
While educating parents about the benefits of immunization is valuable, it does not directly address the immediate need for the second dose of the MMR vaccine. Direct reminders and actions to ensure vaccinations are up-to-date are more effective in achieving timely compliance.

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Correct Answer is A

Explanation

A) Make a referral to have the scoliosis further evaluated:
Making a referral for further evaluation is the most important intervention. A noticeable unequal symmetry of the upper and lower back suggests the possibility of scoliosis, a condition that requires accurate diagnosis and assessment by a specialist. An orthopedic evaluation or consultation with a healthcare provider can provide a definitive diagnosis and guide appropriate management or treatment.

B) Measure the degree of the thoracic and lumbar curvature:
Measuring the degree of curvature can provide useful information about the severity of scoliosis but should be done by a healthcare professional specializing in scoliosis. Initial steps should focus on referring the student for a comprehensive evaluation, which will include assessing the degree of curvature along with other diagnostic procedures.

C) Ask about the student's ability to participate in sports:
While it is important to consider the student's ability to participate in sports, this is not the immediate priority. The primary concern should be obtaining a proper diagnosis and assessment of the potential scoliosis to determine if there are any limitations or necessary modifications in physical activities.

D) Review students' health record for a recent growth spurt:
Reviewing the health record for a recent growth spurt may provide context, as rapid growth can influence scoliosis development or progression. However, the most critical step is to refer the student for further evaluation to address the observed signs of scoliosis and determine the appropriate course of action.

A. A 12-year-old child with history of asthma who is wheezing and reporting shortness of breath. B. A 7-year-old child who has type 1 diabetes mellitus and is experiencing extreme hunger and shakiness. C. A 10-year-old child with bleeding lacerations on both knees after falling in gym class. D. A 5-year-old child who is crying uncontrollably because of an incontinent bowel episode.

Correct Answer is A,B,C,D

Explanation

1. A 12-year-old child with a history of asthma who is wheezing and reporting shortness of breath.

Rationale: The child with asthma who is wheezing and experiencing shortness of breath is the highest priority. Wheezing and shortness of breath are signs of a potentially severe asthma exacerbation, which can quickly become life-threatening if not addressed promptly. Immediate intervention is needed to ensure adequate oxygenation and prevent further respiratory distress.

2. A 7-year-old child who has type 1 diabetes mellitus and is experiencing extreme hunger and shakiness

Rationale: The child with type 1 diabetes mellitus who is experiencing extreme hunger and shakiness may be showing symptoms of hypoglycemia, which can also be potentially dangerous. While not as immediately life-threatening as severe respiratory distress, hypoglycemia needs to be addressed quickly to prevent complications such as loss of consciousness or seizures.

3. A 10-year-old child with bleeding lacerations on both knees after falling in gym class.

Rationale: The child with bleeding lacerations requires prompt care to manage the bleeding and prevent infection. However, this situation is less critical compared to the respiratory distress and hypoglycemia, which have more immediate implications for the child’s health.

4. A 5-year-old child who is crying uncontrollably because of an incontinent bowel episode.

Rationale: While the child’s distress and the need for clean-up are important, this situation is the least urgent in terms of immediate health risks compared to the other three cases. Addressing the child’s comfort and hygiene can follow after more critical needs are met.

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The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received one dose of the measles, mumps, rubella (MMR) vaccine. Which intervention should the nurse implement?

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Naxlex Comprehensive Predictor Exams

The school nurse is assessing a group of middle school students for signs of scoliosis and discovers a student with a noticeable unequal symmetry of the upper and lower back. Which intervention is most important for the nurse to implement?

Correct Answer is A

Explanation

Four students come to the school clinic simultaneously, seeking help from the school nurse. In which order of priority should the nurse provide care to these students? (Arrange the client with the highest priority first, on top, and lowest priority last, on bottom.)

Correct Answer is A,B,C,D

Explanation

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