Which of the following clients would NOT be an appropriate candidate for the measles, mumps, and rubella (MMR) vaccine?
A female client with HIV who is admitted for Pneumocystis carinii pneumonia
A female client at 12 weeks' gestation
A male client with a history of hypersensitivity reactions to neomycin
A school-age child with HIV
The Correct Answer is B
Choice A reason: Mild to moderate HIV infection does not contraindicate MMR vaccination; however, severe immunosuppression may require deferral.
Choice B reason: MMR is a live attenuated vaccine and is contraindicated in pregnancy due to potential risk to the fetus. Vaccination should be deferred until postpartum.
Choice C reason: History of neomycin allergy may contraindicate MMR, but mild or past reactions may be assessed individually; often, only severe anaphylaxis is an absolute contraindication.
Choice D reason: A school-age child with HIV who is not severely immunocompromised may safely receive the MMR vaccine to prevent infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: HELLP syndrome is a severe form of preeclampsia characterized by Hemolysis, Elevated Liver enzymes, and Low Platelets. The patient’s lab values and clinical symptoms of right upper quadrant pain and chest tenderness are classic indicators of HELLP.
Choice B reason: Gestational diabetes involves hyperglycemia during pregnancy and does not typically present with liver enzyme elevations, hemolysis, or low platelets.
Choice C reason: Toxoplasmosis is an infectious condition that can affect the fetus but does not produce the constellation of maternal lab abnormalities seen here.
Choice D reason: Cytomegalovirus infection can cause systemic symptoms, but it does not explain the combination of preeclampsia, elevated liver enzymes, low platelets, and hemolysis.
Correct Answer is D
Explanation
Choice A reason: Trichotillomania involves hair pulling often due to tension or boredom without a preoccupation with symmetry. In this case, the pulling is driven by a compulsion for symmetry, making this diagnosis less appropriate.
Choice B reason: BDD involves distress over perceived physical flaws. While the patient is concerned about asymmetry, the hair pulling is specifically performed to alleviate compulsive distress, consistent with OCD rather than BDD.
Choice C reason: Delusional disorder, somatic type, involves a fixed false belief about bodily functions or appearance. The patient acknowledges the asymmetry is "all in her head," indicating insight, which rules out delusional disorder.
Choice D reason: OCD is characterized by obsessions (distressing thoughts) and compulsions (ritualized behaviors to alleviate distress). The patient’s repetitive eyebrow tweezing to achieve symmetry despite knowing it is unnecessary reflects a compulsion, confirming OCD.
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