A 2-month-old client is brought to the well-baby clinic. The parent is completing the consent forms for routine infant immunizations. Which immunization should the practical nurse (PN) prepare to administer?
Measles Mumps Rubella (MMR).
Varicella vaccine.
Hepatitis A.
Hepatitis B.
The Correct Answer is D
A. Measles Mumps Rubella (MMR) vaccine is typically administered at 12-15 months of age, not at 2 months. It is part of the recommended immunization schedule but is not given during the 2-month visit.
B. Varicella vaccine is usually given at 12-15 months of age. It is essential for preventing chickenpox but is not included in the 2-month immunization schedule.
C. Hepatitis A vaccine is recommended starting at 12 months of age. It is not part of the immunizations administered at 2 months.
D. Hepatitis B vaccine is part of the routine immunization schedule for infants and is given at birth, 1-2 months, and 6-18 months. At the 2-month visit, it is appropriate to administer the second dose of the Hepatitis B vaccine if it was not given at 1 month.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Assisting a client with urinary urgency and incontinence with a bedpan is a basic care task that the UAP can perform under supervision.
B. A client with continuous urinary bladder irrigation via a 3-way catheter requires tasks that involve monitoring and potentially troubleshooting the system, which are within the PN's scope of practice and not appropriate for a UAP.
C. Changing a urinary condom catheter is a routine task that can be performed by a UAP, as it does not require complex decision-making or assessment skills.
D. Managing a full urinary bedside drainage unit after receiving a diuretic is a task that the UAP can handle as long as there are no specific complications or concerns to address.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}
Explanation
Response 1
A. Fluid volume deficit
The client has signs of dehydration such as dry mucous membranes and a recent history of not having much to eat or drink in the past 2 days, which indicates a fluid volume deficit.
B. Respiratory alkalosis
There is no evidence to support respiratory alkalosis. The client's primary issues are related to infection and dehydration.
C. Hypoxia
The client’s oxygen saturation is 100% on 2 L/minute nasal cannula, so hypoxia is not a current issue.
D. Diarrhea
Diarrhea is not mentioned in the history, symptoms, or findings. It is not relevant to the client's condition.
Response 2
A. Decreased fluid intake
The client has not had much to eat or drink in the past 2 days, contributing directly to the fluid volume deficit.
B. Increased respiratory rate
While the client has an increased respiratory rate, it is a symptom of pneumonia rather than a cause of fluid volume deficit.
C. Infection
Although the client has pneumonia, the fluid volume deficit is more directly related to decreased fluid intake than to infection.
D. Heart disease
Heart disease is not mentioned and is not relevant to the client’s current presentation.
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