A nurse is assisting with planning care for a 2-month-old infant during a well-child visit. The nurse should plan to administer which of the following Immunizations?

Rotavirus (RV)

Measles, mumps, and rubella (MMR)

Varicella (VAR)

Influenza (IV)

Answer and Explanation

The Correct Answer is A

A. Rotavirus (RV): The first dose of the rotavirus vaccine is recommended at 2 months of age as part of the routine immunization schedule. Rotavirus vaccination protects infants from severe gastroenteritis caused by rotavirus, which can lead to dehydration and hospitalization. Administration at this age supports early immunity before peak exposure to the virus.

B. Measles, mumps, and rubella (MMR): The MMR vaccine is typically administered starting at 12 months of age, with a second dose at 4–6 years. Giving it at 2 months is not appropriate because maternal antibodies can interfere with vaccine efficacy, and the infant’s immune system is not sufficiently mature to mount an adequate response.

C. Varicella (VAR): Varicella vaccination is also recommended at 12 months of age, with a second dose at 4–6 years. Administering it at 2 months would be ineffective due to interference from maternal antibodies and the immature immune system.

D. Influenza (IV): Routine influenza vaccination is recommended starting at 6 months of age. Infants younger than 6 months are !not eligible for the vaccine, so it is not appropriate to administer during a 2-month well-child visit.

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Correct Answer is B

Explanation

A. Vomiting: Vomiting is not a common adverse effect of electroconvulsive therapy (ECT). While anesthesia or premedication may occasionally cause nausea, it is not a typical expected response directly related to the ECT procedure itself.

B. Confusion: Transient confusion and short-term memory loss are common and expected adverse effects after ECT. Clients may experience disorientation immediately post-treatment, usually resolving within minutes to hours, and this is considered part of the normal recovery process.

C. Incontinence: Urinary or fecal incontinence is not typically associated with ECT. Motor control is usually intact post-procedure, and incontinence would indicate an unrelated neurological or medical issue.

D. Tinnitus: Ringing in the ears is not an expected effect of ECT. Auditory changes are not commonly reported, and if present, they should prompt further evaluation for other causes unrelated to the therapy.

A. Removing a mask after phototherapy B. Applying an identification bracelet C. Measuring axillary temperature D. Changing wet diapers

Correct Answer is D

Explanation

A. Removing a mask after phototherapy: Removing a mask after phototherapy does not involve contact with bodily fluids or potentially contaminated surfaces. Clean gloves are not required for this activity because the risk of transmission is minimal.

B. Applying an identification bracelet: Applying a bracelet involves only superficial contact with the newborn’s skin and does not pose a risk of exposure to blood or body fluids. Standard hand hygiene is sufficient; gloves are not needed.

C. Measuring axillary temperature: Taking an axillary temperature involves minimal contact with the skin and does not expose the AP to blood or body fluids. Clean gloves are not necessary for this procedure unless there is visible soiling or open lesions.

D. Changing wet diapers: Diaper changes involve direct contact with urine and feces, which are potential sources of pathogens. Wearing clean gloves protects the AP from contamination and helps prevent the spread of infection, making glove use essential for this procedure.

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A nurse is assisting with planning care for a 2-month-old infant during a well-child visit. The nurse should plan to administer which of the following Immunizations?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data for a client following electroconvulsive therapy. Which of the following adverse effects should the nurse expect?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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