A nurse is collecting a medication history from the parent of a preschooler who comes to the clinic for routine immunizations. For which of the following findings should the nurse withhold the varicella immunization?

A pregnant parent

Receiving treatment for leukemia

Taking acetaminophen for mild discomfort

An allergy to eggs

Answer and Explanation

The Correct Answer is B

A. A pregnant parent. A child can receive the varicella vaccine even if the parent is pregnant. While the varicella vaccine is a live attenuated vaccine, the vaccinated child does not pose a significant risk of transmission to others. The parent should avoid direct contact with the vaccinee's rash if one develops, but this is not a contraindication to immunization.

B. Receiving treatment for leukemia. Children undergoing treatment for leukemia often have weakened immune systems due to chemotherapy or radiation. The varicella vaccine is a live attenuated vaccine, meaning it contains a weakened form of the virus that could cause severe illness in immunocompromised individuals. These children should not receive live vaccines until their immune function improves and their healthcare provider approves vaccination.

C. Taking acetaminophen for mild discomfort. Acetaminophen is an over-the-counter pain reliever and fever reducer that does not interfere with the efficacy or safety of the varicella vaccine. There is no evidence that mild analgesic use before or after vaccination affects immune response, so it is not a reason to withhold the immunization.

D. An allergy to eggs. Unlike some influenza and yellow fever vaccines, the varicella vaccine is not produced using egg-based components. An egg allergy is not a contraindication to receiving the varicella vaccine, as it does not contain egg proteins.

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Correct Answer is D

Explanation

A. Atropine. Atropine is an anticholinergic medication used to treat bradycardia and reduce secretions before surgery. It has no effect on reversing anticoagulation caused by heparin and would not be an appropriate treatment for heparin overdose.

B. Vitamin K. Vitamin K is used as an antidote for warfarin toxicity, as it helps produce clotting factors that warfarin inhibits. However, it does not reverse the effects of heparin, which works by enhancing the activity of antithrombin to prevent clot formation.

C. Vitamin B12. Vitamin B12 is essential for red blood cell production and neurological function, primarily used to treat conditions like pernicious anemia. It does not have any role in reversing the anticoagulant effects of heparin and would not be beneficial in this situation.

D. Protamine. Protamine sulfate is the specific antidote for heparin overdose. It binds to heparin, neutralizing its anticoagulant effects and preventing excessive bleeding. Protamine is administered intravenously in cases of heparin toxicity or when urgent reversal is needed, such as before surgery or in cases of uncontrolled bleeding.

A. "Place a thick layer of the medication on open areas.” B. “Rub the medication until it disappears.” C. "Cover the area with an occlusive dressing.” D. "Apply the medication to your infant's entire arm.”

Correct Answer is B

Explanation

A. "Place a thick layer of the medication on open areas." Topical corticosteroids like fluticasone should not be applied in thick layers or to open wounds, as excessive absorption can lead to systemic side effects such as adrenal suppression. A thin layer is sufficient to achieve the desired anti-inflammatory effects while minimizing adverse reactions.

B. “Rub the medication until it disappears.” Topical corticosteroids should be applied in a thin layer and gently rubbed into the skin until no visible residue remains. This ensures even absorption without excessive medication buildup, reducing the risk of local and systemic side effects, especially in infants who have a higher risk of absorption due to their thinner skin.

C. "Cover the area with an occlusive dressing." Occlusive dressings increase medication absorption, which can lead to systemic corticosteroid effects such as skin thinning, delayed wound healing, and adrenal suppression. Occlusion should only be used under medical supervision, especially in infants who are more susceptible to these effects.

D. "Apply the medication to your infant's entire arm." Fluticasone should be applied only to affected areas, not the entire limb. Applying it over a larger area than necessary increases the risk of systemic absorption and side effects. The medication should be used only as directed for targeted treatment of atopic dermatitis.

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A nurse is collecting a medication history from the parent of a preschooler who comes to the clinic for routine immunizations. For which of the following findings should the nurse withhold the varicella immunization?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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