A nurse is discussing allergies with the guardians of a school-age child prior to administration of the influenza vaccine. The nurse should identify that a prior anaphylactic reaction to which of the following is a contraindication to this immunization?

Neomycin

Gluten

Eggs

Gelatin

Answer and Explanation

The Correct Answer is C

A. Neomycin is not a contraindication to the influenza vaccine. However, if a person has a known neomycin allergy, they should avoid specific vaccines containing neomycin, but this is not typically a concern with the influenza vaccine.

B. Gluten allergies are not a contraindication for the influenza vaccine. Gluten is not an ingredient in most influenza vaccines, so a gluten allergy would not impact vaccine administration.

C. The influenza vaccine contains trace amounts of egg proteins, and individuals who have had a severe allergic reaction (anaphylaxis) to eggs should not receive this vaccine, or they should receive it under close supervision with appropriate precautions. This is because egg-based production methods of the vaccine may pose a risk.

D. Gelatin is a common ingredient in some vaccines, but a gelatin allergy is not typically a contraindication for the influenza vaccine. However, if a child has a severe allergic reaction to gelatin, caution would be taken in administering the vaccine.

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Correct Answer is B

Explanation

A. A decreased white blood cell (WBC) count in the cerebrospinal fluid (CSF) would not support the diagnosis of bacterial meningitis. Bacterial infections typically cause an increased WBC count, specifically neutrophils.

B. Elevated total protein in the CSF is a classic finding in bacterial meningitis, as the infection leads to increased permeability of the blood-brain barrier and results in an increase in protein content.

C. Elevated glucose in the CSF is not consistent with bacterial meningitis. In bacterial meningitis, glucose levels are usually decreased due to the consumption of glucose by bacteria.

D. Decreased pressure in the CSF is not typical in bacterial meningitis. Increased intracranial pressure often results in elevated CSF pressure.

A. Select a catheter that fits snugly into the tracheostomy tube. B. Instill 2 mL of 0.9% sodium chloride prior to suctioning. C. Apply suction in 3 to 4 second increments. D. Use clean technique when performing suctioning.

Correct Answer is C

Explanation

A. Selecting a catheter that fits snugly is important for proper suctioning, but it is more important to ensure the catheter is the correct size for the infant’s tracheostomy tube and airway.

B. Instilling saline prior to suctioning is generally not recommended unless specified by the healthcare provider, as it can increase the risk of aspiration and discomfort.

C. Suctioning should be done in short 3 to 4 second increments to avoid injury to the airway and to minimize the infant’s distress. Prolonged suctioning can cause hypoxia and trauma to the mucosa.

D. Suctioning for infants with tracheostomies requires sterile technique to prevent infection, not clean technique.

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A nurse is discussing allergies with the guardians of a school-age child prior to administration of the influenza vaccine. The nurse should identify that a prior anaphylactic reaction to which of the following is a contraindication to this immunization?

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Correct Answer is B

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Correct Answer is C

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