A nurse is performing a pre-college physical assessment on an adolescent. Which of the following immunizations should the nurse anticipate administering?

Choice A: Iron deficiency anemia is a condition in which the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the blood. Toddlers who drink too much milk and eat too few solid foods may not get enough iron from their diet, as milk is a poor source of iron. Iron deficiency anemia can cause fatigue, weakness, pale skin, and increased susceptibility to infections.

Choice B: Diabetes mellitus is a condition in which the body does not produce enough insulin or use it properly, resulting in high blood glucose levels. Toddlers who drink too much milk and eat too few solid foods are not at increased risk for diabetes mellitus, as milk does not contain glucose and does not affect insulin secretion or action.

Choice C: Obesity is a condition in which the body has excess fat that can impair health and increase the risk of chronic diseases. Toddlers who drink too much milk and eat too few solid foods may be at risk for obesity, as milk is high in calories and fat and can displace other nutritious foods from their diet. However, obesity is not a disorder but a risk factor for other disorders.

Choice D: Rickets is a condition in which the bones become soft and weak due to a lack of vitamin D or calcium. Toddlers who drink too much milk and eat too few solid foods are not at risk for rickets, as milk is a good source of vitamin D and calcium and can prevent rickets.

Choice A: Performing range of motion on the infant's hips is not appropriate for an infant who has myelomeningocele, which is a type of spina bifida that causes a sac-like protrusion of the spinal cord and nerves through an opening in the spine. Performing range of motion on the infant's hips can cause nerve damage or pain in the lower extremities, which may already be affected by the condition.

Choice B: Taking an axillary temperature is appropriate for an infant who has myelomeningocele, as it is a non-invasive and accurate method of measuring body temperature. An axillary temperature is taken by placing a thermometer under the armpit and holding the arm close to the body. Taking an axillary temperature can help monitor for signs of infection or inflammation, which are common complications of myelomeningocele.

Choice C: Placing the infant in a side-lying position is not appropriate for an infant who has myelomeningocele, as it can cause pressure or friction on the sac and increase the risk of rupture or infection. The correct position for an infant with myelomeningocele is prone with hips slightly flexed and legs abducted. This position can prevent trauma and promote drainage from the sac.

Choice D: Maintaining a dry dressing over the sac is not appropriate for an infant who has myelomeningocele, as it can cause irritation or infection of the sac and surrounding skin. The correct dressing for an infant with myelomeningocele is moist and sterile with saline or antibiotic solution. This dressing can prevent drying and cracking of the sac and reduce bacterial growth.