A nurse is preparing to administer a vaccine to a toddler. Which of the following actions should the nurse plan to take?
Massage the injection site for 15 seconds after administration.
Administer the vaccine into the dorsogluteal muscle.
Ensure the guardian signed an informed consent form for the immunization.
Aspirate for the presence of blood return prior to administering the vaccine.
The Correct Answer is C
A. Massaging the injection site is not recommended, as it can cause irritation or tissue damage, especially after certain types of injections.
B. The dorsogluteal muscle is no longer recommended for vaccine administration due to the risk of injury to the sciatic nerve. The preferred site is the vastus lateralis or deltoid muscle.
C. It is essential to ensure that the guardian has signed an informed consent form prior to administering the vaccine. This confirms that the guardian is aware of the vaccine's benefits and potential risks.
D. Aspirating for blood return before administering vaccines is no longer recommended or necessary for intramuscular injections.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This response reassures the child that they are not to blame for the abuse and provides emotional support. It also establishes a sense of safety for the child to express their feelings.
B. Telling the child that they should have spoken up earlier may cause shame or guilt, which can further harm the child’s emotional well-being.
C. Promising not to tell anyone would be unethical because it is necessary to report suspected abuse to the appropriate authorities for the child's safety.
D. While this response acknowledges the injustice of the situation, it doesn't validate the child's feelings of fear or confusion in a way that encourages trust and healing.
Correct Answer is A
Explanation
A. A 9-month-old infant is expected to demonstrate a crude pincer grasp, which involves picking up small objects between the thumb and forefinger. This is a developmental milestone for this age.
B. While infants may shake their heads by this age, it is typically not used in the context of saying "no." This action is usually a sign of exploration or reaction to stimulation.
C. A 9-month-old typically does not use two-word phrases. By this age, infants are usually babbling and may say single words like "mama" or "dada."
D. A 9-month-old is not expected to build a tower of four blocks. By 12-15 months, infants may begin to stack blocks.
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