A nurse is preparing to administer recommended immunizations to an 11-year-old child who is up-to-date with current immunizations. Which of the following immunizations should the nurse plan to administer?

Rotavirus.

Haemophilus influenzae type b.

Hepatitis A.

Human papillomavirus.

Answer and Explanation

The Correct Answer is B

Choice A rationale:
The Rotavirus vaccine is typically administered to infants, usually starting at 2 months of age, to protect against severe diarrhea and vomiting caused by rotavirus infection. However, the child in question is 11 years old, and the rotavirus vaccine is not recommended for administration at this age. The vaccine's protection window is within the infant and early childhood period, and the child would likely have received this vaccine earlier.
Choice B rationale:
Haemophilus influenzae type b (Hib) Hib vaccine is recommended as a series of doses to protect against Haemophilus influenzae type B infection, which can lead to severe illnesses like meningitis and pneumonia. While the child may have received this vaccine in infancy, a booster dose is often recommended around age 11 to ensure ongoing protection. This choice is correct for the given age group.
Choice C rationale:
Hepatitis A Hepatitis A vaccine is typically administered in two doses, with the first dose given at age 1 and the second dose administered at least 6 months later. The child in question is 11 years old, and assuming the child received the vaccine as per the standard schedule, there would be no need to administer this vaccine again.
Choice D rationale:
Human papillomavirus (HPV) HPV vaccine is recommended for adolescents to protect against several strains of the human papillomavirus that can lead to various cancers later in life. It's usually administered in a series of doses starting around age 11 or 12. However, the prompt states that the child is already up-to-date with current immunizations, and if the child received the HPV vaccine at the appropriate age, there would be no need for another dose at this time.

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Correct Answer is C

Explanation

Choice A rationale:
Placing the infant in a supine position during naps might not be the best action for an infant with heart failure. In heart failure, infants often experience difficulty breathing due to fluid accumulation in the lungs. Placing the infant in a more upright position, such as semi-Fowler's, can help alleviate some of this respiratory distress.
Choice B rationale:
Feeding the infant a bottle every 4 hours is important, but it might not directly address the immediate concerns of an infant with heart failure. Infants with heart failure might have difficulty feeding due to fatigue and respiratory distress. Feeding smaller, more frequent meals and assessing the infant's feeding tolerance is crucial.
Choice C rationale:
Correct Answer. Documenting the infant's respiratory rate every 2 hours is an important action. Infants with heart failure often have respiratory distress and an increased respiratory rate, as the body tries to compensate for decreased cardiac output. Documenting the respiratory rate will help the healthcare team monitor the infant's condition and assess the effectiveness of interventions.
Choice D rationale:
Withholding digoxin if the infant's heart rate is greater than 100/min is not necessarily the correct action. Digoxin is a medication commonly used in heart failure to improve cardiac contractility. While it's important to monitor the infant's heart rate, a heart rate of greater than 100/min might be due to the body's compensatory mechanisms in response to heart failure. Withholding the medication without consulting a healthcare provider might not be appropriate.

A. "Wash your child's pillow in cold water twice monthly.". B. "Use a humidifier in your child's bedroom.". C. "Use a damp cloth to dust your child's furniture weekly.". D. "Install carpet in your child's bedroom.".

Correct Answer is C

Explanation

Choice A rationale:
Washing the child's pillow in cold water twice monthly is not a relevant instruction for controlling allergens in asthma management. Asthma triggers are often related to airborne allergens such as dust mites, pollen, and pet dander, and focusing on pillow washing alone does not address the broader issue of allergen exposure.
Choice B rationale:
Using a humidifier in the child's bedroom can actually worsen asthma symptoms. Humidifiers can increase the humidity in the air, promoting the growth of mold and dust mites, which are common allergens that can trigger asthma symptoms. Therefore, this instruction is not appropriate for asthma management.
Choice C rationale:
This is the correct answer. Using a damp cloth to dust the child's furniture weekly is a relevant instruction for controlling allergens. Dusting with a damp cloth helps to capture and remove allergens such as dust mites, pollen, and pet dander from surfaces, reducing the child's exposure to these triggers and potentially minimizing asthma symptoms.
Choice D rationale:
Installing carpet in the child's bedroom is not recommended for asthma management. Carpets can harbor dust mites, mold, and other allergens that can exacerbate asthma symptoms. Hard flooring surfaces that can be easily cleaned and do not trap allergens are a better choice for individuals with asthma.

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A nurse is preparing to administer recommended immunizations to an 11-year-old child who is up-to-date with current immunizations. Which of the following immunizations should the nurse plan to administer?

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