A nurse is preparing to administer the hepatitis B vaccine to a newborn. Which of the following actions should the nurse take?
Use a 20-gauge needle to administer the vaccine.
Choose a 3/8-inch needle to administer the vaccine.
Administer the vaccine into the dorsal gluteal muscle.
Administer 0.5 mL of the vaccine.
The Correct Answer is B
A) Incorrect- A 20-gauge needle is too large and could cause unnecessary pain for the newborn.
B) Correct - Choosing a 3/8-inch needle is appropriate for administering vaccines to newborns. he hepatitis B vaccine is given intramuscularly in the anterolateral thigh of newborns. The needle size should be appropriate for the muscle mass and age of the infant. A 3/8-inch needle is recommended for newborns, while a 20-gauge needle is too large and may cause tissue damage.
C) Incorrect- Administering the vaccine into the dorsal gluteal muscle is not recommended because of the risk of injury to the sciatic nerve; the recommended site is the vastus lateralis muscle in the anterolateral thigh.
D) Incorrect- The hepatitis B vaccine is usually administered in a dose of 0.5 mL for newborns, but this is not the only action that the nurse should take.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Incorrect- Applying a heat pack to the area might increase inflammation and discomfort. Heat is generally not recommended for healing episiotomies and hemorrhoids.
B) Correct - "I will apply witch hazel pads after urination" is the correct statement. Witch hazel pads have a cooling and soothing effect that can provide relief from discomfort associated with episiotomies and hemorrhoids.
C) Incorrect- Using a numbing spray before cleansing might not be necessary and could interfere with proper cleansing. It's generally recommended to cleanse the area before applying any products.
D) Incorrect- Remaining in a sitz bath for 10 minutes is beneficial for perineal care, but it doesn't specifically address the use of witch hazel pads or understanding of the overall perineal care regimen. Furthermore, prolonged sitz baths, as can interfere with healing and increase the risk of infection.
Correct Answer is C
Explanation
Rationale:
A) Incorrect - A blood pressure of 120/70 mm Hg is within the normal range and is not a contraindication for the transdermal contraceptive patch.
B) Incorrect - Peptic ulcer disease is not a contraindication for the transdermal contraceptive patch.
C) Correct - A weight of 98 kg (216 lb) is considered a contraindication for the transdermal contraceptive patch due to potential reduced efficacy in women with a body mass index (BMI) over 30. This method might be less effective for individuals with higher body weights.
D) Incorrect - A history of spontaneous abortion is not a contraindication for the transdermal contraceptive patch.
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