A nurse is preparing to administer the measles, mumps, and rubella (MMR) vaccine to an adolescent. Which of the following should the nurse identify as a contraindication to administering this vaccine?

Choice A rationale:
This response indicates an understanding of the teaching about celiac disease. Rice is a gluten-free grain, which makes rice pudding a suitable dessert option for a child with celiac disease. Gluten is a protein found in wheat, barley, and rye, and individuals with celiac disease need to avoid gluten-containing foods.
Choice B rationale:
Barley is a gluten-containing grain, and feeding a child a barley-based breakfast cereal is not appropriate for someone with celiac disease. Gluten-containing grains can trigger adverse reactions in individuals with celiac disease due to their inability to properly digest gluten.
Choice C rationale:
Rye bread contains gluten, and making sandwiches using rye bread is not a suitable choice for a child with celiac disease. Gluten-free bread options, typically made from rice, corn, or other gluten-free flour, should be chosen instead.
Choice D rationale:
Chocolate malt may contain ingredients that could potentially contain gluten, and it's not a safe snack option for a child with celiac disease. Individuals with celiac disease need to be cautious about hidden sources of gluten in processed foods.

Choice A rationale:
Acute otitis media is not a risk factor for physical maltreatment. It's an ear infection and does not directly contribute to the risk of physical abuse. The child's medical history should be assessed for factors that are more closely related to abuse.
Choice B rationale:
Myopia, or nearsightedness, is also not a risk factor for physical maltreatment. Myopia is a visual impairment and is not related to the risk of abuse. The nurse should focus on identifying factors that might indicate an increased likelihood of abuse.
Choice C rationale:
Prematurity can be a risk factor for various health issues in a child, but it is not directly linked to physical maltreatment. While preterm infants might have unique medical needs, being born prematurely does not inherently increase the risk of physical abuse.
Choice D rationale:
Correct Answer. Being adopted can be considered a potential risk factor for physical maltreatment. Children who are adopted might face certain challenges related to attachment, identity, and adjustment. It's important for healthcare providers to be vigilant and assess the child's situation comprehensively to ensure their safety and well-being.