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:
"Provide your child with long-term goals to increase self-esteem." While setting long-term goals can indeed contribute to increasing a child's self-esteem, this choice may not be the most directly related to promoting a child's learning, especially for a child with attention deficit hyperactivity disorder (ADHD). Children with ADHD often struggle with attention and focus, and setting long-term goals might not address their immediate needs in terms of learning strategies.
Choice B rationale:
"Offer your child frequent breaks in activity during the day." Children with ADHD often benefit from frequent breaks in activities to help manage their attention and energy levels. These breaks can help prevent mental fatigue, increase focus, and enhance overall learning. This choice is appropriate for promoting the child's learning and is often recommended as part of ADHD management strategies.
Choice C rationale:
"Administer your child's medication at bedtime to prevent insomnia." This statement is not necessarily accurate for all medications used to treat ADHD. Some ADHD medications can indeed cause insomnia as a side effect, but the timing of medication administration can vary based on the specific medication and the child's individual response. It's essential for parents to follow the healthcare provider's instructions regarding medication timing.
Choice D rationale:
"Schedule a different routine for your child each day." Children with ADHD often benefit from consistent routines and schedules, as they provide structure and predictability, which can help manage their symptoms. Introducing a different routine each day could actually exacerbate symptoms and make it more challenging for the child to focus and engage in learning activities.

Choice A rationale:
Hypertension is a common manifestation of acute glomerulonephritis. The inflammation of the glomeruli in the kidneys can lead to impaired filtration, causing fluid retention and an increase in blood pressure. Monitoring the child's blood pressure is crucial to assess the severity of the condition and guide appropriate interventions.
Choice B rationale:
Dehydration is not a typical manifestation of acute glomerulonephritis. In fact, this condition often leads to fluid retention due to impaired kidney function. The child might experience edema and hypertension rather than dehydration.
Choice C rationale:
Muehrcke lines on the nails are not associated with acute glomerulonephritis. Muehrcke lines are white lines that appear horizontally across the nails and are typically indicative of hypoalbuminemia, which is not a primary feature of glomerulonephritis.
Choice D rationale:
Hypokalemia, or low potassium levels, is not a characteristic manifestation of acute glomerulonephritis. This condition primarily affects the kidneys' ability to filter waste and excess fluid, leading to fluid retention, electrolyte imbalances, and hypertension.