A nurse is preparing to administer vaccines to a 1-year-old child. Which of the following vaccines should the nurse give? (Select two)

Choice A: This statement indicates an understanding of the teaching, as washing all recently used clothing, bedding, and towels in hot water can help eliminate lice and nits (eggs). Lice and nits can survive on fabrics for up to two days and can spread from one person to another through direct or indirect contact. Washing items in hot water can kill lice and nits by exposing them to high temperatures.

Choice B: This statement indicates a lack of understanding of the teaching, as nits will not always be present after treatment. Nits are tiny white or yellow oval-shaped eggs that are attached to the hair shaft near the scalp. Nits can hatch into nymphs (young lice) within seven to ten days and mature into adult lice within nine to twelve days. Nits can be removed by using a fine-toothed comb or by applying products that loosen their grip on the hair.

Choice C: This statement indicates a lack of understanding of the teaching, as treating all family members may not be necessary or effective. Treating all family members can expose them to unnecessary chemicals or medications that may have side effects or cause resistance. Treating all family members may also not prevent reinfestation if there are other sources of exposure such as school or daycare. Only family members who have evidence of lice or nits should be treated.

Choice D: This statement indicates a lack of understanding of the teaching, as throwing out toys that can't be dry cleaned or washed may not be required or practical. Throwing out toys can cause emotional distress or financial burden for the child or the parents. Throwing out toys may also not prevent reinfestation if there are other sources of exposure such as clothing or bedding. Toys that can't be dry cleaned or washed can be sealed in plastic bags for two weeks to suffocate the lice and nits.

Choice A reason: This choice is correct because a child who has nephrotic syndrome is the most appropriate roommate for a child who has leukemia. Nephrotic syndrome is a kidney disorder that causes proteinuria, edema, hypoalbuminemia, and hyperlipidemia. It does not pose any risk of infection or injury to the child who has leukemia, and it does not require any isolation or special precautions. Therefore, placing these two children in the same room can help to conserve resources and promote socialization.

Choice B reason: This choice is incorrect because a child recovering from a ruptured appendix is not an appropriate roommate for a child who has leukemia. A ruptured appendix is a medical emergency that occurs when the appendix becomes inflamed and bursts, releasing bacteria and pus into the abdominal cavity. It may cause peritonitis, sepsis, or abscess formation, and it requires surgery and antibiotics. It may pose a risk of infection to a child who has leukemia, who has a weakened immune system due to chemotherapy or bone marrow suppression. Therefore, placing these two children in the same room can increase the chance of cross-contamination and complications.

Choice C reason: This choice is incorrect because a child who has rheumatic fever is not an appropriate roommate for a child who has leukemia. Rheumatic fever is an inflammatory disease that occurs as a complication of streptococcal infection, such as strep throat or scarlet fever. It may affect the heart, joints, skin, or nervous system, and it requires anti-inflammatory and antibiotic medications. It may pose a risk of infection to the child who has leukemia, who has a compromised immune system due to cancer or treatment. Therefore, placing these two children in the same room can increase the likelihood of transmission and infection.

Choice D reason: This choice is incorrect because a child who has cystic fibrosis is not an appropriate roommate for a child who has leukemia. Cystic fibrosis is a genetic disorder that affects the mucus glands of the lungs, pancreas, liver, intestines, and reproductive organs. It causes thick and sticky mucus to build up in the organs, leading to chronic lung infections, pancreatic insufficiency, malnutrition, and infertility. It requires respiratory therapy, enzyme supplements, nutritional support, and antibiotics. It may pose a risk of infection to the child who has leukemia, who has a reduced ability to fight germs due to malignancy or therapy. Therefore, placing these two children in the same room can increase the possibility of exposure and infection.