A nurse is preparing to administer vaccines to a 1-year-old child. Which of the following vaccines should the nurse give? (Select two)
Measles, mumps, rubella (MMR)
Rotavirus (RV)
Human papillomavirus (HPV4)
Varicella (VAR)
Diphtheria, tetanus and acellular pertussis (DTaP)
Correct Answer : A,D
The correct answer is a. Measles, mumps, rubella (MMR) and d. Varicella (VAR).
Choice A reason:
Measles, mumps, rubella (MMR): The MMR vaccine is recommended for children at 12-15 months of age. It protects against three serious diseases: measles, mumps, and rubella. The first dose is typically given at 12-15 months, with a second dose at 4-6 years. Measles can cause severe complications such as pneumonia and encephalitis. Mumps can lead to meningitis and hearing loss, while rubella can cause congenital rubella syndrome in pregnant women. Administering the MMR vaccine at the recommended age ensures that the child is protected from these potentially severe diseases.
Choice B reason:
Rotavirus (RV): This vaccine is given to infants at 2, 4, and possibly 6 months of age. It is not typically administered to a 1-year-old child as the series should be completed by 8 months. Rotavirus is a leading cause of severe diarrhea and dehydration in infants and young children. The vaccine is given orally and is highly effective in preventing rotavirus gastroenteritis. However, since the vaccine series is completed by 8 months, it is not appropriate for a 1-year-old child.
Choice C reason:
Human papillomavirus (HPV4): The HPV vaccine is recommended starting at 11-12 years of age. It is not suitable for a 1-year-old child. HPV is a common virus that can lead to certain types of cancers, including cervical cancer. The vaccine is most effective when given before exposure to HPV, which is why it is recommended for preteens. Administering the HPV vaccine to a 1-year-old would not be appropriate as it is not within the recommended age range.
Choice D reason:
Varicella (VAR): The VAR vaccine is recommended for children at 12-15 months of age to protect against chickenpox. A second dose is given at 4-6 years. Chickenpox can cause an itchy rash, fever, and tiredness. In some cases, it can lead to severe skin infections, pneumonia, and encephalitis. Vaccinating at the recommended age ensures that the child is protected from these complications. The first dose at 12-15 months is crucial for building immunity against the varicella virus.
Choice E reason:
Diphtheria, tetanus and acellular pertussis (DTaP): The DTaP vaccine is given in a series of five doses at 2, 4, 6, 15-18 months, and 4-6 years. The 4th dose is given at 15-18 months, not at 1 year. DTaP protects against three serious diseases: diphtheria, which can cause breathing problems and heart failure; tetanus, which causes painful muscle stiffness; and pertussis (whooping cough), which can lead to severe coughing spells and pneumonia. The timing of the doses is crucial for ensuring effective immunity, and the 1-year mark is not one of the recommended times for the DTaP vaccine.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A: This instruction is correct, as iron supplements can cause a change in the color and consistency of stools, making them dark, green, or black. This is not a sign of bleeding or infection, but a normal side effect of iron therapy. The parents should be informed of this possibility and reassured that it is harmless.
Choice B: This instruction is incorrect, as iron supplements should not be administered at bedtime, but rather one hour before or two hours after meals. This is because iron absorption is reduced by food, especially dairy products, antacids, or calcium supplements. The parents should be instructed to give the medication on an empty stomach or with a small amount of food if it causes nausea.
Choice C: This instruction is incorrect, as iron supplements should not be given with milk, as milk contains calcium, which can interfere with iron absorption and reduce its effectiveness. The parents should be instructed to avoid giving milk or other dairy products within two hours of the medication.
Choice D: This instruction is incorrect, as iron supplements should not be administered at mealtimes, but rather one hour before or two hours after meals. This is because iron absorption is reduced by food, especially dairy products, antacids, or calcium supplements. The parents should be instructed to give the medication on an empty stomach or with a small amount of food if it causes nausea.
Correct Answer is D
Explanation
Choice A: Loosening restrictive clothing is not the priority action, but rather a secondary action for a child who is having a tonic-clonic seizure and vomiting. A tonic-clonic seizure is a type of seizure that involves the stiffening of muscles (tonic phase) followed by jerking movements (clonic phase). Loosening restrictive clothing can prevent injury or discomfort to the child during or after the seizure.
Choice B: Placing a pillow under the child's head is not the priority action, but rather an inappropriate action for a child who is having a tonic-clonic seizure and vomiting. A pillow under the head can obstruct the airway or cause aspiration of vomitus into the lungs. The nurse should remove any pillows or objects from around the head and neck area and support the head with their hands or on a flat surface.
Choice C: Clearing the area of hazards is not the priority action, but rather a secondary action for a child who is having a tonic-clonic seizure and vomiting. Clearing the area of hazards can prevent injury or harm to the child or others during or after the seizure. The nurse should remove any sharp, hard, or flammable objects from near or under the child and move any furniture or equipment away.
Choice D: Positioning the child side-lying is the priority action for a child who is having a tonic-clonic seizure and vomiting, as it can protect the airway and prevent aspiration of vomitus into the lungs. Aspiration can cause pneumonia, which is an infection of the lungs that can cause fever, cough, difficulty breathing, or death. The nurse should turn the child's head to one side and place them on their side with their knees bent and one arm under their head. The nurse should also suction any vomitus from their mouth and nose if needed.
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