A parent asked the nurse how to care for their 4-year-old child after receiving the Haemophilus influenzae Type b (Hib) conjugate vaccine.
Which instruction should the nurse provide?
Any level of fever is serious and should be reported right away.
Keep the child home from daycare for the next two days.
Apply a cool pack to the injection site to reduce discomfort.
Chewable children’s aspirin will help prevent inflammation.
The Correct Answer is C
Choice A rationale:
While it’s important to monitor for any adverse reactions following a vaccination, not all fevers are serious. Mild fever can be a common side effect of vaccinations and is usually not a cause for concern. However, if the child develops a high fever, or if the fever is accompanied by other severe symptoms such as difficulty breathing or extreme lethargy, it should be reported to a healthcare provider immediately.
Choice B rationale:
There is no need to keep the child home from daycare following the Hib vaccine unless the child is feeling unwell or has other symptoms that warrant staying home. The Hib vaccine is not a live vaccine, so the child cannot transmit the vaccine strain to others.
Choice C rationale:
Applying a cool pack to the injection site can help reduce discomfort or swelling that may occur after the vaccination. This is a safe and effective method for managing minor side effects of vaccinations.
Choice D rationale:
Aspirin should not be given to children due to the risk of Reye’s syndrome, a rare but serious condition that can affect the liver and brain. Instead, over-the-counter pain relievers such as acetaminophen or ibuprofen can be used to help manage any pain or fever following the vaccination, if approved by a healthcare provider. Always follow the dosing instructions on the package and consult with a healthcare provider if unsure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
The correct answers are B, C, and E: Gently close the eyes, Place a small pillow under the head, and Remove resuscitation equipment from the room.
Choice B rationale: Gently closing the eyes demonstrates respect for the deceased and can provide a more peaceful appearance for the family.
Choice C rationale: Placing a small pillow under the head is a way to provide comfort and dignity in death, as well as to create a more natural appearance.
Choice E rationale: Removing resuscitation equipment from the room allows for a more serene environment for the family to grieve and say their final goodbyes.
Choice A rationale: Dentures should be left in place, as they contribute to a more natural appearance of the deceased. The exception is if the family requests their removal or if it is the facility's policy to remove dentures.
Choice D rationale: Applying a body shroud is unnecessary when the family has requested to view the body before it is taken to the funeral home. Shrouds are typically used during transportation or if the family does not wish to view the body.
Correct Answer is A
Explanation
Choice A rationale:
Encouraging the client to face their fear gradually is an appropriate nursing intervention for a client with a phobia. This approach is consistent with exposure therapy, which is a widely recognized and effective treatment for phobias. Exposure therapy involves gradually exposing the client to the feared object or situation in a controlled and supportive environment. By doing so, the client can learn to confront and manage their fear over time. This approach is evidence-based and helps the client build resilience and reduce anxiety.
Choice B rationale:
Administering benzodiazepines as needed for acute anxiety (Choice B) is not the first-line treatment for phobias. While benzodiazepines can provide temporary relief from anxiety symptoms, they do not address the underlying phobia and can lead to dependence and tolerance with prolonged use. Moreover, they are generally reserved for acute anxiety episodes and not considered a primary treatment for phobias.
Choice C rationale:
Providing psychoeducation about the causes and effects of phobias (Choice C) is a valuable component of treatment, but it alone may not be sufficient. Psychoeducation can help clients understand the nature of their phobia and reduce stigma, but it should be combined with evidence-based therapies like exposure therapy for comprehensive care.
Choice D rationale:
Teaching the client relaxation techniques to manage anxiety (Choice D) can be a helpful adjunct to treatment, but it is not the primary intervention for phobias. Relaxation techniques can be part of a broader strategy to reduce anxiety, but the client also needs exposure therapy or cognitive-behavioral therapy to address the phobia directly.
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