A school nurse is informed that a student has recently been diagnosed with idiopathic thrombocytopenia purpura. The nurse should identify that which of the following scheduled vaccines should be withheld?

Polio

Measles, mumps, and rubella virus

Diphtheria and tetanus toxoids and pertussis

Hepatitis B

Answer and Explanation

The Correct Answer is B

A. Polio: The inactivated polio vaccine does not contain live virus and does not increase bleeding risk in clients with thrombocytopenia. It is generally considered safe to administer and does not worsen platelet destruction. Routine immunization schedules can usually be continued with this vaccine.

B. Measles, mumps, and rubella virus: The MMR vaccine is a live attenuated vaccine and is associated with the development or worsening of thrombocytopenia. In a client with idiopathic thrombocytopenic purpura, this vaccine should be withheld due to the risk of further platelet reduction and bleeding complications. Careful timing or deferral is recommended until platelet counts stabilize.

C. Diphtheria and tetanus toxoids and pertussis: This vaccine is inactivated and does not pose a risk of viral replication or immune-mediated platelet destruction. While injection technique may need to be adjusted to reduce bleeding risk, the vaccine itself is not contraindicated.

D. Hepatitis B: Hepatitis B vaccine is non-live and safe for clients with thrombocytopenia. Although intramuscular injections can increase the risk of localized bleeding, the vaccine itself does not exacerbate ITP. Applying firm pressure after injection helps minimize bruising or hematoma formation.

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Correct Answer is A

Explanation

A. Grapes: Grapes are a common choking hazard for toddlers because of their size, shape, and firmness. They can easily block a child’s airway if not cut into small, manageable pieces. Including grapes in the pamphlet raises awareness for parents and caregivers to prevent choking.

B. Potatoes: Cooked, soft potatoes are generally safe for toddlers to eat. They do not pose a significant choking risk when properly prepared, so they are not a primary concern in choking prevention education.

C. Corn: Whole corn kernels are usually safe for toddlers because they are small and soft enough to swallow. Corn does not commonly obstruct the airway unless the child has swallowing difficulties.

D. Oranges: Orange segments are soft and unlikely to cause choking. While seeds or membranes could pose minor risks, oranges are generally considered safe and are not a primary choking hazard for toddlers.

A. Gown B. Gloves C. Dosimeter badge D. N95 respirator

Correct Answer is D

Explanation

A. Gown: Gowns are typically used to protect against contact with infectious body fluids or contaminated surfaces. Tuberculosis is primarily transmitted via airborne droplets, so gowns are not required for routine care of a client with suspected TB.

B. Gloves: Gloves protect against direct contact with infectious materials or bodily fluids. While gloves may be used during procedures involving secretions, they are not the primary protective equipment for preventing inhalation of airborne TB particles.

C. Dosimeter badge: Dosimeter badges monitor exposure to ionizing radiation and are irrelevant in the context of airborne infectious diseases like tuberculosis. Wearing a dosimeter does not protect against TB transmission.

D. N95 respirator: An N95 respirator is specifically designed to filter airborne particles, including Mycobacterium tuberculosis. Nurses must wear an N95 respirator when entering the room of a client with suspected or confirmed TB to prevent inhalation of infectious droplets.

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A school nurse is informed that a student has recently been diagnosed with idiopathic thrombocytopenia purpura. The nurse should identify that which of the following scheduled vaccines should be withheld?

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