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reason: This choice is incorrect because mumps is not the common name for pertussis. Mumps is a viral infection that causes inflammation of the salivary glands, especially the parotid glands. It may cause symptoms such as fever, headache, and swelling of the cheeks or jaw. It can be prevented by vaccination with the measles-mumps-rubella (MMR) vaccine.

reason: This choice is incorrect because the fifth disease is not the common name for pertussis. The fifth disease is a viral infection that causes a rash on the face, trunk, and limbs, which may resemble a slapped cheek appearance. It may cause mild symptoms such as fever, runny nose, or joint pain. It usually affects children and is self-limiting.

reason: This choice is incorrect because chickenpox is not the common name for pertussis. Chickenpox is a viral infection that causes an itchy rash with fluid-filled blisters all over the body. It may cause symptoms such as fever, headache, or loss of appetite. It can be prevented by vaccination with the varicella-zoster (VZV) vaccine.

reason: This choice is incorrect because having them share a room with a child with active mumps may expose them to infection and worsen their condition. A child who is immunosuppressed due to leukemia or chemotherapeutic agents has a weakened immune system and is more susceptible to infections from bacteria, viruses, fungi, or parasites. Therefore, they should be placed in a private room or cohorted with another immunosuppressed child.

reason: This choice is incorrect because restricting oral fluids may cause dehydration and electrolyte imbalance in the child who is immunosuppressed due to leukemia or chemotherapeutic agents. A child who is immunosuppressed due to leukemia or chemotherapeutic agents may have increased fluid losses from vomiting, diarrhea, fever, or sweating. Therefore, they should be encouraged to drink adequate fluids to maintain hydration and electrolyte balance.

reason: This choice is incorrect because strict isolation may cause psychological distress and social isolation in the child who is immunosuppressed due to leukemia or chemotherapeutic agents. A child who is immunosuppressed due to leukemia or chemotherapeutic agents may benefit from protective isolation, which involves using standard precautions and additional measures such as wearing gloves, gowns, masks, or eye protection when in contact with the child or their body fluids. However, strict isolation, which involves limiting visitors and activities, may harm the child's emotional and developmental well-being.

reason: This choice is incorrect because a regular diet, no added salt may not be sufficient to prevent fluid retention and hypertension in a child who has acute glomerulonephritis. Acute glomerulonephritis is an inflammation of the glomeruli, which are the tiny blood vessels that filter blood in the kidneys. It may cause symptoms such as hematuria, proteinuria, oliguria, edema, or hypertension. Therefore, avoiding salt alone may not reduce sodium and water intake and excretion.

reason: This choice is incorrect because a low-protein, low-potassium diet may not be necessary for a child who has acute glomerulonephritis. A low-protein, low-potassium diet may be indicated for a child who has chronic kidney disease or end-stage renal disease, which can cause uremia, hyperkalemia, or metabolic acidosis. However, in acute glomerulonephritis, the kidney function usually recovers within weeks or months, and the protein and potassium levels are not significantly affected.

reason: This choice is incorrect because a low-carbohydrate, low-protein diet may not be appropriate for a child who has acute glomerulonephritis. A low-carbohydrate, low-protein diet may be used for a child who has diabetes mellitus or ketosis-prone epilepsy, which can cause hyperglycemia or ketone production. However, in acute glomerulonephritis, carbohydrate metabolism is not impaired, and the protein intake should be adequate to prevent malnutrition and promote healing.

Erythema and edema of the affected ear are more indicative of otitis externa (swimmer's ear) rather than otitis media. Otitis media involves inflammation and infection of the middle ear, which is not typically visible externally. The primary signs of otitis media are observed through otoscopic examination, showing a bulging or erythematous tympanic membrane.

Pain when manipulating the affected ear lobe is also more characteristic of otitis externa. In otitis media, the pain is usually deeper within the ear and not exacerbated by touching the outer ear. The pain in otitis media is due to the pressure and inflammation in the middle ear space.

Clear drainage from the affected ear is not typical of otitis media. If there is drainage, it is usually purulent (pus-like) and indicates a ruptured eardrum due to the infection. Clear drainage is more commonly associated with conditions like otitis externa or a perforated eardrum without infection.

reason: This choice is incorrect because the BCG vaccine is not recommended for adolescents in the United States. The BCG vaccine is a vaccine that protects against tuberculosis (TB), a bacterial infection that affects the lungs and other organs. It may be used for children who live in countries where TB is common or who have a high risk of exposure to TB, but it is not routinely given in the United States because of the low incidence of TB and the possibility of false-positive results on TB skin tests.

reason: This choice is incorrect because the pneumococcal polysaccharide vaccine is not recommended for adolescents unless they have certain medical conditions. The pneumococcal polysaccharide vaccine is a vaccine that protects against pneumococcal disease, a bacterial infection that can cause pneumonia, meningitis, or sepsis. It may be used for adults who are 65 years or older or who have chronic diseases, immunosuppression, or cochlear implants, but it is not routinely given to adolescents who are healthy.

reason: This choice is incorrect because the influenza vaccine is recommended for adolescents every year, not just before college. The influenza vaccine is a vaccine that protects against influenza, a viral infection that affects the respiratory system. It may be given as an injection or a nasal spray, and it may prevent or reduce the severity of influenza and its complications. It is recommended for everyone who is 6 months or older, especially those who have a high risk of influenza-related complications.

reason: This choice is incorrect because 1 cup of cooked rice provides more than 1 oz of grains. According to the U.S. Department of Agriculture (USDA), one-ounce equivalent of grains equals one slice of bread, one cup of ready-to-eat cereal, or half a cup of cooked rice, pasta, or cereal. Therefore, 1 cup of cooked rice provides about 2 oz of grains.

reason: This choice is incorrect because 1/2 slice of white bread provides less than 1 oz of grains. As explained above, one-ounce equivalent of grains equals one slice of bread, so 1/2 slice of white bread provides only 0.5 oz of grains.

reason: This choice is incorrect because 1/2 white flour tortilla provides less than 1 oz of grains. According to the USDA, one-ounce equivalent of grains equals one small tortilla (6 inches in diameter), so 1/2 white flour tortilla provides only about 0.4 oz of grains.

reason: This choice is incorrect because initiating contact precautions is not necessary for an infant who has spina bifida and is to undergo surgical closure of the myelomeningocele sac. Contact precautions are infection control measures that prevent the transmission of microorganisms that can be spread by direct or indirect contact with the client or their environment. They may be indicated for clients who have multidrug-resistant organisms, clostridium difficile, or scabies, but they are not required for clients who have spina bifida unless they have a concurrent infection.

reason: This choice is incorrect because limiting visitors to immediate family members is not indicated for an infant who has spina bifida and is to undergo surgical closure of the myelomeningocele sac. Limiting visitors may be indicated for clients who have immunosuppression, isolation, or terminal illness, but it may not be beneficial for clients who have spina bifida. Allowing visitors may provide emotional and social support for the client and their family, as long as they follow standard precautions and do not pose any risk of infection or injury.

reason: This choice is incorrect because maintaining the infant in the supine position is not an appropriate intervention for an infant who has spina bifida and is to undergo surgical closure of the myelomeningocele sac.
Maintaining the infant in the supine position may cause pressure or trauma to the sac, which can lead to rupture, infection, or nerve damage. Therefore, positioning the infant in a prone or side-lying position with the hips flexed and knees abducted can help to protect the sac and prevent complications.

reason: This choice is incorrect because taking glyburide with breakfast is not recommended for an adolescent who has type 1 diabetes mellitus. Glyburide is an oral hypoglycemic medication that lowers blood glucose levels by stimulating insulin secretion from the pancreas. It may be used for clients who have type 2 diabetes mellitus, but it does not work for clients who have type 1 diabetes mellitus or DKA.

reason: This choice is incorrect because administering glucagon for hyperglycemia is not indicated for an adolescent who has type 1 diabetes mellitus. Glucagon is a hormone that raises blood glucose levels by stimulating glycogen breakdown in the liver. It may be used for clients who have hypoglycemia, which is a condition in which blood glucose levels are lower than normal (less than 70 mg/dL). It may cause symptoms such as sweating, trembling, confusion, or loss of consciousness. However, in type 1 diabetes mellitus, hyperglycemia (high blood glucose levels) rather than hypoglycemia is more likely to occur due to insulin deficiency or resistance.

reason: This choice is incorrect because injecting insulin in the deltoid muscle is not an optimal method for an adolescent who has type 1 diabetes mellitus. Insulin is a hormone that lowers blood glucose levels by facilitating glucose uptake into the cells. It may be administered by injection or infusion, and it may vary in onset, peak, and duration of action. The preferred sites for insulin injection are the abdomen, the thighs, the buttocks, or the upper arms, as they have more subcutaneous fat and less muscle tissue. Injecting insulin into the deltoid muscle may cause faster absorption and shorter duration of action, which can affect blood glucose control and increase the risk of hypoglycemia.

reason: This choice is incorrect because bradycardia is not a common finding in a child who is in a sickle cell crisis. Bradycardia is a condition in which the heart rate is slower than normal (less than 60 beats per minute). It may be caused by various factors such as hypothermia, hypothyroidism, or medication side effects, but it does not indicate a sickle cell crisis.

reason: This choice is incorrect because constipation is not a common finding in a child who is in a sickle cell crisis. Constipation is a condition in which the bowel movements are infrequent, hard, or difficult to pass. It may be caused by various factors such as dehydration, a low-fiber diet, or lack of physical activity, but it does not indicate a sickle cell crisis.

reason: This choice is incorrect because high fever is not a specific finding in a child who is in a sickle cell crisis. High fever may indicate infection, inflammation, or dehydration, but it does not indicate sickle cell crisis. However, the infection can trigger or worsen the sickle cell crisis, so it should be treated promptly with antibiotics and fluids.

reason: This choice is incorrect because the radial artery is not an ideal site to assess the heart rate in an infant. The radial artery is located on the thumb side of the wrist, and it can be palpated by placing two fingers over it. It may be used for adults or older children who have a strong pulse, but it may be difficult to locate or feel in an infant who has a small or weak pulse.

reason: This choice is incorrect because the carotid artery is not an ideal site to assess the heart rate in an infant. The carotid artery is located on either side of the neck, and it can be palpated by placing two fingers over it. It may be used for adults or older children who have a cardiac arrest or shock, but it may be risky to use in an infant who has a fragile neck or airway.

reason: This choice is incorrect because the brachial artery is not an ideal site to assess the heart rate in an infant. The brachial artery is located on the inner side of the upper arm, and it can be palpated by placing two fingers over it. It may be used for infants or young children who have a blood pressure measurement, but it may be uncomfortable or inaccurate to use for a heart rate assessment.