Peds- Immune Practice Questions
The nurse provides home care instructions to the parent of a child with AIDS. Which statement by the parent indicates the need for further teaching? -"i will wash my hands frequently" -"I will keep my child's immunizations up to date" -"I will aboid direct unprotected contact with my child's body fluids" -"I can send my child to day care if he has a fever, as long as it is a low grade fever."
"I can send my child to day care if he has a fever, as long as it is a low grade fever." rationale: AIDS is caused by HIV and characterized by generalized dysfunction of the immune system. A child w AIDS who is sick or has a fever should be kept home and not brought to a day care center.
The home care nurse provides instructions regarding basic infection control to the parent of an infant w HIV infection. Which statement, if made by the parent, indicates the need for further instruction? -"I will clean up any spills from the diaper with diluted alcohol" -"I will wash baby bottles, nipples, and pacifiers in the dishwasher" -"i will be sure to prepare foods that are high in calories and high in protein" -"I will be sure to wash my hands carefully before and after caring for my infant"
"I will clean up any spills from the diaper with diluted alcohol" rationale: HIV is transmitted through blood, semen, vaginal secretions, and breast milk. The mother of an infant w HIV should be using bleach solution for disinfecting or cleaning up spills. Alcohol is not effective enough in destroying the virus.
The nurse provides discharge teaching for a patient who has two fractured ribs from an automobile accident. Which statement, if made by the patient, would indicate that teaching has been effective? a. "I am going to buy a rib binder to wear during the day." b. "I can take shallow breaths to prevent my chest from hurting." c. "I should plan on taking the pain pills only at bedtime so I can sleep." d. "I will use the incentive spirometer every hour or two during the day."
"I will use the incentive spirometer every hour or two during the day."
The nurse is caring for a 4yo child w HIV infection. The nurse should expect which statement that is aligned w the psychosocial expectations of this age? -"being sick is scary" -"i know it hurts to die" -"i know i will be healthy soon" -"i know i am different than other kids"
"i know it hurts to die" rationale: a preschool age child begins to conceptualize the death process as involving physical harm. adolescent=fear withdraw and anger. birth-2yo=unable to grasp concept of death.
A 6yo child with HIV has been admitted to the hospital for pain management. The child asks the nurse if the pain will ever go away. The nurse should make which best response to the child? -"the pain will go away if you lie still and let the medicine work" -"try not to think about it. the more you think it hurts, the more it will hurt" -"i know it must hurt, but if you tell me when it does, i will try to make it hurt a little less" -"every time it hurts, press on the call button and i will give you something to make the pain go away"
"i know it must hurt, but if you tell me when it does, i will try to make it hurt a little less" rationale: aggressive pain management is essential for the child to have an acceptable quality of life. The nurse must acknowledge the child's pain and let the child know that everything will be done to decrease the pain
The mother with HIV infection brings her 10mo infant to the clinic for a routine checkup. The hcp has documented that the infant is asymptomatic for HIV infection. After the checkup, the mother tells the nurse that she is so pleased that the infant will not get HIV infection. The nurse should make which most appropriate response? -"I am so pleased also that everything has turned out fine" -"because symptoms have not developed, it is unlikely that your infant will develop HIV infection" -"everything looks great, but be sure to return with your infant next month for the scheduled visit" -"most children infected with HIV develop symptoms within the first 9mo of life, and some become symptomatic sometime before they are 3 years old"
"most children infected with HIV develop symptoms within the first 9mo of life, and some become symptomatic sometime before they are 3 years old" rationale: AIDS is caused by HIV infection and characterized by generalized dysfunction of the immune system. Most children infected with HIV develop symptoms within the first 9mo. The remaining infected children become symptomatic sometime before age 3. with their immature immune systems, children have a much shorter incubation period than adults.
Which home care instructions should the nurse provide to the parent of a child with acquired immunodeficiency syndrome? SATA -monitor the child's weight -frequent hand washing is important -the child should avoid exposure to other illnesses -the child's immunization schedule will need revision -clean up body fluid spills with bleach solution (10:1 ratio) -fever, malaise, fatigue, weight loss, vomiting, and diarrhea are expected to occur and do not require special ix
-monitor the child's weight -frequent hand washing is important -the child should avoid exposure to other illnesses -clean up body fluid spills with bleach solution (10:1 ratio) rationale: Home care instructions include the following: frequent hand washing, monitoring for fever, malaise, fatigue, weight loss, vomiting and diarrhea, and notifying hcp is symptoms occur; administer antiretroviral meds and other meds as prescribed; avoid exposure to other illnesses; keep immunizations up to date; monitor weight and provide high calorie high protein diet, washing eating utensils in dishwasher and avoiding sharing eating utensils; gloves worn for care especially when body fluids present; diapers are changed frequently and away from food areas.
The clinic nurse is assessing a child who is scheduled to receive a live virus vaccine. what are the general contraindications associated with receiving a live virus vaccine? SATA -the child has symptoms of a cold -the child had a previous anaphylactic reaction to the vaccine -the mother reports that the cild is having intermittent episodes of diarrhea -the mother reports that the child has not had an appetite and has been fussy -the child has a disorder that caused a severely deficient immune system -the mother reports that the child has been exposed to an infectious disease
-the child had a previous anaphylactic reaction to the vaccine -the child has a disorder that caused a severely deficient immune system self explanatory
A parent brings her 4mo infant to a well baby clinic for immunizations. The child is up to date with the immunization schedule. The nurse should prepare to administer which immunizations to this infant? -varicella, hepB vaccine -diphtheria, tetanus, acellular pertussis DTaP, measles mumps rubella MMR, and inactive poliovirus vaccine IPV -MMR, haemophilus influenza type b Hib, DRaP -DRaP, Hib, IPV, pneumococcal pneumonia PCV, rotavirus vaccine RV
DRaP, Hib, IPV, pneumococcal pneumonia PCV, rotavirus vaccine RV rationale: DRaP, Hib, IPV, pneumococcal pneumonia PCV, rotavirus vaccine RV are adminstered at 4mo
A child is receiving a series of the hep B vaccine and arrives at the clinic with his parent for the second dose. Before administering the vaccine, the nurse should ask the child and parents about history of severe allergy to which substance? -eggs -penicillin -sulfonamides -a previous dose of hep B vaccine or component
a previous dose of hep B vaccine or component rationale: a contraindication to receiving hep B vaccine is previous anaphylactic reaction to a previous dose of hepB or component (aluminum hydroxide or yeast protein). An allergy to eggs, penicillin, and sulfonamides are unrelated to contraindication to this vaccine.
An infant of a mother infected with human immunodeficiency virus is seen in the clinic each month and is being monitored for symptoms indicative of HIV infection. With knowledge of the most common opportunistic infection of children infected with HIV, the nurse assessed the infant for which sign? -cough -liver failure -watery stool -nuchal rigidity
cough rationale: AIDS is a disorder caused by HIV and characterized by generalized dysfunction of the immune system. The most common opportunistic infection of children infected with HIV is pneumocystis jiroveci pneumonia, which occurs most frequently between the ages 3 & 6 months, when HIV status may be indeterminate. Cough is a common sign of this opportunistic infection. Cytomegalovirus is also characteristic of HIV infection; however, it is not the most common opportunistic infection. Liver failure is a common sign of this complication. Although GI disturbances and neuro abnormalities may occur, not opportunistic. Watery stool is notes with gastroenteritis and nuchal rigidity is seen in meningitis.
A hcp prescribes lab studies for an infant of a woman positive for HIV. The nurse anticipates that which lab study will be prescribed for the infant? -chest x ray -western blot -CD4+ count -p24 antigen assay
p24 antigen assay rationale: infants born to HIV infected mothers need to be screened for the HIV antigen. The detection of HIV in infants is confirmed by a p24 antigen assay, virus culture of HIV, or polymerase chain reaction. A western blot test confirms the presence of HIV antibodies. The CD4+ cell count indicates how well the immune system is working. A chest x ray evaluates the presence of other manifestations of HIV infection, such as pneumonia.
The clinic nurse is instructing the parent of a child with human immunodeficiency virus HIV infection regarding immunizations. The nurse should provide which instruction to the parent? -the hep B vaccine will not be given to the child -the inactivated influenza vaccine will be given yearly -the varicella vaccine will be given before 6mo -a western blot test needs to be performed and results evaluated before immunizations
the inactivated influenza vaccine will be given yearly rationale: immunizations against common childhood illnesses are recommended for all children exposed to or infected w HIV. The influenza vaccine given IM will be administered, the Hep B vaccine is administered according to recommended schedule, varicella zoster virus b\vaccine should not be given because it is a live virus.
