6-Study Guide

Conjugate Vaccine

A carrier protein with proven immunologic potential combined with a less antigenic polysaccharide antigen to enhance the type and magnitude of the immune response

Antitoxin

A solution of antibodies derived from the serum of animals immunized with specific antigens and used to confer passive immunity

Immunoglobulin

A sterile solution containing antibodies from large pools of human blood plasma

Children with pinworm infections are seen with the principal symptom of:

A. Perineal itching

Universal Precautions

Blood and body fluid precautions designed to reduce the risk of transmission of blood borne pathogens.

When administering vaccines, a(n) __________________ is considered a condition in a person that does increase the risk for a serious adverse reaction (e.g, not administering a live virus vaccine to a severely immunocompromised child) When administering vaccines, a(n) __________________ is a condition in a person that might increase the risk for a serious adverse reaction of that might compromise the ability of the vaccine to produce immunity.

Contraindication Precaution

Pertussis

Cough occurs at night, and inspirations sound like crowing

transmission-based precautions

Designed for patients documented or suspected to be infected or colonized with highly transmissible or epidemiologically important pathogens for which interventions beyond Standard Precautions are needed to interrupt transmission in hospitals

Droplet precautions

Designed to reduce the risk for transmission of infectious agents that are spread when large particles generated during coughing, senescing, or talking come into contact with the conjunctiva or the mucous membrane of the nose or mouth of a susceptible person; suctioning or bronchoscope generates these particles

Contact Precautions

Designed to reduce the risk of transmission of microorganisms by direct or indirect contact

Airborne precautions

Designed to reduce the transmission of infectious agents that remain suspended in air or by dust particles contains the infectious agent,

Monovalent Vaccine

Designed to vaccinate against a single antigen or organism

Polyvalent Vaccine

Designed to vaccinate against multiple antigens or organisms; meningococcal polysaccharide vaccine.

Rubella

Discrete pinkish red maculopapular rash appears eruption on face and then spreads downward to neck, arms, trunk and legs; greatest danger in teratogenic effect on fetus

Herpetic gingivostomatitis is associated with sexual transmission

False

Topical anesthestics like lidocaine can be prescribed for children who are old enough to keep the drug on the mouth for 2-3 and then swallow the drug

False

Treatment for stomatitis is aimed at relief of complications

False

When examining herpetic lesions, the nurse uses her uncovered index finger to check for cracks in the skin surface

False

Active Immunity

Immune bodies sre actively formed against specific antigens by having had the disease or by introducing the antigen into the individual

Hospital -Acquired Infection (HIA)

Infections occur when there is interaction among patients, health care personnel, equipment, and bacteria.

Natural Immunity

Innate resistance to infection

Standard Precautions

Interventions that synthesize the major features of Universal (blood and body fluids) Precautions and body substance isolation; involve the use of barrier protection; designed for the care of all patients to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection.

Indirect Contact Transmission

Involves contact of a susceptible host with a contaminated intermediate object usually an inanimate object in the patients environment.

Direct Contact Transmission

Involves skin-to-skin contact and physical transfer of microorganisms to a susceptible host from an infected or colonized person.

Combination Vaccine

Multiple vaccines into one parenteral form

Acquired Immunity

Occurs from exposure to the invading agent

Poliomyeltitis

Permanent paralysis may occur

Rubeola

Rash appears 3 to 4 days after onset and maculopapular eruption on face with gradual spread downward; Koplik spots are present before the rash.

Fifth Disease

Rash appears in three stages; stage I is erythema on face, chiefly on cheeks

Roseola

Rash composed of rose-pink macules or maculopapules, appearing first on trunk, then spreading to neck, face, and extremities; rash is nonpruritic.

Cocooning

Strategy of protecting infants from pertussis by vaccinating all persons who come in close contact with the infant, including the mother, grandparents, and healthcare workers

Passive Immunity

Temporary immunity obtained by transfusing immunoglobulin or antitoxins form a person or animal that has been actively immunized against the antigen

Herd Immunity

The majority of the population is vaccinated and the spread of disease stopped without the rest of the population getting vaccinated

Varicella

This condition has a rash that begins as macules, rapidly progressing to papules, and then to vesicles eventually breaking and forming crusts

Mumps

This condition results in earache that is aggravated by eating

Attenuate

To reduce the virulence of a pathogenic microorganismT by treating it or cultivating it on a certain medium

Diptheria

Tonsillar pharyngeal areas are covered with white or gray membrane; complications include myocarditis and neuritis

Scarlet Fever

Tonsils are enlarged, edematous, reddened, and covered with patches of exudate, rash is absent on face, desquamation occurs

Aphthous stomatitis is characterized by painful, small, whitish ulcerations that heal without complication in 4-12 days

True

Aphthous stomatitis may be associated with mild traumatic injury, allergy, emotional stress

True

Herpetic gingivostomatitis is caused by herpes simplex virus, usually type 1

True

Herpetic ginivostomatitis is commonly called "cold sores" or "fever blisters"

True

Treatment for children with severe cases of herpetic gingivostomatitis include oral acyclovir

True

Name the two diseases caused by the varicella-zoster virus (VZV)

Varicella (chickenpox) and zoster (herpes zoster or shingles)

Toxoid

a modified bacterial toxin that has been made nontoxic but retains the ability to stimulate the formation of antitoxin

Clinical manifestations differentiate bacterial conjunctivitis from viral conjunctivitis. Which one of the following is present with bacterial conjunctivitis but not usually found with viral conjunctivitis? a. Child awakens from crusting of eyelids. b. Child has increase in water drainage from eyes. c. Child has inflamed conjunctiva. d. Child has swollen eyelids.

a. Child awakens from crusting of eyelids.

In hospitals, which of the following is the most significant source of MRSA and the major mode of transport? a. Patient to patient via the hands of the health care provider. b. Patients coming in direct contact with other patients. c. Failure of hospital personnel to wear face masks when working with patients in an airborne infection isolation room. d. Indirect contact transmission from hospital equipment.

a. Patient to patient via the hands of the health care provider.

Which of the following statements about rotavirus disease or immunization against rotavirus is correct? a. Rotavirus is one of the leading causes of diarrhea in infants and young children. b. Rotavirus is one of the leading causes of otitis media in young children. c. One vaccine for rotavirus is RotaTeq, which is approved for children 32 weeks of age or older. d. Rotavirus vaccine usually causes only mild reaction, redness, and soreness at the injection site.

a. Rotavirus is one of the leading causes of diarrhea in infants and young children.

Meningococcal conjugate vaccines (MCV4) are not recommended for which of the following populations? a. Routinely for children ages 9 months to 10 years. b. Children aged 2 years to 18 years who travel to or reside in countries where N. meningitides is hyper endemic or epidemic. c. Children and adolescents 11 to 12 years of age. d. College freshmen living in dormitories.

a. Routinely for children ages 9 months to 10 years.

Which one of the following techniques is recommended to provide atraumatic care for immunization administration to infants? a. Select a 25-mm needle to deposit vaccine deep into the muscle mass. b. Use an air bubble to clear the needle before injection. c. Use the deltoid muscle. d. Use the EMLA patch before administration.

a. Select a 25-mm needle to deposit vaccine deep into the muscle mass.

Which of the following statements about Haemophilus influenzae type b (Hib) vaccine is true? a. The vaccine protects against a number of infections including bacterial meningitis, epiglotties, bacterial pneumonia, septic arthritis, and sepsis. b. The vaccine protects against the virus that produces influenza. c. Only two doses of Hib vaccine should be given to children 15 months of age or older who have not been previously vaccinated. d. Hiberix is a conjugate vaccine licenses for use in infants over the age of 2 months.

a. The vaccine protects against a number of infections including bacterial meningitis, epiglotties, bacterial pneumonia, septic arthritis, and sepsis.

The American Academy of Pediatrics has recommended vitamin A supplements for certain pediatric patients with measles. Correct dosage of vitamin A and instructions to parents of these children include: i. single oral dose of 200,000 IU in children 1 year old. ii. single oral dose of 100,000 IU in children 6 to 12 months old. iii. dosage may be associated with vomiting and headache for a few hours. iv. safe storage of the drug to prevent accidental overdose. a. i, ii, iii, and iv. b. i, ii, and iv. c. i, iii, and iv. d. ii and iv.

a. i, ii, iii, and iv.

For which of the following populations is pertussis vaccine currently recommended? i. All children from 6 weeks to the seventh birthday. ii. Children ages 11 to 12 years who have completed the DTaP/DTP childhood series. iii. A second booster for previously immunized adolescents and adults. iv. Children ages 7 through 10 years who are not fully vaccinated for pertussis (i.e., did not receive 5 doses of DTaP, or who received 4 doses of DTaP with the fourth dose being administered on or after the fourth birthday). v. Pregnant adolescents between 27 and 36 weeks' gestation, if not previously administered. a. i, ii, iv, and v. b. i, iii, and iv. c. ii, iii, and v. d. i, ii, iii, and iv.

a. i, ii, iv, and v.

Primary prevention of communicable disease is best accomplished by: a. immunization. b. control of the disease spread. c. adequate water supply. d. implementing good hand-washing practices among hospital personnel.

a. immunization.

Rubella vaccine administration: a. is given as protection for the unborn child rather than for the recipient of the immunization. b. is recommended for all children beginning at 4 to 6 years of age. c. is given to all pregnant women if not previously immunized. d. is not given to children whose mother is currently pregnant.

a. is given as protection for the unborn child rather than for the recipient of the immunization.

A drug used to treat children with giardiasis is: a. metronidazole (Flagyl). b. amoxicillin. c. erythromycin. d. tetracycline.

a. metronidazole (Flagyl).

Bryan, age 6 months, is starting daycare as his mother is returning to work. Bryan has had no immunizations. Which of the following statements provided by the nurse to the mother is the most appropriate at this time? a. "Since Bryan has not started his immunization for streptococcal pneumococci yet, it is best to wait until after he gets established at daycare before beginning his injections." b. "Streptococcal pneumococci are responsible for a number of bacterial infections that are especially problematic for children under 2 years of age who attend daycare. Bryan should start his series of pneumococcal vaccine right away." c. "Why has Bryan not received any immunizations? He is past due. Don't you care about his health?" d. "Pneumococcal vaccine (PCV13) is the only vaccine recommended for Bryan at this time."

b. "Streptococcal pneumococci are responsible for a number of bacterial infections that are especially problematic for children under 2 years of age who attend daycare. Bryan should start his series of pneumococcal vaccine right away."

What antiviral agent is used to treat varicella infections in children at increased risk for complications associated with varicella? a. Varicella-zoster immune globulin. b. Acyclovir. c. Salicylates. d. Steroids.

b. Acyclovir.

When administering the pertussis vaccine the nurse recognizes which of the following as incorrect? a. Can be given any time during pregnancy. b. Cannot be given to the postpartum mother who is breastfeeding. c. The acellular pertussis vaccine, from the same manufacturer, is recommended for the first three immunizations and is given along with diphtheria and tetanus at 2, 4, and 6 months of age. d. Is recommended for health care workers having close contact with infants under the age of 12 months.

b. Cannot be given to the postpartum mother who is breastfeeding.

The following statements are about hepatitis A illness or vaccination. Which one is correct? a. The illness has a gradual onset ,with often dark urine and jaundice being the only symptoms. b. The vaccine is recommended for all children between the ages of 12 and 23 months. c. The vaccine consists of a series of 3 injections timed 2 months apart. d. The illness is spread by all body secretions.

b. The vaccine is recommended for all children between the ages of 12 and 23 months.

Bedbugs, although once considered to be practically nonexistent, have remerged within the past decade as troublesome. Which of the following does the nurse recognize as incorrect information about bedbugs? a. They tend to inhibit warm, dark areas such as furniture and emerge at night to feed. b. They act as vectors for disease transmission. c. The treatment of bedbugs should focus on proper identification, treatment of symptoms, and eradication. d. Their bits are often misdiagnosed as scabies, spider bites, or mosquito bites.

b. They act as vectors for disease transmission.

The nurse knows, regarding pertussis, that: a. the incidence has decreased in infants younger than 6 months of age. b. a booster vaccine (Tdap) is now recommended for all children 11 to 18 years of age. c. treatment should begin as soon as exposure is confirmed and includes the antibiotic amoxicillin. d. the disease is not contagious, so close household members do not need treatment.

b. a booster vaccine (Tdap) is now recommended for all children 11 to 18 years of age.

When educating the public about diphtheria vaccine, the nurse recognizes which one of the following as correct? i. Diptheria vaccine is commonly administered in combination with tetanus and pertussis vaccines (DTaP) or DTaP and Hib vaccines for children under 7 years of age. ii. Diptheria vaccine is administered with tetanus and acellular partisan (TDaP) for children 11 years and older. iii. Diphtheria vaccine produces absolute immunity after 3 doses. iv. Several vaccines contain diphtheria toxoid (Hib, meningococcal, pneumococcal), which infers immunity to the disease. a. i, ii, iii, and iv. b. i and ii. c. i, ii, and iii. d. iii and iv.

b. i and ii.

Mumps immunization: a. is recommended for children ages 4 years of age or older. b. is typically given in combination with measles and rubella. c. can be administered to infants as young as 6 months of age. d. All of the above.

b. is typically given in combination with measles and rubella.

The HBsAg negative mother of Daniella, a premature infant weighing 4 pounds and born 6 hours ago, asks, "Have you already given Daniella her hepatitis B vaccine?" What is your correct response? a. "Don't worry, we will give it before she leaves the hospital." b. "Daniella is sleeping right now. I will give it as soon as she wakes up." c. "Because Daniella only weighs 4 pounds, she will not receive her vaccine until she is 1 month of age." d. "Because Daniella is premature and weights only 4 pounds, she will be given one vaccine dose now and then she will need another in two months."

c. "Because Daniella only weighs 4 pounds, she will not receive her vaccine until she is 1 month of age."

Anne, an 8-year-old, has been diagnosed with giardiasis. The nurse would expect Anne to have most likely been seen initially with which of the following signs and symptoms? a. Diarrhea with blood in the stools. b. Nausea and vomiting with a mild fever. c. Abdominal cramps with intermittent loose stools. d. Weight loss of 5 lb in the past month.

c. Abdominal cramps with intermittent loose stools.

Which of the following statements about polio vaccine and immunization is not correct? a. Inactivated poliovirus vaccine (IPV) is now recommended for routine childhood vaccination in the US. b. Oral polio vaccine (OPV) has been associated with vaccine-associated paralysis. c. KINRIX contains DTaP, hepatitis B, and IPV and may be used only in children aged 4 years or older as the fourth dose. d. The combination vaccine PEDIARIX (containing DTaP, hepatitis B, and IPV) may be used as the primary immunization beginning at 2 months of age.

c. KINRIX contains DTaP, hepatitis B, and IPV and may be used only in children aged 4 years or older as the fourth dose.

Which of the following statements about varicella vaccine is correct? a. Varicella vaccine is recommended for all children regardless of past disease history. b. A single dose of 0.5 mL of varicella vaccine should be given by deep IM injection. c. The first dose of varicella is recommended for children ages 12 to 15 months, and to ensure adequate protection, a second varicella vaccination is recommended for children at 4 to 6 years of age. d. Varicella vaccine should not be administered simultaneously with MMR.

c. The first dose of varicella is recommended for children ages 12 to 15 months, and to ensure adequate protection, a second varicella vaccination is recommended for children at 4 to 6 years of age.

The nurse is conducting an educational session of a child diagnosed with varicella. Which one of the following is not an appropriate comfort measure to include in this session? a. Use Aveeno bath treatment or oatmeal in bath water for added skin comfort. b. Use Caladryl lotion on rash to decrease itching. c. Use hot bath water to promote skin rash healing. d. Keep nails short and smooth to decrease chances of infection from scratching.

c. Use hot bath water to promote skin rash healing.

Which one of the following does the nurse recognize as contraindicated in providing comfort measures to children with communicable diseases? a. Use of acetaminophen or ibuprofen for control of an elevated temperature in children with varicella. b. Use of diphenhydramine or hydroxyzine for itching. c. Use of aspirin to control elevated temperature and/or symptoms with varicella. d. Use of lozenges and saline rinses in an 8-year-old with sore throat.

c. Use of aspirin to control elevated temperature and/or symptoms with varicella.

Human papillomavirus (HPV) vaccine is recommended for all of the following populations except: a. female adolescents to prevent HPV-related cervical cancer. b. boys and men (9-26 years) to reduce the likelihood of genital warts. c. female preadolescents ages 7 to 9 years. d. female adolescents who are not sexually active.

c. female preadolescents ages 7 to 9 years.

Measles immunization includes which of the following? a. Given at 12 to 15 months of age with a second dose given at age 4 to 6 years of age and revaccination at 11 to 12 years of age. b. Child vaccinated before 12 months of age should receive two additional doses beginning at 12 to 15 months and separated by at least 4 weeks. c. Revaccination of all individuals born after 1956 who have not received two doses of measles vaccine after 12 months of age. d. All of the above.

d. All of the above.

Certain groups of children are at risk for serious complications from communicable diseases. These children do not include which of the following groups? a. Children with an immunodeficiency or immunologic disorder. b. Children receiving steroid therapy. c. Children with leukemia. d. Children who have recently undergone a surgical procedure.

d. Children who have recently undergone a surgical procedure.

The nurse is instructing parents on the test-tape diagnostic for enterobiasis. Which one of the following is included in the explanation? a. Use a flashlight to inspect the anal area while the child sleeps. b. Perform the test 2 days after the child receives the first dose of anti parasitic medication. c. Test all members of the family at the same time using frosted tape. d. Collect the tape in the morning before the child has a bowel movement or bath.

d. Collect the tape in the morning before the child has a bowel movement or bath.

Assessment of which of the following is not helpful in identifying potentially communicable diseases? a. Prodromal symptoms. b. Immunization history. c. Past medical history. d. Family history.

d. Family history.

Joey, a 14-year-old adolescent, has recently relocated from Mexico to the US. While helping his dad do farm work, Joey suffered a laceration in the horse barn. Review of Joey's immunization record from Mexico shows that Joey has had 2 previous tetanus and diphtheria vaccine immunization shots, the last one being at the age of 6 years. Which of the following would the nurse in the ER expect to give at this time? a. Tdap. b. DTaP. c. Td booster. d. Tetanus immunization (TIG) human and Tdap.

d. Tetanus immunization (TIG) human and Tdap.

Which of the following is not an influenza vaccine recommendation? a. The vaccine is administered in early fall before the flu season begins and is repeated yearly. b. Fluzone, a quadrivalent influenza vaccine, offers protection against type A and type B and is approved for vaccine use in children ages 6 months and older. c. Children with severe egg allergy history should not routinely receive the influenza vaccine. d. The live attenuated influenza vaccine (LAIV) form is recommended for children 2 to 4 years of age with a history of wheezing or asthma.

d. The live attenuated influenza vaccine (LAIV) form is recommended for children 2 to 4 years of age with a history of wheezing or asthma.

When instructing the parents caring for an infant with conjunctivitis, the nurse will include which of the following in the plan? a. Accumulated secretions are removed by wiping from out canthus inward. b. Hydrogen peroxide placed on cotton swabs is helpful in removing crusts from eyelids. c. Compresses of warm tap water are kept in place on the eye to prevent crusting. d. Washcloth and towel used by the infant are kept separate and not used by others.

d. Washcloth and towel used by the infant are kept separate and not used by others.

In scheduling immunizations, the nurse knows which of the following is correct? a. The beginning primary immunization for infants begins at 2 months of age. b. Children who are born preterm receive only half the normal dose of each vaccine followed by the second half of the vaccine 2 weeks later. c. Children who begin primary immunization at the recommended age but fail to receive all the doses by suggested age need to begin the series again. d. When there is doubt that the child will return for follow-up immunizations according to the optimum schedule, HBV vaccine (HepB), DTaP, IPV (poliovirus vaccine), MMR, varicella, and Hib vaccines can be administered simultaneously at separate injection sites.

d. When there is doubt that the child will return for follow-up immunizations according to the optimum schedule, HBV vaccine (HepB), DTaP, IPV (poliovirus vaccine), MMR, varicella, and Hib vaccines can be administered simultaneously at separate injection sites.

Standard Precautions involve the use of barrier protection to prevent contamination from: a. blood. b. body fluids. c. mucous membranes. d. all of the above.

d. all of the above.

The general contraindication for all immunizations is: a. minor illness such as common cold. b. breastfeeding. c. pregnancy. d. severe febrile illness.

d. severe febrile illness.

To prevent the spread of contamination from one patient to another after procedures, the most important strategy the nurse can use is to: a. follow disease-specific infection control guidelines. b. wear vinyl gloves. c. avoid wearing nail polish. d. wash the hands routinely after each patient and after removing gloves.

d. wash the hands routinely after each patient and after removing gloves.

The nurse is administering immunizations to a 2-month-old Brian. Describe what should be documented on the medical record?

day, month, and year of administration name of vaccine given and manufacturing of the vaccine with the lot number name and title of the person administering and where the vaccine was administered site and route of administration evidence of informed consent Vaccine information sheet for each vaccine administered

Body Substance Isolation

designed to reduce the risk of transmission of pathogens from moist body surfacest