Child Health - Infectious & Communicable Disease

A child who is 4 years old is seen for a well-child checkup. He has been regularly receiving immunizations. Which immunizations should the child receive at this visit? Select all that apply. 1. Varicella vaccine 2. Rotavirus vaccine 3. Inactivated polio vaccine (IPV) 4. Meningococcal conjugate vaccine 5. Measles, mumps, rubella (MMR) vaccine 6. Haemophilus influenzae type B vaccine

1. Varicella vaccine 3. Inactivated polio vaccine (IPV) 5. Measles, mumps, rubella (MMR) vaccine

The home care nurse provides instructions regarding basic infection control to the parent of an infant with human immunodeficiency virus (HIV) infection. Which statement, if made by the parent, indicates the need for further instruction? 1. "I will clean up any spills from the diaper with diluted alcohol." 2. "I will wash baby bottles, nipples, and pacifiers in the dishwasher." 3. "I will be sure to prepare foods that are high in calories and high in protein." 4. "I will be sure to wash my hands carefully before and after caring for my infant."

1. I will clean up any spills from the diaper with diluted alcohol."

A nurse is caring for a hospitalized child with a diagnosis of measles (rubeola). In preparing to care for the child, which supplies should the nurse bring to the child's room to prevent transmission of the virus? 1. Mask and gloves 2. Gown and gloves 3. Goggles and gloves 4. Gown, gloves, and goggles

1. Mask and gloves

Which home care instructions should the nurse provide to the parent of a child with acquired immunodeficiency syndrome (AIDS)? Select all that apply. 1. Monitor the child's weight. 2. Frequent hand-washing is important. 3. The child should avoid exposure to other illnesses. 4. The child's immunization schedule will need revision. 5. Clean up body fluid spills with bleach solution (10:1 ratio of water to bleach). 6. Fever, malaise, fatigue, weight loss, vomiting, and diarrhea are expected to occur and do not require special intervention.

1. Monitor the child's weight. 2. Frequent hand-washing is important. 3. The child should avoid exposure to other illnesses. 5. Clean up body fluid spills with bleach solution (10:1 ratio of water to bleach).

A child is sent to the school nurse by the teacher. On assessment of the child the nurse notes the presence of a rash. The nurse suspects that the child has erythema infectiosum (fifth disease) based on which assessment finding? 1. A discrete rose-pink maculopapular rash on the trunk 2. Erythema on the face, giving a "slapped cheeks" appearance 3. A highly pruritic, profuse macule-to-papule rash on the trunk 4. A discrete pinkish red maculopapular rash on the arms and trunk

2. Erythema on the face, giving a "slapped cheeks" appearance

The mother of a 6-year-old child arrives at a clinic because the child has been experiencing scratchy, red, and swollen eyes. The nurse notes a discharge from the eyes and sends a culture to the laboratory for analysis. Chlamydial conjunctivitis is diagnosed. On the basis of this diagnosis, the nurse determines that which requires further investigation? 1. Possible trauma 2. Possible sexual abuse 3. Presence of an allergy 4. Presence of a respiratory infection

2. Possible sexual abuse

An adolescent is seen in the health care clinic with complaints of chronic fatigue. On physical examination, the nurse notes swollen lymph nodes and laboratory test results indicate the presence of Epstein-Barr virus (mononucleosis). The nurse provides instruction regarding care of the adolescent. Which statement made by the mother indicates an understanding of the care measures? 1. "I need to keep my child on bed rest for 3 weeks to discourage physical activity." 2. "I will notify the health care provider if my child is still feeling tired in 1 week." 3. "I need to isolate my child so that the respiratory infection is not spread to others." 4. "I will call the health care provider if my child has abdominal or left shoulder pain."

4. "I will call the health care provider if my child has abdominal or left shoulder pain."

A school-age child is seen in the health care provider's office for complaints of intense itching mostly at night. The health care provider makes a diagnosis of scabies and prescribes permethrin 5% for treatment of the skin condition. Which at-home instruction should the nurse provide to the mother? 1. Retreatment is recommended the next day. 2. The child's bedding and clothing should be washed in cold water. 3. Leave the lotion on throughout the day and rinse off within 6 hours. 4. Apply the lotion liberally to the body and head, avoiding the eyes and mouth.

4. Apply the lotion liberally to the body and head, avoiding the eyes and mouth

A 12-month-old child with human immunodeficiency virus (HIV) infection is currently immunocompromised. The nurse determines that the immunization needs of this child include which action? 1.Withholding the inactivated polio vaccine (IPV) 2.Recommending against any influenza vaccinations 3.Administering the measles-mumps-rubella (MMR) vaccine 4.Delaying the administration of the varicella virus vaccine until the child is not immunocompromised

4.Delaying the administration of the varicella virus vaccine until the child is not immunocompromised

The nurse is providing anticipatory guidance to the mother of a 10-month-old child. The mother asks how soon her daughter will be able to receive the chickenpox (varicella) vaccine. What is the best nursing response? 1. "She will receive it today." 2. "She can receive it when she is 12 months old." 3. "She can receive it any time before her first birthday." 4. "She will receive it before entry into kindergarten, at 4 to 6 years of age."

2. "She can receive it when she is 12 months old."

An infant is brought to the clinic for his third diphtheria-tetanus toxoid-acellular pertussis vaccination (DTaP). The mother reports that the infant developed a 99.4° F temperature after the last DTaP. Which action is most appropriate? 1. Withhold the vaccination. 2. Administer the vaccination. 3. Draw blood for a pertussis titer. 4. Notify the health care provider (HCP).

2. Administer the vaccination.

A child with rubeola (measles) is being admitted to the hospital. In preparing for the admission of the child, the nurse should plan to place the child on which precautions? 1. Enteric 2. Airborne 3. Protective 4. Neutropenic

2. Airborne

A child with acquired immunodeficiency syndrome is hospitalized for the treatment of Pneumocystis jiroveci pneumonia. The child will be receiving nebulizer treatments at home when discharged. The nurse instructs the mother regarding the maintenance of the nebulizer equipment. What should the nurse tell the mother to do? 1. Boil the nebulizer pieces for 15 minutes after each treatment. 2. Clean the nebulizer pieces with warm water after each treatment and allow to air dry. 3. Clean the nebulizer pieces after each treatment with one-fourth strength bleach and water. 4. Clean the mouthpiece with alcohol after each use, and soak in alcohol for 30 minutes at the end of each day.

2. Clean the nebulizer pieces with warm water after each treatment and allow to air dry.

The nursing student is assigned to administer immunizations to children in a clinic. The nursing instructor asks the student about related precautions and general contraindications to immunization. The student responds correctly by telling the instructor that the presence of which condition would be a reason to delay an immunization in a child? 1. A cold 2. Otitis media 3. Mild diarrhea 4. A severe febrile illness

4. A severe febrile illness

A child seen in the clinic is found to have rubeola (measles), and the mother asks the nurse how to care for the child. The nurse should tell the mother to implement which action? 1. Keep the child in a room with dim lights. 2. Give the child warm baths to help prevent itching. 3. Allow the child to play outdoors because sunlight will help the rash. 4. Take the child's temperature every 4 hours and administer 1 baby aspirin for fever.

1. Keep the child in a room with dim lights.

The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction? 1. "We need to encourage our child to drink fluids." 2. "Coughing spells may be triggered by dust or smoke." 3. "Vomiting may occur when our child has coughing episodes." 4. "We need to maintain droplet precautions and a quiet environment for at least 2 weeks."

4. "We need to maintain droplet precautions and a quiet environment for at least 2 weeks."

A child is seen in the health care clinic, and the nurse suspects the presence of pinworm infection (enterobiasis). The nurse instructs the mother as to how to obtain a cellophane tape rectal specimen. Which statement by the mother indicates an understanding of the correct procedure to obtain the specimen? 1. "I need to collect the specimen after I give my child a bath." 2. "I need to collect the first bowel movement of the day and place it in a sealed container." 3. "I need to place a piece of transparent cellophane tape lightly over the anal area as soon as my child awakens and bring it to the clinic for examination." 4. "I need to place a piece of transparent cellophane tape lightly over the anal area after my child has a bowel movement and bring it to the clinic for examination."

3. "I need to place a piece of transparent cellophane tape lightly over the anal area as soon as my child awakens and bring it to the clinic for examination."

At what age should the child receive the first dose of the measles, mumps, and rubella (MMR) vaccine? 1. 2 years 2. 4 years 3. 12 months 4. 22 months

3. 12 months

A child is scheduled to receive inactivated polio vaccine (IPV), and the nurse preparing to administer the vaccine reviews the child's record. The nurse questions the administration of IPV if which is documented in the child's record? 1. Recent recovery from a cold 2. A history of frequent respiratory infections 3. A history of an anaphylactic reaction to neomycin 4. A local reaction at the site of injection of a previous IPV

3. A history of an anaphylactic reaction to neomycin

The clinic nurse prepares to administer a measles, mumps, rubella (MMR) vaccine to a 5-year-old child. The nurse should administer this vaccine by which route and in which best site? 1. Subcutaneously in the gluteal muscle 2. Intramuscularly in the deltoid muscle 3. Subcutaneously in the outer aspect of the upper arm 4. Intramuscularly in the anterolateral aspect of the thigh

3. Subcutaneously in the outer aspect of the upper arm

A child hospitalized with pertussis is in the convalescent stage, and the nurse is preparing the child for discharge. The nurse has provided instructions to the parents for home care of the child. Which statement by a parent indicates a need for further teaching? 1. "It is important that my child drinks plenty of fluids." 2. "A quiet environment helps to prevent episodes of coughing spells." 3. "We need to teach the other members of the family how to use good hand washing techniques to prevent the spread of infection." 4. "I need to make sure that the child is isolated from the other children for at least 2 weeks to prevent the spread of the virus to them." .

4. "I need to make sure that the child is isolated from the other children for at least 2 weeks to prevent the spread of the virus to them

A child is seen in a health care clinic, and a diagnosis of chickenpox is confirmed. The mother expresses concern for two other children at home and asks the nurse if the child is infectious to the other children. Which response by the nurse is most appropriate? 1. "The infectious period occurs after the lesions begin." 2. "The infectious period begins with the onset of the rash." 3. "The infectious period is not known, and it is possible that the children may develop the chickenpox within the next 2 weeks." 4. "The infectious period begins 1 to 2 days before the onset of the rash to about 5 days after the onset of the lesions and crusting of the lesions."

4. "The infectious period begins 1 to 2 days before the onset of the rash to about 5 days after the onset of the lesions and crusting of the lesions."

A child is receiving a series of the hepatitis 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 parent about a history of a severe allergy to which substance? 1. Eggs 2. Penicillin 3. Sulfonamides 4. A previous dose of hepatitis B vaccine or component

4. A previous dose of hepatitis B vaccine or component

An infant receives a diphtheria, tetanus, and acellular pertussis (DTaP) immunization at a well-baby clinic. The parent returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which intervention should the nurse suggest to the parent? 1. Monitor the infant for a fever. 2. Bring the infant back to the clinic. 3. Apply a hot pack to the injection site. 4. Apply a cold pack to the injection site.

4. Apply a cold pack to the injection site.

The home health nurse visits a child with infectious mononucleosis and provides home care instructions to the parents about the care of the child. Which instruction should the nurse give to the parents? 1. Maintain the child on bed rest for 2 weeks. 2. Maintain respiratory precautions for 1 week. 3. Notify the health care provider (HCP) if the child develops a fever. 4. Notify the HCP if the child develops abdominal pain or left shoulder pain.

4. Notify the HCP if the child develops abdominal pain or left shoulder pain.

A mother brings her 6-year-old child to the clinic because the child has developed a rash on the trunk and scalp. The mother reports that the child has had a low-grade fever, has not felt like eating, and has been tired. The child is diagnosed with chickenpox. The mother inquires about the communicable period associated with chickenpox, and the nurse bases the response on which statement? 1. The communicable period is unknown. 2. The communicable period ranges from 2 weeks or less to 4 weeks. 3. The communicable period is 10 days before the onset of symptoms to 15 days after the rash appears. 4. The communicable period is 1 to 2 days before the onset of the rash to 6 days after the first crop of vesicles, when crusts have formed.

4. The communicable period is 1 to 2 days before the onset of the rash to 6 days after the first crop of vesicles, when crusts have formed.

A child diagnosed with scarlet fever is being cared for at home. The home health nurse performs an assessment on the child and checks for which clinical manifestations of this disease? Select all that apply. 1. Pastia's sign 2. Koplik's spots 3. White strawberry tongue 4. Edematous and beefy-red pharynx 5. Petechial red, pinpoint spots on the soft palate 6. Small red spots with a bluish-white center and a red base located on the buccal mucosa

1. Pastia's sign 3. White strawberry tongue 4. Edematous and beefy-red pharynx

The clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). What are the general contraindications associated with receiving a live virus vaccine? Select all that apply. 1. The child has symptoms of a cold. 2. The child had a previous anaphylactic reaction to the vaccine. 3. Mother reports that the child is having intermittent episodes of diarrhea. 4. Mother reports that the child has not had an appetite and has been fussy. 5. The child has a disorder that caused a severely deficient immune system. 6. Mother reports that the child has recently been exposed to an infectious disease.

2. The child had a previous anaphylactic reaction to the vaccine. 5. The child has a disorder that caused a severely deficient immune system.

The nurse provides instructions to the mother of a child with mumps regarding respiratory precautions, and the mother asks the nurse about the length of time required for the respiratory precautions. The nurse should make which statement to the mother? 1. "Precautions are not necessary once the swelling appears." 2. "Precautions are not necessary before the swelling begins." 3. "Precautions are indicated during the period of communicability." 4. "Precautions are indicated for 20 days following the onset of parotid swelling."

3. "Precautions are indicated during the period of communicability.

Several children have contracted rubeola (measles) in a local school, and the school nurse conducts a teaching session for the parents of the schoolchildren. Which statement made by a parent indicates a need for further teaching regarding this communicable disease? 1. "Small blue-white spots with a red base may appear in the mouth." 2. "The rash usually begins on the face and spreads downward toward the feet." 3. "The disease can be spread to others 10 days before any sign of the disease appears to 15 days after the rash appears." 4. "Respiratory symptoms such as a profuse runny nose, cough, and fever occur before the development of a rash."

3. "The disease can be spread to others 10 days before any sign of the disease appears to 15 days after the rash appears."

The nurse is caring for a child with a diagnosis of roseola. The nurse provides instructions to the mother regarding prevention of the transmission to siblings and other household members. Which instruction should the nurse provide? 1. Isolate the child from others for 2 weeks because the virus is transmitted by breathing and coughing. 2. Wash sheets and towels used by the child separately in bleach to prevent spread of the infection to others. 3. Have the child use a separate bathroom for urination and bowel movements to prevent the spread of infection. 4. Avoid allowing the children to share drinking glasses or eating utensils, because the disease is transmitted through saliva.

4. Avoid allowing the children to share drinking glasses or eating utensils, because the disease is transmitted through saliva.

A child is scheduled to receive immunizations. The child's mother reports to the nurse that the child has been receiving long-term immunosuppressive therapy. The nurse prepares the scheduled immunizations knowing that which vaccine is contraindicated? 1. Hepatitis B 2. MMR (measles-mumps-rubella) 3. Hib (Haemophilus influenzae type b) 4. DTaP (diphtheria-tetanus-acellular pertussis)

2. MMR (measles-mumps-rubella)

A parent brings her 4-month-old 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? 1. Varicella, hepatitis B vaccine (HepB) 2. Diphtheria, tetanus, acellular pertussis (DTaP); measles, mumps, rubella (MMR); inactivated poliovirus vaccine (IPV) 3. MMR, Haemophilus influenzae type b (Hib), DTaP 4. DTaP, Hib, IPV, pneumococcal vaccine (PCV), rotavirus (RV)

4. DTaP, Hib, IPV, pneumococcal vaccine (PCV), rotavirus (RV)

The mother of a preschooler who attends day care calls a clinic nurse and tells the nurse that the child is constantly scratching the perianal area and that the area is irritated. The nurse suspects the possibility of pinworm infection (enterobiasis) and instructs the mother to obtain a rectal specimen by a tape test. At what time should the nurse tell the mother to obtain the specimen? 1. After bathing 2. After toileting 3. When the child is put to bed 4. In the morning, when the child awakens

4. In the morning, when the child awakens