Pediatrics; Study Guide Chapter 6

When educating the public about diphtheria vaccine, the nurse recognizes which of the following as correct? i. Diphtheria 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. Diphtheria vaccine is administered with tetanus and acellular pertussin (Tdap) for children 11 years and older. iii. Diphtheria vaccine produces absolute immunity after three doses. iv. Several vaccines contain diphtheria toxoid (Hib, meningococcal, pneumococcal), which confers immunity to the disease. a. i, ii, iii, and iv b. i and ii c. i, ii, and iii d. iii and iv

B

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 United States. b. Oral polio vaccine (OPV) has been associated with vaccine-associated polio 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

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 intramuscular injection. c. The first dose of varicella vaccine 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

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. Trivalent inactivated influenza vaccine 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 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 at age 1 year. c. The vaccine consists of a series of three injections timed 2 months apart. d. The illness is spread by all body secretions.

B

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 12 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

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

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 outer 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

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, epiglottitis, 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 licensed for use in infants over the age of 2 months.

A

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 site of injection.

A

Which of the following techniques is recommended to provide atraumatic care for immunization administration to infants? a. Select a 1 inch needle to deposit vaccine deep into the vastus lateralis. b. Use an air bubble to clear the needle before injection. c. Use the deltoid muscle. d. Use the EMLA patch before administration.

A

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 inhabit 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 bites are often misdiagnosed as scabies, spider bites, or mosquito bites.

B

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

To prevent 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 contact and after removing gloves.

D

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 international units in children 1 year old. ii. single oral dose of 100,000 international units 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

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

A

Children with pinworm infections are seen with the principal symptom of: a. perianal itching. b. diarrhea with blood. c. evidence of small, ricelike worms in their stool and urine. d. abdominal pain.

A

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

A

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 five doses of DTaP, or who received four 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 protected a. i, ii, iv, and v b. i, iii, and iv c. ii, iii, and v e. i, ii, iii, and iv

A

In hospitals, which of the following is the most significant source of methicillin-resistant Staphylococcus aureus (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

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. meningitidis is hyperendemic or epidemic c. Children and adolescents 11 to 12 years of age d. College freshmen living in dormitories

A

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

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

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 immunizations 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

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. is correct for all of the above.

B

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

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 to 26 years) to reduce the likelihood of genital warts. c. female preadolescents ages 6 to 8 years. d. female adolescents who are not sexually active.

C

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 weighs only 4 pounds, she will be given one vaccine dose now and then she will need another in 2 months."

C

The nurse is conducting an educational session for the parents of a child diagnosed with varicella. Which one of the following is not an appropriate comfort measure to include in this session? a. Promote skin care including daily bathing and changing clothes. 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

Which 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 elevated temperature in children with varicella b. Use of diphenhydramine (Benadryl) or hydroxyzine (Atarax) 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 child with sore throat

C

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

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

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 the 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

Joey, a 14-year-old adolescent, has recently relocated from Mexico to the United States. 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 two 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 emergency department expect to give at this time? a. Tdap b. DTaP c. Td booster d. Tetanus immunoglobulin (TIG) human and Tdap

D

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

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

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

D

The nurse is instructing parents on the test-tape diagnostic procedure for enterobiasis. Which 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 antiparasitic 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