Question 1

The hospital has just provided its nurses with information about biologic threats and terrorism. After completing the course, a group of nurses is discussing its responsibility in relation to bioterrorism. Which statement by the nurse indicates a correct understanding of the concepts presented?

Accepted Answer

The nurse's statement about notifying the CDC if a large number of people present with the same life-threatening infection shows an understanding of the need to report potential bioterrorism events to the appropriate authorities. The other statements are important infection control practices but do not specifically address bioterrorism.

Question 2

A nurse is providing information to a group of new mothers. Which statement best explains why newborns and young infants are more susceptible to infection?

Accepted Answer

Newborns and young infants are more susceptible to infection because their immune systems are not fully mature at birth. Maternal antibodies and passive transplacental immunity do offer some protection, but the baby's own immune system needs time to develop and mature. The birth process can also expose infants to microorganisms, but this is not the primary reason for their increased susceptibility to infection.

Question 3

A mother brings her 4-month-old infant in for a routine checkup and vaccinations. The mother reports that the infant was exposed to a brother who has the flu. Which action by the nurse is most appropriate based on these assessment findings?

Accepted Answer

The infant should still receive the scheduled vaccinations, as they are important for the child's health and protection from other vaccine-preventable diseases. Exposure to the flu does not necessarily mean the infant will contract the illness, and the vaccinations will not interfere with the flu if the child were to get sick. However, the nurse should educate the mother on the signs and symptoms of the flu and what to do if the infant develops them.

Question 4

The school nurse is trying to prevent the spread of a flu virus through the school. Which infection-control strategies can be employed to prevent the spread of the flu virus? Select all that apply.

Accepted Answer

C) Sanitizing toys, telephones, and door knobs to kill pathogens can prevent the spread of the flu virus.
D) Separating children with infections from children who are well can prevent the spread of the flu virus.
E) Teaching children to wash their hands after using the bathroom can prevent the spread of the flu virus. 
A is not directly related to preventing the spread of the flu, and B is potentially harmful as immunizations are recommended to prevent the flu.

Question 5

The nurse prepares the second diphtheria, tetanus toxoid, and acellular pertussis (DTaP) and second inactivated polio vaccine (IPV) immunization injections for an infant who is 4 months old. The nurse may also give which of immunizations during the same well-child-care appointment?

Accepted Answer

The HIB vaccine is recommended to be given at 4 months of age. The Var (varicella), TIV (influenza), and MMR (measles, mumps, rubella) vaccines are not recommended until later in infancy or childhood.

Question 6

The hospital admitting nurse is taking a history of a child's illness from the parents. The nurse concludes that the parents treated their 6-year-old child appropriately for a fever related to otitis media. Which action by the parents brought the nurse to this conclusion?

Accepted Answer

Offering generous amounts of fluids frequently is appropriate for a child with a fever related to otitis media as it helps prevent dehydration. Aspirin is not recommended for children due to the risk of Reye's syndrome. Alternating acetaminophen with ibuprofen every two hours is not recommended as it can lead to medication errors and overdosing. Putting the child in a tub of cold water can cause shivering and may actually cause the fever to increase.

Question 7

Reducing the number of preventable childhood illnesses is a major national goal in Healthy People 2020. What will the school nurse teach families regarding immunizations in order to reach this goal?

Accepted Answer

The school nurse will teach families that maintaining vaccination coverage for recommended vaccines in early childhood and throughout kindergarten is important in reducing the number of preventable childhood illnesses. Option A is incorrect as a low-grade fever is not a contraindication for receiving an immunization. Option B is incorrect as giving vaccines one at a time is not recommended by medical professionals as it can delay the time it takes to get full immunization coverage. Option C is incorrect as premature infants and low-birth-weight infants should receive the same doses of vaccines as full-term infants.

Question 8

The nurse is teaching a prenatal class about infant care. Under which circumstances should the nurse emphasize that parents should call their healthcare provider immediately? Select all that apply.

Accepted Answer

A temperature over 40.1°C in a child under 3 months, difficulty awakening with a pulsing fontanel, purple spots with lethargy, and a stiff neck with irritability are all serious symptoms that require immediate medical attention.

Question 9

A mother refuses to have her child be immunized with measles, mumps, and rubella (MMR) vaccine because she believes that letting her infant get these diseases will help him fight off other diseases later in life. Which response by the nurse is most appropriate?

Accepted Answer

This response explains the potential serious and permanent complications that could result from contracting measles, mumps, or rubella, which may help the mother better understand the importance of vaccination.

Question 10

The nurse prepares a DTaP (diphtheria, tetanus toxoid, and acellular pertussis) immunization for a 6-month-old infant. To administer this injection safely, the nurse chooses which needle, size and length, injection type, and injection site?

Accepted Answer

The recommended injection site for infants and young children for the DTaP immunization is the anterolateral thigh. The recommended needle size and length is 25-gauge and 5/8-inch for intramuscular injections.

Question 11

A child is admitted with a diagnosis of early localized Lyme disease. Which clinical manifestations would the nurse expect to find on the initial assessment of this client? Select all that apply.

Accepted Answer

Early localized Lyme disease is characterized by the development of erythema migrans (EM) rash, which appears at the site of the tick bite after a few days to weeks. The rash usually starts as a red papule, expands gradually to form a characteristic circular or oval lesion with central clearing, and may reach up to 5-15 cm in diameter. Other common clinical manifestations may include fever, headache, fatigue, myalgias, arthralgias, and malaise. Hyperactivity and cranial nerve palsies are not typical features of early localized Lyme disease.

Question 12

The family and school-age child are at the healthcare clinic for immunizations. The nurse takes the time to talk with the child and family about reducing the transmission of infection. What practices should the nurse suggest for the family? Select all that apply.

Accepted Answer

The answer of The family and school-age child are at...

Question 13

A parent brings her school-age child to the clinic because the child has a temperature of100.2°F. The child remains active without other symptoms. Which statement by the nurse to the parents is most appropriate?

Accepted Answer

Option B is the most appropriate because the child is active without other symptoms and the temperature is only slightly elevated. Unless there are other symptoms or the temperature rises significantly, it is best to let the body's natural defenses fight the infection. Option A may cause unnecessary concern for the parents and option C is incorrect because keeping the child warm may lead to further increase in temperature. Option D is not appropriate because alternating acetaminophen and ibuprofen is not recommended without consulting a healthcare provider.

Question 14

A toddler client with a fever is prescribed amoxicillin clavulanate 250 mg/5 cc three times daily by mouth × 10 days for otitis media. Which teaching point will guard against antibiotic resistance to the disease process?

Accepted Answer

Giving the antibiotic for the full 10 days ensures that all bacteria causing the infection are completely eradicated, preventing the development of antibiotic resistance. Stopping the antibiotic early can lead to some bacteria surviving and developing resistance to the antibiotic, making future infections harder to treat. Administering a loading dose is not necessary for this medication, and measuring in a household teaspoon can lead to dosing errors. Stopping the antibiotic if the child is afebrile does not guarantee complete eradication of the bacteria causing the infection.

Question 15

A nurse working in a pediatric clinic is responsible for monitoring and maintaining the vaccinations on site. Which actions are appropriate for this nurse to implement? Select all that apply.

Accepted Answer

Vaccines should be stored in the center of the unit to ensure consistent temperature. The temperature should be checked and recorded twice daily to ensure proper storage conditions. Having a plan for power outages is crucial to prevent vaccine spoilage. Placing bottles of water in the unit helps maintain a stable temperature.

Question 16

The student nurse is learning a lesson about communicable diseases and how they are spread. On a quiz the next day the nurse uses the information learned in this lesson and demonstrates learning. For a communicable disease to occur what factors must be in place? Select all that apply.

Accepted Answer

For a communicable disease to occur, there must be a pathogen (such as a virus or bacteria) present, a method of transmission (such as contact with the bodily fluids of an infected person or exposure to contaminated surfaces), and a susceptible host (an individual who can become infected). Antibodies and toxoids are not necessarily required for the occurrence of a communicable disease, although they may be involved in the body's response to an infection or in preventing future infections.

Question 17

A parent reports that her school-age child, who has had all recommended immunizations, had a mild fever one week ago and now has bright red cheeks and a lacy red maculopapular rash on the trunk and arms. Which disease process does the nurse suspect based on the parent's description?

Accepted Answer

The combination of mild fever followed by a lacy, maculopapular rash on the trunk and arms with bright red cheeks is consistent with fifth disease, also known as erythema infectiosum. This disease is caused by parvovirus B19 and is typically a mild, self-limiting illness. It is important to note that the child in the scenario has had all recommended immunizations, which would rule out measles and chicken pox. Roseola would not present with the rash described in this scenario.

Question 18

The nurse is discussing ways to treat fever in the home environment to a group of parents in the community. Which statement is appropriate for the nurse to include in the presentation?

Accepted Answer

It is important for parents to purchase a new bottle of medication for their newborn as medication concentrations can vary, and using an incorrect concentration can lead to overdosing or underdosing which can be harmful to the infant's health. Option A is incorrect because fever can also be treated with acetaminophen, not just Ibuprofen. Option B is incorrect because antibiotics are not used to treat fever, they are used to treat bacterial infections. Option D is incorrect because it is crucial to follow the recommended dosage on the bottle of medication to avoid overdosing or underdosing, which can be dangerous for the child's health.

Quiz 16: Immunizations and Communicable Diseases