Deck 45: Immunization and Communicable Diseases

Question 1

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 of the following needles (size and length),injection type,and injection site?

A)25 gauge ⅝-inch needle,IM (intramuscular),anterolateral thigh
B)22 gauge 1-2-inch needle,IM (intramuscular),ventrogluteal
C)25 gauge ⅝-inch needle,ID (intradermal),deltoid
D)25 gauge ¾-inch needle,SQ (subcutaneous),anterolateral thigh

Answer 1

25 gauge ⅝-inch needle,IM (intramuscular),anterolateral thigh

Question 2

The hospital has instructed its nurses that they must participate in disease surveillance associated with infectious agents.The nurses are warned that,of the following diseases,which is/are likely to be weapons of terrorists?

A)Severe acute respiratory syndrome (SARS)
B)Plague,anthrax,smallpox
C)Rubella,mumps,chickenpox
D)Rocky Mountain spotted fever,Lyme disease

Answer 2

Plague,anthrax,smallpox

Question 3

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.Provided a separate injection site is used for all injections,the nurse also may give which of the following immunizations during the same well child care appointment?

A)Varicella (Var)
B)Influenza (TIV)
C)Measles,mumps,rubella (MMR)
D)Haemophilus influenzae type B (Hib)

Answer 3

Haemophilus influenzae type B (Hib)

Question 4

A 2-year-child with a fever is prescribed amoxicillin clavulanate 250 mg/5 cc t.i.d.PO × 10 days for otitis media.To guard against antibiotic resistance,the nurse instructs the parent to:

A)Administer a loading dose for the first dose.
B)Measure the prescribed dose in a household teaspoon.
C)Give the antibiotic for the full 10 days.
D)Stop the antibiotic if the child is afebrile.

Question 5

A nurse is providing information to a group of new mothers.The nurse would explain that newborns and young infants are more susceptible to infection because they have:

A)High levels of maternal antibodies to diseases to which the mother has been exposed.
B)Passive transplacental immunity from maternal immunoglobulin G.
C)Immune systems that are not fully mature at birth.
D)Been exposed to microorganisms during the birth process.

Question 6

A parent reports that her 5-year-old child,who has had all recommended immunizations,had a mild fever 1 week ago,and now has bright red cheeks and a lacy red rash on the trunk and arms.The nurse recognizes that this child might have:

A)Chickenpox (varicella).
B)German measles (rubella).
C)Roseola (Exanthem subitum).
D)Fifth disease (Erythema infectiosum).

Question 7

The hospital has just provided its nurses with information about biologic threats and terrorism.After completing the course,a group of nurses are discussing their responsibility in relation to terrorism.The nurses who correctly understood the presentation are the ones who identify their action to be:

A)Separating clients according to cultural,religious,or ethnic group.
B)Disposing of blood-contaminated needles in the sharps container.
C)Notifying the Centers for Disease Control and Prevention (CDC)if a large number of persons with the same life-threatening infection present to the Emergency Department.
D)Initiating isolation precautions for a hospitalized client with methicillin-resistant Staphylococcus aureus (MRSA).

Question 8

A goal of Healthy People 2010 is full immunization of 95% of children in kindergarten and first grade in the United States.To help reach this goal,the school nurse can teach families about which of the following?

A)A minor illness with a low-grade fever is a contraindication to receiving an immunization.
B)Vaccines should be given one at a time for optimum active immunity.
C)Premature infants and low-birth-weight infants should receive half-doses of vaccines for protection from communicable diseases.
D)The risks of communicable diseases and the risks and benefits of vaccines from vaccine information statements as required by the National Vaccine Injury Act of 1986 and 1993

Question 9

A parent is given a prescription of amoxicillin for his 1-year-old son.The prescription reads "amoxicillin 125mg/5mL PO t.i.d.× 10 days." What is the total volume in milliliters of amoxicillin that must be dispensed? _____

Question 10

A mother brings her 4-month-old infant in for a routine checkup and vaccinations.The mother reports that the 4-month-old was exposed to a brother who has the flu.In this case,the nurse will:

A)Withhold the vaccinations.
B)Give the vaccinations as scheduled.
C)Withhold the DTaP vaccination,but give the others as scheduled.
D)Give the infant the flu vaccination,but withhold the others.

Question 11

A mother refuses to have her child immunized with the 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.The nurse's most appropriate response to this mother is to:

A)Honor her request because she is the parent.
B)Explain that antibodies can fight many diseases.
C)Tell her that not immunizing her infant might protect pregnant women.
D)Explain that if her child contracts measles,mumps,or rubella,he could have very serious and permanent complications from these diseases.

Question 12

The school nurse is trying to prevent the spread of a flu virus through the school.Infection control strategies that may be employed include: (Select all that apply. )

A)Teaching parents safe food-preparation and storage techniques.
B)Withholding immunizations for children with compromised immune systems.
C)Sanitizing toys,telephones,and doorknobs to kill pathogens.
D)Separating children with infections from well children.
E)Teaching children to wash their hands after using the bathroom.

Question 13

The nurse is planning equipment needs for a new health provider office in which immunizations will be given among other services.Which indicates the priority consideration?

A)A new office is not allowed to have vaccines for at least one year.
B)At least one refrigerator for cold storage is needed in this office.
C)Cabinet space should be allocated specifically for the vaccines.
D)A medication refrigerator is necessary for vaccine storage.

Question 14

A 3-year-old child is lying in a fetal position.The child has pale skin,glassy eyes,and a flat affect.The child is irritable,and refuses food and fluids.The child's vital signs are a temperature of 40.1ºC (104.2ºF),pulse of 120/minute,and respirations of 28/minute.The best,most comprehensive description of this child's condition is:

A)Toxic.
B)Feverish.
C)Flushed.
D)Tired.

Question 15

The hospital admitting nurse is taking a history on a child's illness from the parents.The nurse concludes that the parents treated their 6-year-old child appropriately for a fever when they report that they:

A)Used aspirin.
B)Alternated acetaminophen with ibuprofen.
C)Put the child in a tub of cold water.
D)Offered generous amounts of fluids frequently.