Chapter 67: Childhood Immunization

Chapter 67: Childhood Immunization

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. The nurse at the immunization clinic is providing vaccines to children. The parent of a child waiting to receive the vaccine tells the nurse that the child has had immune deficiencies from birth. The nurse understands that the vaccine that should not be administered to the child is the

a.	DTaP.
b.	Hib.
c.	polio injection.
d.	varicella virus vaccine.

 

 

ANS:   D

The varicella vaccine should be avoided by individuals who are immunocompromised, which includes those infected with the human immunodeficiency virus (HIV) and those who have a congenital immunodeficiency.

The DTaP, Hib vaccine, and polio injection may be administered to immunocompromised individuals, because these are not live vaccines.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 808

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Health Promotion and Maintenance

 

2. The nurse is teaching an immunization class to a group of parents. To evaluate the group’s understanding, the nurse stimulates discussion and poses questions. Which response by one of the parents demonstrates a need for further teaching?

a.	“The DTaP vaccine helps prevent pertussis and tetanus.”
b.	“The IPV vaccine helps prevent polio and is a live vaccine.”
c.	“The MMR vaccine helps prevent measles, mumps, and rubella.”
d.	“The Hib vaccine helps prevent type b H. influenzae.”

 

 

ANS:   B

The IPV vaccine is inactive. The oral poliovirus vaccine (OPV) is the live vaccine; this statement indicates a need for further teaching.

DTaP is given to prevent pertussis and tetanus; no further teaching is necessary.

MMR is given to prevent measles, mumps, and rubella; no further teaching is necessary.

The Hib vaccine is administered to help prevent type b H. influenzae; no further teaching is necessary.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 807

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Health Promotion and Maintenance

 

3. A nurse is providing education to an immunocompromised patient who has just received hepatitis B immune globulin. Which statement by the patient best demonstrates understanding of the hepatitis B immune globulin?

a.	“The antibodies provide immediate protection.”
b.	“It will take several months for my immune system to respond to the antibodies.”
c.	“Active immunity will develop in several weeks.”
d.	“Immunity will begin in 3 to 7 days and last indefinitely.”

 

 

ANS:   A

The passive immunity of the hepatitis B immune globulin protects the body immediately.

The immune system responds to the antibodies immediately. It does not take several months for a response to develop.

Immune globulin is passive, not active, immunity.

The passive immunity protects the body immediately but persists only as long as the antibodies remain in the body.

 

DIF:    Cognitive Level: Application             REF:    p. 809

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Health Promotion and Maintenance

 

4. Concerned parents bring their 3-year-old child to the emergency department. They state that the child has had vomiting and diarrhea for 2 days, is lethargic, and has had a fever. Upon assessment, vital signs reveal: temperature 103.7° F, pulse 148, BP 90/39, and respirations 28. The nurse suspects _________ and should prepare to ____________.

a.	meningococcal infection; administer a blood thinner to prevent thrombosis
b.	influenza; administer antipyretics and a cooling blanket
c.	rotavirus; administer IV fluids
d.	prodromal phase of chickenpox; monitor the child

 

 

ANS:   C

Rotavirus infects the intestinal mucosa and is the most common diarrheal pathogen in the world. Manifestations include fever, diarrhea, and vomiting and may lead to life-threatening dehydration. IV fluids should be given to prevent dehydration.

The signs and symptoms are not consistent with meningococcal infection or chickenpox.

The symptoms may be indicative of a gastroenteritis flu virus. However, IV fluids still are indicated, given the signs of dehydration. Antipyretics would treat the fever and mild discomforts but not address the fluid volume loss.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 801

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

 

5. The public health nurse is providing an educational activity to a group of nurses at the public health clinic. The nurse asks, “Which of the following patients may receive the measles, mumps, and rubella (MMR) vaccine without caution?” Which response best demonstrates understanding of the administration of the MMR vaccination?

a.	Child with a history of an allergy to neomycin
b.	Child being treated for a mild febrile illness
c.	Child with a history of thrombocytopenic purpura
d.	Child who is allergic to gelatin

 

 

ANS:   B

MMR can be administered to children with a mild febrile illness but not to children with a moderate or severe febrile illness.

The vaccine should be used with caution in children with a history of anaphylactic-like reactions to gelatin, eggs, or neomycin.

The vaccine should be used with caution in children with a history of thrombocytopenia or thrombocytopenic purpura.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 803

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential