Chapter 68: Childhood Immunization

Chapter 68: Childhood Immunization

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse at an immunization clinic is providing vaccines to children. The parent of a child waiting to receive vaccines tells the nurse that the child has an immune deficiency disorder. The nurse understands that which vaccine should not be administered to this child?

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

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 827

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

2. A nurse is preparing to administer vaccines to a 1-year-old child. The parents ask the nurse to give the child acetaminophen before administering the vaccine to reduce the pain. Which response by the nurse is correct?

ANS:  D

Giving analgesic/antipyretic medications before or shortly after vaccines can reduce the immune response, so giving them to prevent pain or fever is not recommended. Children do remember pain, and it is important to provide other comfort measures and to give the injections rapidly. Small needles cause less discomfort, and it is important to reassure the parents about this; however, it is more important to explain why acetaminophen is not recommended. Topical anesthetics are useful before giving the injections, not afterwards.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 819

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

3. The parents of an infant who will be attending day care tell the nurse that they do not want their child vaccinated against rotavirus because an older cousin developed intussusception after receiving this vaccine. Which response by the nurse is correct?

ANS:  C

The rotavirus vaccine product RotaShield was withdrawn because of the high rate of intussusception associated with it. The two products currently on the market—RotaTeq and Rotarix—do not carry a risk for intussusception. Intussusception can be life threatening, so telling parents it is less serious than the disease is incorrect. Intussusception was not merely a coincidental reaction. Herd immunity is not guaranteed.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 822

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

4. A -year-old child who has been receiving high-dose systemic glucocorticoids for several months comes to a clinic for school immunizations, which usually include the DTaP vaccine; varicella virus vaccine [Varivax]; the measles, mumps, and rubella virus (MMR) vaccine; and the inactivated poliovirus vaccine (IPV). The clinic nurse will expect to administer which vaccines to this child?

ANS:  B

Children who are immunocompromised should not receive live virus vaccines, including the MMR vaccine and Varivax. Children taking high-dose systemic glucocorticoids are immunocompromised and should not receive the vaccine until therapy is stopped and normal glucocorticoid production returns. The oral polio vaccine (OPV) contains live virus and is contraindicated. Immunoglobulins are not indicated unless children are exposed to the diseases themselves.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 823 | pp. 824-825 | p. 826

TOP:   Nursing Process: Planning

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