A nurse in a clinic is preparing to administer pre-kindergarten vaccines to a 5-year-old child whose medical record indicates that his immunizations are up to date. Which of the following vaccines should the nurse plan to administer?
Pneumococcal conjugate vaccine (PCV)
Hepatitis B (HBV)
Haemophilus influenzae type B (Hib)
Measles, mumps, and rubella (MMR)
The Correct Answer is D
A. Pneumococcal conjugate vaccine (PCV): This vaccine is generally completed before the age of 5, so it is not typically administered at this stage.
B. Hepatitis B (HBV): The HBV series is usually completed during infancy and early childhood, so it is not needed at 5 years if the child is up to date.
C. Haemophilus influenzae type B (Hib): Hib is typically completed by 18 months of age and is not required for pre-kindergarten.
D. Measles, mumps, and rubella (MMR): A second dose of MMR is typically required at 4-6 years, aligning with pre-kindergarten vaccination schedules.
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Correct Answer is ["B","D","E"]
Explanation
A. Clear CSF: Clear CSF is typically seen in viral meningitis or normal findings, not bacterial meningitis.
B. Cloudy CSF: Cloudy CSF indicates the presence of infection and is characteristic of bacterial meningitis.
C. Negative gram stain: A negative gram stain indicates the absence of bacterial pathogens, which is not consistent with bacterial meningitis.
D. Decreased glucose content: Bacteria consume glucose, leading to decreased glucose levels in bacterial meningitis.
E. Positive gram stain: A positive gram stain confirms the presence of bacterial organisms in the CSF, supporting a diagnosis of bacterial meningitis.
Correct Answer is ["A","B","D"]
Explanation
A. Dropping held object: Loss of motor activity during absence seizures may result in dropping objects.
B. Loss of consciousness: Absence seizures involve brief, sudden loss of consciousness without convulsions.
C. Falling to the floor: This is associated with atonic or tonic-clonic seizures, not absence seizures.
D. Appearance of daydreaming: A hallmark of absence seizures is the "staring spell" or daydream-like appearance.