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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?

A.

Pneumococcal conjugate vaccine (PCV)

B.

Hepatitis B (HBV)

C.

Haemophilus influenzae type B (Hib)

D.

Measles, mumps, and rubella (MMR)

Answer and Explanation

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 D

Explanation

A. Pulling a wagon with toys in the hallway: A child on airborne precautions cannot leave the room to prevent the spread of infection.

B. Watching a video game in the playroom: Access to communal areas like the playroom is prohibited for children on airborne precautions.

C. Constructing a model airplane: While constructive, small parts in models can be hazardous and inappropriate for some children in a hospital setting.

D. Putting a puzzle together: Puzzles are a safe, quiet activity that can be done independently in the isolation room.

Correct Answer is C

Explanation

A. Integumentary: Meningitis affects the central nervous system (CNS), not the skin, though a rash can sometimes appear with meningococcal meningitis.

B. Digestive: Digestive symptoms like nausea and vomiting may occur, but the primary system affected is the CNS.

C. Central Nervous: Meningitis is an inflammation of the meninges, which are protective coverings of the brain and spinal cord in the CNS.

D. Cardiopulmonary: Cardiopulmonary symptoms are not primary features of meningitis, though severe cases may affect vital systems indirectly.

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