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 A
Explanation
A. Whooping cough. Pertussis is commonly called "whooping cough" due to the characteristic "whooping" sound heard during coughing fits.
B. Fifth disease. Fifth disease is caused by parvovirus B19, not Bordetella pertussis, the bacteria causing pertussis.
C. Chickenpox. Chickenpox is caused by the varicella-zoster virus and has no relation to pertussis.
D. Mumps. Mumps is caused by the mumps virus, unrelated to pertussis.
Correct Answer is D
Explanation
A. "I promise I won't tell anyone about this.": This is inappropriate as nurses are mandated reporters and must inform authorities when abuse is suspected.
B. "Let's discuss what you have told me with your family members.": Involving the alleged abuser(s) directly can put the child at greater risk and is inappropriate.
C. "Your family is bad for doing this to you.": Judging or labeling the family is unprofessional and could make the child feel conflicted or guilty.
D. "It is not your fault that this happened.": This response reassures the child, alleviating feelings of guilt and fostering trust, while remaining supportive and professional.