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","C","E"]
Explanation
A. Febrile episode: Fever is a common trigger for febrile seizures in children, especially between 6 months and 5 years.
B. Low blood lead levels: Elevated, not low, blood lead levels can increase the risk of seizures due to neurotoxicity.
C. Sodium imbalance: Both hyponatremia and hypernatremia can cause seizures by disrupting neuronal function.
D. Presence of diphtheria: Diphtheria does not directly increase the risk of seizures. Neurological complications are rare and secondary.
E. Hypoglycemia: Low blood sugar levels deprive the brain of energy, which can lead to seizures.
Correct Answer is ["A","D"]
Explanation
A. Clear the area of hard objects: This prevents injury to the child during the seizure.
B. Place a tongue depressor in the child's mouth: This is contraindicated as it can cause injury to the oral cavity or obstruct the airway.
C. Place the child in prone position: This position is unsafe during a seizure and could compromise the airway. The lateral position is recommended to reduce aspiration risk.
D. Loosen restrictive clothing: Loosening clothing promotes easier breathing and comfort during the seizure.