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
Explanation
A. Hide the medication in apple slices: This is inappropriate as the child might distrust caregivers if they realize the medication was hidden.
B. Offer the child an ice pop prior to administering the medication: An ice pop numbs taste buds and can reduce the unpleasant taste of medication.
C. Tell the child the medicine tastes like candy: Providing false information undermines trust and is unethical.
D. Inform the child that if he does not take the medication he will need a shot: Threats increase anxiety and do not foster cooperation.
Correct Answer is A
Explanation
A. "Give her acetaminophen, not aspirin.": Aspirin is contraindicated in children due to the risk of Reye's syndrome, a rare but serious condition that affects the liver and brain, especially during viral illnesses like the flu or chickenpox. Acetaminophen is a safer alternative for fever management in children.
B. "You'll have to call your physician.": While seeking physician advice is important, the nurse has a duty to provide accurate, immediate, evidence-based guidance to prevent harm.
C. "Give her no more than three baby aspirin every 4 hours.": Recommending aspirin dosing is unsafe due to the risk of Reye's syndrome.
D. "Follow the directions on the aspirin bottle for her age and weight.": Providing this advice without addressing safety concerns is inappropriate and potentially harmful.