. An adolescent has just had a generalized seizure and collapsed in the school nurse's office. When should the nurse call 911?
The child is confused and cannot remember anything regarding the seizure.
The child fell at the onset of the seizure
The seizure lasts more than 5 minutes.
The child is sleepy and lethargic after the seizure
The Correct Answer is C
A. The child is confused and cannot remember anything regarding the seizure: Postictal confusion is normal after a seizure and does not require emergency services.
B. The child fell at the onset of the seizure: Falls can occur with seizures, but unless there is a suspected injury or prolonged seizure activity, calling 911 is unnecessary.
C. The seizure lasts more than 5 minutes: A seizure lasting more than 5 minutes is considered status epilepticus and is a medical emergency requiring immediate intervention.
D. The child is sleepy and lethargic after the seizure: Postictal sleepiness is a common and expected phase after a generalized seizure.
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Correct Answer is D
Explanation
A. Haemophilus Influenza Type B (HIB) Vaccine and TDAP. HIB vaccine reduces the incidence of meningitis caused by Haemophilus influenzae, but TDAP does not target pathogens responsible for meningitis.
B. Inactivated polio vaccine (IPV) and Pneumococcal Conjugate Vaccine (PCV). IPV prevents polio but has no impact on meningitis incidence. PCV is correct for preventing Streptococcus pneumoniae meningitis.
C. DTAP and Varicella Vaccine. DTAP does not prevent bacterial meningitis, and varicella vaccine prevents chickenpox, not meningitis.
D. Pneumococcal Conjugate Vaccine (PCV) and Haemophilus Type B (HIB Vaccine). These vaccines directly prevent bacterial meningitis caused by Streptococcus pneumoniae and Haemophilus influenzae, which were previously leading causes of meningitis in children.
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.