The nurse is reviewing the immunization schedule with the parent of a child who is positive for human immunodeficiency virus (HIV). What statement by the parents indicates that teaching has been effective?
"The varicella vaccine should be withheld if my child is symptomatic of their illness."
"The vaccination schedule does not apply to my child."
"The pneumococcal (PCV) vaccine should be delayed until my child's first birthday."
"The human papillomavirus (HPV) vaccine is contraindicated for my child."
The Correct Answer is A
Rationale:
A. The varicella vaccine, which is a live attenuated vaccine, may be withheld if the child is symptomatic of their illness or has a significantly compromised immune system. This is due to the increased risk of severe reactions or complications in immunocompromised individuals.
B. The vaccination schedule is still applicable to children with HIV, but there may be adjustments based on the child’s immunocompetence and specific health status.
C. The pneumococcal vaccine is recommended for children with HIV and is typically administered according to the standard schedule, not delayed until the first birthday.
D. The HPV vaccine is generally recommended for children with HIV, as they are at increased risk for HPV-related complications. It is not contraindicated.
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Correct Answer is D
Explanation
Rationale:
A. While reviewing the CBC is important, it is not the priority.
B. Assessing joint pain is necessary for managing symptoms, but it is not the most critical initial action.
C. Evaluating the erythematous rash is part of the assessment, but it does not take precedence.
D. Auscultating the heart is the priority because acute rheumatic fever can lead to carditis, which can cause significant and potentially life-threatening heart complications. Early detection of abnormal heart sounds is crucial.
Correct Answer is B
Explanation
Rationale:
A. Granola often contains gluten, so this meal would not be suitable for someone with celiac disease.
B. Cheese, banana slices, rice cakes, and whole milk are gluten-free and appropriate for a child with celiac disease.
C. Rye toast contains gluten, which is contraindicated for someone with celiac disease.
D. Flour tortillas generally contain gluten, so this meal is not appropriate for someone with celiac disease.