a 6 month old female is scheduled to receive diphtheria tetanus toxoid and acellular pertussis vaccine dtap and ipv inactivated poliovirus vaccine imm
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Nursing Elites

HESI RN

Pediatric HESI

1. A 6-month-old female is scheduled to receive diphtheria, tetanus toxoid, and acellular pertussis vaccine (DTaP) and IPV (inactivated poliovirus vaccine) immunizations. She is recovering from a cold but is otherwise healthy and afebrile. Her 5-year-old sister is receiving chemotherapy. Which considerations should the nurse make for this situation?

Correct answer: A

Rationale: DTaP and IPV can be safely administered to a child with a mild illness like a cold, even if there is an immunocompromised family member, as these vaccines do not contain live viruses. It is important to ensure that the child is otherwise healthy and afebrile before administering the vaccines. The presence of a cold is not a contraindication for receiving DTaP and IPV vaccines. Choice A is correct because the infant can receive both vaccines as scheduled. Choice B is incorrect as having a cold does not contraindicate DTaP and IPV administration. Choice C is incorrect because IPV is not contraindicated due to the sister's immunocompromised status. Choice D is incorrect as both DTaP and IPV can be given in this scenario.

2. When should the surgical correction of hypospadias in a newborn infant typically be done?

Correct answer: C

Rationale: Surgical repairs for hypospadias are typically recommended to be performed before the child is potty trained. This timing helps in avoiding complications, ensures better outcomes, and makes the surgical process smoother. Early correction also minimizes the psychological impact on the child regarding genital differences and can improve long-term psychological well-being. Choices A, B, and D are incorrect because repairing hypospadias at one month to prevent bladder infection, after sexual maturity to form a proper urethra, or delaying the repair until school age to reduce castration fears are not the standard recommendations. The optimal timing for surgical correction is before the child is potty trained to achieve the best results and psychological outcomes.

3. A 5-year-old child is brought to the emergency department with severe abdominal pain and vomiting. The child’s parent reports that the pain started suddenly and is located in the lower right abdomen. What should the nurse do first?

Correct answer: B

Rationale: The correct answer is to notify the healthcare provider immediately. The child's presentation of sudden, severe abdominal pain in the lower right abdomen is highly concerning for appendicitis, a medical emergency. Promptly notifying the healthcare provider is crucial for further evaluation and management. Administering pain medication as the first action might mask symptoms and delay diagnosis. Starting an IV line for fluid administration and obtaining a complete blood count are important interventions but should come after healthcare provider notification.

4. A child with pertussis is receiving azithromycin (Zithromax Injection) IV. Which intervention is most important for the nurse to include in the child’s plan of care?

Correct answer: C

Rationale: Monitoring for signs of an allergic reaction, such as facial swelling or urticaria, is crucial when administering antibiotics like azithromycin. It is important to watch for these signs to promptly identify and manage any potential adverse reactions during the course of treatment.

5. During a follow-up clinical visit, a mother tells the nurse that her 5-month-old son, who had surgical correction for tetralogy of Fallot, has rapid breathing, often takes a long time to eat, and requires frequent rest periods. The infant is not crying while being held, and his growth is in the expected range. Which intervention should the nurse implement?

Correct answer: B

Rationale: Auscultating the heart and lungs while the infant is held is the most appropriate intervention to assess his current condition. This action allows the nurse to gather important information regarding the cardiovascular and respiratory status of the infant, which is crucial in evaluating his post-surgical recovery and overall well-being. Option A is incorrect as stimulating the infant to cry intentionally is not necessary and could cause distress. Option C is incorrect as the infant's growth is within the expected range, indicating no signs of failure to thrive. Option D is incorrect as obtaining a 12-lead electrocardiogram is not the initial intervention needed in this situation; assessing the heart and lungs through auscultation is more immediate and informative.

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