Nursing Elites

1. The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine?

• A. The hepatitis B vaccination series should be begun at birth
• B. All are applicable
• C. Any child not vaccinated at birth should receive two doses at least 4 months apart
• D. An unimmunized 10-year-old child should receive three doses administered 4 weeks apart

Correct answer: B

Rationale: Hepatitis B vaccination should start at birth, and any child or adolescent not vaccinated should complete the series. Adolescents should receive three doses if they were not previously vaccinated.

2. Which disease requires strict isolation due to its mode of transmission?

• A. Mumps
• B. Chickenpox
• C. Exanthema subitum (roseola)
• D. Erythema infectiosum (fifth disease)

Correct answer: B

Rationale: The correct answer is Chickenpox (choice B). Chickenpox is highly communicable and requires strict isolation to prevent the spread of the virus through direct contact, droplet transmission, and contaminated objects. Mumps (choice A) is also contagious but does not typically require strict isolation. Exanthema subitum (roseola) (choice C) and Erythema infectiosum (fifth disease) (choice D) are not as highly contagious as chickenpox and do not necessitate strict isolation.

3. What is a key distinguishing feature of bronchiolitis in infants?

• A. Dry cough
• B. Wheezing
• C. Stridor
• D. Productive cough

Correct answer: B

Rationale: The correct answer is B: Wheezing. Wheezing is a key distinguishing feature of bronchiolitis in infants, typically caused by respiratory syncytial virus (RSV) infection. Bronchiolitis is characterized by inflammation and mucus buildup in the small airways of the lungs, leading to wheezing sounds during breathing. Choices A, C, and D are incorrect because dry cough, stridor, and productive cough are not typical features of bronchiolitis in infants.

4. What statement is most descriptive of Meckel diverticulum?

• A. It is present from birth.
• B. Intestinal bleeding may be mild or profuse.
• C. It occurs with equal frequency in both genders.
• D. Surgical interventions are always necessary to treat the problem.

Correct answer: B

Rationale: The correct answer is B. Meckel diverticulum often presents with intestinal bleeding, which can vary in severity. It is a congenital condition, meaning it is present from birth, not acquired during childhood (choice A). Meckel diverticulum is slightly more common in males than in females, so it does not occur more frequently in females (choice C). While some cases of Meckel diverticulum may require surgical intervention, medical interventions can also be sufficient to treat the problem, so it is not always necessary to resort to surgery (choice D).

5. Which is a consequence of the physical punishment of children, such as spanking?

• A. The psychological impact is usually minimal.
• B. The child's development of reasoning increases.
• C. Children rarely become accustomed to spanking.
• D. Misbehavior is likely to occur when parents are not present.

Correct answer: D

Rationale: Physical punishment, such as spanking, may result in children misbehaving when parents are not present, as it does not teach appropriate behavior or self-regulation.

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