the mother of a child is hepatitis b surface antigen hbsag negative when should the child receive the first dose of the hepatitis b virus hbv vaccine
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Nursing Elites

ATI RN

RN Nursing Care of Children 2019 With NGN

1. When should a child receive the first dose of the hepatitis B virus (HBV) vaccine if the mother is hepatitis B surface antigen (HBsAg) negative?

Correct answer: B

Rationale: If the mother is HBsAg negative, it is recommended that the child receives the first dose of the hepatitis B vaccine at birth before discharge from the hospital. This is to provide early protection against the hepatitis B virus. The second dose of the vaccine is typically given at the first well-child visit, and the third dose is usually administered at a later date. The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention and the Committee on Infectious Diseases of the American Academy of Pediatrics govern the recommendations for immunization, including the hepatitis B virus vaccine. Choice A is incorrect as the first dose should ideally be given at birth. Choice C is incorrect as waiting until 6 months of age may leave the child vulnerable to infection during the early months of life. Choice D is incorrect as the hepatitis B vaccine is recommended for all newborns, especially if the mother is HBsAg negative, to prevent transmission of the virus.

2. The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other traumatic injuries from a motor vehicle crash. The child is experiencing severe pain. What is an important consideration in managing the child’s pain?

Correct answer: C

Rationale: For severe postoperative pain, a preventive around-the-clock schedule is necessary to prevent decreased plasma levels of medications. Providing only an opioid analgesic at this time may not be sufficient for effective pain management. Increasing the dosage without an order is unsafe and may lead to oversedation. Planning a preventive schedule of pain medication around the clock ensures consistent pain relief and better management. Giving the child a clock and explaining when they can have pain medications may increase the child's focus on waiting for relief rather than addressing the pain promptly, making it a less effective strategy.

3. The nurse is administering the first hepatitis A vaccine to an 18-month-old child. When should the child return to the clinic for the second dose of hepatitis A vaccination?

Correct answer: D

Rationale: The second dose of the hepatitis A vaccine is recommended 6 months after the first dose to ensure full immunity.

4. Which heart sound is produced by vibrations within the heart chambers or in the major arteries from the back-and-forth flow of blood?

Correct answer: C

Rationale: A murmur is produced by turbulent blood flow within the heart or major arteries, resulting in audible vibrations.

5. A 3-year-old child was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guideline concerning adoption should the nurse use in planning a response?

Correct answer: D

Rationale: It is important to tell children about their adoption early, in an age-appropriate manner, as part of building trust and openness in the family relationship.

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