the nurse is working in an immunization clinic which patient will the nurse identify as not eligible to receive routine immunizations
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Nursing Elites

ATI RN

RN Pediatric Nursing 2023 ATI

1. In an immunization clinic, which patient will the nurse identify as not eligible to receive routine immunizations?

Correct answer: C

Rationale: The nurse should identify the 4-year-old with a fever and upper respiratory tract infection as not eligible to receive routine immunizations. It is contraindicated to administer vaccines in the presence of moderate to severe illness, whether with or without fever, to prevent potential complications or reduced vaccine efficacy.

2. Which urinary diversion procedure is the least damaging to the body image of the adolescent?

Correct answer: B

Rationale: The correct answer is B: Ileal conduit. The ileal conduit diverts urine to the colon, and the urine is excreted with the feces. Unlike urostomy, nephrostomy, and suprapubic placement, the ileal conduit does not require an external appliance, which can be less damaging to an adolescent's body image.

3. A child receives a vaccine for MMR. Six hours after the injection, the child’s parent reports local soreness, erythema, lethargy, and a fever of 101°F to a nurse. Which action should the nurse take?

Correct answer: A

Rationale: Low-grade fever, malaise, and muscle aches are common reactions. Acetaminophen usually alleviates these problems. MMR is a live vaccine but it is attenuated or completely avirulent and does not cause measles in healthy children, only immunocompromised children.

4. When the home health nurse visits the home of a 10-month-old child, she observes the environment for risks of injury to the child. Which observation will the nurse discuss with the mother?

Correct answer: A

Rationale: The correct answer is A because leaving a filled mop bucket on the floor poses a drowning hazard for a 10-month-old child. Water in the bucket can be a potential drowning risk if the child falls into it. Pan handles turned to the back of the stove prevent accidental spills or burns, which is a safety measure in the kitchen. Filling the bathtub before bringing the baby into the bathroom helps in preventing burns from hot water. Placing the child in a car seat in the middle of the back seat provides safety by minimizing the risk of injury during a car ride, but it is not the most immediate risk to address in the scenario provided.

5. A patient is receiving glucocorticoids for the treatment of rheumatoid arthritis. The patient complains of having a headache. Which ordered medication should the nurse administer?

Correct answer: B

Rationale: When a patient is already receiving glucocorticoids for rheumatoid arthritis and complains of a headache, it is essential to consider the potential interactions and side effects of additional medications. Aspirin and NSAIDs like ibuprofen and naproxen sodium can increase the risk of gastrointestinal irritation and ulceration when used concurrently with glucocorticoids. Acetaminophen is a safer choice in this scenario for managing the patient's headache without exacerbating the gastrointestinal issues associated with the use of glucocorticoids. Acetaminophen does not have the same gastrointestinal side effects as aspirin, ibuprofen, or naproxen sodium, making it the most appropriate option for headache relief in this case.

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