what time frame has the advisory committee on immunization practices acip of the centers for disease control and prevention cdc and american college o

ATI RN

Nursing Care of Children ATI

1. What time frame has the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists recommended that pregnant adolescents and women who are not protected against pertussis receive the tetanus, diphtheria, and pertussis (Tdap) vaccine?

A. Between 27 and 36 weeks of gestation or postpartum before discharge from the hospital
B. During the first prenatal visit when pregnancy is confirmed
C. The vaccine should be administered 24 hours prior to delivery
D. This vaccine is only recommended during the first trimester

Correct answer: A

Rationale: The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists recommend that pregnant adolescents and women without protection against pertussis should receive the Tdap vaccine ideally between 27 and 36 weeks of gestation or postpartum before discharge from the hospital. This timeframe allows for the development of antibodies in the mother to protect her and provide passive immunity to the infant. Administering the vaccine during the first trimester (Choice D) is not recommended as the optimal time is between 27 and 36 weeks. Choice B, during the first prenatal visit, is too early for optimal protection, and Choice C, 24 hours prior to delivery, does not provide enough time for the vaccine to be effective before birth.

2. At what point in the hospitalization of the pediatric patient should discharge planning and teaching begin?

A. Post-operatively
B. Right when the patient is being discharged with the parents and support members present
C. On the morning that the patient is scheduled to go home
D. On admission

Correct answer: D

Rationale: Discharge planning should begin on admission to ensure that all necessary teaching and preparations are completed in a timely manner. Starting discharge planning early allows for a comprehensive assessment of the patient's needs, coordination with the healthcare team, and adequate time for patient and family education. Choice A, post-operatively, is too late in the process and may lead to rushed planning. Choice B, right at discharge, may not allow enough time for thorough preparation. Choice C, on the morning of discharge, also does not provide sufficient time for effective planning and education.

3. What statement is descriptive of renal transplantation in children?

A. It is an acceptable means of treatment after age 10 years.
B. Children can receive kidneys only from other children.
C. It is the preferred means of renal replacement therapy in children.
D. The decision for transplantation is difficult because a relatively normal lifestyle is not possible.

Correct answer: C

Rationale: Renal transplantation is the preferred method of treatment for children with end-stage renal disease, as it offers the best chance for a normal lifestyle compared to long-term dialysis. Transplantation can be performed at any age, and kidneys can come from adult donors as well.

4. A 5-year-old has patient-controlled analgesia (PCA) for pain management after abdominal surgery. What information does the nurse include in teaching the parents about the PCA?

A. The child may not be pain-free.
B. The parents or nurse may push the button for a bolus if needed.
C. The pump allows for a continuous basal rate to deliver a constant amount of medication for pain control.
D. Monitoring is required every 1 to 2 hours to assess patient response.

Correct answer: C

Rationale: The correct answer is C because the PCA pump can be programmed to deliver a continuous basal rate of pain medication to maintain pain control. While the goal of PCA is effective pain relief, it does not guarantee a pain-free state. In the case of a 5-year-old child, the parents or nurse can administer boluses if necessary since the child may not fully comprehend using the PCA button. Monitoring every 1 to 2 hours for patient response is adequate and there is no need for monitoring every 15 minutes, as stated in choice D, unless specific circumstances dictate more frequent monitoring.