Which intervention is appropriate for a child receiving high doses of steroids?
Limit activity and receive home schooling.
Decrease the amount of potassium in the diet.
Substitute a killed virus vaccine for live virus vaccines.
Monitor for seizure activity. Substitute a killed virus vaccine for...
NUR 370 Exam 3 Review Questions and
Solutions
Which intervention is appropriate for a child receiving high doses of steroids?
Limit activity and receive home schooling.
Decrease the amount of potassium in the diet.
Substitute a killed virus vaccine for live virus vaccines.
Monitor for seizure activity. ✅Substitute a killed virus vaccine for live virus vaccines.
A. Limiting activity and home schooling are not routine for a child receiving high doses
of steroids.
B. The child receiving steroids is at risk for hypokalemia and needs potassium in the
diet.
C. The child on high doses of steroids should not receive live virus vaccines because of
immunosuppression.
D. Children on steroids are not typically at risk for seizures.
A nurse in a well-child clinic is teaching parents about their child's immune system.
Which statement by the nurse is correct?
The immune system distinguishes and actively protects the body's own cells from
foreign substances.
The immune system is fully developed by 1 year of age.
The immune system protects the child against communicable diseases in the first 6
years of life.
The immune system responds to an offending agent by producing antigens. ✅The
immune system distinguishes and actively protects the body's own cells from foreign
substances.
A. The immune system responds to foreign substances, or antigens, by producing
antibodies and storing information. Intact skin, mucous membranes, and processes
such as coughing, sneezing, and tearing help maintain internal homeostasis.
,B. Children up to age 6 or 7 years have limited antibodies against common bacteria.
The immunoglobulins reach adult levels at different ages.
C. Immunization is the basis from which the immune system activates protection against
some communicable diseases.
D. Antibodies are produced by the immune system against invading agents, or antigens.
The Center for Disease Control (CDC, 2009) recommendation for immunizing infants
who are HIV positive is
Follow the routine immunization schedule.
Routine immunizations are administered; assess CD4+ counts before administering the
MMR and varicella vaccinations.
Do not give immunizations because of the infant's altered immune status.
Eliminate the pertussis vaccination because of the risk of convulsions. ✅Routine
immunizations are administered; assess CD4+ counts before administering the MMR
and varicella vaccinations.
A. Routine immunizations are appropriate; however, CD4+ cell counts should be
assessed before administering the MMR and varicella vaccines to establish adequate
immune system function.
B. Routine immunizations are appropriate. CD4+ cells are monitored when deciding
whether to provide live virus vaccines. If the child is severely immunocompromised, the
MMR vaccine is not given. The varicella vaccine can be considered on the basis of the
child's CD4+ counts. Only inactivated polio virus (IPV) should be used for HIV-infected
children.
C. Immunizations are given to infants who are HIV positive.
D. The pertussis vaccination is not eliminated for an infant who is HIV positive.
What is the most common mode of transmission of human immunodeficiency virus
(HIV) in the pediatric population?
Perinatal transmission
Sexual abuse
Blood transfusions
Poor handwashing ✅Perinatal transmission
,A. Perinatal transmission accounts for the highest percentage (91%) of HIV infections in
children. Infected women can transmit the virus to their infants across the placenta
during pregnancy, at delivery, and through breastfeeding.
B. Cases of HIV infection from sexual abuse have been reported; however, perinatal
transmission accounts for most pediatric HIV infections.
C. Although in the past some children became infected with HIV through blood
transfusions, improved laboratory screening has significantly reduced the probability of
contracting HIV from blood products.
D. Poor handwashing is not an etiology of HIV infection.
The mother of an HIV-positive infant who is 2 months old questions the nurse about
which childhood immunizations her child will be able to receive. Which immunizations
should an HIV-positive child be able to receive according to the American Academy of
Pediatrics recommendation for immunizing infants who are HIV positive?
Select all that apply.
Hepatitis B
DTaP
MMR
IPV
HIB" ✅Hepatitis B
DTaP
IPV
HIB
The nurse observes a red butterfly-shaped rash that spreads across the child's cheeks
and nose. This assessment finding is characteristic of which condition?
A. A red, flat or raised malar "butterfly" rash over the cheeks and bridge of the nose is a
clinical manifestation of SLE.
B. A major manifestation of rheumatic fever is erythema marginatum, which appears as
red skin lesions spread peripherally over the trunk.
C. An erythematous rash, induration of the hands and feet, and erythema of the palms
and soles are manifestations of Kawasaki disease.
D. Initial symptoms of anaphylaxis include severe itching and rapid development of
erythema.
Once an allergen is identified in a child with allergic rhinitis, the treatment of choice
about which to educate the parents is
Using appropriate medications
Beginning desensitization injections
Eliminating the allergen
Removing the adenoids ✅Eliminating the allergen
A. Medications are not a first-line treatment but can be helpful in controlling allergic
rhinitis.
B. Immunotherapy is usually the final component of controlling allergic rhinitis.
C. The first priority is to attempt to remove the causative agent from the child's
environment.
D. Adenoids are tissues that can swell with constant rhinitis; however, a surgical
procedure is not indicated for allergic rhinitis. Dealing with the cause is the first priority
What information should the nurse teach families about reducing exposure to pollens
and dust?
Select all that apply.
Replace wall-to-wall carpeting with wood and tile floors.
Use an air conditioner.
Put dust-proof covers on pillows and mattresses.
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