ANSWERS
•Arthroplasty correct answer •Total joint replacement
•Damaged joint is removed and replaced with plastic, metal, or ceramic
prosthesis
•Choice of prosthesis based on patient's weight, sex, age, activity level, health
•Artificial joints usually last 15-20 years
•Most common: hip, knee arthroplasties
•Total recovery time: 4-6 weeks to 6 months
•Complications: infection, blood clots, long-term breakdown of artificial joint
•Joint fusion (arthrodesis) correct answer •Permanent fusion of two or more
bones at a joint using pins, plates, screws, rods
•Bone graft may be used to stimulate bone growth at site
•Used for badly damaged smaller joints in spine, wrist, ankle, finger, toe
•To minimize the potential for errors the nurse should instruct the client to:
correct answer •Know name of all medications (use, dose and how they should be
taken)
•Know what side effects need to be reported immediately
•Use the correct measuring device
•Carry a list of updated medications including OTC< herbal and dietary
supplements
,1. The nurse is discussing vaccines with the mother of a 4-year-old child who
attends a day care center that requires the DTaP vaccine. The mother, who is
pregnant, tells the nurse that she does not want her child to receive the pertussis
vaccine because she has heard that the disease is "not that serious" in older
children. What information will the nurse include when discussing this with the
mother?
a.
If she gets the vaccine, both she and her 4 year-old child will be protected.
b.
If the 4-year-old child contracts pertussis, it can be passed on to her newborn.
c.
The vaccine will not be given to her child while she is pregnant.
d.
Vaccinating the 4-year-old will provide passive immunity for her unborn child.
correct answer ANS: B
Even though pertussis is not as serious in older children, it is important to
vaccinate children to prevent the spread of the disease to infants and others who
are not immunized and who are at risk for significant morbidity and mortality
from this disease. Vaccinating the mother will not protect the 4-year-old from
getting pertussis. The DTaP vaccine may be given to children whose mothers are
pregnant. Vaccinating the child does not confer passive immunity to the unborn
child.
2. A woman who is pregnant tells the nurse she has not had any vaccines but
wants to begin so she can protect her unborn child. Which vaccine(s) may be
administered to this patient?
a.
Gardasil vaccine
b.
,Trivalent influenza vaccine
c.
MMR vaccine
d.
Varivax vaccine correct answer ANS: B
The influenza vaccine is recommended for pregnant women and should be given.
Gardasil is given to young women who are not yet sexually active. The MMR is
contraindicated because rubella can cause serious teratogenic effects. Varivax is
contraindicated during pregnancy.
3. A 4-year-old child is receiving amoxicillin (Amoxil) to treat otitis media and is in
the clinic for a well-child checkup on the last day of antibiotic therapy. The
provider orders varicella (Varivax); mumps, measles, and rubella (MMR);
inactivated polio (IPV); and diphtheria, tetanus, and acellular pertussis (DTaP)
vaccines to be given. Which action by the nurse is correct?
a.
Administer the vaccines as ordered.
b.
Discuss giving the MMR vaccine in 4 weeks.
c.
Hold all vaccines until 2 weeks after antibiotic therapy.
d.
Recommend aspirin for fever and discomfort. correct answer ANS: A
Antibiotic therapy is not generally a contraindication to the use of vaccines.
Vaccines may be given in cases of mild acute illness or during the convalescent
phase of an illness. All four vaccines may be given. If the MMR or other live virus
vaccine is not given the same day as the varicella vaccine, administration of the
, two vaccines should be separated by at least 4 weeks. Aspirin should not be given
because of the increased risk of Reye's syndrome.
4. A patient is preparing to travel with a 4-year-old child to India in 10 days and is
in the clinic to receive typhoid vaccines. Which vaccines will be given to the
parent and child?
a.
Four capsules of live, oral vaccine to both patients
b.
Four capsules of live, oral vaccine for the parent and the IM polysaccharide
vaccine for the child
c.
Four capsules of live, oral vaccine for the child and the IM polysaccharide vaccine
for the parent
d.
IM polysaccharide for both patients correct answer ANS: D
While the live, oral vaccine may be given to patients older than 6 years, each
capsule must be taken 48 hours apart with the last capsule given 1 week prior to
travel. There would not be enough time to complete the regimen since the
patients leave in 10 days. Children under age 6 cannot receive the oral vaccine.
5. A 48-month-old child is scheduled to receive the following vaccines: MMR,
Varivax, IPV, and DTaP. The child's parents want the child to receive two vaccines
today and the other two in 1 week. To accommodate the parents' wishes, the
nurse will administer
a.
the DTaP and Varivax today and the MMR and IPV in 1 week.
b.