NR 328 PEDS TEST #1 STUDY EXAM
QUESTIONS AND ANSWERS
What age group should receive the Hep A vaccine? - ANSWER-First dose is given at
12 months of age, then second 6 to 12 months after the first dose.
When should dosing start for the HPV vaccine? - ANSWER-Before the patient
becomes sexually active. 9 years of age is the recommendation according to the
power point.
How are HPV doses scheduled out? - ANSWER-The first is given, the second is
given 2 months after (minimum is 4 weeks between 1st and 2nd dose), then 6
months.
What are some common side effects of the HPV vaccine? - ANSWER-Pain, swelling,
erythema, pruritus and fever, dizziness after injection
What are some potential reactions to an HPV vaccine administration? - ANSWER-
HA, Gastroenteritis, bronchospasm, asthma, arthritis.
How is the meningococcal vaccine given and when? - ANSWER--IM injection
-This is a one time dose usually given either at 11-12 (before entering HS) or before
entering college.
What are the contraindications for the meningococcal vaccine? - ANSWER-Hx of
Guillain Barre Syndrome
How is the pneumococcal vaccine given and at what ages? - ANSWER--IM
-Given at 2,4,6, and 12 to 15 months of age
How is the rotavirus vaccine given and at what ages? - ANSWER--It's an oral
vaccine
- Given at 2, 4, and 6 months
What are the possible serious adverse effects of the rotavirus vaccine? - ANSWER--
Seizure
-Bronchiolitis
-Gastroenteritis
-Pneumonia
-Fever
-UTI
What is the defining characteristic for identification of varicella (Chickenpox)? -
ANSWER-Vesicles and papules that with severe pruritus; these are relatively
profuse on the trunk and arms and sparse on the lower extremeties in most cases
How is varicella spread? - ANSWER-Direct contact, isolation, contact c
contamminated objects
,What is the communicability of varicella? - ANSWER-1 day prior to appearance of
the lesions to six days after their appearance. If the lesions are scabbed over they
are no longer considered contagious.
-Incubation period is 10-21 days
What are some nursing interventions for varicella infected individuals? - ANSWER--
Immunoglobulin in high risk children
-Acyclovir for immunocompromised kids
-Diphenhydramine and calamine lotion for itching
-Keep fingernails trimmed to avoid bleeding while scratching, or use mittens.
-Avoid aspirin (as always) to avoid the risk of Reye's syndrome.
What is another term for Rubeola? - ANSWER-Measles
What is the defining characteristic for identification of rubeola? - ANSWER--Koplik
spots; located on the buccal mucosa
-Body rash of maculopapules that begins and hairline and spreads down, turning
brown in color.
How is rubeola spread? - ANSWER-It's viral and spread through droplet and direct
contact
What are the RN interventions for rubeola? - ANSWER--Isolate the patient until after
the 5th day of the rash.
-Administer antipyretics
-Keep eyelids clean and the child from rubbing them.
-Encourage fluids and soft/bland foods
What does the paramyxovirus cause? - ANSWER-Mumps
How is paramyxovirus spread? - ANSWER-Direct contact and droplet
What is the defining characteristic for identification of paramyxovirus? - ANSWER-
The patient gets a very swollen neck area (Like a large waddle or huge double chin)
What are some assessment findings with a paramyxovirus patient? - ANSWER--
Swollen neck
-Fever
-HA
-Malaise
-Acute anorexia usually lasting 24 hours
-Earaches that worsen with chewing
-Swollen and tender/painful parotid glands
What are some nursing interventions for paramyxovirus? - ANSWER--Fluid
replacement to combat dehydration from anorexia
-Pain management
-Soft foods that are easy to swallow
-Hot/Cold compress for neck
, What is whooping cough? - ANSWER-Pertussis (Bordetella Pertussis)
What are some important developmental milestones for a 9 month old? - ANSWER--
Imitates speech sounds you make
-Can pull self up to standing
-Is able to hold bottle with both hands while feeding.
What are some important developmental milestones for a 10 month old? -
ANSWER--Understands single words like "bye bye" and "night night".
-Sidesteps around furniture while holding on
What are some important developmental milestones for a 11 month old? -
ANSWER--Uses mama and dada specifically for parent
-Stands alone well
-Can pick up a spoon by the handle
What are some important developmental milestones for a 1 year old? - ANSWER--
Can say one word clearly
-Climbs on chairs or other furnature and can walk with one hand being held for
assistance
-Can transition to "sippy cup" and milk instead of bottle and formula
-They cooperate with dressing and can remove socks, hold out their foot for shoe or
arm for sleeves and assist by pushing legs or arms through the clothings.
Where is the recommended area for IM injections for children <12 months old? -
ANSWER-Anterolateral thigh
Where is the recommended area for IM injections in a child that is 12 months old or
more? - ANSWER-The deltoid although the ventrogluteal site is an option if
completely necessary
What are the 3 live vaccines given? - ANSWER-MMR, Varicella, and Rotavirus
What ages is the MMR given? - ANSWER-(1): 12-15 months
(2): 4-6 years
Can an MMR be given at the same time as other vaccinations? - ANSWER-Yes, but
in different sites.
Is the MMR IM or SubQ? - ANSWER-Subcutaneous Injection in most cases (of
about 0.5 mL)
What are some contraindications for an MMR vaccine? - ANSWER--Hx of
hypersensitivity/anaphylaxis to neomycin or eggs.
-Those with known altered immunodeficiency and pregnant women.
*NOTE:* This vaccine CAN be given to HIV+ individuals
What is the DTaP vaccine? - ANSWER-Diphtheria, pertussis, tetanus.
QUESTIONS AND ANSWERS
What age group should receive the Hep A vaccine? - ANSWER-First dose is given at
12 months of age, then second 6 to 12 months after the first dose.
When should dosing start for the HPV vaccine? - ANSWER-Before the patient
becomes sexually active. 9 years of age is the recommendation according to the
power point.
How are HPV doses scheduled out? - ANSWER-The first is given, the second is
given 2 months after (minimum is 4 weeks between 1st and 2nd dose), then 6
months.
What are some common side effects of the HPV vaccine? - ANSWER-Pain, swelling,
erythema, pruritus and fever, dizziness after injection
What are some potential reactions to an HPV vaccine administration? - ANSWER-
HA, Gastroenteritis, bronchospasm, asthma, arthritis.
How is the meningococcal vaccine given and when? - ANSWER--IM injection
-This is a one time dose usually given either at 11-12 (before entering HS) or before
entering college.
What are the contraindications for the meningococcal vaccine? - ANSWER-Hx of
Guillain Barre Syndrome
How is the pneumococcal vaccine given and at what ages? - ANSWER--IM
-Given at 2,4,6, and 12 to 15 months of age
How is the rotavirus vaccine given and at what ages? - ANSWER--It's an oral
vaccine
- Given at 2, 4, and 6 months
What are the possible serious adverse effects of the rotavirus vaccine? - ANSWER--
Seizure
-Bronchiolitis
-Gastroenteritis
-Pneumonia
-Fever
-UTI
What is the defining characteristic for identification of varicella (Chickenpox)? -
ANSWER-Vesicles and papules that with severe pruritus; these are relatively
profuse on the trunk and arms and sparse on the lower extremeties in most cases
How is varicella spread? - ANSWER-Direct contact, isolation, contact c
contamminated objects
,What is the communicability of varicella? - ANSWER-1 day prior to appearance of
the lesions to six days after their appearance. If the lesions are scabbed over they
are no longer considered contagious.
-Incubation period is 10-21 days
What are some nursing interventions for varicella infected individuals? - ANSWER--
Immunoglobulin in high risk children
-Acyclovir for immunocompromised kids
-Diphenhydramine and calamine lotion for itching
-Keep fingernails trimmed to avoid bleeding while scratching, or use mittens.
-Avoid aspirin (as always) to avoid the risk of Reye's syndrome.
What is another term for Rubeola? - ANSWER-Measles
What is the defining characteristic for identification of rubeola? - ANSWER--Koplik
spots; located on the buccal mucosa
-Body rash of maculopapules that begins and hairline and spreads down, turning
brown in color.
How is rubeola spread? - ANSWER-It's viral and spread through droplet and direct
contact
What are the RN interventions for rubeola? - ANSWER--Isolate the patient until after
the 5th day of the rash.
-Administer antipyretics
-Keep eyelids clean and the child from rubbing them.
-Encourage fluids and soft/bland foods
What does the paramyxovirus cause? - ANSWER-Mumps
How is paramyxovirus spread? - ANSWER-Direct contact and droplet
What is the defining characteristic for identification of paramyxovirus? - ANSWER-
The patient gets a very swollen neck area (Like a large waddle or huge double chin)
What are some assessment findings with a paramyxovirus patient? - ANSWER--
Swollen neck
-Fever
-HA
-Malaise
-Acute anorexia usually lasting 24 hours
-Earaches that worsen with chewing
-Swollen and tender/painful parotid glands
What are some nursing interventions for paramyxovirus? - ANSWER--Fluid
replacement to combat dehydration from anorexia
-Pain management
-Soft foods that are easy to swallow
-Hot/Cold compress for neck
, What is whooping cough? - ANSWER-Pertussis (Bordetella Pertussis)
What are some important developmental milestones for a 9 month old? - ANSWER--
Imitates speech sounds you make
-Can pull self up to standing
-Is able to hold bottle with both hands while feeding.
What are some important developmental milestones for a 10 month old? -
ANSWER--Understands single words like "bye bye" and "night night".
-Sidesteps around furniture while holding on
What are some important developmental milestones for a 11 month old? -
ANSWER--Uses mama and dada specifically for parent
-Stands alone well
-Can pick up a spoon by the handle
What are some important developmental milestones for a 1 year old? - ANSWER--
Can say one word clearly
-Climbs on chairs or other furnature and can walk with one hand being held for
assistance
-Can transition to "sippy cup" and milk instead of bottle and formula
-They cooperate with dressing and can remove socks, hold out their foot for shoe or
arm for sleeves and assist by pushing legs or arms through the clothings.
Where is the recommended area for IM injections for children <12 months old? -
ANSWER-Anterolateral thigh
Where is the recommended area for IM injections in a child that is 12 months old or
more? - ANSWER-The deltoid although the ventrogluteal site is an option if
completely necessary
What are the 3 live vaccines given? - ANSWER-MMR, Varicella, and Rotavirus
What ages is the MMR given? - ANSWER-(1): 12-15 months
(2): 4-6 years
Can an MMR be given at the same time as other vaccinations? - ANSWER-Yes, but
in different sites.
Is the MMR IM or SubQ? - ANSWER-Subcutaneous Injection in most cases (of
about 0.5 mL)
What are some contraindications for an MMR vaccine? - ANSWER--Hx of
hypersensitivity/anaphylaxis to neomycin or eggs.
-Those with known altered immunodeficiency and pregnant women.
*NOTE:* This vaccine CAN be given to HIV+ individuals
What is the DTaP vaccine? - ANSWER-Diphtheria, pertussis, tetanus.
