Midterm Exam: NR 602/ NR602 (Latest 2025/ 2026
Update) Primary Care of the Childbearing and
Childrearing Family Guide| Questions & Answers|
Grade A| 100% Correct (Verified Solutions)-
Chamberlain
NR602 Midterm
pediatric NP
health promotion, protection, and disease prevention
Primary care NP
well childcare and prevention and/or management of both common pediatric acute illness and
any childhood diseases.
Acute care NP
acute, chronic, or critically ill children. Unstable, experiencing life-threatening illness, medically
fragile and tech dependent.
Primary prevention
keep diseases from being established. Eliminate cause or increase people's resistance. 2 types of
primary prevention are health promotion and specific protection. Health promotion includes
efforts, including lifestyle changes/choices, nutrition, and maintenance of safe environments.
Specific protection involves actions targeted at specific diseases, such as immunizations, anti-
malarial prophylaxis, and environmental modifications (such as fluoride).
secondary prevention
early diagnosis and prompt treatment- interrupt disease process- screening early detection and
prompt treatment. Goal is to eliminate or reduce symptoms/progression..
Tertiary care
,requires both specialized expertise and equipment. Goal improves survival and quality of life.
There are 2 types: 1) disability limitation-early symptom management 2) rehabilitation- late
symptom management.
Quaternary care
highly specialized expertise and highly unusual or specialized equipment
Barriers to vaccination
patients feel vaccines are unsafe, may cause autism, overload or weaken a child's immune
system, or are traumatic for the child. Parents may feel there is a lack of concern about the
diseases that are being prevented. Poverty was a factor, as was a lack of education.
How to encourage parents to get vaccines for their kids
• Acknowledge and respect the trusted relationship between provider and parent.
• Communicatjm0h e a strong shared commitment with the parent to the health and well-being of
their child.
• Listen to and query parents' reasons for refusing or delaying vaccines; not all vaccine-hesitant
individuals have the same concerns.
• Be familiar with misconceptions and controversies regarding vaccines and be prepared to
address them (e.g., thimerosal-free vaccines).
• Emphasize the safety of vaccines, the extensive testing before licensure, and the post-licensure
safety surveillance programs. Explain the serious consequences of not vaccinating.
• Educate the family about the safety of multiple vaccines to be given simultaneously. Mention
that a healthy infant's/child's immune system capably fights off an estimated 2000 to 6000 germs
(antigens) daily when playing, eating, and breathing. The number of antigens in any combination
of vaccines on the current schedule is much lower than the daily exposure to many substances
(150 antigens for the entire Advisory Committee on Immunization
live vaccine
an attenuated form of the virus that induces immunity but does not produce disease. Broader and
longer-lived immunity. Common fever and rash. This means the immune system has responded
appropriately. Do not give before 1 year of age. When you give live attenuated vaccines, you
,must give both on the same day or you have to wait 4 weeks to give the second one or neither
will be effective. NOT TO BE GIVEN WHILE PREGNANT OR 28 days prior to being preg.
● Precautions- pay close attention when giving immunocompromised indv live vaccine.
Recommendations differ according to condition.
● Measles mump rubella-trivalent vaccine.MMR (2 doses, starting age 12mos)- after
receiving 2 vaccines, efficacy is 98%. S/E rash, high fever 5-12 days after the vaccine. If given
varicella in the quad valiant, the chance of seizures is 2-fold. It is reduced by giving at the same
time and in different spots. NOT TO BE GIVEN WHILE PREGNANT OR 28 days prior to
being preg.
Vaccines
Varicella(2 doses)- 98% efficacy after the 2nd dose. Severe cases have become uncommon.
● Rotavirus(2 doses)- side effect and contraindication could be intussusception. (an exception to
the rule to not give before age 1).
● Smallpox(0)- irradicated.
● Passive immunization Involves administering an exogenous antibody such as immunoglobulin
○ Immunoglobulins:
■ ***Respiratory Syncytial Virus Prophylaxis (RSV)
■ Palivizumab (Synagis) is the only product on the American market for use in infants at high
risk for adverse outcomes from respiratory syncytial virus (RSV) infection
■ Given IM, and is a humanized mouse monoclonal antibody, given in 5 monthly IM injections
during RSV season (usu Nov- march or april)
■ and effective in reducing RSV hospitalizations in high-risk infants by 39% to 82%
■ Consider RSV Prophylaxis:
● Infants born 29 wks and 0 days of gestation during RSV season until 12 months old
● Children born prematurely at or before 32 weeks and 0 days of gestation who are younger than
2 years old with chronic lung disease (CLD) and who required treatment for their CLD within 6
months of the onset of RSV season (including oxygen therapy); prophylaxis can be given to 2-
year-old children with CLD of prematurity who continue to require medical support during the 6
months prior to the onset of RSV season
● Infants up to 12 months old with hemodynamically significant cyanotic or complicated
, congenital heart disease
● Infants up to 12 months old with neuromuscular disorder or congenital anomalies that
compromise clearing of respiratory secretions
killed (inactivated) vaccine
Killed and inactivated vaccines provide systemic protection (immune globulin G [IgG]
antibodies). Still, they may fail to trigger local mucosal antibody (immune globulin A [IgA])
production, resulting in local colonization or infection that can be a problem during an epidemic.
The inactivate vaccines include diphtheria-tetanus-pertussis, polio, Hib, hepatitis A, hepatitis B,
human papillomavirus, meningococcus, and pneumococcus.
Common side effects- common side effects-mild to moderate fever and/or local swelling, pain,
and erythema, usually within the first 24 to 72 hours (e.g., to DTaP, tetanus-diphtheria [Td], or
tetanus-diphtheria-acellular pertussis [Tdap], Hib conjugate, hepatitis B virus [HBV],
pneumococcal conjugate [PCV-13]; AAP et al., 2015b). Concerned about allergic reaction.
TDAP, meningococcal and HPV- Common reaction syncope. Systemic reaction.
Common side effects of the meningococcal vaccine can also include headache and irritability.
DtAP (4 doses)-Diphtheria-Tetanus-Acellular Pertussis Vaccine
given younger ages than 7. Pertussis is not long-acting and needs to be given multiple times.
TDAP is given multiple times throughout life, even to the elderly.
● The adult version is actually recommended antenatal vaccination at 27-36 weeks (third
trimester) pregnant (Tdap),
■ Tdap is also a booster vaccine recommended to get every 10yrs as an adult.
Polio (4 doses)
inactivated only available in the US. CDC recommendations are for immunocompromised
individuals. It used to be live, no longer.
Haemophilus influenzae Type B Vaccine(3 doses)
causes pneumonia, bacteremia, meningitis, epiglottitis, septic arthritis, cellulitis, otitis media,
purulent pericarditis, and other less common infections in children under age 4. Rates
significantly decreased due to immunization
Update) Primary Care of the Childbearing and
Childrearing Family Guide| Questions & Answers|
Grade A| 100% Correct (Verified Solutions)-
Chamberlain
NR602 Midterm
pediatric NP
health promotion, protection, and disease prevention
Primary care NP
well childcare and prevention and/or management of both common pediatric acute illness and
any childhood diseases.
Acute care NP
acute, chronic, or critically ill children. Unstable, experiencing life-threatening illness, medically
fragile and tech dependent.
Primary prevention
keep diseases from being established. Eliminate cause or increase people's resistance. 2 types of
primary prevention are health promotion and specific protection. Health promotion includes
efforts, including lifestyle changes/choices, nutrition, and maintenance of safe environments.
Specific protection involves actions targeted at specific diseases, such as immunizations, anti-
malarial prophylaxis, and environmental modifications (such as fluoride).
secondary prevention
early diagnosis and prompt treatment- interrupt disease process- screening early detection and
prompt treatment. Goal is to eliminate or reduce symptoms/progression..
Tertiary care
,requires both specialized expertise and equipment. Goal improves survival and quality of life.
There are 2 types: 1) disability limitation-early symptom management 2) rehabilitation- late
symptom management.
Quaternary care
highly specialized expertise and highly unusual or specialized equipment
Barriers to vaccination
patients feel vaccines are unsafe, may cause autism, overload or weaken a child's immune
system, or are traumatic for the child. Parents may feel there is a lack of concern about the
diseases that are being prevented. Poverty was a factor, as was a lack of education.
How to encourage parents to get vaccines for their kids
• Acknowledge and respect the trusted relationship between provider and parent.
• Communicatjm0h e a strong shared commitment with the parent to the health and well-being of
their child.
• Listen to and query parents' reasons for refusing or delaying vaccines; not all vaccine-hesitant
individuals have the same concerns.
• Be familiar with misconceptions and controversies regarding vaccines and be prepared to
address them (e.g., thimerosal-free vaccines).
• Emphasize the safety of vaccines, the extensive testing before licensure, and the post-licensure
safety surveillance programs. Explain the serious consequences of not vaccinating.
• Educate the family about the safety of multiple vaccines to be given simultaneously. Mention
that a healthy infant's/child's immune system capably fights off an estimated 2000 to 6000 germs
(antigens) daily when playing, eating, and breathing. The number of antigens in any combination
of vaccines on the current schedule is much lower than the daily exposure to many substances
(150 antigens for the entire Advisory Committee on Immunization
live vaccine
an attenuated form of the virus that induces immunity but does not produce disease. Broader and
longer-lived immunity. Common fever and rash. This means the immune system has responded
appropriately. Do not give before 1 year of age. When you give live attenuated vaccines, you
,must give both on the same day or you have to wait 4 weeks to give the second one or neither
will be effective. NOT TO BE GIVEN WHILE PREGNANT OR 28 days prior to being preg.
● Precautions- pay close attention when giving immunocompromised indv live vaccine.
Recommendations differ according to condition.
● Measles mump rubella-trivalent vaccine.MMR (2 doses, starting age 12mos)- after
receiving 2 vaccines, efficacy is 98%. S/E rash, high fever 5-12 days after the vaccine. If given
varicella in the quad valiant, the chance of seizures is 2-fold. It is reduced by giving at the same
time and in different spots. NOT TO BE GIVEN WHILE PREGNANT OR 28 days prior to
being preg.
Vaccines
Varicella(2 doses)- 98% efficacy after the 2nd dose. Severe cases have become uncommon.
● Rotavirus(2 doses)- side effect and contraindication could be intussusception. (an exception to
the rule to not give before age 1).
● Smallpox(0)- irradicated.
● Passive immunization Involves administering an exogenous antibody such as immunoglobulin
○ Immunoglobulins:
■ ***Respiratory Syncytial Virus Prophylaxis (RSV)
■ Palivizumab (Synagis) is the only product on the American market for use in infants at high
risk for adverse outcomes from respiratory syncytial virus (RSV) infection
■ Given IM, and is a humanized mouse monoclonal antibody, given in 5 monthly IM injections
during RSV season (usu Nov- march or april)
■ and effective in reducing RSV hospitalizations in high-risk infants by 39% to 82%
■ Consider RSV Prophylaxis:
● Infants born 29 wks and 0 days of gestation during RSV season until 12 months old
● Children born prematurely at or before 32 weeks and 0 days of gestation who are younger than
2 years old with chronic lung disease (CLD) and who required treatment for their CLD within 6
months of the onset of RSV season (including oxygen therapy); prophylaxis can be given to 2-
year-old children with CLD of prematurity who continue to require medical support during the 6
months prior to the onset of RSV season
● Infants up to 12 months old with hemodynamically significant cyanotic or complicated
, congenital heart disease
● Infants up to 12 months old with neuromuscular disorder or congenital anomalies that
compromise clearing of respiratory secretions
killed (inactivated) vaccine
Killed and inactivated vaccines provide systemic protection (immune globulin G [IgG]
antibodies). Still, they may fail to trigger local mucosal antibody (immune globulin A [IgA])
production, resulting in local colonization or infection that can be a problem during an epidemic.
The inactivate vaccines include diphtheria-tetanus-pertussis, polio, Hib, hepatitis A, hepatitis B,
human papillomavirus, meningococcus, and pneumococcus.
Common side effects- common side effects-mild to moderate fever and/or local swelling, pain,
and erythema, usually within the first 24 to 72 hours (e.g., to DTaP, tetanus-diphtheria [Td], or
tetanus-diphtheria-acellular pertussis [Tdap], Hib conjugate, hepatitis B virus [HBV],
pneumococcal conjugate [PCV-13]; AAP et al., 2015b). Concerned about allergic reaction.
TDAP, meningococcal and HPV- Common reaction syncope. Systemic reaction.
Common side effects of the meningococcal vaccine can also include headache and irritability.
DtAP (4 doses)-Diphtheria-Tetanus-Acellular Pertussis Vaccine
given younger ages than 7. Pertussis is not long-acting and needs to be given multiple times.
TDAP is given multiple times throughout life, even to the elderly.
● The adult version is actually recommended antenatal vaccination at 27-36 weeks (third
trimester) pregnant (Tdap),
■ Tdap is also a booster vaccine recommended to get every 10yrs as an adult.
Polio (4 doses)
inactivated only available in the US. CDC recommendations are for immunocompromised
individuals. It used to be live, no longer.
Haemophilus influenzae Type B Vaccine(3 doses)
causes pneumonia, bacteremia, meningitis, epiglottitis, septic arthritis, cellulitis, otitis media,
purulent pericarditis, and other less common infections in children under age 4. Rates
significantly decreased due to immunization
