NR 328 Peds Exam Question Bank / NR328 Peds Exam Question Bank: Pediatric Nursing:
Chamberlain College of Nursing
CHAPTER 6: Childhood Communicable and Infectious Diseases
MULTIPLE CHOICE
1. Pertussis vaccination should begin at which age?
a. Birth
b. 2 months
c. 6 months
d. 12 months
ANS: B
The acellular pertussis vaccine is recommended by the American Academy of Pediatrics beginning at age 6 weeks.
Infants are at greater risk for complications of pertussis. The vaccine is not given after age 7 years, when the risks of
the vaccine become greater than those of pertussis. The first dose is usually given at the 2-month well-child visit.
Infants are highly susceptible to pertussis, which can be a life-threatening illness in this age group.
DIF: Cognitive Level: Understanding REF: p. 209
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
2. A mother tells the nurse that she does not want her infant immunized because of the discomfort associated
with injections. What should the nurse explain?
,a. This cannot be prevented.
b. Infants do not feel pain as adults do.
c. This is not a good reason for refusing immunizations.
d. A topical anesthetic can be applied before injections are given.
ANS: D
To minimize the discomfort associated with intramuscular injections, a topical anesthetic agent can be used on the
injection site. These include EMLA (eutectic mixture of local anesthetic) and vapor coolant sprays.Pain associated
with many procedures can be prevented or minimized by using the principles of atraumatic care. Infants have
neural pathways that will indicate pain. Numerous research studies have indicated that infants perceive and react to
pain in the same manner as do children and adults. The mother should be allowed to discuss her concerns and the
alternatives available. This is part of the informed consent process.
DIF: Cognitive Level: Analyzing REF: p. 207
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
3. A 4-month-old infant comes to the clinic for a well-infant checkup. Immunizations she should receive are
DTaP (diphtheria, tetanus, acellular pertussis) and IPV (inactivated poliovirus vaccine).She is recovering
from a cold but is otherwise healthy and afebrile. Her older sister has cancer and is receiving chemotherapy.
Nursing considerations should include which?
,a. DTaP and IPV can be safely given.
b. DTaP and IPV are contraindicated because she has a cold.
c. IPV is contraindicated because her sister is immunocompromised.
d. DTaP and IPV are contraindicated because her sister is immunocompromised.
ANS: A
These immunizations can be given safely. Serious illness is a contraindication. A mild illness with or without
fever is not a contraindication.These are not live vaccines, so they do not pose a risk to her sister.
DIF: Cognitive Level: Analyzing REF: p. 202
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
4. Which serious reaction should the nurse be alert for when administering vaccines?
a. Fever
b. Skin irritation
c. Allergic reaction
d. Pain at injection site
, ANS: C
Each vaccine administration carries the risk of an allergic reaction. The nurse must be prepared to intervene if the
child demonstrates signs of a severe reaction. Mild febrile reactions do occur after administration. The nurse
includes management of fever in the parent teaching. Local skin irritation may occur at the injection site after
administration. Parents are informed that this is expected. The injection can be painful. The nurse can minimize the
discomfort with topical analgesics and nonpharmacologic measures.
DIF: Cognitive Level: Understanding REF: p. 209 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
5. Which muscle is contraindicated for the administration of immunizations in infants and young children?
a. Deltoid
b. Dorsogluteal
c. Ventrogluteal
d. Anterolateral thigh
ANS: B
Chamberlain College of Nursing
CHAPTER 6: Childhood Communicable and Infectious Diseases
MULTIPLE CHOICE
1. Pertussis vaccination should begin at which age?
a. Birth
b. 2 months
c. 6 months
d. 12 months
ANS: B
The acellular pertussis vaccine is recommended by the American Academy of Pediatrics beginning at age 6 weeks.
Infants are at greater risk for complications of pertussis. The vaccine is not given after age 7 years, when the risks of
the vaccine become greater than those of pertussis. The first dose is usually given at the 2-month well-child visit.
Infants are highly susceptible to pertussis, which can be a life-threatening illness in this age group.
DIF: Cognitive Level: Understanding REF: p. 209
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
2. A mother tells the nurse that she does not want her infant immunized because of the discomfort associated
with injections. What should the nurse explain?
,a. This cannot be prevented.
b. Infants do not feel pain as adults do.
c. This is not a good reason for refusing immunizations.
d. A topical anesthetic can be applied before injections are given.
ANS: D
To minimize the discomfort associated with intramuscular injections, a topical anesthetic agent can be used on the
injection site. These include EMLA (eutectic mixture of local anesthetic) and vapor coolant sprays.Pain associated
with many procedures can be prevented or minimized by using the principles of atraumatic care. Infants have
neural pathways that will indicate pain. Numerous research studies have indicated that infants perceive and react to
pain in the same manner as do children and adults. The mother should be allowed to discuss her concerns and the
alternatives available. This is part of the informed consent process.
DIF: Cognitive Level: Analyzing REF: p. 207
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
3. A 4-month-old infant comes to the clinic for a well-infant checkup. Immunizations she should receive are
DTaP (diphtheria, tetanus, acellular pertussis) and IPV (inactivated poliovirus vaccine).She is recovering
from a cold but is otherwise healthy and afebrile. Her older sister has cancer and is receiving chemotherapy.
Nursing considerations should include which?
,a. DTaP and IPV can be safely given.
b. DTaP and IPV are contraindicated because she has a cold.
c. IPV is contraindicated because her sister is immunocompromised.
d. DTaP and IPV are contraindicated because her sister is immunocompromised.
ANS: A
These immunizations can be given safely. Serious illness is a contraindication. A mild illness with or without
fever is not a contraindication.These are not live vaccines, so they do not pose a risk to her sister.
DIF: Cognitive Level: Analyzing REF: p. 202
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
4. Which serious reaction should the nurse be alert for when administering vaccines?
a. Fever
b. Skin irritation
c. Allergic reaction
d. Pain at injection site
, ANS: C
Each vaccine administration carries the risk of an allergic reaction. The nurse must be prepared to intervene if the
child demonstrates signs of a severe reaction. Mild febrile reactions do occur after administration. The nurse
includes management of fever in the parent teaching. Local skin irritation may occur at the injection site after
administration. Parents are informed that this is expected. The injection can be painful. The nurse can minimize the
discomfort with topical analgesics and nonpharmacologic measures.
DIF: Cognitive Level: Understanding REF: p. 209 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
5. Which muscle is contraindicated for the administration of immunizations in infants and young children?
a. Deltoid
b. Dorsogluteal
c. Ventrogluteal
d. Anterolateral thigh
ANS: B
