Practice Quiz: Chapter 18 Immunological and Infectious Conditions Maternal child Flashcards

A student nurse learning about medication classes and administration correctly identifies which of the following medications as the most common to cause a reaction in older children and teens?

A. Penicillins

B. NSAIDs

C. Narcotics

D. Macrolides

A nurse teaching a group of nursing students about cytomegalovirus (CMV) in the pediatric population knows further remediation is needed based on which statement? Select all that apply.

A. Transmission is prevented with proper hand washing.”

B. “CMV is highly contagious.”

C. “CMV is a herpes virus.”

D. “CMV has symptoms similar to mononucleosis.”

E. “Hospitalized children with CMV should be on droplet precautions."

An 18-year-old female presents with cutaneous vesicular lesions on the upper right area. She describes the area as painful and itchy 1-2 days before the lesions appeared. Which question is most important when taking a history?

A. “Are you up-to-date with all immunizations?”

B. “Have you had chickenpox?”

C. “What have you done to treat it?”

D. “Do you have any allergies?”

A 10-year-old child is in the health-care provider’s office for a well-child check. Before bringing the child to the exam room, the nurse reviews the patient chart and noticed the child has a previous diagnosis of dermatomyositis. The nurse may notice all of the following signs and symptoms of this disorder except:

A. Muscle weakness

B. Butterfly rash

C. Dysphagia

D. Poor wound healing

A student nurse needs further remediation based on which statement regarding infectious diseases in children? Select all that apply.

A. “A fever is the most common early symptom of a fungal infection.”

B. “Pruritus is a potential risk for a secondary infection from an infectious disease.”

C.“Aspirin should be avoided for fevers.”

D. “Warm mist humidifiers should be used for symptomatic relief of respiratory infections.”

E. “Younger children are more susceptible to infections than older children.”

The mother of an unvaccinated 4-year-old child calls the health-care provider’s office with concerns that the child was exposed to another child 2 days ago who has been diagnosed with Varicella. Which statement by the nurse is appropriate?

A. If the child contracted the disease, symptoms should appear within the next 5-7 days.”

B. “If the child receives the vaccine today, their symptoms if the disease was contracted will be lessened and the child will have immunity for future exposures.”

C.“If the child has contracted the disease, the first symptoms will be a pruritic rash on the face and trunk.”

D. “Children are contagious for a couple of days before any lesions erupt.”

A nurse caring for a newborn born to an HIV-positive mother discharged the infant to home on trimethoprim sulfamethoxazole. Within 48 hours, the mother brings the infant to the ER for vomiting, diarrhea, and red blistering rash. The infant is admitted to the pediatric intensive care unit. What is the anticipated treatment for this complication?

A. Intravenous immune globulin

B. Bactrim

C. Benadryl

D. AZT

A nurse caring for a child experiencing anaphylaxis from administration of a medication may see all of the following as a result of the anaphylaxis except?

A. Bronchospasm

B. Vasoconstriction

C.Hypotension

D. Laryngeal constrictionNext

A nursing instructor teaching a group of students about primary immunodeficiency disorders. The instructor provides remediation when the students identify which of the following associated with combined T- and B-cell disorders? Select all that apply.

A. Infections that arise after 6 months of age

B. Recurrent candidiasis

C. Toxoplasma gondii

D. Osteomyelitis

E. Failure to thrive

Aiden, the 4-year-old boy in the picture, presents to the health-care provider’s office. Per the mother’s report, Aiden had a mild to moderate fever that started about 4 days ago that today has reached 104.1°F. With the fever, he also has had a runny nose and mild cough off and on over the past 4 days. Upon assessment, the nurse notices tiny spots with red base on his buccal mucosa. The mother states, “I noticed the spots a day or two ago.” The nurse suspects that Aiden has which of the following?

A. Roseola

B. Rubeola

C. Chickenpox

D. Systemic Lupus Erythematosus (SLE)

Which of the following would result in a potential break in the child’s primary defense against infection? Select all that apply.

A. Peripheral IV

B.Proton-pump inhibitor medication administration

C. Corticosteroid administration

D. Suture surgical wound

E. Vomiting

A woman in labor presents to the labor and delivery unit. The mother was diagnosed with HIV during prenatal screening and has been taking AZT for the last 3 months. The pediatric nurse is called to the delivery unit to care for the newborn when born. The nurse knows which risk factors increase the likelihood of perinatal HIV transmission to the infant? Select all that apply.

A. Increased maternal CD4 count

B. Birth postdue dates

C. Advanced maternal age

D. Vaginal birth

E. High maternal viral load

A nurse working in the newborn nursery has just admitted a newborn of a known HIV-positive mother. Which nursing implications are appropriate when caring for the newborn? Select all that apply.

A. Assess for allergy to sulfonamides.

B. Obtain Western blot test within the first 48 hours of birth

C. Monitor serum bilirubin.

D. Implement contact precautions.

E. Strict I & Os

A child on long-term corticosteroids for treatment of a chronic illness is seen in the office for routine immunizations. Which immunization is contraindicated?

A. Hib

B. Inactive poliovirus

C. Tetanus toxoid

D. Smallpox

A nurse working in an allergy office is assisting with preparation for a 5-year-old to have skin allergy testing. Which medication does the nurse include in the preparation supplies to be set up?

A. Epinephrine

B. Prednisone

C. Albuterol

D. Narcan

The caregiver of a 17-year-old boy recently diagnosed with HIV states they do not believe the diagnosis because “he does not seem sick.” The caregiver further asks, “Is he going to die soon?” What is the nurse’s best response?

A.“Initially, CD4 levels may rise because of the body’s immune reaction so that may be why he does not seem sick.”

B.“He could have a latent period for up to 2 years until symptoms begin to be noticeable.”

C. “Children who are infected with the HIV virus between 13-25 years old survive longer than those infected later in life.”

D. “Symptoms will begin to appear once CD4 levels rise in response to his body’s immune response to the virus.”

An infant born to an HIV-positive mother is discharged home on prophylactic trimethoprim sulfamethoxazole. The infant weighs 22 pounds. The child is prescribed 150/30 q 12 hours. The medication is supplied as seen in the label. How much does the nurse administer per dose? Round to the tenths place. Give numeral only.

A nurse caring for an infant born to an HIV-positive mother knows which of the following are possible complications of an infant with HIV? Select all that apply.

A. Pneumocystis jiroveci pneumonia

B. Pain

C. Obesity

D. Malabsorption-induced immunodeficiency

E. Eczema

A 16-year-old girl presents to the health-care provider’s office with a rash on her face that looks like a butterfly across her nose and cheeks. She states she is concerned she might have lupus “because the rash looks just like a rash my mom has and she has SLE”. Which test does the nurse anticipate to rule out her concerns?

A.Antinuclear antibody

B. Lupus anticoagulant

C. Antiphospholipid antibodies

D. CBC with differential

A 16-year-old girl presents to the health-care provider’s office during an exacerbation of systemic lupus erythematosus (SLE). Based on the anticipated treatment, what should the nurse teach the child and parents? Select all that apply.

A.The medication should be taken for 14 days.

B.The child should not drive due to drowsiness.

C.Proper hand hygiene is crucial.

D.The medication should not be stopped abruptly.

E.Allow for down or alone time.

The nurse identifies all of the following as fungal infections except:

A. Tinea capitis

B. Histoplasmosis

C. Mononucleosis

D. Pneumocystis Jiroveci Pneumonia

The mother of a 2-year-old child is concerned about the side effects of the immunizations the child is to receive during the well-child visit while in the office today despite receiving all recommended immunizations at previous well-child visits. Which of the following is not an appropriate nursing action regarding immunizations?

A. Instruct to apply heat to help with pain at the injection site.

B. Administer acetaminophen prior to immunization administration.

C. Provide time for questions before immunization administration.

D. Administer the first hepatitis B vaccine in the series starting at this 2-year visit.

An HIV-positive mother of a 9-month-old calls the pediatric office nurse with concerns that her infant has HIV. When the mother explains the symptoms to the nurse, the nurse knows which signs and symptoms are consistent with HIV in infants? Select all that apply.

A. Swollen lymph nodes

B. Chronic diarrhea

C. Hypothermia

D. Thrush

E. Reflux

When teaching a class to a group of caregivers with children with HIV, the nurse should include information about which topics? Select all that apply.

A. Malnutrition

B. Obesity

C. Aggressive oral care

D. Immunizations

E. HAART

The mother of a child with known asthma and seasonal allergies asks the nurse which antibodies are most responsible for the child’s allergies. The nurse identifies which antibody?

A. IgG

B. IgM

C. IgE

D. IgA

The caregiver of a 14-month-old that has been seen by the health-care provider four times for illness since birth expresses concern the infant may have an immunodeficiency disorder making it more prone to infections. The nurse knows which of the following are warning signs associated with primary immunodeficiency? Select all that apply.

A.Failure to thrive

B. More than four ear infections per year

C. More than 3 months of antibiotics with little improvement

D. Pneumonia two or more times in 1 year

E. Continued yeast on the skin after 1 year of age

A nurse working in an allergy office is assisting with preparation for a 5-year-old to have skin allergy testing. Which medication does the nurse include in the preparation supplies to be set up?

A. Epinephrine

B. Prednisone

C. Albuterol

D. Narcan

A 2-year-old is seen in the office for a well-child check. The child was born to an HIV-positive mother, and the child has tested positive for HIV but has a high CD-4 count and is receiving antiretroviral therapy. The child is due for immunizations at this well-child visit. The nurse correctly administers which of the following vaccines? Select all that apply.

Pneumococcal vaccine

Meningococcal vaccine

MMR vaccine

Intranasal flu vaccine

OPV vaccine

A 3-year-old boy presents to the ER in anaphylaxis. The child has a known tree-nut allergy. While at a birthday party, the child likely ingested a food containing cashews. The nurse anticipates which of the following priority interventions? Select all that apply.

A. Apply oxygen therapy

B. Administer hypertonic IV fluids

C. Administer epinephrine IM

D. Administer antihistamines

E. Administer corticosteroids

A nurse is providing teaching to the mother of a child diagnosed with Fifth disease. Which teaching point is priority?

A.Avoid contact with pregnant women.

B.The rash may recur with heat exposure for up to 4 months.

C.Correct acetaminophen dosage.

D. Diagnosis can be made on clinical appearance.

A community nurse is providing outreach at a local health fair. The nurse focuses on West Nile virus since local cases have been on the rise. Prevention teaching should include which of the following? Select all that apply.

A. Apply a net to baby carriers when outdoors.

B. Apply repellant with DEET to exposed areas when outdoors.

C. Limit outdoor activity in spring and early summer.

D. Avoid use of bird baths in the yard.

E. Avoid use of DEET in children younger than 12 months.

An 8-month-old infant is seen in the outpatient clinic and diagnosed with otitis media. Last month, the child was diagnosed with a different virus, and the child has since recovered. The caregiver asks the nurse why children are vulnerable to getting sick. What is the nurse’s appropriate response? Select all that apply.

A. “Young children have greater susceptibility to infectious organisms until full development of immunoglobulin A.”

B. “Young children have immature endocrine glands making it harder for them to regulate body temperature.”

C. “Children have thin skin making it more likely to become irritated and invaded by microorganisms.”

D. “Only children who are not breastfed are more vulnerable to infections.”

E. “Antibodies are not fully developed until age 5.”

A young child was suspected of having pediatric HIV. However, the diagnostic test for HIV has returned negative. The nurse knows which immunodeficiency disorder mimics symptoms of HIV?

A. Hypogammaglobulinemia

B.Leukemia

C. Autosomal recessive congenital agammaglobulinemia

D. Severe combined immunodeficiency disease (SCID)

A 2-month-old is brought to the clinic for a well-child check. The child was born to a known HIV-positive mother with no prenatal care. The nurse informs the mother that the infant’s PCR test at 1 month was negative. How does the nurse explain the result to the mother?

A. “Since the infant was negative, the infant does not need further testing.”

B. “Since the infant was negative at 1 month, there is a very high likelihood HIV has not been transmitted to the child.”

C. “Since the infant was negative at 1 month, the ELISA test will be used for final confirmation of negative diagnosis.”

D. “Maternal antibodies will cause the PCR test to be negative for the first 18 months of life.”Next

When a child receives scheduled immunizations at a 2-year-old well-child check, this is an example of which type of immunity?

A. Innate

B. Adaptive

C.Passive

D. Acquired

An infection control nurse is teaching an in-service for staff regarding care measures when caring for children with MRSA. Which of the following should not be included in the in-service?

Wash hands with a chlorhexidine-soap solution

Place laundry in water-soluble bags and use designated waste bags

Use protective shoe coverings during patient care

Wear a mask when handling respiratory secretions.

When providing community education at an immunization clinic, which of the following would be least likely for the nurse to encourage receiving the influenza vaccine?

A 12-month-old infant born full-term.

A 5-year-old American Indian child.

A 15-year-old on long-term aspirin therapy.

A 35-year-old mother of two preteen children.

A nurse working in a health department is teaching a class about HIV and pregnancy. Which of the following does the nurse include in her teaching about HIV testing during pregnancy? Select all that apply.

A. All women are tested for HIV during initial prenatal testing.

B. At-risk women should wait to be tested during the third trimester.

C.If a woman in labor has not been previously tested during the pregnancy, prophylactic antiretroviral therapy should be started during labor.

D.A woman who tests HIV-negative during prenatal testing should be tested again during the third trimester if high-risk.

E. HIV transmission to a fetus from a positive mother is low if the mother takes antibiotic therapy throughout the pregnancy.

A child is being evaluated for Ehlers-Danos syndrome. Which criteria must be met for this diagnosis? Select all that apply.

Paula is a 39-year-old who has just given birth vaginally to a 35-week premature baby boy, Henry. Paula is HIV-positive and received prenatal care starting late in her second trimester of pregnancy. The birth was uneventful and Henry is now a few hours old and currently being bottle-fed and bonding with mom.

When caring for Henry, the nurse identifies which of the following as the functions of the primary line of defense against infection? Select all that apply.

Synthesis of vitamin D

IgM Immunoglobulins

Temperature regulation

Protection from deep tissue injury

Antibodies

Which of the following are risk factors for increased perinatal transmission of HIV to Henry? Select all that apply.

A.Paula is in an advanced stage of disease.

B.Paula has been on AZT therapy since seeking prenatal care.

C.Paula’s current viral load is low.

D.Paula has a high CD4⁺ count.

E. Henry is premature.

Paula is concerned she has transmitted HIV to Henry and asks the nurse, “How long will it take before I will know if Henry is sick with HIV?” Which of the following are correct responses from the nurse? Select all that apply.

A. “Due to maternal antibodies, testing in infants is different than testing in older children.”

B. “A negative DNA/RNA polymerase chain reaction confirms an HIV diagnosis.”

C.“Testing should be completed before Henry is 48 hours old, at age 1 to 2 months, and again at 3 to 6 months old.”

D.“Since you were taking AZT therapy, Henry is not at risk for developing HIV.”

E.“An enzyme-linked immunosorbent assay, or ELISA, test is the most accurate for identifying the presence of HIV antibodies.”

At Henry’s 6-month visit, the caregiver is informed that the most recent PCR test results are positive. The caregiver asks when they can expect to start seeing signs and symptoms of AIDS. The nurse’s appropriate response is which of the following statements?

A.“He has likely already been showing symptoms that you are unaware of, and hospice care will need to be implemented as soon as possible.”

B.“Henry will be started on highly active antiretroviral therapy, or HAART, immediately, which has a 99% remission rate, so he will live a normal life.”

C.“His CD4 levels will need to be monitored, as the body’s immune response may raise CD4 levels, known as helper T cells, creating a latent period that may last 10 years or more before the child becomes sick with symptoms of AIDS.”

D. “It is likely a false-positive result since you were taking AZT during pregnancy; therefore, there is no need to be worried about AIDS symptoms at this time. A second PCR test will be done in 1 year.”

Priority nursing care for Henry should focus on decreasing the potential for fungal infections that affect his compromised immune system, such as which of the following? Select all that apply.

A.Pneumocystis jiroveci pneumonia

B.Candida albicans infection

C.Haemophilus influenzae infection

D. Cytomegalovirus infection

E.Group A beta-hemolytic streptococcus infection

Julien is in the office for his 2-year-old well-child checkup. He is currently 27 pounds and 2 feet 11 inches tall. He was born full-term, with no complications at birth, and has been relatively healthy, other than being very recently diagnosed with a peanut allergy. He has had normal growth and development, meeting all expected milestones. Up to this point, Julien has received all immunizations according to the CDC guidelines and recommended schedule of pediatric immunizations. He attends daycare daily.

When explaining the benefit and safety of immunizations to Julien’s caregiver, the nurse should include which of the following statements regarding immunizations? Select all that apply.

A. There has been a reduction in the overall number of injections due to combined immunizations.

B. Systemic effects typically include a high fever and severe irritability, but these are easily treated for 48 hours after immunization administration with acetaminophen.

C.Inactive vaccines have a low rate of side effects, as they stimulate only a weak immune response.

D.The goal of immunizations is acquisition of passive immunity.

E. Live immunizations are not recommended until after 18 years of age.

The nurse is reviewing teaching with the caregiver regarding Julien’s peanut allergy to ensure appropriate collaboration with Julien’s daycare. Which of the following should be included? Select all that apply.

A. Due to HIPAA, only the teacher should have information regarding the child’s allergies.

B. One EpiPen should be available in case of a reaction.

C.A “peanut-free” zone should be identified.

D.Emergency phone numbers should be displayed in a designated area.

E.Benadryl should always be available for administration.

The caregiver mentions to the nurse that the family is planning a camping trip soon. The caregiver asks for information about insect repellants. Which of the following are true statements? Select all that apply.

A.Long-sleeved shirts and pants are recommended during the peak mosquito season.

B. Diethyltoluamide (DEET)-containing insect repellents are most effective as preventative agents.

C.DEET can be used on children older than 2 months of age.

D.DEET is the safest insect repellant available.

E.Repellant should be applied on all uncovered skin except the face.

It has been several weeks since Julien was seen in the office. His caregiver has been notified by the daycare Julien attends that another student has been diagnosed with Fifth disease. What symptoms are indicative of Julien’s having Fifth disease? Select all that apply.

A. Nausea and vomiting

B.Fever

C.“Slapped cheek” appearance

D.Wheezing

E. Lacy-appearing rash on trunk

A nurse is teaching first-time caregivers about immunization. which of the following are common childhood immunizations. Select all that apply

A.DPT

B. Shingles

C. MMR

D. polio

E . Herpes

Infant and young children typically have weaker immune system compared with older children and adult. which of the following helps explain this? select all that apply?

A. Physical immunity

B. Assisted immunity

C. Immunization

D. Natural immunity

E. Adaptive immunity

A child’s first line of defense against infection serves which of the following functions? Select all that apply.

A. Antibody response

B. Temperature regulations

C. B-cell production

D. Synthesis of vitamin D

E. Sensation of pain, heat, and cold

Jonathan is a 4-month-old born with congenital HIV. He is currently hospitalized with a diagnosis of cytomegalovirus (CMV). The nurse knows a major complication of CMV associated with AIDS is which of the following?

Kate is a 6-month-old infant in the health care provider’s office for immunizations. The caregiver mentions to the nurse that Kate was fussy after receiving her 4-month vaccinations. The nurse educates the caregiver on proper administration of which medications that can be given for mild irritability and fever after vaccines? Select all that apply.