Question

A nurse in a Health Department is participating in immunization clinic. The nurse should identify that which of the following children requires an alteration in the standard immunization schedule?

1.An 18 month old toddler who has failure to thrive

2. a three year old toddler has leukemia

A nurse is providing teaching to a 50 year old female client. Which of the following statement should the nurse include in teaching?

1 You should have your fasting blood glucose level checked every 6 years

2. You should have your hearing screen every 5 years

3. you should have a complete eye examination every two years until the age of 64

4. you should have your stool tested for blood every other year until the age of 74

3. a four-month-old infant who has Down syndrome

4. a 12 month old infant who has sickle cell disease

The partner of an older adult client who has Alzheimer's disease reports that he is not eating. The home health aide tells the nurse that the client partner refuses to assist the client with feeding. The partner insist that the client feed himself without help. Which of the following is the priority action of the nurse should take?

1.Determine the client's ability to self feed

2. Refer the clients partner to an Alzheimer's support group

3. arrange for meals-on-wheels assistance

4. Direct the home health aide to assist with meals

Answer 1

A) 2.

• Considering the fact that every child’s health and safety are of utmost importance to the child’s healthcare provider, exceptions are allowed in the immunization schedule. The child with leukemia needs an alteration in the standard immunization schedule because of the fatal illness and ongoing medical treatment.
• Since vaccines are not given based on weight, the failure-to-thrive child with very low weight doesn't need an alteration in the standard immunization schedule.
• Since down's syndrome is an immunocompromised condition and there are no issues to stand in the way of timely immunization, an alteration in the standard immunization schedule is not required.
• Since sickle cell disease is an immunocompromised condition and there are no issues to prevent timely immunization, an alteration in the standard immunization schedule is not required for the 12-month-old infant who has sickle cell disease.

B) 3.

• The statement that the nurse should include in teaching a 50-year-old female is "you should have a complete eye examination every two years until the age of 64." A lifetime healthy vision can be maintained by having a comprehensive eye exam every two years.
• Considering the statement "you should have your stool tested for blood every other year until the age of 74," stool is tested for blood every year. So this can be excluded.
• Considering the statement "You should have your hearing screen every 5 years," the hearing screen is done every 3 years.
• Considering the statement "You should have your fasting blood glucose level checked every 6 years," the time interval 1-3 years for this screen.

C) 4.

• The priority action the nurse should take is "direct the home health aide to assist with meals."
• The option "determine the client's ability to self feed" can be excluded as this cant be considered as a priority action for an Alzheimer's disease patient.
• The option "Refer the client's partner to an Alzheimer's support group" can be excluded as this will take some time and will depend on the partner's attitude.
• The option " arrange for meals-on-wheels assistance" can be excluded as this is not a viable option. There is nobody to feed the Alzheimer's patient at meals-on-wheels.