Pediatric Nurse Exam Pediatric Nurse Infectious Diseases and Immunizations 2 — Questions and Answers
Question 1: An unvaccinated 3-year-old is exposed to pertussis. Which intervention is most appropriate?
- Administer azithromycin prophylaxis and initiate DTaP vaccination (Correct answer)
- Administer MMR vaccine immediately
- No intervention is needed if the child is currently asymptomatic
- Isolate for 21 days without antibiotic prophylaxis
Correct answer: Administer azithromycin prophylaxis and initiate DTaP vaccination
Post-exposure prophylaxis with a macrolide antibiotic (azithromycin) and initiation of the DTaP series is recommended for unvaccinated contacts of pertussis.
Question 2: A 2-month-old presents with paroxysmal coughing episodes followed by an inspiratory 'whoop.' Which pathogen is responsible?
- Bordetella pertussis (Correct answer)
- Respiratory syncytial virus
- Haemophilus influenzae type b
- Streptococcus pneumoniae
Correct answer: Bordetella pertussis
The classic whooping cough with post-tussive vomiting in infants is caused by Bordetella pertussis, targeted by the 'P' component of DTaP.
Question 3: Roseola (exanthem subitum) follows which characteristic sequence of symptoms?
- High fever for 3–5 days followed by a rose-colored rash as the fever abruptly breaks (Correct answer)
- Rash appears first, followed by high fever
- Rash and high fever appear simultaneously
- Rash without fever in most cases
Correct answer: High fever for 3–5 days followed by a rose-colored rash as the fever abruptly breaks
Roseola, caused by HHV-6, presents with high fever for 3–5 days that suddenly resolves, followed by a characteristic rose-colored macular trunk rash.
Question 4: A child is diagnosed with erythema infectiosum (fifth disease). What is the causative agent?
- Parvovirus B19 (Correct answer)
- Enterovirus
- Human herpesvirus 6 (HHV-6)
- Group A Streptococcus
Correct answer: Parvovirus B19
Fifth disease is caused by Parvovirus B19 and classically presents with a 'slapped cheek' facial rash followed by a lacy rash on the trunk and extremities.
Question 5: Which of the following vaccines is classified as a live attenuated vaccine?
- Varicella (chickenpox) vaccine (Correct answer)
- Hepatitis B vaccine
- Inactivated poliovirus vaccine (IPV)
- Hib conjugate vaccine
Correct answer: Varicella (chickenpox) vaccine
The varicella vaccine contains a live but weakened form of varicella-zoster virus and is contraindicated in severely immunocompromised patients.
Question 6: At the 2-month well-child visit, which vaccines are routinely administered according to the CDC immunization schedule?
- DTaP, IPV, Hib, PCV13, rotavirus, and HepB (Correct answer)
- MMR and varicella only
- DTaP and IPV only
- Influenza and hepatitis A only
Correct answer: DTaP, IPV, Hib, PCV13, rotavirus, and HepB
The 2-month visit includes DTaP, IPV, Hib, PCV13, rotavirus (RV), and the second dose of hepatitis B, making it one of the most vaccine-intensive visits.
Pediatric Nurse Exam Pediatric Nurse Infectious Diseases and Immunizations 2
An unvaccinated 3-year-old is exposed to pertussis.
Which intervention is most appropriate?