Pediatric Nurse Exam Pediatric Nurse Infectious Diseases and Immunizations 1 — Questions and Answers
Question 1: At what age does the CDC immunization schedule recommend the first dose of the MMR vaccine?
- 12–15 months (Correct answer)
- 2 months
- 6 months
- 9 months
Correct answer: 12–15 months
The first MMR dose is given at 12–15 months, after maternal antibody protection has waned, with the second dose at 4–6 years.
Question 2: A child presents with a 'strawberry tongue,' sandpaper-like rash, and fever of 102°F. Which diagnosis does the nurse anticipate?
- Scarlet fever (Correct answer)
- Kawasaki disease
- Roseola
- Rubella
Correct answer: Scarlet fever
Strawberry tongue with a diffuse sandpaper-textured rash and fever is the classic presentation of scarlet fever, caused by Group A Streptococcus.
Question 3: Which vaccine is contraindicated in a child receiving high-dose chemotherapy?
- MMR (live attenuated vaccine) (Correct answer)
- Hepatitis B vaccine
- Pneumococcal conjugate vaccine (PCV13)
- Inactivated influenza vaccine
Correct answer: MMR (live attenuated vaccine)
Live attenuated vaccines such as MMR are contraindicated in immunocompromised children because the weakened pathogen can cause disease in a child unable to mount a defense.
Question 4: A child with varicella (chickenpox) should be excluded from school until which point?
- All lesions have crusted over (Correct answer)
- Fever resolves for 24 hours
- Five days after rash onset regardless of lesion status
- 24 hours after starting antiviral therapy
Correct answer: All lesions have crusted over
Varicella is contagious until all lesions have crusted, indicating the end of viral shedding and the infectious period.
Question 5: Which organism is responsible for hand, foot, and mouth disease (HFMD) in children?
- Coxsackievirus A16 (enterovirus) (Correct answer)
- Herpes simplex virus type 1
- Varicella-zoster virus
- Streptococcus pyogenes
Correct answer: Coxsackievirus A16 (enterovirus)
HFMD is most commonly caused by Coxsackievirus A16, an enterovirus, producing vesicular lesions on the hands, feet, and oral mucosa.
Question 6: Koplik spots on the buccal mucosa are pathognomonic for which infectious disease?
- Measles (rubeola) (Correct answer)
- Mumps
- Rubella
- Roseola
Correct answer: Measles (rubeola)
Koplik spots — small white spots with a red halo on the buccal mucosa — appear 2–3 days before the measles rash and are diagnostic of rubeola.
Pediatric Nurse Exam Pediatric Nurse Infectious Diseases and Immunizations 1
At what age does the CDC immunization schedule recommend the first dose of the MMR vaccine?