A nurse is preparing a 12-month-old for routine well-child immunizations per the CDC ACIP schedule. Which actions and statements reflect correct evidence-based practice? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Option 1 is correct because routine vaccination at 12-15 months includes the first MMR, varicella, and hepatitis A doses and the indicated PCV dose. Option 2 is correct because the nurse verifies the child with two identifiers, follows medication-administration rights, and obtains the required consent. Option 3 is correct because live vaccines such as MMR and varicella are contraindicated with severe immunocompromise or immunosuppressive high-dose systemic corticosteroid therapy. Option 4 is correct because the appropriate Vaccine Information Statement must be given before vaccination. Option 5 is incorrect as written: current product guidance may permit intramuscular or subcutaneous administration for varicella-containing products, but intramuscular administration does not provide faster seroconversion; the nurse must follow the route specified for the product and current guidance.
Common pediatric immunization NCLEX traps: (1) "live virus IV" — wrong, never IV; (2) "skip VIS to save time" — wrong, federally required; (3) "give all vaccines despite severe immunocompromise" — wrong, live virus contraindicated. Mild illness without fever is NOT a contraindication to vaccination.
Healthy 12-month-old at routine well-child visit. Immunizations up to date through 6 months. The nurse reviews the CDC ACIP schedule for 12-month vaccines.
12-month ACIP vaccines — MMR, varicella, hepatitis A, PCV20 4th dose, plus catch-up if needed.
Vaccine Information Statement (VIS) — Federally mandated handout describing benefits and risks of each vaccine; given before administration.
Live vaccine route — MMR and varicella subcutaneously; rotavirus orally; never IV.