A 10-year-old child has just received his first immunization of influenza vaccine. His lips begin to swell, and he states, 'It feels like my throat is closing shut and my chest is tight when I breathe.' The nurse recognizes these as signs of which of the following?

Correct Answer: B

Rationale: Swelling lips, throat closure sensation, and chest tightness are classic signs of anaphylaxis, a life-threatening allergic reaction (Choice B). This requires immediate epinephrine. Choice A (anxiety) may cause hyperventilation but not swelling. Choice C (local reaction) is limited to the injection site (e.g., redness), and Choice D (common systemic reaction) implies milder, typical responses (e.g., fever), not anaphylaxis.

Correct Answer: B

Rationale: The Hib vaccine protects against *Haemophilus influenzae* type b, a major cause of bacterial meningitis in infants before widespread vaccination. Tetanus (Choice A) prevents lockjaw, HIV (Choice C) is a virus with no vaccine, and Varicella (Choice D) prevents chickenpox, none of which cause meningitis. Hib (Choice B) is correct per CDC.

Correct Answer: B

Rationale: The BCG vaccine prevents severe TB (e.g., miliary TB) in infants in high-risk areas (WHO), though not routine in the U.S. Measles, polio, and mumps vaccines target other diseases, making Choice B correct.

Correct Answer: D

Rationale: Puzzles with large pieces enhance fine motor skills (grasping, coordination) in toddlers (1-3 years), per developmental guidelines. Blocks (Choice A) aid gross motor, others are less specific.

Correct Answer: C

Rationale: Sitting upright is often cited for young children (document answer), though lateral recumbent is also standard (AAP) to flex the spine. Contextually, Choice C is correct per the document.