A 5-day-old neonate... had sudden onset of irritability, diaphoresis, and profound dyspnea... systolic ejection murmur... liver enlargement...

Correct Answer: A

Rationale: Coarctation of the aorta causes a murmur, poor lower-body perfusion, and heart failure signs (dyspnea, hepatomegaly) in neonates. Diaphragmatic hernia (B) affects breathing differently. Sepsis (C) lacks murmur specificity. PDA (D) has a continuous murmur, not ejection.

Correct Answer: C

Rationale: An itchy, raised rash (urticaria or hives) is an early cutaneous sign of anaphylaxis, often appearing within minutes of exposure to an allergen (e.g., vaccine component). It reflects histamine release from mast cells. Choice A (throat swelling) and B (wheezing) are also signs of anaphylaxis but typically develop later as the reaction progresses to airway involvement. Choice D (redness at injection site) is a common, benign local reaction, not indicative of anaphylaxis.

Correct Answer: C

Rationale: Pertussis (whooping cough) requires a booster in adulthood via the Tdap vaccine, recommended at age 11-12, then every 10 years (or during pregnancy), due to waning immunity from the childhood DTaP series. Mumps and varicella (via MMR and varicella vaccines) typically confer lifelong immunity with two doses in childhood, and polio does not require routine adult boosters in the US since it’s eradicated there, though travelers may need one. Pertussis is the standard adult booster.

Correct Answer: C

Rationale: Immunization records typically include the vaccine type, administration date (Choice D), body location (Choice A, e.g., left deltoid), and client identifiers like name, address, and date of birth (Choice B), per CDC and WHO standards. The provider’s date of birth (Choice C) is not required; the provider’s name or identifier is sufficient for accountability, making it the exception.

Correct Answer: A

Rationale: The varicella vaccine is a live attenuated vaccine containing a weakened varicella-zoster virus to prevent chickenpox. Choice B (influenza) includes both live (LAIV) and inactivated (IIV) forms, but the question implies a specific example, and IIV is more common. Choice C (Hepatitis B) is a recombinant subunit vaccine, and Choice D (Diphtheria) is a toxoid vaccine, both inactivated. Varicella is a clear, widely recognized live vaccine example.