ATI Nur235 Pediatrics Final Exam | Nurselytic

Correct Answer: B

Rationale: The correct answer is B: Evaluate for presence of allergies to vaccine components. This is the appropriate action for the nurse because before administering any vaccine, it is crucial to assess for potential allergies to vaccine components to prevent adverse reactions. This step ensures the safety of the child and helps in making an informed decision regarding the administration of the varicella vaccine.


Choice A (Delay the immunization if the child presents with nasopharyngitis) is incorrect because mild illness, such as a cold, is not a contraindication for administering the varicella vaccine.


Choice C (Refrain from administering since the first dose is not given until 4 years of age) is incorrect as the first dose of the varicella vaccine is typically given between 12-15 months of age.


Choice D (Administer intramuscularly into the vastus lateralis) is incorrect because the varicella vaccine is usually administered subcutaneously, not intramuscularly.

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