Immunization

25 July 2022
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question
Emily is a 16-year-old high-school student with no chronic medical conditions. Emily's immunization record shows that she completed the primary series for IPV, HepA, Hib, DTaP, and MMR, and she had a physician-diagnosed case of chickenpox at 2 years of age. Which of the following would be the most appropriate recommendation for her today?
answer
Tdap, HPV, MCV, HepB, and influenza, if during influenza season.
question
Robert is a 48-year-old pharmacist who is preparing to provide immunizations in his pharmacy for the first time next fall. He has no documentation of receiving the hepatitis B vaccine and would like to be vaccinated before administering vaccines in his practice. What is the recommended routine schedule for vaccination against hepatitis B?
answer
0, 1, and 6 months.
question
Upon giving a VIS to a patient who is to receive a vaccine cover under the National Childhood Vaccine Injury Act, what must be documented?
answer
...
question
Which of the following is a requirement of the Occupational Safety and Health Administration's (OSHA's) Bloodborne Pathogens Standard?
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Health care providers must use safety devices when administering injectable vaccines
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Which of the following statements is true regarding varicella-containing vaccines?
answer
The potency of HZV is greater than that of varicella vaccine.
question
When Mary turned 64, she was diagnosed with type 2 diabetes. At that time, she received PPSV23. Which of the following represents appropriate pneumococcal coverage for Mary.
answer
Administer PCV13 at age 65, then PPSV23 at age 69 after 65, give PPSV23 if it has been 5 yrs since last PPSV23 and one year after after PCV13
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HealthMap Vaccine Finder is a free online tool that allows pharmacists to:
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List their vaccination services so patients can find them when searching the website for nearby immunizers.
question
A history of anaphylaxis caused by gelatin would be a contraindication to receiving which of the following vaccines?
answer
Varicella
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According to ACIP recommendations, which of the following needle lengths would be appropriate for administering HZV to an adult patient?
answer
⅝ inch.
question
At what point during pregnancy is it recommended to administer the influenza vaccine?
answer
Anytime is safe
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Which of the following statements is true regarding how vaccines evoke an immune response?
answer
The antigen in the vaccine activates B cells, which produce antigen specific antibodies and memory cells.
question
After reconstitution, within what time frame must HZV be administered?
answer
30 minutes.
question
Which of the following statements about establishing clinics for administering vaccines is true?
answer
Technicians can administer screening questionnaires and distribute VISs
question
Alex is a 32-year-old man who is scheduled to travel to a country where hepatitis A is endemic. He leaves in 3 weeks and will be gone a month. He received his first dose of hepatitis A vaccine today. Alex should be counseled to return for his second dose of hepatitis A vaccine:
answer
In 6 months.
question
When looking at the schedule for vaccines that might be indicated for children and adolescents aged 18 years or younger based on medical indications, what does the orange bar represent?
answer
Precautions for vaccination
question
David is a healthy 5-year-old boy who is scheduled to see his pediatrician for a checkup in July prior to starting kindergarten. David's immunization record reveals that he has received the following vaccines: 3 doses of HepB 4 doses of PCV13 2 doses of HepA 3 doses of IPV 2 doses of rotavirus 1 dose of MMRV 4 doses of DTaP 4 doses of Hib Which vaccines should David receive at this visit?
answer
DTaP, IPV, MMR, and varicella
question
Which of the following statements would be accurate when responding to a patient's concerns about the safety of vaccines?
answer
The immune system is capable of stimulating an immune response to multiple vaccines administered at the same time
question
After completion of a primary vaccine series and documentation of a one-time dose of Tdap, Td booster doses are recommended every:
answer
10 years
question
Which type of vaccine involves stimulation of B cells without the assistance of T helper cells?
answer
Pure polysaccharide vaccines
question
Which of the following tetanus booster vaccines would be most appropriate for administration to a 12-year-old boy who has completed a primary series with DTaP and has no known allergies?
answer
Tdap.
question
Which of the following patients would be a candidate for PPSV23?
answer
25-year-old man who smokes cigarettes.
question
Name the vaccine-preventable disease that may be contracted by unimmunized children from adults serving as reservoirs for the disease, which causes a paroxysmal cough and potentially can result in pneumonia, seizures, encephalopathy, hypoxia, and death.
answer
Pertussis.
question
Barbara is a 60-year-old woman who presents to the pharmacy for two vaccines: HZV and IIV. Which of the following are the appropriate doses and routes for administering these vaccines to this patient?
answer
HZV 0.65 mL subcutaneously; IIV 0.5 mL intramuscularly.
question
Which of these vaccines is a live attenuated vaccine?
answer
Zoster.
question
HZV should not be administered to a patient with a history of anaphylaxis to:
answer
Gelatin.
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RotaTeq (RV5) should be administered as a:
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3-dose series to infants at 2, 4, and 6 months of age
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Adolescents should be routinely vaccinated with MCV4 on the following schedule:
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1 dose at age 11 to 12 years, followed by a booster dose at age 16 years.
question
What is the minimum needle length recommended for administering HepB vaccine to an adult patient weighing 130 lb?
answer
1 inch.
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What is the most common complication of pertussis?
answer
Pneumonia
question
Justin is a healthy 16-year-old boy who has no documentation of varicella vaccine or history of the disease. He should receive:
answer
2 doses of varicella vaccine separated by at least 4 weeks
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Which of the following best describes how to administer Tdap vaccine to an adult patient weighing 185 lb?
answer
Inject intramuscularly at a 90° angle in the deltoid muscle.
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Which of the following is recognized by sociologists as a factor in a patient's decision whether to be vaccinated?
answer
Influence of a health care provider.
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Alan is a 47-year-old man who has no documentation of a primary series of tetanus-containing vaccine. Which of the following would be an appropriate primary series for Alan?
answer
Tdap today; Td in 4 weeks; Td 6 months after the second dose.
question
During which step of the Pharmacists' Patient Care Process would a pharmacist analyze a patient's need for certain vaccines?
answer
Assess
question
In 2014, which vaccination rate was lowest among adolescents 13 through 17 years of age?
answer
HPV
question
Which of the following statements about pharmacy-based vaccination programs is true?
answer
Administratively, billing for vaccines covered by Medicare Part D may be easier for pharmacists than physicians.
question
Why are adjuvants added to vaccines?
answer
To strengthen the immune response to the antigen.
question
According to ACIP recommendations, what is the maximum number of doses of PPSV23 a patient should receive in his or her lifetime?
answer
3 doses.
question
Kate is a 24-year-old woman with asthma. She requests a refill of her albuterol inhaler on November 1st. Kate's immunization record indicates that she completed the primary series of MMR, varicella, DTaP, HepA, and HepB vaccines, and she received a dose of Tdap 2 years ago. For complete coverage, which of the following vaccines should she receive?
answer
PPSV23, IIV, and HPV.
question
Kimberly is a 34 year-old woman who is 30 weeks pregnant. She received a Td booster dose 1 year ago when she cut her hand while working in the kitchen. She has no documentation of receiving a Tdap vaccine. The most appropriate recommendation would be to administer:
answer
Tdap as soon as possible
question
Which of the following diseases has been successfully eradicated worldwide through vaccination efforts?
answer
ď Smallpox
question
Which of the following best describes how to administer MMR vaccine to an adult patient weighing 210 lb?
answer
Inject subcutaneously at a 45° angle in the outer aspect of the upper arm
question
Which of the following is most likely to result in an influenza pandemic?
answer
Antigenic shift in an influenza A virus.
question
According to ACIP recommendations, HZV is indicated for the prevention of herpes zoster in adults aged:
answer
60 years and older
question
A history of anaphylaxis caused by neomycin would be a contraindication to receiving which of the following vaccines?
answer
IPV
question
Which vaccine does ACIP recommend for all college freshmen, aged 21 years or younger, living in dormitories, who have not been previously vaccinated?
answer
ď MCV4.
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For a patient who needs to receive IIV and HZV, which of the following best describes appropriate administration of these vaccines?
answer
Administer these 2 vaccines at the same visit.
question
For which age group is the adjuvanted inactivated influenza vaccine approved?
answer
65 years and older
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Which of the following documents must be given to every patient or patient's caregiver before administration of a vaccine covered under the National Childhood Vaccine Injury Act (NCVIA)?
answer
VIS.
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What is the time interval for which the development of Guillain-Barré syndrome following influenza vaccination would result in a precaution for future influenza vaccines?
answer
Within 6 weeks
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The childhood/adolescent and adult immunization schedules are updated and published annually during which months?
answer
January or February
question
Which viruses are associated with the development of cancer?
answer
Human papillomavirus and hepatitis B virus
question
If a patient with an egg allergy experiences hives following influenza vaccination, what is ACIP's recommendation for vaccinating this patient against influenza?
answer
Administer any age-appropriate inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV)
question
Which of the following is the best example of a group with which individual pharmacists can collaborate to increase immunization rates in their communities?
answer
Local health departments
question
Even though state laws may have specific mandates, how long should pharmacists maintain records of immunizations?
answer
For the patient's lifetime.
question
In which publication does the CDC initially publish new or updated vaccine recommendations?
answer
Morbidity and Mortality Weekly Report (MMWR)
question
Why should refrigerated vaccines be stored in the middle of the refrigerator?
answer
There are fewer temperature fluctuations
question
Ava has arrived at the clinic for her well-child visit. She is 4 months old. Ava's immunization record reveals that she has received the following vaccines: 2 doses of HepB 1 dose of Hib 1 dose of rotavirus 1 dose of PCV13 1 dose of DTaP 1 dose of IPV Which vaccines should Ava receive at today's visit?
answer
DTaP, Hib, PCV13, IPV, and rotavirus.
question
The monitoring system that health care providers should use to report serious adverse events after vaccination is:
answer
VAERS.
question
Which of the following statements about live attenuated vaccines is true?
answer
They should generally be avoided in immunocompromised individuals
question
Which of the following patients is a candidate for both MenACWY and MenB vaccines?
answer
A 10 year-old who just had his spleen removed.
question
Which of the following patients are appropriate candidates for the 2-dose schedule of HPV9?
answer
11 year-old girl with no medical conditions, series has not been started
question
If a vial of influenza vaccine is left out of the refrigerator on the pharmacy counter overnight, what should be done with the vaccine?
answer
Mark "do not use," place in the refrigerator, and call the manufacturer for further guidance.
question
Which of the following key questions is important to ask a patient before administering IIV?
answer
ď Are you sick today?
question
If a patient received the first dose of HepB but did not return for the remaining doses in the series, under what circumstances should the HepB series be restarted?
answer
The series should not be restarted; resume the series where it was interrupted.
question
Which of the following immunization strategies is preferred for adults under the age of 65 years with immunocompromising conditions who require both PCV13 and PPSV23?
answer
PCV13 first, followed by PPSV23 at least 8 weeks later.
question
What is the type of immunity that occurs when a pregnant woman is vaccinated with Tdap to protect the infant from pertussis after birth?
answer
Passive immunity
question
Jackie is a 34-year-old woman who received an influenza vaccine from you today. She wants to know how long it will take for the vaccine to begin working to protect her from getting the flu. What would be the most appropriate response to this patient?
answer
14 days
question
Federal law makes offering an annual influenza vaccination a requirement for continued federal funding in which setting?
answer
Long-term care facilities
question
Herd immunity refers to which of the following situations?
answer
Vaccination of enough individuals in a community to protect those who cannot be vaccinated
question
With the exception of rotavirus, the routinely recommended live vaccines are contraindicated in a patient who:
answer
Is immunosuppressed.
question
Which of the following vaccines may be administered to boys and young men aged 9 through 26 years to reduce the likelihood of acquiring genital warts?
answer
HPV9.
question
The incubation period for influenza can range from
answer
1 to 4 days
question
If a patient is a candidate for revaccination with PPSV23, what is the ACIP-recommended interval between doses of this vaccine?
answer
5 years.
question
How is the live, cholera vaccine administered?
answer
Orally.
question
What is the standard dose of epinephrine for managing anaphylaxis?
answer
0.01 mg per kg body weight, up to a maximum of 0.5 mg.
question
Why was the live attenuated influenza vaccine (LAIV) removed from the ACIP's influenza vaccine recommendations?
answer
Low effectiveness of this vaccine was seen during the 2013-2014 and 2015-2016 influenza seasons.
question
Aiden is a 6-month-old healthy boy with no known allergies. He has received vaccinations in the past with no reported adverse reactions. Aiden's father asks about having his son vaccinated against influenza. The most appropriate response would be to inform the father that Aiden:
answer
Should receive 1 dose of IIV4 today followed by a second dose of IIV4 administered 4 weeks later
question
Tom is a 9-year old boy who has never had an influenza vaccine. Tom's mother shows you his up-to-date immunization record and reports that he has never had any adverse reactions to vaccinations. What dose and schedule of IIV should be administered to Tom?
answer
Inject 0.5 mL; one dose only
question
According to the Advisory Committee on Immunization Practices (ACIP), which of the following would be considered adequate evidence of immunity to varicella, indicating that administration of varicella vaccine is unnecessary?
answer
Diagnosis of chickenpox by a health care provider
question
Austin is a healthy 16-year-old boy who has no documentation of varicella vaccine or history of the disease. He should receive:
answer
2 doses of varicella vaccine separated by at least 4 weeks
question
John is a 46-year-old man with diabetes. He requests a refill of his diabetes testing supplies on October 21st. His immunization record indicates that he has completed the primary series of MMR, DTaP, HepA, and HepB vaccines. John has a documented history of chickenpox, and his last Td booster dose was 19 years ago. Which of the following vaccines should he receive?
answer
PPSV23, Tdap, and IIV.
question
Arthus reactions, which are exaggerated local reactions that can occur if a patient is vaccinated too frequently, are most commonly reported after which vaccine?
answer
Tetanus and diphtheria toxoids-containing vaccines.
question
There should be a flat hard surface in the area where vaccines will be administered to ensure:
answer
There is room for the patient to lie down if fainting occurs or CPR is required.
question
Administration of immunoglobulin following exposure to a pathogen is an example of which type of immunity?
answer
Passive immunity.
question
Which type of immune response targets pathogens that have entered the cells of the host?
answer
Cell-mediated immunity.
question
Which disease was the leading cause of acquired mental retardation before introduction of a vaccine?
answer
Haemophilus influenzae type b.
question
Emily is a 16-year-old high-school student with no chronic medical conditions. Emily's immunization record shows that she completed the primary series for IPV, HepA, Hib, DTaP, and MMR, and she had a physician-diagnosed case of chickenpox at 2 years of age. Which of the following would be the most appropriate recommendation for her today?
answer
Tdap, HPV, MCV, HepB, and influenza, if during influenza season.
question
To reduce liability, pharmacists administering immunizations should take the following three steps:
answer
Receive specialized training and stay current with vaccine information updates; educate patients about the benefits and risks of vaccinations; and emulate local standards of care.
question
What is the FDA-licensed age range for the use of LAIV?
answer
2 to 49 years of age.