Health Promotion and Disease Prevention

Which wound presents with the greatest risk for tetanus infection? A. A puncture wound obtained while gardening B. A laceration obtained while trimming beef C. A human bit D. An abrasion obtained by falling on a sidwalk

A. A puncture wound obtained while gardening C. tetani is found in soil, particularly if it contains manure.

The components of brief intervention for treating tobacco use include? A. Ask, Advise, Assess, Assist, Arrange B. Advise, Intervene, Counsel, Follow up, Prescribe C. Document, Counsel, Caution, Describe, Demostrate D. Advise, Describe, Confer, Prescribe, Document

A. Ask, Advise, Assess, Assist, Arrange 5 As: Ask about tobacco use Advise to quit Assess willingness to make a quit attempt Assist in quit attempt Arrange follow-up

Peak infectivity of persons with hepatitis A usually occurs: A. Before onset of jaundice B. At the time of maximum elevation of liver enzymes C. During the recovery period D. At the time of maximum disease-associated symptoms

A. Before onset of jaundice Peak infectivity in acute hepatitis A occurs during the 2-week period before onset of jaundice or elevation of liver enzymes, when concentration of the virus in stool is highest.

Which of the following best describes how the variola virus that causes smallpox is transmitted? A. Direct deposit of infective droplets B. Surface contact C. Blood and body fluids D Vertical transmission

A. Direct deposit of infective droplets Direct and fairly prolonged face-to-face contact is required. The infected person is contagious until the last smallpox scab falls off.

How is the varicella virus most commonly transmitted? A. Droplet transmission B. Contact with inanimate reservoirs C. Contact transmission D. Water-borne transmission

A. Droplet transmission

Which of the following products provides passive immunity? A. Hepatitis B immune globulin (HBIG) B. MMR vaccine C. Pneumococcal conjugate vaccine D. Live attenuated influenza vaccine

A. HBIG

Jason is a healthy 18-year-old who presents for primary care. According to his immunization record, he received two doses of HBV vaccine 1 month apart at age 14 years. Which of the following best descries his HBV vaccination needs? A. He should receive a single dose of HBV vaccine now B. A 3-dose HBV vaccine series should be started during today's visit C. He has completed the recommended HBV vaccine series D. He should be tested for HBsAb and further immunization recommendations should be made according to the test results

A. He should receive a single dose of HBV vaccine now The second dose should be administered 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose). If the vaccine series was interrupted after the first dose, the second dose should be administered ASAP. If only the third dose is delayed, it should be administered asap.

A 30-year-old man with HIV lives with his 2 preschool-aged children. Which of the following statements best represents advice you should give him about immunizing his children? A. Immunization should take place without regard for his health issue B. The children should not receive influenza vaccine C. MMR vaccine should not be given D. The children should no receive poliovirus immunization

A. Immunization should take place without regard for his health issue

Which of the following statements best describes zanamivir (Relenza) or oseltamivir (Tamiflu) use in the are of patients with or at risk for influenza? A. Initiation of therapy early in acute influenza illness can help minimize the severity of disease when the illness is caused by a nonresistant viral strain B. The primary indication is in preventing influenza A during outbreaks C. The drugs are active only against influenza B D. The use of the medications is an acceptable alternative to influenza vaccine

A. Initiation of therapy early in acute influenza illness can help minimize the severity of disease when the illness is caused by a nonresistant viral strain IF treatment with either of these drugs is started during the first 2 days of illness, the time a person feels ill is shortened by about 1 day. Zanamivir is inhaled and can cause bronchospasm, especially in patients with asthma or other chronic lung disease. Adverse effects of oseltamivir is largely GI; the risk of n/v is significantly reduced if the medication is taken with food.

Which of the following statements is true about poliovirus infection? A. It is transmitted via the fecal-oral route B. Rates of infection among household contacts are about 30% C. Sporadic outbreaks continue to occur in North America D. It is transmitted via aerosol and droplets

A. It is transmitted via the fecal-oral route

Smallpox vaccine contains: A. Live vaccinia virus B. A virus fragment C. Dead smallpox virus D. An antigenic protein

A. Live vaccinia virus

Identify whether the item has the characteristics of 23-valent pneumococcal polysaccharide vaccine (PPSV23) or 13-valent pneumococcal conjugate vaccine (PCV13). A. Routinely used in early childhood _____ B. Use is associated with greater immunogenicity _____ C. Routinely used in all well adults age 65 years or older _____ D. Not licensed for use in children younger than 2 years of age _____

A. PCV13 B. PCV13 C. PPSV23 D. PPSV23

When considering an adult's risk for measles, mumps, and rubella (MMR), the NP considers the following: A. Patients born before 1957 have a high likelihood of immunity against these diseases because of a history of natural infection B. Considerable mortality and morbidity occur with all three diseases C. Most cases in the U.S. occur in infants D. The use of the MMR vaccine is often associated with protracted arthralgia

A. Patients born before 1957 have a high likelihood of immunity against these diseases because of a history of natural infection

During an office visit, a 48-year-old man who smokes two packs of cigarettes per day states, "My kids are begging me to quit. My dad smoked and died when he was 80. I'm not sure what all the fuss is about." According to the Stages of Change Theoretical Model, his statement is most consistent with a person at the stage of: A. Precontemplation B. Contemplation C. Preparation D. Action

A. Precontemplation Precontemplation: the patient is not interested in change and might be unaware that the problem exists or minimizes the problem's impact. Contemplation: the patient is considering change and looking at its positive and negative aspects. The person often reports feeling "stuck" with the problem, unable to figure out how to change to solve or minimize the health issue. Preparation: the patient exhibits some change behaviors/thoughts and often reports feeling that he/she does not have the tools to proceed. Action: the patient is ready to go forth with change, often takes concrete steps to change, but is often inconsistent with carrying through. Maintenance/Relapse: the patient learns to continue the change and has adopted and embraced the healthy habit. Relapse can occur, however, and the person learns to deal with backsliding.

Which of the following is usually viewed as the most cost-effective form of healthcare? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Cancer-reduction measures

A. Primary prevention

Active Immunity is defined as: A. Resistance developed in response to an antigen B. Immunity conferred by an antibody produced in another host C. The resistance of a group to an infectious agent D. Defense against disease acquired naturally by the infant from the mother

A. Resistance developed in response to an antigen

Secondary prevention measures for a 78-year-old man with COPD include: A. Screening for mood disorders B. Administering influenza vaccine C. Obtaining a serum theophylline level D. Advising about appropriate use of a car passenger restraints

A. Screening for mood disorders

Which of the following statements best describes amantadine or rimantadine use in the care of patients with or at risk for influenza? A. Significant resistance to select strains of influenza limits the usefulness of these medications B. The primary action of these therapies is in preventing influenza A during outbreaks C. These therapies are active against influenza A and B D. The use of these products is an acceptable alternative to influenza vaccine

A. Significant resistance to select strains of influenza limits the usefulness of these medications The adamantane derivatives (amantadine and rimantadine) are approved only for treatment and prevention of influenza A. Because of a significant level of resistance of influenza A viruses to these medications, they are no longer recommended by the CDC for the treatment of influenza

Brief intervention that provides motivation to quit tobacco use should be: A. Used at every clinical visit that the tobacco user has, regardless of reason for the visit B. Offered when the tobacco user voices concern about he health effects of smoking C. Applied primarily during visits for conditions that are clearly related to or exacerbated by tobacco use, such as respiratory tract disease D. When the clinician is conducting a comprehensive health assessment, such as with the annual physical examination

A. Used at every clinical visit that the tobacco user has, regardless of reason for the visit

A sedentary, obese 52-year-old woman is diagnosed with HTN and states, "it is going to be too hard to diet, exercise, and take these pill." What is the least helpful response to her statement? A. "Try taking your medication when you brush your teeth." B. "You really need to try to improve your health." C. "Tell me what you feel will get in your way of improving your health." D. "Could you start with reducing the amount of salty foods in your diet?"

B. "You really need to try to improve your health."

In an immunocompetent adult, the length of incubation for the influenza virus is on average: A. Less than 24 hours B. 1 to 4 days C. 4 to 7 days D. More than 1 week

B. 1 to 4 days In an immunocompetent adult, the influenza virus has a short incubation period, with a range of 1 to 4 days (average of 2 days). Adults pass the illness 1 day before the onset of symptoms and continue to remain infectious for approximately 5 days after the onset of the illness. Children remain infectious for 10 or more days after the onset of symptoms and can shed the virus before the onset of symptoms. People who are immunocompromised can remain infectious for up to 3 weeks.

A health 6-year-old girl presents for care. Her parents request that she receive vaccination for influenza and report that she has not received this vaccine int he past. How many doses of influenza vaccine should she receive this flue season? A. 1 B. 2 C. 3 D. 4

B. 2 Children younger than 9 years who are receiving initial influenza immunization need two doses of vaccine separated by 4 or more weeks.

Which of the following is not recommended to receive the MMR vaccination? A. A 1-year-ild boy with a history of hive-form reaction to egg ingestion B. A 24-year-old woman who is 20 weeks pregnant C. A 4-year-old girl who was born at 32 weeks of gestation D. A 32-year old woman who is breastfeeding a 2 week old

B. A 24-year-old woman who is 20 weeks pregnant

Of the following, who is at greatest risk for invasive pneumococcal infection? A. A 68-year-old man with COPD B. A 34-year-old woman who underwent splenectomy after a MVA C. A 50-year-old man with a 15-year- history of DMII D. A 75-year-old woman with decreased mobility as a result of severe osteoporosis

B. A 34-year-old woman who underwent splenectomy after a MVA

All fo the following patients received pneumococcal vaccine 5 years ago. Who is a candidate for receiving a second dose of antipneumococcal immunization at this time? A. A 45-year old man who is a cigarette smoker B. A 66-year-old woman with COPD C. A 35-year-old man with moderate persistent asthma D. A 72-year-old woman with no chronic health problems

B. A 66-year-old woman with COPD Revaccination after 5 years after the first PPSV 23 dose is recommended for individuals older than age 2 but younger than age 65 years who are at highest risk of pneumococcal infection or are at greatest risk of having a rapid decline in antibody levels, including sickle cell disease, splenectomy, chronic renal failure, nephrotic syndrome, immunocompromised, generalized malignancy, or on immunpsuppressing medications.If initial PPSV23 vaccine was received at age 65 years or older, a repeat dose is not required

Which of the following represents the food or beverage that is least likely to be contaminated with the HAV? A. A lettuce salad B. A bowl of hot soup C. A plate of peeled mango D. A glass of ice tea

B. A bowl of hot soup Effective methods to inactivate HAV include heating or cooking foods to temperatures > 185F (>85C) for 1 minute or disinfecting surfaces with a 1:00 dilution of sodium hypochlorite (bleach) and tap water.

For which of the following patients should an NP order varicella antibody titers? A. A 14-year-old with an uncertain immunization history B. A healthcare worker who reports having had varicella as a child C. A 22-year-old woman who received two varicella immunizations 6 weeks apart A 72-year-old with shingles

B. A healthcare worker who reports having had varicella as a child Confirming varicella immunity through varicella titers, even in the presence of a history of varicella infection, should be done in healthcare workers because of their risk of exposure and potential transmission of the disease.

Tertiary prevention measures for a 69-year-old woman with heart failure include: A. Administering antipneumococcal vaccine B. Adjusting therapy to minimize dyspnea C. Surveying skin for precancerous lesions D. Reviewing safe handling of food

B. Adjusting therapy to minimize dyspnea

In the U.S., what proportion of all reported hepatitis A cases have no specific risk factor identified? A. Approximately 25% B. Approximately 50% C. Approximately 75% D. Nearly 100%

B. Approximately 50%

When working with a middle-aged man with a body mass index of 33 kg/m2 on weight reduction, an NP considers that one of the first actions should be to: A. Add an exercise program while minimizing the need for dietary changes B. Ask the patient about what he believes contributes to his weight issues C. Refer the patient to a nutritionist for diet counseling D. Ask for a commitment to lose weight

B. Ask the patient about what he believes contributes to his weight issues

Hepatitis B vaccine should not be given to a person with a history of anaphylactic reaction to: A. Egg B. Baker's yeast C. Neomycin D. Streptomycin

B. Baker's yeast

Linda is a 52-year-old woman who presents for a follow-up visit for HTN, DMII, and dyslipidemia. She has a 50-pack year cigarette smoking history, quit smoking 6 months ago, and now reports smoking about 10 cigarettes per day for the past 2 weeks while being particularly stressed during her 78-year-old mother's recent serious illness. Linda states. "I give up. I guess I cannot quit." Which of the following is the most appropriate response to Linda's statement? A. Do you think your mother's illness was a trigger for your smoking? B. Can we work on a plan to help you to get back to being smoking-free? C. Once your mom is well again, you should try quitting again. D. You sound really discouraged about this.

B. Can we work on a plan to help you to get back to being smoking-free?

An example of a primary prevention measure of a 78-year-old man with COPD is: A. Reviewing the use of prescribed medications B. Conducting a home survey to minimize fall risk C. Checking FEV1 to FVC ratio D. Ordering fecal occult blood test (FOBT)

B. Conducting a home survey to minimize fall risk

During an office visit, a 38-year-old woman states, "I drink way too much but do not know what to do to stop." According to the Stages of Change Transtheoretical Model, her statement is most consistent with a person at the sate of: A. Precontemplation B. Contemplation C. Preparation D. Action

B. Contemplation Precontemplation: the patient is not interested in change and might be unaware that the problem exists or minimizes the problem's impact. Contemplation: the patient is considering change and looking at its positive and negative aspects. The person often reports feeling "stuck" with the problem, unable to figure out how to change to solve or minimize the health issue. Preparation: the patient exhibits some change behaviors/thoughts and often reports feeling that he/she does not have the tools to proceed. Action: the patient is ready to go forth with change, often takes concrete steps to change, but is often inconsistent with carrying through. Maintenance/Relapse: the patient learns to continue the change and has adopted and embraced the healthy habit. Relapse can occur, however, and the person learns to deal with backsliding.

An 18-year-old woman with allergic rhinitis presents for primary care. She is sexually active with a male partner and is 1 year post-coitarche; during this time she had 2 sex partners. An example of a primary prevention activity for this patient is: A. Screening for STI B. Counseling about safer sexual practices C. Prescribing therapies for minimizing allergy D. Obtaining a liquid-based Pap test

B. Counseling about safer sexual practices

A 22-year-old man is starting a job in a college health center and needs proof of German measles, measles, and mumps immunity. He received childhood immunizations and supplies documentation of MMR vaccination at age 1.5 years. Your best response is to: A. Obtain rubella, measles (rubeola), and mumps titers B. Give MMR immunization now C. Advise him to obtain IG if he has been exposed to measles or rubella D. Adnise him to avoid individuals with skin rashes

B. Give MMR immunization now

Maria is 28-year-old healthy woman who is 6 weeks pregnant. her routine prenatal laboratory testing reveals she is not immune to varicella. She voices her intent to breastfeed her infant for at least 6 months. Which of the following represents the best advice for Maria? A. She should receive VZV vaccine once she is in her second trimester of pregnancy B. Maria should be advised to receive two doses of VZV vaccine after giving birth C. Once Maria is no longer breastfeeding, she should receive one dose of VZV vaccine D. A dose of VZIG should be administered now

B. Maria should be advised to receive two doses of VZV vaccine after giving birth Women who do not have evidence of immunity should receive the first dose of varicella vaccine on completion or termination of pregnancy and before discharge from the facility. The second dose should be administered 4 to 8 weeks after the first dose.

You see Harold, a 25-year-old man who recently had multiple sexual encounters without condom use with a male partner who has chronic hepatitis B. Harold provides documentation of receiving a properly timed hepatitis B immunization series. In addition to counseling about safer sexual practices, you also advise that Harold: A. Needs to repeat his hepatitis B immunization series B. Receive a single dose of HBV vaccine C. Be tested for HBsAB D. Should receive HBIG and a single dose of the hepatitis B immunization series

B. Receive a single dose of HBV vaccine In a person who has written documentation of a complete HBV vaccine series and who did not receive post vaccination testing, a single vaccine booster dose should be given with a nonoccupational known HBsAG-positive exposure source.

The use of FDA-approved pharmacologic intervention in tobacco use: A. Makes little difference in smoking cessation rates B. Reliably increases long-term smoking abstinence rates C. Is helpful but generally poorly tolerated D. Poses a greater risk to health than continued tobacco use

B. Reliably increases long-term smoking abstinence rates Pharmacological interventions include nicotine replacement therapy (NRT)(eg. patch, gum, inhaler, nasal spray, and lozenge) and medications to reduce the desire to smoke (buproprion [Zyban, Wellbtrin] and varenicline [Chantix])

The most common mode of influenza virus transmission is via: A. Contact with a contaminated surface B. Respiratory droplet C. Saliva contact D. Skin-to-skin contact

B. Respiratory droplet

When answering questions about HAV vaccine, the NP considers that it: A. Contains live virus B. Should be offered to adults who frequently travel to developing countries C. Is contraindicated for use in children younger than age 6 years D. Usually confers lifelong protection after a single injection

B. Should be offered to adults who frequently travel to developing countries

Concerning the MMR vaccine, which of the following is true? A. The link between use of MMR vaccine and childhood autism has been firmly established B. There is no credible scientific evidence that MMR use increases the risk of autism C. The use of the combined vaccine is associated with increased autism risk, but giving the vaccine's three components as separate vaccines minimizes this risk D. The vaccine contains thimerosal, a mercury dervivative

B. There is no credible scientific evidence that MMR use increases the risk of autism

In the U.S., universal childhood HBV began in what year? A. 1962 B. 1972 C. 1982 D. 1992

C. 1982 As a result, one major at-risk group is adults born before that date who have not been offered the vaccine.

Which of the following should not receive vaccination against influenza? A. A 19-year-old with a history of hive-form reaction to eat eggs B. A 24-year-old woman who is 8 weeks pregnant C. A 4-month-old infant who was born at 32 weeks of gestation D. A 28-year-old woman who is breastfeeding a 2 week old

C. A 4-month-old infant who was born at 32 weeks of gestation

Which of the following is a recommended method of annual colorectal cancer screening for a 62-year-old man? A. Digital rectal exam B. In-office fecal occult blood test (FOBT) C. At-home FOBT D. Sigmoidoscopy

C. At-home FOBT

A 44-year-old woman with asthma presents asking for a "flu shot." She is seen today for an urgent care visit, is diagnosed with a lower UTI, and is prescribed trimethoprim-sulfamethoxazole. She is without fever or GI upset with stable respiratory status. You inform her that she: A. Should return for the immunization after completing her antibiotics therapy B. Would likely develop a significant reaction if immunized today C. Can receive the immunization today D. Is not a candidate for any form of influenza vaccine

C. Can receive the immunization today

Which of the following type of cancer screening is not routinely recommended in a 55-year-old woman? A. Breast B. Skin C. Endometrial D. Colorectal

C. Endometrial

Which of the following is an example of a primary prevention activity in a 76-year-old woman with osteoporosis? A. Biphosphonate therapy B. Calcium supplementation C. Ensuring adequate illumination in the home D. Use of back brace

C. Ensuring adequate illumination in the home

You see a 48-year-old patient who started taking varenicline (Chantix) 4 weeks ago to aid in smoking cessation. Which of the following is the most important question to ask during today's visit? A. how many cigarettes a day are you currently smoking? B. On a scale of 0 to 10, how strong is your desire to smoke? C. Have you noticed any changes in your mood? Are you having any trouble sleeping?

C. Have you noticed any changes in your mood? Depressed mood, agitation, changes in behavior, SI, and suicide have been reported in patients attempting to quit smoking while using varenicline. Patients should tell their HCP about any history of psychiatric illness before starting this medication; clinicians should ask about mental health history before starting this medication.

Of the following, the most common route of hepatitis A virus (HAV) transmission is: A. Needle sharing B. Raw shellfish ingestion C. Ingestion of contaminated food or water D. Exposure to blood and body fluids

C. Ingestion of contaminated food or water Transmission is via fecal-oral route.

When advising a patient about the influenza nasal spray vaccine, the NP considers the following: A. Its use is acceptable during pregnancy B. Its use is limited to children younger than 6 years C. It contains live, attenuated virus D. This is the preferred method of influenza protection in the presence of airway disease

C. It contains live, attenuated virus Is also called FluMist. LAIV contains influenza viruses that are sufficiently weakened as to be incapable of causing disease but with enough strength to stimulate a protective immune response. The viruses in LAIV are cold-adapted and temperature-sensitive. As a result, the viruses can grow in the nose and throat but not in the lower respiratory tract where the temperature is higher. LAIV is approved for use in healthy people ages 2 to 49 years old. Individuals who should not receive LAIV include patients with a health condition that places them at high risk for complications from influenza, including CHD, chronic lung disease (asthma or reactive airways disease), DM, kidney failure, and immunosuppression; children or adolescents receiving long-term high-dose aspirin therapy; people with Guillain-Barre syndrome; pregnant women; and people with a history of allergy to any of the components of LAIV. Adverse effects of LAIV include nasal irritation and discharge, muscle aches, sore throat, and fever.

A middle-aged man with COPD who is about to receive injectable influenza vaccine should be advised that: A. It's more than 90% effective in preventing influenza B. Its use is contraindicated in the presence of psoriasis vulgaris C. Localized reactions such as soreness and redness at the site of immunization are fairly common D. A short, intense, flu-like syndrome typically occurs after immunization

C. Localized reactions such as soreness and redness at the site of immunization are fairly common

In which of the following groups is routine HBsAg screening recommended? A. Hospital laboratory workers B. Recipients of hepatitis B vaccine series C. Pregnant women D. College students

C. Pregnant women Without intervention, about 40% of infants born to mothers with HBV will develop chronic hepatitis B and about 1/4 of the infected infants will go on to die from chronic liver disease. As a result, all pregnant women should be screen for HsAg at the first prenatal visit, regardless of HBV vaccine history. Women with particularly high risk for new HBV acquisition during pregnancy should be retested in later pregnancy.

Influenza protection options for a 62-year-old man with HTN, dyslipidemia, DMII include receiving: A. Live attenuated influenza vaccine via nasal spray B. High-dose trivalent inactivated vaccine (TIV) via IM injection C. TIV in standard dose via IM injection D. Appropriate antiviral medication as the initial onset of influenza-like illness

C. TIV in standard dose via IM injection Adults aged 65 and older can receive the standard-dose IIV or the high-dose IIV (Fluzone High-Dose)

A 50-year-old man with HTN and dylipidemia presents for a primary care visit. He states, "It has been at least 10 years since my last tetanus shot." He should be immunized with: A. Td B. Tetanus IG C. Tdap D. None of the above, owing to his concomitant health problems

C. Tdap

An 18-year-old man has no primary tetanus immunization series documented. Which of the following represents the immunization needed? A. 3 doses of diptheria, tetanus, and acellular pertussis (DTaP) vaccine 2 months apart B. Tetanus IG now and 2 doses of tetanus-diptheria (Td) vaccine 1 month apart C. Tdap vaccine now with a dose of Td vaccine in 1 and 6 months D. Td vaccine as a single dose

C. Tdap vaccine now with a dose of Td vaccine in 1 and 6 months For adults receiving initial immunization, a series of three vaccine doses is needed. 2 of the 3 can be Td, and one should be Tdap.

Concerning hepatitis B virus (HBV) vaccine, which of the following is true? A. The vaccine contains live, whole HBV B. Adults should routinely have anti-hepatitis B surface antibody titers measured after three doses of vaccine C. The vaccine should be offered during treatment for STDs in unimmunized adults D. Serologic testing for hepatitis B surface antigen (HBsAg) should be done before hepatitis B vaccination is initiated in adults

C. The vaccine should be offered during treatment for STDs in unimmunized adults

Which of the following women should have screening for cervical cancer? A. An 18-year-old who has a history of genital warts B. A 17-year-old with coitarche 3 years ago and 4 male sexual parterns C. An 80-year-old with heart failure and a remote history of normal Pap test results D. A 21-year-old who has had one male sexual partner and consistent condom use

D. A 21-year-old who has had one male sexual partner and consistent condom use

All of the following individuals have not received vaccination against HBV. The vaccine should not be given in which of the following patients? A. A 35-year-old man with multiple sclerosis B. A 25-year-old woman with a past history of Guillain-Barre Syndrome C. A 48-year-old woman with systemic lupus erythematosus D. A 28-year-old man who is acutely ill with bacterial meningitis

D. A 28-year-old man who is acutely ill with bacterial meningitis Immunization against HBV should be delayed in the face of serious or life-threatening illness

Which of the following statements is correct about the varicella vaccine? A. It contains killed varicella-zoster virus (VZV) B. The use of the vaccine is associated with an increase in reported cases of shingles C. Varicella vaccine should be offered to adults who were U.S. born prior to 1980 and report a childhood history of chickenpox D. Although highly protective against invasive varicella disease, mild cases of chickenpox have been reported in immunized individuals

D. Although highly protective against invasive varicella disease, mild cases of chickenpox have been reported in immunized individuals

When a critical portion of a community is immunized against a contagious disease, most members of the community, even the unimmunized, are protected against that disease because there is little opportunity for an outbreak. This is known as _____ immunity. A. Passive B. Humoral C. Epidemiologic D. Community

D. Community

When advising a patient about injectable influenza immunization, the NP considers the following about the use of this vaccine: A. Its use is not recommended in sickle cell anemia B. Its use is limited to children older than 2 years C. Its use is limited due to containing live virus D. Its use is recommended for virtually all members of the population

D. Its use is recommended for virtually all members of the population

When advising an adult patient about pneumococcal immunization, the NPN considers the following about the vaccine: A. The vaccine contains inactivated bacteria B. Its use is contraindicated in individuals with asthma C. It protects against community acquired PNA caused by atypical pathogens D. Its use is seldom associated with significant adverse reactions

D. Its use is seldom associated with significant adverse reactions

Smallpox disease includes which fo the following characteristics? A. Usually mild disease B. Lesions that erupt over several days C. Loss of contagiousness when vesicles form D. Lesions all at the same stage during the eruption phase of the illness

D. Lesions all at the same stage during the eruption phase of the illness In varicella, lesions are typically erupt over days are at various stages; some are vesicular, whereas some older lesions may be starting to crust over. In smallpox, all the skin lesions are usually at the same stage

A woman who has been advised to received varicella-zoster immune globulin (VZIG) asks about its risks. You respond that IG is a: A. Synthetic product that is well tolerated B. Pooled blood product that often transmits infectious disease C. Blood product obtained from a single donor D. Pooled blood product with an excellent safety profile

D. Pooled blood product with an excellent safety profile

You see a woman who has been sexually active with a man newly diagnosed with acute hepatitis B. She has not received hepatitis B vaccine in the past. You advise her that she should: A. Start a hepatitis B immunization series B. Limit the number of sexual partners she has C. Be tested for hepatitis B surface antibody D. Receive hepatitis B immune globulin (HBIG) and hepatitis B immunization series

D. Receive hepatitis B immune globulin (HBIG) and hepatitis B immunization series Unvaccinated persons should receive HBIG and hepatitis B vaccine ASAP after exposure, preferably within 24 hours.

Usual treatment for an adults with acute hepatitis A includes: A. Interferon-alfa therapy B. High-dose ribavirin C. Parenteral acyclovir D. Supportive care

D. Supportive care Treatment is largely supportive. There is no chronic form of HAV infection

Risks associated with chronic hepatitis B include all of the following except: A. Hepatocellular carcinoma B. Cirrhosis C. Continued infectivity D. Systemic HTN

D. Systemic HTN About 5% of adults with HBV infection develop chronic hepatitis B; chronic hepatitis B is a potent risk factor for the development of hematoma or primary hepatocellular carcinoma and hepatic cirrhosis. Although appearing clinically well, a person with chronic hepatitis B continues to be able to transmit the virus.

Approximately _____ of healthcare providers receive influenza immunization annually. A. One-quarter B. One-half C. Two-thirds D. Three-quarters or more

D. Three-quarters or more

Which of the following is true about the MMR vaccine? A. It contains inactivated virus B. Its use is contraindicated in patients with a history of egg allergy C. Revaccination of an immune person is associated with risk of significant systemic allergic reaction D. Two doses at least 1 month apart are recommended for young adults who have not been previously immunized

D. Two doses at least 1 month apart are recommended for young adults who have not been previously immunized

List of 5 live, attenuated virus vaccines

MMR Varicella Intranasal influenza virus vaccine (FluMist) Zoster (Zostavax) Rotavirus vaccine (oral vaccine only given to young infants)