P1 Immunization Exam
For healthy patients 65 years of age and older who are indicated to receive both PCV13 and PPSV23, what is the recommended time period for separation of administration of the two vaccines?
1 year
Which of the following is a candidate for the 9vHPV vaccine?
11-year-old healthy male
Temperature and freezer logs must be kept for a period of at least:
3 years
Which of the following patients is a candidate for varicella vaccine?
5-year-old who received DTaP four weeks ago
Following the ACIP guidelines, for which of the following individuals is live attenuated influenza vaccine (LAIV) recommended?
A 10-year-old patient with a fear of needles
For which of the following individuals is Tdap recommended? (Select all that apply)
A 12-year-old female who completed the childhood DTaP series A 30-year-old pregnant female of 32 weeks gestation A 65-year-old female caring for her newborn granddaughter (all of them)
Which of the following individuals is a candidate for hepatitis A vaccine?
A 15-month-old male also receiving a 3rd dose of hepatitis B vaccine
For which of the following individuals is the human papillomavirus vaccine series indicated?
A 16-year-old female who recently became sexually active
For which of the following individuals is inactivated influenza vaccine (IIV) NOT recommended?
A 2-month-old healthy infant
For which of the following individuals is a mumps vaccine recommended?
A 22-year-old female who received a single dose of MMR and just accepted a position as a nurse on a general surgery unit
For which of these individuals is pneumococcal polysaccharide vaccine recommended today?
A 23-year-old healthy male who smokes
Which of the following patients should receive one dose of pneumococcal conjugate vaccine (PCV13)?
A 40 year old female status post recent splenectomy
For which of the following individuals would it be acceptable to use live attenuated influenza vaccine?
A 48 year old mechanical engineer whose spouse has type 2 diabetes
Which of the following patients can receive RZV?
A 57-year-old male with COPD treated with inhaled fluticasone/salmeterol
Following the ACIP guidelines, for which of the following individuals is recombinant zoster vaccine recommended?
A 65-year-old patient who received ZVL 2 years ago
Which of the following individuals has a risk factor for poor response to the hepatitis B vaccine series?
A 66-year-old male who is waiting for a cadaveric kidney transplant
Which of the following is a CDC best practice in regards to vaccine storage and handling?
A bio-safe glycol-based or buffered thermometer should be used to monitor the temperature of the refrigerator
Which of the following is not a permanent contraindication to vaccination?
A condition which would compromise the ability of the vaccine to produce immunity or protection from infection
Which is true about the incidence of measles in the United States?
A majority of cases are a result of importation in unvaccinated populations
Which of the following is NOT an example of active immunity?
Administration of high titer immune globulin
Which of the following is a valid contraindication to vaccination?
Anaphylaxis after a previous dose or vaccine component
Which of the following is a contraindication to receipt of routine vaccines?
Anaphylaxis to a previous dose
Which of the following vaccines is recommended for all healthcare workers?
Annual influenza vaccine
Which of the following is/are presyncopal signs? Select all that apply
Anxiety Sweating Clammy skin
Which of the following scenarios are healthcare professionals encouraged to use VAERS for reporting?
Any clinical significant adverse event after vaccination
Which of the following influenza vaccines may be administered to a patient who experiences only hives when eating eggs or egg-containing foods?
Any recommended and age-appropriate influenza vaccine that is otherwise appropriate for the person's health status
How should the disposal of sharps containers be handled?
Arranged with the local waste management company
Which of the following skills is among the standards of practice among immunizing pharmacists?
Basic life support (CPR)
Which of the following is a meningococcal serogroup B vaccine?
Bexsero
Which of the following is specifically listed as a VAERS reportable event for tetanus vaccine?
Brachial neuritis
Which of the following is the appropriate schedule for polio immunization in the United States?
Childhood immunization series with IPV at 2, 4, 6-18 months, and 4-6 years of age
Which of the following is a likely benefit of annual influenza immunization of school-aged children?
Decreases the magnitudes of influenza epidemics in the community
Which of the following statements is true?
Employers must offer the hepatitis B vaccine series to immunizing employees free of charge
Which of the following is true regarding bloodborne pathogen exposure and immunizations?
Every pharmacy providing immunizations must have a bloodborne pathogen exposure control plan
Anaphylaxis generally will not occur until 1-2 hours after administration of a vaccine.
False
If the date on the label of a vaccine or diluent has a specific month and year, the vaccine can be used only until the first day of the month listed.
False
Per OSHA (Occupational Safety and Health Administration), bloodborne pathogens training must be completed every 2 years for immunizers.
False
Polio is currently considered eradicated worldwide.
False
Which of the following influenza vaccines is produced using no eggs and no influenza virus?
Flublok (RIV4)
A 26-year-old female received the second dose in her series of varicella vaccine two weeks ago. Today she stepped on a rusty nail while working on her farm. Her last tetanus-diptheria (Td) dose was 6 years ago. Which of the following immunization strategies is appropriate? (Hint: Table 3-1 in General Best Practices)
Give Tdap now
Joe is a 28-year-old accountant who traveled to Bangkok for a two-month visit two years ago. As part of his preparations for that trip he received a dose of hepatitis A vaccine. He has received only a Tdap booster for a finger laceration since his return. He is now planning a trip to Beijing and seeks your advice regarding hepatitis A vaccination. What do you recommend?
He should receive a dose of hepatitis A vaccine now to complete the series.
Which of the following is a contraindication to receipt of the rotavirus vaccine?
History of intussusception
A US born 67-year-old was recently diagnosed with diabetes. His vaccine records indicate that he received his Tdap, pneumococcal (PPSV23), and influenza vaccines in October 2017. What vaccines would you recommend for him?
IIV, RZV, PCV13, and hepatitis B vaccine series
Which of the following are inactivated vaccines?
IIV4, PPSV23, Tdap
Joseph, a healthy 55-year-old male, is employed as a pharmacist at a chain pharmacy. The chain pharmacy will be implementing a corporate immunization program this October. Joseph wants to make sure he is up-to-date on his immunizations before the program begins. He has received no vaccinations since childhood. Which of the following vaccines are recommended for this patient?
IIV4, Tdap, Hepatitis B
Which of the following antibody classes is the mediator of allergy and anaphylaxis?
IgE
Which of the following is an advantage of immunization in nontraditional settings, such as a pharmacy?
Increased access and convenience for the patient
Which of the following describes the benefits of using standing orders for immunization?
Increases immunization coverage among adults in a variety of practice settings
Which of the following is the appropriate timing for influenza vaccine administration?
Influenza vaccine should be administered as soon as the clinician has a vaccine supply and if possible by October and should continue throughout the season
Which of the following most accurately describes the federally-mandated training for employees with blood and body fluid exposure?
Initial training and annual retraining are required for bloodborne pathogens
Most, but not all, states allow student pharmacist interns to administer vaccines. Which of the following is/are true in regards to student pharmacist immunization?
Interns who provide immunizations must be current in CPR and blood borne pathogens training
Which of the following is true regarding the use of Haemophilus influenzae type b vaccine?
Is a polysaccharide vaccine conjugated to a protein to improve immunogenicity in infants
Which of the following vaccines is administered via the subcutaneous route?
MMR
Mary received a blood transfusion following a recent motor vehicle accident. Response to which of the following vaccines will be most affected by this event?
Measles vaccine
Which of the following vaccines is contraindicated for a pregnant woman?
Measles, mumps, and rubella vaccine (MMR)
The recommendations for prevention of vaccine preventable diseases made by the Advisory Committee on Immunization Practices (ACIP) are published in which of the following?
Morbidity and Mortality Weekly Report (MMWR)
Refrigerator and freezer temperature(s):
Must be maintained between +36 and +46 F and -58 and +5 F respectively
Which of the following describe appropriate storage conditions for inactivated vaccines?
Must not be frozen
Which of the following describes a limitation of the quadrivalent meningococcal conjugate vaccine?
No protection from serogroup B
All pregnant women should optimally receive one dose of Tdap when?
Optimally between 27 and 36 weeks gestation of each pregnancy
Which of the following is an appropriate response to a patient who tells you that she is concerned that she will get influenza from the inactivated influenza vaccine (IIV)?
Other than a higher incidence of sore arm, influenza vaccine has a side effect profile similar to placebo
Which of the following is an advantage of passive immunity compared to active immunity?
Passive immunity protects almost immediately
Which of the following can be done to prevent vaccine storage problems?
Place containers of water labeled "do not drink" into refrigerator to stabilize temperatures
Which of the following vaccines should NOT be stored frozen?
Pneumococcal polysaccharide vaccine
Which of the following is a contraindication to receiving live vaccines?
Prednisone 40 mg po daily (started 1 month ago)
Which process correctly describes cocooning against pertussis?
Process of vaccinating close contacts including mother, father, siblings, grandparents, and out of home care providers
Which of the following describes the role of helper T cells in mounting an immune response to a vaccine?
Produce cytokines that stimulate B cells to produce antibodies
Which of the following describes the Vaccine Injury Compensation Program?
Protects the immunization provider and vaccine manufacturer from personal liability
The Countermeasures Injury Compensation Program (CICP):
Provides benefits to seriously injured individuals that resulted from using certain antivirals
Sam is a 48-year-old male presenting to a pharmacy wondering if he would be able to get the new zoster vaccine. You explain the guidelines to Sam, which explanation is correct?
RZV is indicated in immunocompetent patients aged 50 and older.
Martha is a 68-year-old female seeking your advice regarding immunization. Her son and daughter-in-law are expecting their first child in the next few months. She has received no vaccinations since childhood. Which of the following vaccines should she receive today?
RZV, IIV4, Tdap, PCV13
Pharmacists are an integral part of increasing vaccination rates in the community. Which of the following would be the LEAST effective strategy for a pharmacist to employ?
Recommend that a patient return for a vaccine at a later time when it is less busy
Which of the following methods describes how vaccines are covered under Medicare Part D?
Reimbursement based on negotiated amount based on vaccine, dispensing fee, sales tax, and vaccine administration fee
Hepatitis B is a virus spread by parenteral routes including blood transfusions, sharing of needles, sexual contact, and mother to neonate. Which is true about hepatitis B?
Renal failure will decrease response to hepatitis B vaccine Patients with diabetes are at an increased risk of hepatitis B due to sharing of diabetes supplies including blood glucose meters Using needles which are not long enough will decrease response rates Death commonly occurs as a result of cirrhosis and hepatocellular carcinoma All of the above
Rotavirus is a common childhood illness accounting for 1/3 of hospitalizations due to diarrhea. What is the appropriate vaccine recommendation for a 2-month-old child with a known history of latex allergy?
Rotateq at age 2, 4, and 6 months
The liquid diluent for the Shingrix vaccine:
Should be stored in the refrigerator
For a post-kidney transplant patient on chronic immunosupression with no history of pneumococcal vaccination, which of the following is correct?
Single dose of PCV13 followed by a single dose of PPSV23 8 weeks later
How should you proceed if vaccine arrives from the manufacturer under questionable conditions?
Store the vaccine as recommended separately from other stock, label with "Do Not Use", and call the manufacturer's quality control office for advice
Which of the following is true regarding vaccine preparation?
Syringes other than those filled by the manufacturer should be administered immediately
Which of the following describes a difference between Tdap and DTaP?
Tdap has a lower dose of diphtheria toxoid for use in individuals aged 10-11 years and older
A 13-year-old male and his mother go to the community pharmacy for a refill on his ADHD medication. His mother notices the pharmacy's immunization clinic sign and realizes her son has not seen his primary care provider for several years. She wonders if he is up-to-date with immunizations. He was up-to-date at his 4 to 6-year-old well child visit and has received no immunizations since. Which of the following vaccines are recommended for this patient?
Tdap, 9vHPV, MCV4, IIV4
Which of the following is the appropriate strategy for giving the Vaccine Information Statement (VIS) to patients?
The VIS should be given to the patient prior to immunization so the patient has time to review it and ask questions
Which of the following is/are true regarding live attenuated vaccines?
The injectable live attenuated vaccines usually product immunity with one dose
Which of the following is the reason that a second dose of measles vaccine is recommended for all college students?
The second dose provides another opportunity for seroconversion for those who failed to respond to the first dose
Which of the following items should be included in immunization records for vaccines administered in the pharmacy?
The vaccine and date administered, site of administration, vaccine manufacturer and lot number, VIS publication date with the date given to the patient/parent or guardian, and the initials and title of the practitioner administering the vaccine
Which of the following best describes immunization information registries?
The value of the registry is that it allows healthcare providers to access immunization records to facilitate clinical decision making
Why is the safety of vaccines held to a higher standard than for most medications?
They are administered to healthy people to prevent disease rather than to sick people to cure disease
Which of the following is true regarding Vaccine Information Statements (VIS)?
They are designed to provide information about vaccines, or, in the case of a minor, the child's parent or guardian about the risks and benefits of each vaccine
Which of the following is specifically listed as a VAERS reportable event for measles vaccine?
Thrombocytopenic purpura
Which of the following should be completed in all pharmacies that provide immunizations?
Training employees about bloodborne pathogens and the pharmacy's bloodborne exposure control plan
A patient using a fluticasone metered-dose inhaler BID for asthma is considered immunocompromised
True
Is the following statement true or false? Increasing the interval between doses of a multi-dose vaccine does not diminish the effectiveness of the vaccine.
True
Joe is a 20-year-old patient stating that he remembers having the chicken pox when he was young. He is a candidate for the varicella vaccine.
True
One of the Clinical Immunization Safety Assessment (CISA) project's main goal is to serve as a vaccine safety resource for consultation on clinical vaccine safety issues.
True
Which of the following describes the procedure for intramuscular administration of a vaccine to an adult patient?
Use a 25 gauge, 1 inch needle
A vaccine-related error should be reported to which of the following programs? (Select all that apply)
VERP (ISMP) VAERS (FDA)
Which of the following is true regarding the timing of immunization?
Vaccinate two weeks before elective splenectomy or after acute recovery from splenectomy
Which of the following represents a true contraindication to measles vaccine?
Vaccine candidate is pregnant
HPV vaccine is currently indicated for females and males as young as 9 years old and up to age 26. A mother is considering vaccination for her young son, but some commercials that she recalls lead her to believe this vaccine is for prevention of cervical cancer, and does not see how this will benefit her son. How do you expain to this mother the importance of this vaccine for her son?
Yes, this does prevent cervical, vulvar, and vaginal cancer in women; however it also protects against genital warts, anal cancer, as well as other cancer strains There are benefits for protection for him contracting strains of virus as well as spreading the virus to others This is the most common sexually transmitted infection All of the above
The primary vaccine coordinator at a practice site should be responsible for:
b) Ensuring that vaccines are stored and handled correctly c) Ensuring that staff is adequately trained
