Ch 12: Immunizations

The nurse should be prepared to administer an infant's first dose of polio vaccine at what age? 2 months As a newborn, provided the neonate is healthy 12 months 4 to 6 years, or before starting school

2 months Explanation: The first recommended dose of polio vaccine is at age 2 months

After teaching a parent about common adverse effects associated with routine immunizations, which of the following, if stated by the parent, would indicate the need for additional teaching? A) Difficulty breathing and fainting B) Fever and rash C) Drowsiness and fretfulness D) Swelling and nodule formation at the site of injection

A) Difficulty breathing and fainting

A pt is to receive immune globulin after exposure to hepatitis A. The pt has a previous history of allergies to various drugs. Before giving the immune globulin the nurse should: A) Have emergency equipment readily available B) Premedicate the pt with aspirin C) Make sure all the pt's vaccinations are up to date D) Make sure the pt has a ride home

A) Have emergency equipment readily available

An adult client being treated for breast cancer inquires about required vaccinations. What information should the nurse provide to this client? A. Receive a tetanus-diphtheria-pertussis booster. B. Avoid all immunizations for the next 24 months. C. Avoid all live vaccines. D. Be immunized against pneumococcal disease promptly.

C. Avoid all live vaccines. Clients with active malignant disease should not receive live vaccines. A tetanus-diphtheria-pertussis booster is not likely necessary, and there is no indication for a pneumococcal immunization. When possible, clients should have needed immunizations 2 weeks before or 3 months after immunosuppressive radiation or chemotherapy treatments.

A nursing instructor is teaching a session illustrating the various forms of immunity utilized by the human body. The instructor determines the session is successful when the students correctly choose which type of immunity as developing after the use of ready-made antibodies from animals? Passive immunity Cell-mediated immunity Humoral immunity Active immunity

Passive immunity Explanation: The nurse is referring to passive immunity. The injection of ready-made antibodies found in the serum of immune individuals or animals is called passive immunity. When a person is exposed to antigens, the body begins to form antibodies. This is called active immunity. Humoral and cell-mediated immunity involve the action by B lymphocytes and T lymphocytes.

To prevent meningococcal infections, the nurse would administer: Vaccine Toxoid Immune globulin Antivenin

Correct response: Vaccine Explanation: Meningococcal infections would be prevented by a vaccine. A toxoid is a type of vaccine made from the toxins produced by the organism. Immune globulins and antivenin are examples of immune sera.

A 70-year-old client is seen in the family practice clinic. Which vaccine should be administered to prevent herpes zoster? Zoster vaccine Haemophilus influenzae type B vaccine Human papillomavirus (HPV) Pneumococcal polyvalent

Correct response: Zoster vaccine Explanation: Zoster vaccine is administered to adults 60 years and older to prevent herpes zoster (shingles). The Haemophilus influenzae type B is not administered to prevent herpes zoster. HPV and pneumococcal vaccine do not address the risk factors for shingles

A 1-year-old child will receive a scheduled MMR vaccination shortly. The nurse should teach the child's parents that the child may develop what possible adverse effect related to the administration of this medication? Cough and fever Pallor and listlessness Serum sickness Nausea and vomiting

Cough and fever Explanation: Adverse effects associated with MMR vaccine include fever and cough. Nausea and vomiting, pallor and listlessness, and serum sickness are not among the noted adverse effects of the MMR vaccine.

The nursing instructor is discussing immunity with the clinical group. What statement would the instructor make that would be an accurate statement concerning immunity? Passive immunity occurs when the body recognizes a foreign protein and begins producing antibodies to react with the specific protein or antigen. People are born with passive immunity. Active immunity occurs when antibodies are injected into the body and react with specific antigens. Passive immunity is limited.

Passive immunity is limited. Explanation: Unlike active immunity, passive immunity is limited. It lasts only as long as the circulating antibodies last because the body does not produce its own antibodies as with active immunity. People are born with active immunity in which the body recognizes a foreign protein and begins producing antibodies to react with specific proteins or antigens.

A nurse is reviewing the history of a child who is scheduled to receive immunizations during this health care visit. A history of what issue would alert the need for cautious use of a vaccine? Febrile convulsions Immune deficiency Blood transfusion 3 weeks ago Allergy to vaccine component

Febrile convulsions Explanation: Caution is necessary any time a vaccine is given to a child with a history of febrile convulsions. Immune deficiency would contraindicate the use of vaccines. An allergy to a vaccine component would contraindicate the use of vaccines. A blood transfusion within the past 3 months would contraindicate the use of vaccines.

An immunocompromised client is exposed to hepatitis A. The health care provider orders an injection of immunoglobulin as prophylaxis against the hepatitis A. What adverse effects would the nurse advise the client might occur? (Select all that apply.) Fever Severe abdominal pain Rhinitis Urticaria Angiedema

Fever Angiedema Urticaria Explanation: Adverse effects: Tenderness, muscle stiffness at site of injection; urticaria, angiedema, nausea, vomiting, chills, fever, and chest tightness. An immunocompromised client would not be told to watch for rhinitis or severe abdominal pain.

The school nurse is participating in a program to immunize students against human papillomavirus (HPV). What benefit should the nurse describe to students and their families? -Protection against several viral sexually transmitted infections -Reduced risk for polycystic ovary syndrome -Reduced risk for cervical cancer -Reduced risk for pelvic inflammatory disease (PID)

Reduced risk for cervical cancer

Which vaccine would the nurse be least likely to recommend for a 6 month old child? A) Diphtheria, tetanus, pertussis vaccine B) Haemophilus influenzae b vaccine C) Poliovirus vaccine D) Chickenpox vaccine

D) Chickenpox vaccine

The nurse is preparing to administer the rotavirus vaccine to an infant. The nurse would expect to administer this vaccine by which route? Oral Intradermal Intramuscular Subcutaneous

Oral Explanation: The rotavirus vaccine is only administered orally.

Which agent would the nurse expect to administer to a pregnant woman to prevent Rh factor sensitization? Crotalidae polyvalent immune fab RHO immune globulin

RHO immune globulin Correct Explanation: To prevent Rh factor sensitization, the woman would receive RHO immune globulin (RhoGAM). Crotalidae polyvalent immune fab would be used to treat rattlesnake bites.

The nursing instructor is explaining the best way to assess whether active immunity has developed from the administration of the hepatitis B series. What would the instructor cite as the best assessment method?

Serum antibody levels

A patient develops fever and arthralgia 4 days after the administration of tetanus toxoid. What reaction to the vaccine is this? -Distress syndrome -Anaphylaxis -Serum sickness -Infectious process

Serum sickness

Which are used to produce active immunity? (Select all that apply.) Toxoids Antigens Vaccines Immune globulin Antibodies

Vaccines Toxoids Explanation: The immunity produced by the administration of toxoids and vaccines is considered active immunity.

The nurse provides patient teaching to a client. The nurse explains the purpose of vaccines is to promote what? Select all that apply. activation of the immune system passive immunity lifetime immunity active immunity short-term immunity

active immunity lifetime immunity activation of the immune system Explanation: The word vaccine comes from the Latin word for smallpox, vaccinia. Vaccines are immunizations containing weakened or altered protein antigens that stimulate the formation of antibodies against a specific disease. They are used to promote active immunity that will last for a lifetime, although some clients will require smaller booster doses to maintain immunity.

A neonate who weighs 7 lbs, 8 oz kg is prescribed the hepatitis B immune globulin at a dose of 0.06 mL/kg IM. To one decimal place, what dose should the nurse administer?

0.2 Explanation: The neonate's weight in kg is 3.41 kg (7.5 lbs divided by 2.2). The prescribed dose is 0.06 X 3.41, which yields 0.2 mL to one decimal place.

The parents of a two month-old infant have brought their child in to the clinic for the first scheduled immunizations. The parents appear anxious and the child's father says, "We keep hearing about the link between vaccinations and autism. Is there a risk that it could happen to our child?" "There's been shown to be no genuine link between children receiving vaccinations and developing autism." "The risks of developing autism from a vaccination are exceedingly low and were greatly exaggerated in the media." "There's a rigorous process in place to ensure that vaccinations are safe in this country." "Unfortunately, this goes to show that you can't necessarily believe everything that you hear."

Correct response: "There's been shown to be no genuine link between children receiving vaccinations and developing autism." Explanation: The parent's question specifically focuses on a putative link between vaccines and autism. It has been shown that there is no link so the nurse should provide this information to the client. The statement about not believing everything you hear could be construed as condescending. The risks of autism as a direct result of vaccinations are not low; instead, they are absent. The nurse's general statement about the safety of vaccines does not address the client's specific question

A health care worker has received an annual influenza vaccination and has remained at the clinic after administration so that the nurse may observe for adverse reactions. The worker reports pain at the site of IM injection. What should the nurse recommend? Aspirin Acetaminophen Meperidine Heat application

Correct response: Acetaminophen Explanation: Most vaccines can cause fever and soreness at the site of injection. Acetaminophen can be taken two to three times daily for 24 to 48 hours if needed to decrease fever and discomfort. Aspirin and heat are not explicitly recommended; opioids are not necessary.

A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive? Immune globulin Antivenin crotalidae Zoster vaccine BCG vaccine

Immune globulin Explanation: Hepatitis B immune globulin would be used for post-exposure prophylaxis for hepatitis B. Zoster vaccine would be used to prevent herpes zoster (shingles) in persons over the age of 60 years. Antivenin (Crotalidae) would be used to neutralize the venom of pit vipers, rattlesnakes, and copperheads. BCG vaccine (Bacillus Calmette-Guérin vaccine) would be used to prevent tuberculosis in those with a high risk for exposure.

A landscaper has sought care because of a puncture wound to her foot and the provider has prescribed 250 units of the tetanus immune globulin. In preparation for administration, the nurse should: establish reliable intravenous access. educate the client about the availability of the tetanus vaccine. assess the skin integrity of potential intramuscular injection sites. assess the client for signs of tetany.

assess the skin integrity of potential intramuscular injection sites. Explanation: The tetanus immune globulin is administered by the IM route. Education is likely necessary but the administration of the immune globulin is the priority. Tetany develops several days after tetanus infection.

The nurse is working with an 18-year-old client who recently immigrated and who did not receive childhood immunizations. The client is "catching up" on immunizations and is scheduled to receive a measles, mumps and rubella (MMR) vaccine today. What should the nurse teach the client about potential adverse effects? "Some people have a strong reaction to immunizations so we'll ask you to stay at the clinic for the next few hours." "Fortunately, modern vaccines are effective without causing any adverse effects." "You might feel a bit unwell or get a slight fever after receiving your immunization." "Make sure you seek care immediately if you experience any chills because it could be a sign of an emergency."

"You might feel a bit unwell or get a slight fever after receiving your immunization." Explanation: In general, immunizations are well tolerated. However, there is a possibility of a mild immune or inflammation reaction that sometimes causes a mild fever or malaise. Chills can also occur, but this does not constitute an emergency unless it is accompanied by other symptoms that cause distress. Clients are often monitored briefly after receiving a vaccine, but this does not normally require multiple hours of direct observation.

A 82-year-old client is brought to the clinic by their adult child. The adult child asks how often their parent should receive the influenza vaccine. What would be the nurse's appropriate response? "Your parent should receive the vaccine once, with two booster injections, 6 months apart." "Your parent needs the influenza vaccine every 10 years." "Your parent needs the influenza vaccine once each year." "A decision about the influenza vaccine is made on the basis of your parent's individual risk factors."

"Your parent needs the influenza vaccine once each year."

A mother brings her 18-month-old into the clinic for a well-baby check-up. A nurse will administer measles, mumps, and rubella vaccine (MMR) to the 18-month-old. What dosage will the nurse administer? Blood pressure Temperature Respirations Pulse

0.5 mL The nurse will administer 0.5 mL. This is the recommended dose for adults and children older than 15 months of age.

The onset of protection after the administration of an immune globulin to a patient is rapid, but its duration is short on the order of which of the following? (Choose one) 1 to 3 months 3 to 6 months 6 - 12 months 1 - 2 years

1 to 3 months Explanation: While onset after immune globulin administration is rapid, the duration is short, only 1 to 3 months. Vaccinations have some minor adverse reactions, such as fever, rashes, and aching joints, are possible with the administration of a vaccine. In most cases, these reactions subside within 48 hours. It is recommended that the live virus vaccines be administered 14 to 30 days before or 6 to 12 weeks after administration of immune globulins.

A nurse is required to administer a varicella vaccine to a female patient planning to start a family. How long after the vaccination should the nurse instruct the patient to wait before getting pregnant? Two weeks Four weeks Eight weeks 12 weeks OR The nurse has just administered the measles, mumps, and rubella vaccine to a female client. The nurse instructs the woman to avoid becoming pregnant for how long? at least 1 month at least 3 months at least 14 days at least 7 days

12 weeks OR at least 3 months Explanation: Women are instructed to avoid becoming pregnant for at least 3 months after receiving the measles, mumps, rubella, and varicella vaccines. Less time than 3 months is considered unsafe and can pose potential harm to the fetus.

The nurse is explaining a schedule for vaccinations to the parents of a new patient. When would the nurse explain that the measles, mumps, and rubella (MMR) vaccine is initially administered? 1 month 15 months 3 months 6 months

15 months Explanation: MMR is administered initially as a combined vaccine at 15 months.

The nurse understands that administration of the routine and booster vaccines are indicated for immunization against polio in which of the following age groups? Select all that apply. 7 years 2 months 6 months 8 years 4 months

2 months 4 months 6 months Explanation: The inactivated polio vaccine (IPV) routine and booster doses are indicated for immunization against polio at 2 months, 4 months, and 6 to 18 months of age. A booster is given between 4 and 6 years of age.

A nurse has to administer 0.06 ml/kg of hepatitis B immune globulin IM to a patient. The total body weight of the patient is 50 kg. How many ml of the drug should be administered to the patient? 5 ml 3 ml 4 ml 2 ml

3 ml Explanation: The nurse should administer 0.06 ml/kg of vaccine. Therefore, for 50 kg body weight, the required dose is 3 ml (0.06 ml/kg x 50 kg).

A female client is receiving chemotherapy for breast cancer. She requires a vaccine booster. For when would the healthcare provider order the administration of the vaccine? OR A male client is treated for his cancer of colon with a combination of chemotherapy and radiation therapy. During a routine physician's visit, the nurse determines that the client is behind in his immunizations. When should the nurse schedule immunizations? 30 days after chemotherapy is completed 6 months after chemotherapy is completed 3 months after chemotherapy is completed 1 year after chemotherapy is completed

3 months after chemotherapy is completed Explanation: When vaccines are used, they should be given at least 2 weeks before the start of chemotherapy or 3 months after chemotherapy is completed. Passive immunity with immunoglobulins may be used in place of active immunity.

If a nurse is administering immune globulin to a patient in the physician's office, how long should the patient stay to be observed for hypersensitivity reactions?

30 minutes Explanation: The client should be asked to stay in the health care provider's office for about 30 minutes after the injection of immune globulin so the nurse can observe for any signs of hypersensitivity. Reactions usually occur within the first 30 minutes.

The nurse is educating an older adult client following administration of a tetanus-diphtheria (Td) booster. Which statement indicates that the client correctly understands current recommendations related to this immunization? OR An elderly client has been given a tetanus-diphtheria (Td) booster after stepping on a rusty nail. Which statements indicate an understanding of vaccine schedules? A. ''I know that this booster is good for 10 years.'' B. ''I will need to return in 1 year for another injection.'' C. ''I do not need to worry about infection after getting this injection.'' D. ''I will need to return in 6 months for another injection.''

A. ''I know that this booster is good for 10 years.'' Recommended immunizations for older adults consist of a tetanus-diphtheria (Td) booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age.

A client is undergoing a yearly physical. While discussing immunizations, the client states not wanting any immunizations because ''they have too many risks''. The nurse's best response should include what statement? A. ''Immunizing agents are quite safe, and risks of the diseases they prevent are greater than the risks of the vaccines.'' B. ''That was true a long time ago, but the new vaccines are completely safe.'' C. ''Vaccines are no longer made with live viruses, so you do not have to worry about being infected.'' D. ''Vaccines made from live viruses can cause illnesses, but they are only used for clients with immunosuppression.'' n

A. ''Immunizing agents are quite safe, and risks of the diseases they prevent are greater than the risks of the vaccines.'' In general, immunizing agents are quite safe, and risks of the diseases they prevent are greater than the risks of the vaccines. However, risks and benefits for particular recipients should be considered because no vaccine is completely effective or completely safe. Some people may develop a disease after being immunized against it. However, if this happens, symptoms are usually less severe and complications are fewer than if the person had not been immunized. Adverse effects are usually mild and of short duration. Although the FDA evaluates vaccine safety before and after a vaccine is marketed, some adverse effects become apparent only after a vaccine is used in a large population. Vaccines made with live viruses are still used widely; their use in clients with immunosuppression, however, may be limited or contraindicated, depending on the type of vaccine and the underlying health condition.

What recommendation concerning vaccinations should the nurse provide to a 50-year-old adult client? A. Annual influenza vaccination B. One-time human immunodeficiency virus (HIV) vaccination C. One-time human papillomavirus (HPV) D. Annual measles, mumps, rubella (MMR)

A. Annual influenza vaccination Middle-aged adults should maintain immunizations against influenza with an annual flu vaccination. There is no HIV vaccine. Annual MMR and HPV are not recommended or necessary.

The nurse is preparing to administer an injection of influenza vaccine to a client. What possible short-term adverse effects should the nurse mention in client teaching? Select all that apply. A. Malaise B. Muscle aches C. Low-grade fever D. Erythema at the injection site E. Anorexia

A. Malaise B. Muscle aches C. Low-grade fever D. Erythema at the injection site Influenza vaccine via injection may cause pain, induration, and erythema at injection sites and flu-like symptoms such as chills, fever, malaise, and muscle aches. Anorexia is not generally associated with the short-term adverse effects of an influenza vaccination.

The school nurse at a junior high school shares with the students' parents that which vaccination will require administration of booster? A. Meningococcal vaccine B. Measles, mumps, rubella (MMR) C. Zoster vaccine D. Hepatitis C vaccine

A. Meningococcal vaccine Adolescents should receive meningococcal vaccine at age 11 or 12 with a booster dose at age 16. The MMR vaccine does not require a booster, although adolescent clients should receive the vaccine if they were not given it at a younger age. The zoster vaccine is for clients aged 60 years and older. There is no vaccine for hepatitis C.

Which statement should the nurse include in a discussion about passive immunity? A. Passive immunity provides temporary protection from disease. B. Passive immunity is safer than active immunity. C. Passive immunity involves the direct administration of antigens. D. Passive immunity confers immunity without the involvement of antibodies.

A. Passive immunity provides temporary protection from disease. Passive immunity results from parenteral administration of immune serum containing disease-specific antibodies to a nonimmune person. Passive immunity is only temporary, and the person still needs a vaccine against a specific disease to develop antibodies that provide long-term immunity. It is inaccurate to characterize passive immunity as being safer than active immunity. Administration of antigens results in active immunity.

What is the difference between toxoids and vaccines? A. Toxoids always require occasional boosters. B. Only vaccines are free of adverse effects. C. Vaccines offer lifelong immunity, and toxoids do not. D. Toxoids are naturally derived.

A. Toxoids always require occasional boosters. Many (but not all) vaccines produce long-lasting immunity. Attenuated live vaccines produce immunity, usually lifelong, that is similar to that produced by natural infection. Toxoids are bacterial toxins or products that have been modified to destroy toxicity while retaining the ability to induce antibody formation. Immunization with toxoids is not permanent; scheduled repeat doses (boosters) are required to maintain immunity. No immunization is wholly free of adverse effects.

A nurse is explaining to a parent how vaccines work. Vaccines provide which of the following? A. active immunity B. passive immunity C. innate immunity D. nonspecific immunity

A. active immunity Rationale: Active response is mediated by our own antibodies through either antibody naturally occurring through exposure to an illness or through the immunizations we receive. It is called active immunity because it requires the host's own immune system to develop an immunologic response including the development of memory.

What would necessitate cautious use of a vaccine in a child? (Select all that apply.) Blood transfusion within the past 3 months History of febrile convulsions History of brain injury Immune deficiency Acute infection

Acute infection History of febrile convulsions History of brain injury Explanation: Caution should be used any time a vaccine is given to a child with a history of febrile convulsions or brain injury or in any condition in which a potential fever would be dangerous. Caution also should be used in the presence of any acute infection. An immune deficiency and a blood transfusion within the past 3 months are contraindications to the use of vaccines.

The nurse is assessing a client who is to receive multiple vaccinations. Which nursing diagnosis should the nurse prioritize for this client? Acute pain Ineffective coping Hyperthermia Risk for infection

Acute pain Explanation: The client who is receiving an immunization would most likely experience pain at the injection site; therefore, acute pain would be most appropriate. If the drug were not given, then the client would be at risk for infection. Although fever may occur, hyperthermia as a nursing diagnosis would be inappropriate. Ineffective coping would not be associated with immunologic agents.

A client has presented to the emergency department with a puncture wound suffered a few hours ago while demolishing an old house. The nurse's assessment reveals that the client is not in acute distress. The client's immunization status is unknown. What intervention should the nurse prioritize? Administering cytomegalovirus immune globulin as prescribed Assessing the client for signs and symptoms of localized or systemic infection Educating the client about the importance of immunizations Administering tetanus immune globulin as prescribed

Administering tetanus immune globulin as prescribed Explanation: Puncture wounds are a common source of tetanus infection and the administration of tetanus immune globulin is recommended if the client's immunizations are out of date or unknown. Cytomegalovirus immune globulin is administered to transplant recipients. The client would benefit from education, but this intervention is not time dependent or an immediate priority. The client's injury is recent, so there would not yet be signs of infection.

The nursing instructor is illustrating the various immunity's the body utilizes to combat disease. The instructor determines the session is successful when the students correctly choose which example(s) to differentiate artificially acquired active immunity from other types? Select all that apply. An individual who is exposed to chickenpox for the first time and has no immunity to the disease Administration of the influenza vaccine to an individual who has no immunity to the disease Administration of the rubella vaccine to an individual who has no immunity to the disease Administration of the varicella vaccine to an individual who has no immunity to the disease An individual who is exposed to pertussis for the first time and has no immunity to the disease

Administration of the varicella vaccine to an individual who has no immunity to the disease Administration of the influenza vaccine to an individual who has no immunity to the disease Administration of the rubella vaccine to an individual who has no immunity to the disease Explanation: Artificially acquired active immunity occurs when an individual is given a killed or weakened antigen in the form of a vaccine, which stimulates the formation of antibodies against the antigen. The antigen does not cause the disease, but the individual still manufactures specific antibodies against the disease. Administration of the varicella vaccine, administration of the influenza vaccine, and administration of the rubella vaccine to an individual who has no immunity to the disease are examples of artificially acquired active immunity. Naturally acquired active immunity occurs when the person is exposed to and experiences a disease and the body manufactures antibodies to provide future immunity to the disease.

A nurse is teaching a client about the use of immune globulins. The nurse determines the session is successful when the client can successfully point out which fact(s) about immune globulins? Select all that apply. Receive antibodies only to the diseases to which donor blood is immune. Are proteins present in serum or plasma that contain antibodies. Can be obtained from human and animal blood. Are given to provide active immunity against disease. Onset of protection is rapid with a duration of 6-12 months.

Are proteins present in serum or plasma that contain antibodies. Can be obtained from human and animal blood. Receive antibodies only to the diseases to which donor blood is immune. Explanation: The following is true in regard to the use of immune globulin: globulins are proteins present in blood serum or plasma that contains antibodies; globulins are given as passive immunity against disease; immune globulin can be obtained from human and animal blood; clients receiving immune globulins receive antibodies only to the diseases to which donor blood is immune; and the onset of protection is rapid but the duration of action is short (1-3 months).

A client currently undergoing chemotherapy asks the nurse for guidance on immunization over the next several months. Which is the nurse's best response? A. ''There are no contraindications against vaccines while on chemotherapy.'' B. ''You should not be given live vaccines and should wait for 3 months after stopping chemotherapy to get the vaccines.'' C. ''You should be given live vaccines, and getting the flu vaccine is especially important.'' D. ''Get the vaccines, then wait at least 2 months before resuming chemotherapy.''

B. ''You should not be given live vaccines and should wait for 3 months after stopping chemotherapy to get the vaccines.'' Clients with active malignant disease may be given killed vaccines but should not be given live vaccines. When vaccines are used, they should be given at least 2 weeks before the start of chemotherapy or 3 months after chemotherapy is completed. Passive immunity with immunoglobulins may be used in place of active immunity.

A client has been prescribed prednisone 40 mg daily. What information about immunizations should the nurse include during client teaching? A. ''Immunizations are entirely appropriate when taking prednisone.'' B. ''You should wait at least 3 months after corticosteroid therapy to obtain a live vaccine immunization.'' C. ''You cannot be given a live vaccine immunization for the next 2 years.'' D. ''You should wait at least 2 weeks after prednisone therapy to obtain a live vaccine immunization.''

B. ''You should wait at least 3 months after corticosteroid therapy to obtain a live vaccine immunization.'' Clients receiving a systemic corticosteroid in high doses (e.g., prednisone 20 mg or equivalent daily) or for longer than 2 weeks should wait at least 3 months before being given a live virus vaccine. Immunizations are not contraindicated with short-term use (less than 2 weeks) or low to moderate doses (less than 20 mg daily) of prednisone. None of the other options present accurate information concerning immunizations for a client currently prescribed prednisone.

A child is receiving an immunization. The nurse should inform the parents that common aftereffects may include which of the following? OR A nurse is providing patient education to the mother of a child receiving their first immunization. The nurse tells the mother that after the injection it is normal for the child to have: A. skin rash and itching B. redness and soreness at the injection site C. muscle weakness and difficulty in walking D. cause, vomiting, and diarrhea When instructing the parents of a child who has received immunization in the vastus lateralis, which reaction is most common in the days after the administration? -tenderness and redness at the site -weakness and difficulty walking -rash and edema -nausea, vomiting, and diarrhea

B. redness and soreness at the injection site or pain, redness, and swelling at site of injection Rationale: Muscle weakness and difficulty walking seem a lot more severe and rare that redness and soreness at the injection site. Nausea, vomiting and diarrhea don't seem like a common effects either. Skin rash and itching could indicate that the child could be getting an allergic reaction to the vaccination, which is crucial to treat right away rather than considering it a common side effect.

The nurse is caring for a patient with severe immunosuppression. This condition is a contraindication to which of the following? A. all injectable immunizations B. the use of live bacterial or viral vaccines C. the use of immune globulins for passive immunity D. annual influenza vaccine

B. the use of live bacterial or viral vaccines Rationale: Vaccines manufactured from live organisms are contraindicated in people whose immune systems are suppressed because, if given, the vaccines could cause diseaserather than prevent it.Contraindications for immunizations are febrile illnesses, immunosuppressive drug therapy, immunodeficient states, leukemia, lymphoma, generalized malignancy and pregnancy.

A client comes to the clinic and tells the nurse that close family members are suspected of having pulmonary tuberculosis. Which vaccine would the nurse predict the health care provider will prescribe as a preventative measure? BCG vaccine IPV vaccine DPT vaccine MMR vaccine

BCG vaccine Explanation: For the prevention of pulmonary tuberculosis (TB) in high-risk populations such as health care workers, infants, and children in endemic areas, a BCG vaccination is given. The MMR vaccine is used for preventing measles, mumps, and rubella. The DPT vaccine is used for preventing diphtheria, pertussis, and tetanus. IPV is an inactivated poliovirus used to prevent polio.

The nursing students are learning about childhood vaccinations. What would they learn is the recommended childhood and adolescent immunization schedule for measles, mumps, and rubella (MMR)? 2 months, 4 months, between 6 and 18 months, and between 4 and 6 years 2 months, 4 months, 6 months, and between 12 and 15 months Between 12 and 15 months and between 4 and 6 years Between 24 months and 18 years of age

Between 12 and 15 months and between 4 and 6 years Explanation: The recommended schedule for the MMR is the first dose between 12 and 15 months and the second dose between 4 and 6 years. The schedule for inactivated poliovirus is 2 and 4 months, between 6 and 18 months, and between 4 and 6 years. Immunization for Haemophilus influenzae is 2, 4, and 6 months and between 12 and 15 months. The schedule for hepatitis A is between 24 months and 18 years of age.

The nurse is preparing to administer an antivenin to a client. The nurse will explain to the client that the antivenin will provide passive, transient protection against bites from which organism(s)? Select all that apply. Human Rattlesnake Copperhead snake Canine Black widow spider

Black widow spider Rattlesnake Copperhead snake Explanation: Antivenins are used for passive, transient protection from the toxic effects of bites by black widow spiders and rattlesnakes, copperhead snakes, cottonmouth snakes, and coral snakes. Canine bites would be treated with rabies vaccine and if necessary antibiotics. Human bites would be treated with antibiotics and possibly tetanus vaccine.

A school nurse is attempting to determine correct vaccine guidelines. What is the best source for current recommendations? A. National Poison Control Center B. American Medical Association C. Centers for Disease Control and Prevention D. American Nurses Association

C. Centers for Disease Control and Prevention Recommendations regarding immunizations change periodically as additional information and new immunizing agents become available. Consequently, health care providers need to update their knowledge at least annually. The best source of information for current recommendations is the Centers for Disease Control and Prevention.

The nurse is providing wellness information to a 50-year-old client who is employed as a paramedic. The client asks what, if any, vaccines the client should get. What is the nurse's best response? A. Hepatitis B once and influenza vaccine annually B. Tetanus and pertussis C. Tetanus-diphtheria-pertussis; hepatitis B vaccine once; influenza vaccine annually D. Shingles

C. Tetanus-diphtheria-pertussis; hepatitis B vaccine once; influenza vaccine annually Middle-aged adults should maintain immunizations against tetanus-diphtheria-pertussis. Health care providers should receive hepatitis B vaccine once (if not previously taken). The influenza vaccine is recommended annually for everyone over the age of 6 months. An additional vaccine to prevent zoster infections (shingles) is available for adults aged 60 years and older. Middle-aged adults born after 1956 should get at least one dose of measles-mumps-rubella (MMR) vaccine unless they have had either the vaccine or each of the three diseases.

A client has undergone organ transplant and fears that she will die of a virus infection because of the postoperative anti-rejection drug therapy. The nurse knows that some immunization agents are routinely administered to clients to prevent virus infections. To calm the client's fears, the nurse spends time teaching the client about which of the following agents? CMV-IGIV is routinely administered for prevention of cytomegalovirus after organ transplant. Imogam is routinely administered for prevention of specific virus infections after organ transplant.

CMV-IGIV is routinely administered for prevention of cytomegalovirus after organ transplant. Explanation:Cytomegalovirus immune globulin (CMV-IGIV) is routinely administered for prevention of cytomegalovirus infection after organ transplant. BIG-IV treats infant botulism.

Administration of the tetanus toxoid in adults involves two initial injections given four weeks apart, a booster injection given six months to a year later, and periodic injections thereafter. What is the recommended interval for the periodic injections for a 66 year old client ? Every 5 years Every 2 years Every 10 years Annually

Correct response: Every 10 years Explanation: Following the initial booster injection, the tetanus toxoid should be administered to adults every 10 years.

An older adult client asks the nurse to explain the recommended schedule for influenza vaccination. Which statement should the nurse include in the response? A. ''The vaccine is given every 6 months to prevent the flu.'' B. ''Starting at age 75, everyone needs vaccine boosters every 2 years.'' C. ''The vaccine is good for 5 years, so annual re-vaccination is no longer required.'' D. ''Each year a new vaccine is developed based on the strains most prevalent.''

D. ''Each year a new vaccine is developed based on the strains most prevalent.'' Immune serums are the biologic products used for passive immunity. They act rapidly to provide temporary (for 1 to 3 months) immunity in people exposed to or experiencing a particular disease. The goal of therapy is to prevent or modify the disease process; to do this, the most prevalent strains must be identified on an annual basis. Annual influenza vaccination is recommended for all adults.

A nurse is preparing to administer an unfamiliar vaccine. To obtain current information and provide patient teaching about vaccine recommendations and contraindications, it is best to do which of the following? A. Ask a coworker about the vaccine (when and how it should be administered B. Use a drug guide to look up the vaccine information C. Access an Internet search engine to find vaccine information D. Obtain vaccine information and a Vaccine Information Statement (VIS) from the Centers for Disease Control and Prevention (CDC) Website

D. Obtain vaccine information and a Vaccine Information Statement (VIS) from the Centers for Disease Control and Prevention (CDC) Website Current vaccine information on the benefts and risks of immunization outlined in a Vaccine Information Statement (VIS) for each recommended vaccines, along with indications, contraindications, and the timing of immunizations doses, is available at the Centers for Disease Control and Prevention Web site. Te VIS must be given to the client or parent with each vaccine dose. Coworker and internet search engine are not reliable source of information. Even though drug guide could be utilized to obtain the information, the CDC website is an updated and current source of information regarding the vaccine.

A nurse is assessing a client's medical record and determines that the client has naturally acquired active immunity. Which example(s) would most likely apply? Select all that apply. After recovering from pertussis, the client demonstrates immunity against repeat exposures. Administering the rubella vaccine at routine well-baby visits Faithfully reporting to the clinic for the influenza vaccine every year. Administration of the varicella vaccine protects against varicella Experiencing chickenpox results in immunity to the disease

Experiencing chickenpox results in immunity to the disease After recovering from pertussis, the client demonstrates immunity against repeat exposures. Explanation: Naturally acquired active immunity occurs when the person is exposed to and experiences a disease and the body manufactures antibodies to provide future immunity to the disease. This would be an individual who is exposed to chickenpox or pertussis for the first time and has no immunity to the disease. Artificially acquired active immunity occurs when an individual is given a killed or weakened antigen, which stimulates the formation of antibodies against the antigen. The antigen does not cause the disease, but the individual still manufactures specific antibodies against the disease. Administration of a vaccine to an individual who has no immunity would be an example of artificially acquired active immunity.

The nurse is teaching a course to students about immunologic agents. In order for the students to understand active immunity, the nurse explains that there are agents that provide active immunity. Which is an active immunity agent? Haemophilus influenzae type B conjugate Antivenin Immune globulin Antitoxin

Haemophilus influenzae type B conjugate Explanation: A vaccine is an active immunity agent. Haemophilus influenzae type B conjugate is a live vaccination. The remaining answer options offer agents that are either Immune globulins or antivenins which are passive immunity agents.

The perinatal nurse recognizes that what vaccine can be safely given to a neonate? Varicella Hepatitis B Measles, mumps and rubella (MMR) Hepatitis A

Hepatitis B Explanation: Hepatitis B is the only common vaccine that can be given to neonates.

A female client is living with HIV. She is exposed to measles. What is the treatment of choice in this case? No vaccine and presumptive treatment of the disease Live vaccine Varicella-zoster immune globulin for active immunization Immune globulin

Immune globulin Explanation: Persons with asymptomatic HIV infection should receive inactivated vaccines; those exposed to measles or varicella may be given immune globulin or varicella-zoster immune globulin for passive immunization.

A group of nursing students are presenting information on the hepatitis B vaccine. What would the students prepare to tell others about the recommended population? OR For what group of adults is pre-exposure immunization against hepatitis B recommended? Infants and people at high risk for contracting the disease People with diabetes mellitus or renal disease People over the age of 65 Children under the age of 15

Infants and people at high risk for contracting the disease Explanation: As recommended by the World Health Organization and the CDC, the hepatitis B vaccine should be given to infants and should be given to all children under the age of 18/19 that have not been previously recommended. The vaccine is also recommended in certain high-risk populations among adults. While this population includes children under the age of 15, the vaccine is recommended for all children under the age of 18 or 19. There are not indications to receive the vaccine for people with diabetes or renal disease or all people over the age of 65.

A nurse is educating a group of nursing students about the different types of vaccines. Which among the following should the nurse mention as a killed virus vaccine? influenza vaccine MMR vaccine rubella vaccine varicella vaccine

Influenza vaccine Explanation: The influenza vaccine is an example of a killed virus vaccine. Vaccines are formed by using live antigens, attenuated antigens, or killed antigens. The MMR, rubella, and varicella vaccines are examples of vaccines containing a live attenuated virus.

A mother brings her 18-month-old son into the clinic for his diphtheria, tetanus, and pertussis vaccine. The child has a runny nose and a fever of 102.4º F and is coughing. What should the nurse do?

Instruct the mother to bring the child back to the clinic for the immunization when he is free of allergic or cold-like symptoms.

A female client presents to the physician's office with shoulder pain and is diagnosed with bursitis. The physician administers an intra-articular injection of a corticosteroid. The nurse discovers that the client requires a tetanus booster. What would the nurse expect the physician to do?

Order the booster Immunizations are not contraindicated with short-term use (less than 2 weeks) or low-to-moderate doses (less than 20 mg/d) of prednisone.

A nursing instructor is discussing the intended populations for various vaccines. Which groups might the instructor mention when discussing the hepatitis B vaccine? Ventilator-dependent patients Day care workers People over the age of 65 Paramedics and emergency medical technicians

Paramedics and emergency medical technicians Explanation:Pre-exposure immunization against hepatitis B is recommended for people at high risk for exposure to the disease. This can include health care workers (e.g., paramedics and EMTs)

What is a contraindication to an MMR booster for an adolescent female? t History of rubeola A positive titer Current menses Pregnancy

Pregnancy Explanation:MMR is administered to adolescent females if they are not pregnant and their rubella titer is inadequate or proof of immunization is unavailable.

A nurse is participating in an influenza vaccination clinic on a college campus. What action will best prepare the nurse for this role? Review appropriate landmarking for subcutaneous injection Review the procedure for intramuscular injection Ask participants to identify their blood type, if known Prepare to educate each client about serum sickness

Review the procedure for intramuscular injection Explanation: Influenza vaccinations are given by the IM route. The nurse must monitor for adverse effects, but it is unnecessary to teach each client the details of serum sickness. Clients do not need to know their blood types.

A client who is right-handed is to receive a booster injection for a previous vaccination. The nurse prepares to administer the injection at which site? Left leg Right leg Left arm Right arm

Right arm Explanation: The nurse should use the dominant arm, in this case, the right arm, for the injection to help aid in the absorption.

A clinic nurse is administering vaccines at well-baby check-ups. The nurse knows that before administering a DTP vaccine, the nurse should check what vital sign? Blood pressure Temperature Respirations Pulse

Temperature Explanation: Caution should be used any time a vaccine is given to a child with a history of febrile convulsions or cerebral injury, or in any condition in which a potential fever would be dangerous. Caution also should be used in the presence of any acute infection.

What would the nurse identify as a vaccine that is a toxoid? Haemophilus influenza B Hepatitis A Tetanus Pneumococcal polyvalent

Tetanus Explanation: The vaccine for tetanus is a toxoid. The vaccines for haemophilus influenza B and pneumococcal polyvalent are bacterial vaccines. Hepatitis A is a viral vaccine.

Middle aged adults and health care workers should receive which immunizations? Diphtheria-pertussis and influenza vaccine annually Tetanus and hepatitis B vaccine Tetanus-diphtheria-pertussis; hepatitis B vaccine once and influenza vaccine annually Influenza vaccine and hepatitis B vaccine annually

Tetanus-diphtheria-pertussis; hepatitis B vaccine once and influenza vaccine annually Explanation: Middle-aged adults should maintain immunizations against tetanus-diphtheria-pertussis; high-risk groups (e.g., those with chronic illness) and health care providers should receive hepatitis B vaccine once (if not previously taken) and influenza vaccine annually at 50 years of age and older.

A client has presented to the clinic and is requesting the seasonal influenza vaccine. What aspect of the client's health history may contraindicate the safe and effective use of this vaccine? The client is 76 years-old. The client takes a loop diuretic for the treatment of hypertension. The client does not know their blood type and it is not recorded in available health records. The client is currently prescribed prednisone.

The client is currently prescribed prednisone. Explanation: The use of corticosteroids such as prednisone could alter the body's desired response to a vaccine. A loop diuretic has no significant effect and the client's age is not a contraindication. It is unnecessary to know the client's blood type.

A client has come to the clinic requesting a hepatitis A and B vaccination before leaving on a tropical vacation. After assessing the client, the nurse should prioritize what finding to communicate to the provider? The client takes corticosteroids to treat rheumatoid arthritis The client uses marijuana two to three times per month The client received the annual influenza vaccine seven days ago The client has type two diabetes that is controlled by diet

The client takes corticosteroids to treat rheumatoid arthritis Explanation: Corticosteroids decrease the normal immune response and could interfere with the intended stimulation of B cells. Recent influenza vaccination does not contraindicate the hepatitis vaccine, nor does type 2 diabetes. Occasional marijuana use would not contraindicate a hepatitis vaccination.

What type of modification may be necessary for a client with diabetes mellitus who requires immunizations? Immunizations are contraindicated for this client. The client will require reduced doses of vaccines. The client will require less frequent administration of vaccines. The client will require increased doses of vaccines.

The client will require increased doses of vaccines. Explanation: Clients who have diabetes mellitus may require increased dosage and more frequent administration of vaccines.

Mrs. Jones refuses to get a flu vaccination when the pharmacist offers to give her one. She states she always gets the flu the day after getting the vaccine. Why can you not get the flu from the general annual flu vaccine? a. An antiviral in the flu vaccine prevents from getting the flu from the vaccine. b. Your immune system protects you immediately after getting the shot. c. One of the many adverse reactions to the flu shot is getting the flu. d. Most flu vaccines are made with inactivated (killed) virus, so you cannot get the flu from the vaccine.

The correct answer is: Most flu vaccines are made with inactivated (killed) virus, so you cannot get the flu from the vaccine. Explanation: An old popular myth is you can get the flu from the influenza vaccine.

A grandmother 72 years of age comes to the primary care physician's office asking for the varicella virus vaccine to prevent shingles. The nurse knows that the vaccine can only be administrated to people who have never had herpes zoster before for which of the following reasons? or A 72-year-old female client has come to the primary care provider's office asking for the varicella virus vaccine to prevent shingles. The nurse knows that the vaccine can only be administrated to people who have never had herpes zoster before for which reason? The varicella virus vaccine contains the killed varicella virus that does not cause a mild form of the infection, producing immunity against the virus. The varicella virus vaccine contains the killed varicella virus that causes a mild form of the infection, producing immunity against the virus. The varicella virus vaccine does not contain the live varicella virus that causes a mild form of the infection, producing immunity against the virus. The varicella virus vaccine contains the live, attenuated varicella virus that causes a mild form of the infection, producing immunity against the virus.

The varicella virus vaccine contains the live, attenuated varicella virus that causes a mild form of the infection, producing immunity against the virus. Explanation: The varicella virus vaccine contains the live, attenuated varicella virus that causes a mild form of the infection, producing immunity against the virus. The varicella virus vaccine does not include killed varicella virus.

A nurse is teaching a group of clients about immunizations. What benefit of immunization should the nurse describe? They are best reserved for clients under age 65 They provide the person with active immunity. They are generally considered to be risk free Promote the development of antigens for the disease. OR When describing the use of vaccines to a local community group, what would the nurse include? Vaccines are used to provide active immunity. Vaccines promote the development of antigens. Vaccines can result in signs and symptoms of the full-blown disease. Vaccines are associated with severe reactions in children.

They provide the person with active immunity. OR Vaccines are used to provide active immunity. Explanation: Vaccines provide active immunity. Severe reactions are rare and most children have mild to no reaction., even though they are not entirely risk free. The person experiences an immune response to prevent the occurrence of the disease. Vaccines promote the formation of antibodies against a specific disease, not antigens. Older adult client can safely receive most vaccines.

A client with asymptomatic HIV calls the clinic and reports that he just found out that his 2-year-old nephew has just been diagnosed with chickenpox. What therapy will be recommended for this client? Varicella vaccine Shingles vaccine Varicella-zoster immune globulin No therapy is indicated

Varicella-zoster immune globulin Explanation: Clients with asymptomatic HIV who are exposed to chickenpox should receive the varicella-zoster immune globulin for passive immunizations. Vaccinations are not intended to provide the immediate immunity needed when exposed to a disease and may be appropriate for a client with HIV.

A nursing instructor is teaching the concept of immunity. The instructor determines that the session was successful when the students correctly choose that cell-mediated immunity protects the body against what type of infection(s)? Select all that apply. Fungal Bacterial Viral Helminth Protozoal

Viral Fungal Bacterial Explanation: Cell-mediated immunity protects the body against viral, bacterial, and fungal infections. The body does not use immunity to protect the body from the various helminths or protozoa.

The infection control nurse is assessing the immunization status of many of the hospital's current clients. For what client would vaccination most likely be contraindicated? a client who is 82 years old and who has type 1 diabetes a client who takes immunosuppressants post-renal transplant a client with alcoholic liver disease a client who receives dialysis three times weekly for chronic renal failure

a client who takes immunosuppressants post-renal transplant Explanation: The use of vaccines is contraindicated in the presence of immune deficiency because the vaccine could cause disease and the body would not be able to respond as anticipated if in an immunodeficient state. Vaccines are not contraindicated in people with renal impairment or who have hepatic failure nor are they contraindicated in people over the age of 65.

A client receives an immunization. The nurse interprets this as providing the client with which type of immunity? naturally acquired active immunity artificially acquired active immunity passive immunity active immunity

artificially acquired active immunity Explanation: Artificially acquired active immunity occurs when an individual is given a killed or weakened antigen, which stimulates the formation of antibodies against the antigen. The antigen does not cause the disease, but the individual still manufactures specific antibodies against the disease. Naturally acquired active immunity occurs when the person is exposed to and experiences a disease and the body manufactures antibodies to provide future immunity to the disease. Passive immunity occurs when immune globulins or antivenins are administered. This type of immunity provides the individual with ready-made antibodies from another human or an animal. When a person is exposed to certain infectious microorganisms (the source of antigens), the body actively builds an immunity (forms antibodies) to the invading microorganism. This is called active immunity.

The nurse is preparing for a visit with a 4-month-old infant. What immunizations will the nurse prepare? Select all that apply. haemophilus influenzae type b vaccine (Hib) inactivated poliovirus vaccine (IPV) diphtheria and tetanus toxoids and acellular pertussis vaccine, adsorbed (DTaP) varicella meningococcal

diphtheria and tetanus toxoids and acellular pertussis vaccine, adsorbed (DTaP) inactivated poliovirus vaccine (IPV) haemophilus influenzae type b vaccine (Hib) Explanation: At 4 months of age, the child will receive a DTaP, Hib, IPV, and PCV. Varicella vaccine is not given until the child is at least 1 year of age, and meningococcal is usually given at age 11 to 12 years unless the client is at high risk for development of the disease before that age.

The nurse is assessing a 6-month-old infant prior to scheduled immunizations. What finding would the nurse immediately recognize as a reason to reschedule administration? current history of feeding poorly current history of loose stools demonstrating fussiness and crying low-grade fever

low-grade fever Contraindications to most vaccines and toxoids include acute febrile illness. Fussy crying, loose stools, and poor feeding would warrant further assessment but may not contraindicate the administration of a vaccine.

When educating a group of nursing students on immunologic agents, the nurse refers to a substance that is attenuated (or weakened) but still capable of stimulating the formation of antitoxins. The nurse is referring to: vaccines. antivenins. immune globulins. toxoids.

toxoids.

A mother asks the nurse what she can do to help with the discomforts that her child may experience due to an immunization. What would be most appropriate? "Give him aspirin if he develops any fever." "Encourage him to move his arm frequently during the day." "Have him take some time to rest throughout the day." "Apply cold compresses to the injection site every 4 hours."

"Have him take some time to rest throughout the day." Explanation: The nurse should instruct the mother to ensure that the child has ample rest time during the day. Acetaminophen, not aspirin, should be used for fever. Aspirin masks the signs of Reye syndrome. Warm compresses, not cold, would be better for any pain at the injection site. The child should also rest his arm and avoid overuse.

The nursing instructor is teaching the nursing students to assess the immunization status of patients. Which of the following questions could nurses ask patients to assist in the assessment?

"Have you ever received a tetanus shot for a cut or wound?" Explanation: During the assessment, the nurse should learn as much as possible about the patient's immunization history. Asking patients whether they have received a tetanus shot following injury may reveal whether and how recently they have been immunized against the disease. Patients may know the diseases against which they've been immunized, but they are unlikely to be able to identify all the diseases against which they haven't been immunized. It's important to determine whether female patients are pregnant because the condition contraindicates immunization; it is not important to know whether a patient has already had children.

The nurse is caring for a 30-year-old woman who came to her gynecologist today to receive a Gardasil injection, stating that she believes that she may have genital warts. What should the nurse teach this client? "The drug is only effective if administered before exposure to human papillomavirus (HPV)." "Gardasil is only given to women between the ages of 9 and 26 years of age." "The drug cannot be administered until further Food and Drug Administration (FDA) testing has been completed." "The drug cannot be administered to a woman who is sexually active."

"The drug is only effective if administered before exposure to human papillomavirus (HPV)." Explanation: This client is not a candidate for Gardasil primarily because she has most likely already been exposed to HPV, and there would be no benefit to the injection. Gardasil is a vaccine that needs to be administered before exposure to be effective. Although the drug is normally given to women aged 9 to 26 years old, it could be given to an older person who has not become sexually active yet. Although sexual activity would not preclude administering the injection to a young girl who has had only one sexual partner, multiple partners increase the likelihood of exposure to HPV. The FDA continues to monitor testing related to the need for booster shots and the length of time the immunity remains active, as well as long-term adverse effects of the drug but the drug is available to the public by prescription.

The nurse is assigned to perform telephone triage for the clinic and receives a call from a young parent whose 6-month-old baby received their third diphtheria-pertussis-tetanus immunization that morning. The parent reports the baby's temperature is 99.8° axillary, the site of injection is "a little red," and the baby is irritable. After checking the standing orders provided by the pediatrician, what teaching would the nurse provide this parent? Select all that apply. "Symptoms should subside within 2 to 3 days." "Bring the baby back to the clinic for an examination." "These are common adverse effects reported after immunizations." "Apply a warm moist compress to the baby's leg." "Aspirin can be given to manage fever symptoms."

"These are common adverse effects reported after immunizations." "Apply a warm moist compress to the baby's leg." "Symptoms should subside within 2 to 3 days." Explanation: The signs reported by this parent are all common adverse effects following immunization that will subside within 2 to 3 days. In the meantime, the parent can make the baby more comfortable by administering a weight appropriate dosage of acetaminophen, applying warm compresses to the injection site, and providing a quiet environment. If the symptoms do not subside within 2 to 3 days, the baby should be seen for follow-up care. Aspirin should not be given due to risk of Reye syndrome.

The nurse is working with the parents of an infant and has initiated a dialogue about immunizations. The infant's parent states, "We're not comfortable with immunizations because of the safety issue." What is the nurse's best response? "The benefits of immunizations far outweigh any of the potential risks." "Did you read about the risks of immunizations on the internet?" "Immunizations have been proven to be safe and effective and are in your child's best interests." "What are some of the safety risks that most concern you?"

"What are some of the safety risks that most concern you?" Explanation: The nurse should attempt the therapeutically engage with the clients' concerns in an attempt to have a productive dialogue. The nurse should avoid being condescending or confrontational. Categorical statements about the safety of immunizations may be true, but are likely to be met with resistance from parents who are reluctant.

The nurse is preparing to administer a dose of the human papillomavirus vaccine to a middle school student. What assessment question should the nurse prioritize when interacting with the student? "Has anyone explained some of the main side effects of this vaccine?" "Have you gotten all of your required childhood vaccinations so far?" "Do you know when you'll need to get a booster shot of this vaccine?" "What's your understanding of why you're getting this vaccination?"

"What's your understanding of why you're getting this vaccination?" Explanation: The nurse cannot make the assumption that the client knows about the rationale for the vaccination. The client may know nothing about HPV or its relationship to her future cancer risk. This assessment question can be used to introduce client teaching. A middle school student is unlikely to know whether her parents or caregivers have ensured that her immunizations match the recommended schedule. The HPV vaccine does not require a booster and minimal - if any - side effects are anticipated.

For the first time, a 10 year-old female has received an IM injection of Gardasil. What follow-up education should the nurse provide? "Make sure to tell your parents if you have any stomach pain." "You might have a fever for the next couple of days, but that's expected." "You'll have to get another shot in around 2 months." "This will keep you healthy until you're old enough for college."

"You'll have to get another shot in around 2 months." Explanation: Gardasil requires a series, a with a second dose two months after the first. A fever is not expected, nor is stomach pain. Without the appropriate boosters, the client will not be protected later in life.

An adult client is scheduled to receive the inactivated hepatitis A vaccine. The nurse should provide what education to the client? "It will take up to 48 hours before your immune system protects you against hepatitis." "If possible, you should get annual booster of the vaccine to make sure you're protected." "It's best if you avoid drinking any alcohol for the next week." "You'll need another dose of the vaccine in six to 12 months from now."

"You'll need another dose of the vaccine in six to 12 months from now." Explanation: Hepatitis A vaccine requires a repeat dose in six to twelve months. There is no prohibition against drinking alcohol after receiving the vaccine. B cells take more than 48 hours to create the necessary immunoglobulins for conferring immunity. The hepatitis A vaccine does not require an annual booster.

The client has been on a systemic corticosteroid for the last 3 weeks. How long should the client wait before receiving a live virus vaccine? 6 months 6 weeks 1 year 3 months

3 months Explanation: Clients who have been on a systemic corticosteroid longer than 2 weeks should wait 3 months before receiving a live virus vaccine.

The nurse at an ambulatory clinic has seen several clients with suspected or confirmed infectious diseases in recent days. Which client is most likely to benefit from the administration of an immune serum. A client who is known to have contracted hepatitis B from sexual activity A client whose tuberculin skin test is positive A child who has signs and symptoms of varicella (chicken pox) infection An older adult who has respiratory distress due to an influenza infection

A client who is known to have contracted hepatitis B from sexual activity Explanation: There is a hepatitis B immune globulin, but none exists for influenza, tuberculosis or varicella.

The nurse is working in a clinic which is providing the annual influenza A vaccine for staff and residents of a large long-term care facility. For which client would the vaccine most likely be unsafe? -A resident who received four units of packed red blood cells for a gastrointestinal bleed three weeks ago -A staff member with a three month-old infant that she is breastfeeding -A staff member who received the combination hepatitis A and B vaccine two weeks ago -A resident who is 91 years old and who has chronic obstructive pulmonary disease

A resident who received four units of packed red blood cells for a gastrointestinal bleed three weeks ago

A 60-year-old male client received a dose of pneumococcal vaccine during a health care provider's visit. What would the nurse recommend? That he maintain his healthy lifestyle; a second dose is not needed A second dose when he turns 70 That he receive a booster in 6 months A second dose when he turns 65

A second dose when he turns 65 Explanation: A second dose of pneumococcal vaccine may be given at age 65 years if the first dose was given 5 years previously.

A public education campaign to stress the importance of childhood immunizations should include which of the following points? Select all that apply. A) Prevention of potentially devastating diseases outweighs the discomfort and risks of immunizations B) Routine immunization is standard practice in the US C) The practice of routine immunizations has virtually wiped out many previously deadly or debilitating diseases D) The risk of severe adverse rxns is on the rise and is not being addressed E) If there is a family history of autism, that person should avoid immunizations F) The temporary discomfort associated with the immunization can be treated with OTC drugs

A) Prevention of potentially devastating diseases outweighs the discomfort and risks of immunizations B) Routine immunization is standard practice in the US C) The practice of routine immunizations has virtually wiped out many previously deadly or debilitating diseases F) The temporary discomfort associated with the immunization can be treated with OTC drugs

A hospitalized client is about to receive immunological therapy and asks the nurse to explain the difference between passive and active immunity. In order to provide complete information, the nurse knows to include which information during the teaching session? Passive immunity occurs when a client receives a killed or weakened antigen that stimulates antibodies. These antibodies fight the antigen (for example, chickenpox vaccine). Active immunity occurs when a client receives a weak antigen that stimulates antibodies. These antibodies fight the antigen (for example, Cipro). Active immunity occurs when a client receives a killed or weakened antigen that stimulates antibodies. These antibodies fight the antigen (for example, chickenpox vaccine). Active immunity occurs when a client receives a weak antigen that stimulates antibodies. These antibodies fight the antigen (for example, immune globulin).

Active immunity occurs when a client receives a killed or weakened antigen that stimulates antibodies. These antibodies fight the antigen (for example, chickenpox vaccine). Explanation: Active immunity occurs when a client receives a killed or weakened antigen that stimulates antibodies. These antibodies fight the antigen (for example, chickenpox vaccine). Passive immunity occurs when immune globulin or antivenins are given to provide the person with ready-made antibodies from another human or animal. Cipro is an antibiotic, not an immunologic agent.

Several clients have come to the clinic for immunizations. When assessing their medical records, the nurse determines which situation(s) as a contraindication for the administration of a vaccine? Select all that apply. Acute nonfebrile illness Clients older than 70 years Leukemia Chronic prednisone therapy HIV

Acute nonfebrile illness Leukemia Chronic prednisone therapy HIV Explanation: Vaccines and toxoids are contraindicated with acute febrile illnesses, leukemia, lymphoma, immunosuppressive illness (HIV) or drug therapy (prednisone), and nonlocalized carcinoma (leukemia). The age of the client will restrict administering some vaccines and is the basis of the administration of some. Some products, such as IGIV, are not recommended for individuals older than 65 years. Clients older than 60 years should receive the zoster vaccine to prevent shingles.

A nurse determines a nursing diagnosis of acute pain is appropriate for a client receiving a vaccine. Which instruction(s) would the nurse prioritize in the client's plan of care to address this problem? Select all that apply. Apply compresses to the injection site Ensure that the environment is stimulating Provide for adequate rest periods Limit the client's access to fluids Administer acetaminophen every 4 hours

Administer acetaminophen every 4 hours Provide for adequate rest periods Apply compresses to the injection site Explanation: For the client with acute pain related to the administration of a vaccine, the nurse would administer prescribed acetaminophen every 4 hours; provide for frequent rest periods in a quiet, nonstimulating environment; apply warm or cool compresses to the injection site; and encourage fluid intake.

After teaching a class to a group of nursing students about immunity, the instructor determines that the teaching was successful when the students correctly choose which situation(s) as an example of passive immunity? Select all that apply. Administration of the first dose of rubella vaccine to an infant Administration of Crotalidae polyvalent immune fab for the treatment of a rattlesnake bite An individual develops pertussis after exposure from a sibling An individual who is exposed to chickenpox for the first time and develops the disease Administration of botulism immune globulin to an infant

Administration of botulism immune globulin to an infant Administration of Crotalidae polyvalent immune fab for the treatment of a rattlesnake bite Explanation: Passive immunity occurs when immune globulins or antivenins are administered. This type of immunity provides the individual with ready-made antibodies from another human or an animal. Administration of botulism immune globulin for the treatment of infant botulism or administration of Crotalidae polyvalent immune fab for the treatment of mild to moderate North American rattlesnake bites are examples of passive immunity. Active immunity occurs when the person is exposed to a disease, develops the disease, and then the body makes antibodies to provide future protection against diseases such as chickenpox and pertussis. The use of vaccines is also a form of active immunity as it provides the antibodies for the body to utilize to prevent the disease, such as with rubella.

A child is brought to the health care center for MMR vaccination. On assessment, the nurse discovers that the child had received an antivenin injection for a snake bite 2 days before. When should the nurse instruct the caregivers to return for this vaccine for this child? After 3-4 weeks After 1-2 weeks After 6-8 weeks After 4-5 weeks

After 6-8 weeks Explanation: Live attenuated vaccines should be administered to clients after 6-12 weeks of administration of immune globulin preparation. MMR vaccine, being a live attenuated vaccine, should be administered to the child after 6-12 weeks, as the child has received immune globulin for a snake bite. Vaccinations containing live organisms are not administered within 6-12 weeks of immune globulin administration because antibodies in the globulin preparation may interfere with the immune response to the vaccination. To obtain an effective immune response to vaccination, the live vaccine has to be administered 14-30 days before or 6-12 weeks after immune globulin administration.

A nurse should warn a client about which of the following adverse reactions that can occur after the administration of cytomegalovirus immune globulin ? Select all that apply: Angiedema Constipation Urticaria Headache Chills

Angiedema Urticaria Headache Chills Explanation: The most common adverse reactions to the administration of cytomegalovirus immune globulin (CytoGam) include urticaria, angiedema, erythema, malaise, nausea, diarrhea, headache, chills, and fever.

The nurse at the pediatric clinic gives the mother of an infant a written record of the infant's immune sera use. The nurse encourages the mother to keep the information. What is the rationale behind keeping a written record of immune sera use? To identify who gave the immune sera Avert future reactions To identify the lot number of the immune sera used To keep track of where the immune sera was given

Avert future reactions Explanation: Provide a written record of immune sera use and encourage the patient or family to keep that information to ensure proper medical treatment and to avert future reactions. Written records are not kept to keep track of where the immune sera was given or to identify who gave the immune sera or to identify the lot number of the immune sera used.

A toddler has received the varicella vaccine at age 12 months, as scheduled. The nurse should teach the toddler's parents that a booster will be necessary at what age? A) Age 15 B) Age 4-6 yrs C) Age 10-12 yrs D) Age 3

B) Age 4-6 yrs

A nurse suffers a needlestick after injecting a pt with suspected hepatitis B. The nurse should: A) Have repeated titers to determine whether she was exposed to hepatitis B and if she was have hepatitis immune globulin B) Immediately receive hepatitis immune globulin and begin hepatitis B vaccines if she has not already received them C) Start antibiotic therapy immediately D) Go on sick leave until all screening tests are negative

B) Immediately receive hepatitis immune globulin and begin hepatitis B vaccines if she has not already received them

When assessing the medical record of an older adult to evaluate the status of his immunizations the nurse would be looking for evidence of which of the following? A) Yearly pneumococcal vaccination B) Yearly flu vaccination C) Tetanus booster every 10 years D) Tetanus booster ever 5 years E) Measles, Mumps, Rubella vaccine if the pt was born after 1957 F) Varicella vaccine only if there is evidence that the pt had chickenpox as a child

B) Yearly flu vaccination C) Tetanus booster every 10 years

A nurse is caring for a 74 year old man. The nurse recognizes that he would most likely have deceased immune response to the influenza vaccine if he is taking which of the following medications? A. levothyroxine B. prednisone C. metoprolol D. lovastatin

B. prednisone Rationale: Prednisone suppresses inflammation and the normal immune response. Levothyroxine replaces endogenous thyroid hormones. Metoprolol is used to treat angina and hypertension. Lovastatin is utilized to control hyperlipidemia.Vaccines may be contraindicated in clients receivingimmunosuppressive drugs. People taking prednisone havea decreased immune response. Tey cannot produce suf-cient amounts of antibodies for immunity and may developthe illness produced by the particular organism containedin the vaccine. Te disease is most likely to occur with thelive-virus vaccines (e.g., measles, mumps, rubella).

The nurse is preparing to administer a client's prescribed dose of immune sera. How should the nurse describe this treatment to the client? -Chemically weakened actual virus -Weakened bacterial cell membrane -A viral protein coat -Bacterial antibodies in serum

Bacterial antibodies in serum

A mother brings her child to his 18 month well baby visit. The nurse would not give the child his routine immunizations in which of the following situations? A) He cried at his last immunization B) He developed a fever or rash after his last immunization C) He currently has a fever and symptoms of a cold D) He is allergic to Aspirin E) He is currently taking oral corticosteroids F) His siblings are all currently being treated for viral infection

C) He currently has a fever and symptoms of a cold E) He is currently taking oral corticosteroids F) His siblings are all currently being treated for viral infection

Upon return from from active duty in Zimbabwe, a military veteran asks the nurse about a painful rash on her side that is triggered by stress. The nurse knows to ask the history of where the veteran has traveled and about any exposure to rash-causing agents. An order for a PCR shows that the rash is caused by herpes zoster (shingles). The nurse explains that the painful rash is called shingles and is caused later in life by which of the following infections? Chickenpox Measles Mumps Herpes simplex

Chickenpox Explanation:Although chickenpox seems like a minor illness, it can cause herpes zoster (shingles), a painful condition, later in life. Mumps, measles, and herpes simplex virus 1 do not cause s ... (more)

A nurse is preparing to administer influenza A and B vaccine to a client. The nurse should alert the client to which possible adverse reaction(s) to this vaccine? Select all that apply. Lethargy Chills Muscle aches Fever Hypotension

Chills Fever Lethargy Muscle aches Explanation: Adverse reactions from the administration of vaccines or toxoids are usually mild and include chills, fever, muscle aches and pains, rash, and lethargy. Hypotension is a possible sign of an anaphylactic reaction. The nurse should establish any allergies the client may have and, not give if there is a potential allergy to the vaccine.

The nurse educator is teaching a class of community leaders about immunologic agents. The mayor voices concern on behalf of the leaders about bad reactions from vaccines. To minimize the concern, the nurse explains that adverse reactions from vaccines are usually mild. The nurse would include which mild reactions in the teaching plan? Rash and itching Insomnia and hyperactivity Chills and fever Nausea and vomiting

Chills and fever Explanation: Chills and fever are mild adverse reactions observed after administration of vaccines. None of the other options are generally associated with mild adverse reactions to vaccines.

Routine immunization can help reduce the spread of disease. Which of the following is a strategy that is used to promote routine immunization? Immunizing clients without their knowledge Scheduling immunizations so that one vaccine is given at every visit to a clinic Developing vaccines that can be administered at home by a family member Combining vaccines so that only one injection is required

Combining vaccines so that only one injection is required Explanation: Two strategies to promote immunization are the development of combination vaccines and the administration of multiple vaccines during one visit to a health care provider. Combination vaccines decrease the number of injections, and giving multiple vaccines during a single visit allows patients to schedule immunizations more easily.

A 79-year-old client has been prescribed a single dose of influenza A vaccine 0.5 mL SC. What is the nurse's priority action? Contact the provider to confirm the route. Document administration of the vaccine. Educate the client about potential adverse effects. Assess the client, confirm identity, and administer the vaccine.

Contact the provider to confirm the route. Explanation: The influenza vaccine is given IM, not subcutaneously. The dose is appropriate, but the nurse would have to confirm the route before performing education or administering the vaccine.

The nurse is preparing to administer a vaccine to a newborn. What action would the nurse take prior to administering the vaccine? Warm the vaccine to well above room temperature. Vigorously massage the chosen injection site. Check the infant's temperature. Divide the dose for administration to three injection sites.

Correct response: Check the infant's temperature. Explanation: The nurse should check the infant's temperature before administering any vaccine. Three injection sites are not normally required, and vigorous massage is not indicated. Warming the vaccine is not normally necessary.

The elderly client returns from a health care visit and asks the nurse why another flu shot was necessary this year because the client got one last year. The nurse's best response is: Once a client turns 75, he needs vaccine boosters every 2 years. The vaccine is good for 5 years, so he did not need another one yet. The vaccine is given every 6 months to prevent the flu. Each year a new vaccine is developed based on the strains most prevalent.

Correct response: Each year a new vaccine is developed based on the strains most prevalent. Explanation: Immune serums are the biologic products used for passive immunity. They act rapidly to provide temporary (for 1-3 months) immunity in people exposed to or experiencing a particular disease. The goal of therapy is to prevent or modify the disease process; to do this, the most prevalent strains must be identified on an annual basis.

A client who was bitten by a pit viper is to receive antivenin. What is the nurse's best action? Establish IV access Obtain a 1 mL syringe Obtain a 3 mL syringe Assess the client's oral mucosa

Correct response: Establish IV access Explanation: Antivenin given to neutralize the venom of a pit viper is administered intravenously.

An adult client received the annual influenza vaccine yesterday afternoon and has now presented back to the clinic reporting malaise. The client's oral temperature is 37.4°C (99.3°F). What is the nurse's best action? Explain that vaccines often cause a mild immune response and have the client self-monitor Ask the client to remain at the clinic to be monitored for signs of anaphylaxis Explain to the client that the malaise is likely caused by a mild case of influenza Administer epinephrine as prescribed

Correct response: Explain that vaccines often cause a mild immune response and have the client self-monitor Explanation: Vaccines often cause symptoms such as fever, malaise, chills or agitation due to their stimulation of the immune system and the inflammatory process. However, this does not mean the client has an active influenza infection. Anaphylaxis would occur much earlier and with more significant signs and symptoms. Monitoring at the clinic would consequently not be necessary. The client's temperature does not constitute a fever.

An infant is being administered an immunization. Which statement provides an accurate description of an immunization? It should be administered to a pregnant woman prior to the infant's birth. It is the administration of an antigen for an antibody response. It produces many adverse reactions, particularly autism, in the infant. It protects the infant from exposure to infectious antibodies.

Correct response: It is the administration of an antigen for an antibody response. Explanation: Immunization involves administration of an antigen to induce antibody formation. This protects the child against the actions of infectious agents; it does not prevent exposure to them. Immunization must be administered to the child following birth. There are limited adverse effects associated with immunization; autism is not among them.

When discussing vaccines in class, a student asks the instructor what an antitoxin is? What is an example of an antitoxin? Toxoid Vaccine Active immunity Passive immunity

Correct response: Passive immunity Explanation: An antitoxin is an example of passive immunity. Antitoxins contain antibodies to very specific toxins. The antibodies are injected into the system and react with invading pathogens. Active immunity occurs when the body recognizes a foreign protein and begins producing antibodies to react with that specific protein or antigen. Vaccines are immunizations containing weakened or altered protein antigens that stimulate formation of antibodies against a specific disease. They are used to promote active immunity. Toxoids are vaccines that are made from the toxins produced by the microorganisms.

A client has received a rubella immunization. The client was unaware that she was pregnant. What risk is associated with the administration of the rubella immunization in this client? Risk of development of the disease in the newborn Risk of low birth weight infant Risk of preterm labor Risk of birth defects

Correct response: Risk of birth defects Explanation: Rubella during the first trimester of pregnancy is associated with a high incidence of birth defects in the newborn. Rubella is not associated with the development of disease. Rubella is not associated with low birth weight or preterm labor.

The nurse is preparing to administer IGIV to some clients. The nurse will question this prescription if which information is noted in the client's medical record? Select all that apply. Diabetes mellitus Receiving vancomycin Receiving cephalexin Age 65 years or older Preexisting renal disease A nurse is educating a group of nursing students about the contraindications of human immune globulin. Which would the nurse include? Select all that apply. anemic disorder pregnancy diabetes mellitus preexisting renal disease age more than 65 years Human immune globulin intravenous (IGIV) products have been associated with renal problems. To which of the following clients should a nurse not administer IGIV? Select all that apply:

Diabetes mellitus Age 65 years or older Receiving vancomycin Preexisting renal disease Explanation: Human immune globulin intravenous (IGIV) products have been associated with renal problems; therefore, a nurse should not administer IGIV to clients with a predisposition to acute renal failure (those with preexisting renal disease), those with diabetes mellitus, those aged 65 years and older, or those receiving nephrotoxic drugs (vancomycin). Cephalexin is not a contraindication for receiving vaccines or toxoids.

The clinic nurse is explaining recommended vaccines to the local PTA. What vaccine would you tell the attendees is recommended for children > 7 years and adults? MMR Typhoid Diphtheria Varicella B

Diphtheria Explanation: Diphtheria and tetanus toxoids, combined, adsorbed (DT, Td) two IM injections of 0.5 mL at intervals of 4-8 weeks, with booster of 0.5 mL in 6-12 months. Immunization of adults and children >7 years of age against diphtheria and tetanus.

The nurse is providing education regarding immunization to the parent of an 11-year-old client. Which vaccine would the nurse indicate is recommended for both young adolescents and adults? Herpes zoster Rotavirus Typhoid Diphtheria

Diphtheria Explanation: Immunization against diphtheria and tetanus is recommended in young adolescents and adults. Following the 5 initial doses given in infancy and early childhood, a booster is given at age 11 or 12 and again every ten years during adulthood. The rotavirus vaccine is given during infancy. Immunization against typhoid is not routine. The herpes zoster (shingles) vaccine is recommended for adults age 50 or older.

A client is preparing to travel to a foreign country and presents to the clinic to ensure their immunizations are current. A nurse should recommend vaccination against which disease(s) before travel to endemic areas? Select all that apply. Varicella Diphtheria Lyme disease Tetanus Cholera

Diphtheria Lyme disease Cholera Explanation: A nurse should recommend vaccination against the following before travel to endemic areas: cholera, diphtheria, Japanese encephalitis, Lyme disease, smallpox, typhoid, and yellow fever. Immunization against varicella and tetanus are diseases prevented by routine vaccination

The school nurse is interviewing the family of a 5 year-old who is beginning kindergarten. The parents state that the child's immunizations are all "up to date." The nurse recognizes that the child has immunity to what illnesses? Select all that apply. Diphtheria Human papillomavirus Varicella Tetanus Hepatitis B Poliovirus

Diphtheria Varicella Tetanus Hepatitis B Poliovirus Explanation: Childhood immunization schedules dictate immunizations against polio, diphtheria, varicella, tetanus and hepatitis B. Human papillomavirus is administered at age 11 or 12.

A nurse is working at a free vaccination clinic today and expects to give vaccinations to more than one hundred children. Which item is most important to have available? Epinephrine pen Cold packs Oxygen cylinder Crash cart

Epinephrine pen Explanation:Health care providers who are administering vaccines should have aqueous epinephrine 1:1000 readily available to allow immediate treatment of any allergic reaction.

A nurse is teaching the caregiver of a young client about the varicella vaccine that the primary health care provider has prescribed. The nurse should point out which fact(s) to the child and caregivers? Select all that apply. Explain the benefits of immunization. Provide the date for return for the next vaccination. Explain the risk of contracting vaccine-preventable diseases. Discuss common adverse reactions. Instruct the parents to ensure the medical record is up-to-date. Instruct the parents to bring immunization records to all visits.

Explain the risk of contracting vaccine-preventable diseases. Explain the benefits of immunization. Provide the date for return for the next vaccination. Discuss common adverse reactions. Instruct the parents to bring immunization records to all visits. Explanation: The following information should be included when educating the parents of a client receiving a vaccination: explain the risk of contracting vaccine-preventable diseases, explain the benefits of immunization, instruct the parents to bring immunization records to all visits, provide the date for return for the next vaccination, discuss common adverse reactions, and instruct parents to report any unusual or severe adverse reactions after the administration of a vaccination. It is not the responsibility of the parents to ensure the clinic's medical records are up-to-date, but is the responsibility of the staff.

True or False Serum sickness results from the overuse of vaccines.

False

A parent has contacted the nurse and is concerned about media reports of a measles outbreak. The parent wants to confirm that their 9-month-old child has been immunized against measles. What is the best response by the nurse? If the parent has adhered to the recommended schedule, the child was immunized 3 months ago. The child should receive the vaccine promptly. The child was likely immunized prior to discharge post-delivery. Fifteen months is the youngest age at which the child should be vaccinated.

Fifteen months is the youngest age at which the child should be vaccinated. Explanation: MMR is administered initially as a combined vaccine at 15 months.

The school nurse is addressing a parents' group and is discussing an upcoming campaign of human papillomavirus (HPV) vaccination. What should the nurse teach this group of parents? HPV vaccination of recommended for all girls, age 15 and older HPV vaccination is recommended for both boys and girls HPV vaccination confers protection against a variety of sexually-transmitted viruses HPV vaccination is based on a thorough health history of each child

HPV vaccination is recommended for both boys and girls Explanation: HPV vaccination is recommended for males and females alike. It is not offered or withheld on the basis of health history, though high-risk individuals may be offered it at a younger age. Protection is exclusive to the human papillomavirus.

A client has been bitten by a dog, and the dog's rabies status is unknown. The nurse would expect this client to receive a(n): OR Which would a nurse expect to administer to a client who has not been immunized and has sustained a bite from an animal with rabies? A client was bitten by a poisonous snake. Which treatment would be most appropriate to administer? Immune globulin Immune sera Antivenin Antitoxin

Immune globulin Explanation: An immune globulin, specifically rabies immune globulin, would be used to prevent rabies in nonimmunized clients who are exposed to rabies. An antitoxin is used to treat poisonous substances released by invading pathogens, for example, botulism. Antivenin would be used to treat snake bites. Immune sera is a general term that includes immune globulins, antitoxins, and antivenins.

A teenager 16 years of age has just received a kidney transplant from a cadaver donor. The parents voice distress over the possibility of kidney rejection and the subsequent need to pay for dialysis again, because the insurance company raised the copay amount, which is more than the parents can afford. The nurse knows that the client will receive passive immunity to prevent organ rejection and explains how passive immunity works. Which of the following passive immunity agents would the nurse include in the family teaching session? The killed varicella virus vaccine Antivenins The attenuated, live varicella virus vaccine Immune globulins

Immune globulins Explanation: Immune globulins provide passive immunity to prevent organ rejection. The varicella virus vaccine and antivenins are not immune globulins.

A client is to receive a typhoid vaccine. The nurse would prepare to administer this vaccine in which site? -Into the fatty tissue of the upper arm -Deep into the lateral thigh muscle -Into the upper outer quadrant of the buttocks -Directly into the dermis layer of the skin

Into the fatty tissue of the upper arm

What type of vaccine is contraindicated in clients who have active malignant disease?

Live vaccines Explanation:Clients with active malignant disease may be given killed vaccines or toxoids but should not be given live vaccines. (An exception is persons with leukemia who have not recei ... (more)

An employee of a long-term care facility has been administered the hepatitis B series prior to beginning employment. How should the employee's therapeutic response to the vaccination be best assessed? Attempt to palpate the employee's liver and spleen. Monitor the client for signs and symptoms of hepatitis B infection. Measure the employee's serum antibody levels. Monitor the client's bilirubin, AST, ALT, and albumin levels.

Measure the employee's serum antibody levels. Explanation:In many cases, antibody titers (levels of the antibody in the serum) can be used to evaluate a person's response to an immunization and determine the need for a booster dose.

A client has arrived at the clinic and is requesting an update on immunizations. The nurse will point out the client may not be able to have any vaccines due to which current prescribed medication(s)? Select all that apply. Ciprofloxacin Paclitaxel Vincristine Prednisolone Methylprednisolone

Methylprednisolone Prednisolone Paclitaxel Vincristine Explanation: Vaccines containing live organisms are not administered to clients taking corticosteroids (methylprednisolone and prednisolone) or antineoplastic drugs (paclitaxel and vincristine) and those receiving radiation therapy as insufficient numbers of antibodies are produced to prevent the disease because these drugs suppress the immune system. There are no noted interactions between ciprofloxacin and vaccines or toxoids.

A group of student nurses are preparing a community presentation illustrating the various vaccines. The instructor determines the students have successfully presented the information with which vaccine(s) being listed as viral? Select all that apply. Haemophilus influenza type B conjugate Typhoid Mumps Avian influenza Rabies

Mumps Avian influenza Rabies Explanation: Mumps, avian influenza, and rabies are virus vaccines. Haemophilus influenza type B conjugate and typhoid are bacterial vaccines.

A nurse caring for clients at a family health clinic performs preadministration assessments on all clients before administering vaccines. The nurse will prioritize evaluating for possible pregnancy status before administrating which vaccine(s) to women? Select all that apply. Varicella Rubella Influenza Mumps Measles

Mumps Measles Varicella Rubella Explanation: The measles, mumps, and rubella and varicella vaccines are contraindicated during pregnancy, especially during the first trimester, because of the danger for birth defects. Women are further instructed to avoid becoming pregnant at least 3 months after receiving these vaccines. The influenza vaccine does not have teratogenic adverse effects.

A nurse is conducting a preadministration assessment of a client prescribed the MMR and varicella vaccine. The nurse will question this order if which allergic reaction(s) is noted in the client's past history? Select all that apply. Neomycin Pollen Gelatin Amoxicillin Eggs

Neomycin Gelatin Eggs Explanation: The measles, mumps, and rubella (MMR) and varicella vaccines are contraindicated in clients allergic to gelatin and neomycin or in those who had an allergic reaction to a previous dose of one of the vaccines. Individuals with allergies to eggs are also a concern as many vaccines are developed in eggs. It is recommended to see a primary health care provider familiar with egg allergies for vaccination if an allergy is suspected. Allergies to pollen and amoxicillin are not noted to be contraindications.

As a participant in an educational event at a local senior center, the nurse is explaining the administration of vaccines. What group would the nurse identify as being ineligible for live-virus vaccines?

People undergoing systemic, long-term corticosteroid therapy

For what group of adults is pre-exposure immunization against hepatitis B recommended? People with chronic illnesses People over the age of 70 People who receive hemodialysis People in their 20s

People who receive hemodialysis Explanation: Pre-exposure immunization against hepatitis B is recommended for high-risk groups. These may include health care workers; clients with cancer, organ transplants, hemodialysis, immunosuppression drug therapy, or multiple infusions of blood products;sexually active gay and bisexual males; IV drug users; household contacts of HBV carriers; and residents and staff of institutions for people with intellectual disability.

The nurse is aware that an 8-year-old child who had a splenectomy should receive which vaccination in addition to those recommended for his age group? Hib vaccine Quadrivalent human papillomavirus Pneumococcal vaccine Shingles vaccine vaccine

Pneumococcal vaccine Explanation: The pneumococcal vaccine is recommended for children older than 2 years of age who have had a splenectomy. The quadrivalent human papillomavirus vaccine is recommended for adolescents. The Hib vaccine is recommended for infants, and the shingles vaccine is recommended for adults who previously have had chickenpox.

A forest ranger arrives at a community clinic for prophylactic vaccination. Which vaccine would be most important to be administered to the ranger? Measles, mumps, and rubella (MMR) vaccine Varicella vaccine Rotavirus vaccine Rabies vaccine

Rabies vaccine Rabies vaccine Explanation: Due to the high numbers of animals in the forest, the ranger should receive the rabies vaccine as prophylaxis as they are at a high risk for contracting the virus. The MMR vaccine is used in preventing measles, mumps, and rubella. The varicella vaccine is used in preventing chickenpox, and the rotavirus vaccine is used in preventing gastroenteritis caused by the rotavirus.

A child who is recovering from a chickenpox infection is given aspirin for the fever. Which condition develops following the simultaneous administration of salicylates and the varicella vaccine? Acute renal failure Reye's syndrome Lymphoma Angioneurotic edema

Reye's syndrome Explanation: When salicylates are administered along with the varicella vaccine, there is an increased risk of development of Reye's syndrome. It is often associated with children who are given aspirin-containing medicines while they have chickenpox (varicella). Lymphoma, angioneurotic edema, and acute renal failure do not develop with the simultaneous administration of salicylates and the varicella vaccine. Lymphoma is a contraindication for receiving some vaccines. Angioneurotic edema is a sign of hypersensitivity to a substance. IGIV products have been associated with acute renal failure and should be used cautiously in clients with renal disease.

A 65-year-old male client lives in a long-term care facility. The infection control nurse identifies a cluster of clients on the unit diagnosed with shingles. What would the nurse expect the client's prescriber to order? Shingles vaccine HBV vaccine Isolation of the client Isolation of the client's peers

Shingles vaccine Explanation: Vaccine to prevent shingles is available for adults aged 60 years and older.

What occurs when the host human responds to the injected antibodies circulating through the body? The circulating antibodies attack the host cells. The host produces a passive immunity to the antibodies. The host forms antigen-antibody complexes with the injected antibodies. The host produces its own antibodies to the injected antibodies.

The host produces its own antibodies to the injected antibodies. Explanation: In some cases, the host human responds to the circulating injected antibodies, which are foreign proteins to the host's body, by producing its own antibodies to the injected antibodies. This results in serum sickness, a massive immune reaction which is manifested by fever, arthritis, flank pain, myalgia, and arthralgia.

A 65-year-old client is being seen in the emergency department for exposure to rabies. The nurse checks the electronic health record and discovers the client has had no history of allergic reactions to immunization agents. The client's history guides the nurse to take which action? OR A male, 65 years of age, is deer hunting when he is suddenly attacked by a rabid dog. The man is seen in the emergency department for exposure to rabies. The client has become highly agitated and wants immediate treatment for the dog bite. The nurse checks the electronic health record and discovers the client has had no history of allergic reactions to immunization agents. The client's history guides the nurse to take which action? Teach the client that the administration of immune globulin is contraindicated for senior citizens regardless of previous reactions. Teach the client that the there is no known treatment for rabies. Teach the client that the best treatment is to take over-the-counter herbal remedies. Teach the client that the agent of choice is rabies immune globulin

Teach the client that the agent of choice is rabies immune globulin, used if the client has not been previously immunized. Explanation: Exposure to rabies is treated with the immunization agent called rabies immune globulin. Administration is not contraindicated in senior citizens, and herbal remedies are not the recommended treatment of choice.

After teaching a group of students about the standard childhood immunizations given today, the instructor determines that the students need additional teaching when they identify which as a common disease for which immunizations are given? Poliovirus Tuberculosis Pertussis Diphtheria

Tuberculosis Explanation: Immunization for tuberculosis occurs worldwide, but it is not routinely used in the United States.

The nurse is working at a community agency administering the polyvalent pneumococcal vaccine. The nurse understands that administration of this vaccine should be avoided in which patients?

You selected: 1 ½ -year-old Correct Explanation: Polyvalent pneumococcal vaccine is not recommended for children under the age of 2 years.

For children with HIV infection, what is true about most routine immunizations?

You selected: They are recommended. Correct Explanation: For children with HIV infection, most routine immunizations (DTaP, IPV, MMR, Hib, influenza) are recommended.

The nurse should monitor clients receiving human immune globulin intravenous (IGIV) products closely for problems with which organs? kidneys lungs liver heart

kidneys Explanation: IGIV products have been associated with renal impairment, acute renal failure, osmotic nephrosis, and death, so the nurse should monitor a client's renal function carefully during the administration of IGIV products. The liver, heart, and lungs are not affected.

The nurse is educating an older adult client on routine vaccines. Which statement best describes the recommended vaccination schedule for an older adult client? an influenza vaccine booster every 10 years, annual tetanus-diphtheria vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age a tetanus-diphtheria booster and influenza vaccination every fall or winter a tetanus-diphtheriao booster every 2 years, annual influenza vaccine, and a yearly administration of pneumococcal vaccine a tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age

a tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age Recommended immunizations for older adults have usually consisted of a tetanus-diphtheria (Td) booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age. A second dose of pneumococcal vaccine may be given at 65 years if the first dose was given 5 years previously. None of the other options present accurate information concerning currently recommended vaccination scheduling for older clients.

The parent of a preschool aged child asks what immunizations the child needs before starting school. If the child is healthy and has received immunizations on schedule in the past, which immunizations should the nurse anticipate the child needing? Select all that apply. measles, mumps, and rubella vaccine (MMR) inactivated poliovirus vaccine (IPV) diphtheria and tetanus toxoids and acellular pertussis vaccine, adsorbed (DTaP) human papillomavirus hepatitis A

diphtheria and tetanus toxoids and acellular pertussis vaccine, adsorbed (DTaP) inactivated poliovirus vaccine (IPV) measles, mumps, and rubella vaccine (MMR) Explanation: The 4- to 6-year-old, preparing to enter school needs booster DTaP, IPV, MMR, influenza and varicella. Hepatitis A vaccine is administered at age 2 or 3. HPV vaccine is given to older children.

Based on your work as a nurse in a geriatric clinic, the nurse knows that older adults should receive a pneumococcal vaccine: once at 65 years of age. if they exhibit signs and symptoms of infection. once at 65 years of age and then again every 5 years. annually starting at 65 years of age.

once at 65 years of age. Explanation: Recommended immunizations for older adults include one-time administration of the pneumococcal vaccine at 65 years of age. A second dose may be given at 65 if a first dose was administered 5 years previously.

The administration of immune globulins or antivenins to a client is a form of what type of immunity? naturally acquired active immunity passive immunity active immunity artificially acquired active immunity

passive immunity

A client being vaccinated for measles asks the nurse about the contents of the vaccine. During the explanation, the nurse mentions a poisonous substance produced by some bacteria that is capable of stimulating antitoxin production. Which is the nurse referring to in the explanation? toxin vaccine immune globulin toxoid

toxin Explanation: A toxin is a substance that is capable of stimulating the body to produce antitoxins, which act in the same manner as antibodies. Toxins are powerful substances, and they can be attenuated and used as toxoids to produce antitoxins. Toxoids are attenuated toxins, which are capable of stimulating antibody production and creating immunity. Vaccines are attenuated or killed antigens, which are capable of stimulating antibody production and creating immunity. Immune globulins are antibodies containing solutions formed to specific antigens and are obtained from human or animal blood.

The nurse must administer which to a client prior to exposure to the disease-causing organism in order for the client to be protected against the disease? toxoids immune globulins antivenins antibodies

toxoids Explanation: The nurse must administer toxoids and vaccines to a client prior to exposure to the disease-causing organism in order for the client to be protected against the disease. Immune globulins are solutions obtained from human or animal blood containing antibodies that have been formed by the body to specific antigens. Antivenins are used for passive, transient protection from the toxic effects of bites by spiders (black widow and similar spiders) and snakes (rattlesnakes, copperhead and cottonmouth, and coral). An antibody is a globulin (protein) produced by the B lymphocytes as a defense against an antigen.

A nurse prepares to administer antithymocyte immune globulin. The nurse understands that this is used to: -prevent respiratory syncytial virus infection. -prevent chickenpox. -treat acute renal transplant rejection. -provide post exposure prophylaxis for hepatitis B.

treat acute renal transplant rejection.