prep u ch 10

Question 1: (see full question) Which vaccine is recommended for adolescents and adults? You selected: Influenza Incorrect Correct response: Diphtheria Explanation: Immunization against diphtheria and tetanus is recommended in adolescents and adults; following initial immunization, patients should receive booster shots every ten years. The rot ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 2: (see full question) 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? You selected: CMV-IGIV is routinely administered for prevention of cytomegalovirus after organ transplant. Correct Explanation: Cytomegalovirus immune globulin (CMV-IGIV) is routinely administered for prevention of cytomegalovirus infection after organ transplant. BIG-IV treats infant botulism. Imogam treat ... (more) Question 3: (see full question) A nursing instructor is discussing the intended populations for various vaccines. Which groups might the instructor mention when discussing the hepatitis B vaccine? You selected: Paramedics and emergency medical technicians Correct 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); ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 165. Question 4: (see full question) 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? You selected: Temperature Correct 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 dang ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 5: (see full question) 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? You selected: Chills and fever Correct Explanation: Chills and fever are mild adverse reactions observed after administration of vaccines. Seizure, cardiac arrest, death, and brain damage are not considered mild adverse reactions. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 174. Question 6: (see full question) Human immune globulin intravenous (IGIV) products have been associated with renal problems, therefore which of the following clients should a nurse not administer IGIV? Select all that apply: You selected: • Clients with preexisting renal disease • Clients receiving vancomycin Incorrect Correct response: • Clients with diabetes mellitus • Clients 65 years of age or older • Clients receiving vancomycin • Clients with 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 r ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 7: (see full question) A client is undergoing a yearly physical. While discussing immunizations, the client states not wanting any immunizations because they can cause diseases. The nurse's best response is: You selected: Immunizing agents are quite safe, and risks of the diseases they prevent are greater than the risks of the vaccines. Correct Explanation: 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 recipien ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 8: (see full question) When describing the use of vaccines to a local community group, what would the nurse include? You selected: Vaccines are used to provide active immunity. Correct Explanation: Vaccines provide active immunity. They promote the formation of antibodies against a specific disease. The person experiences an immune response without having to suffer the f ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 9: (see full question) 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? You selected: Tuberculosis Correct Explanation: Immunization for tuberculosis occurs worldwide, but it is not routinely used in the United States. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 10: (see full question) A nurse should screen clients of child-bearing age for pregnancy as the administration of which vaccines is contraindicated during pregnancy? (Select all that apply.) You selected: • Mumps • Measles • Rubella Incorrect Correct response: • Varicella • Measles • Mumps • Rubella Explanation: The measles, mumps, rubella, and varicella vaccines are contraindicated during pregnancy, especially during the first trimester, because of the danger for birth defects. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 11: (see full question) Which are used to produce active immunity? (Select all that apply.) You selected: • Antigens • Antibodies • Vaccines Incorrect Correct response: • Vaccines • Toxoids Explanation: The immunity produced by the administration of toxoids and vaccines is considered active immunity. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 12: (see full question) The nurse has just administered the measles, mumps, and rubella vaccine to female patient, how long should the nurse advise the patient to wait before trying to become pregnant? (Choose one) You selected: At least 3 months Correct Explanation: Women are instructed to avoid becoming pregnant at least 3 months after receiving the measles, mumps, rubella, and varicella vaccines. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 174. Question 13: (see full question) The difference between toxoids and vaccines is: You selected: Vaccines induce antibody formation, which prevent the disease or cause a very mild form. Many vaccines produce long-lasting immunity. Toxoids are bacterial toxins or products modified to destroy toxicity. Toxoid immunization is not permanent; scheduled repeat doses (boosters) maintain immunity. Correct Explanation: Vaccines are suspensions of microorganisms that have been killed or attenuated so that they can induce antibody formation while preventing or causing very mild forms of the disease ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 14: (see full question) Your client is taking prednisone 40 mg daily. When providing client education about immunizations, which of the following would you include in your teaching? You selected: You should wait at least 2 weeks after prednisone therapy to obtain a live vaccine immunization. Incorrect Correct response: You should wait at least 3 months after chemotherapy to obtain a live vaccine immunization. Explanation: Patients receiving a systemic corticosteroid in high doses (eg, prednisone 20 mg or equivalent daily) or for longer than 2 weeks should wait at least 3 months before being given a ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 15: (see full question) 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? You selected: Infants and people at risk for contracting the disease Correct Explanation: Indications for receiving the vaccine are susceptible people and in infants born to mothers with hepatitis B. Indications for receiving the vaccine do not include children under th ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 165. Question 16: (see full question) What would necessitate cautious use of a vaccine in a child? (Select all that apply.) You selected: • Immune deficiency • Allergy to a vaccine component • Blood transfusion within the past 3 months • History of febrile convulsions Incorrect Correct response: • History of febrile convulsions • History of brain injury • Acute infection 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 dangerou ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 17: (see full question) Which would a nurse expect to administer to a patient who has not been immunized and has sustained a bite from an animal with rabies? You selected: Antivenin Incorrect Correct response: Immune globulin Explanation: An immune globulin, specifically rabies immune globulin, would be used to prevent rabies in nonimmunized patients who are exposed to rabies. An antitoxin is used to treat poisonous ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 175. Question 18: (see full question) An immune compromised patient is exposed to hepatitis A. The physician orders an injection of immunoglobulin as prophylaxis against the hepatitis A. What adverse effects would the nurse advise the patient might occur? (Mark all that apply.) You selected: • Rhinitis • Fever • Urticaria • Angioedema Incorrect Correct response: • Fever • Angioedema • Urticaria Explanation: Adverse effects: Tenderness, muscle stiffness at site of injection; urticaria, angioedema, nausea, vomiting, chills, fever, and chest tightness. An immune compromised patient would ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 19: (see full question) 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? You selected: Varicella vaccine Incorrect Correct response: Flu vaccine Explanation: Flu 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 ar ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 20: (see full question) 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: You selected: pain, redness, and swelling at site of injection. Correct Explanation: Normal reactions to immunizations include pain, redness, and swelling at the site of the injection. Vomiting, diarrhea, high fever, sweating, lethargy, or drowsiness would not be e ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Before administering a vaccine to a patient, what should the nurse assess?

Question 1: (see full question) What type of vaccine is contraindicated in clients who have active malignant disease? You selected: Live vaccines Correct 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) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 2: (see full question) Before administering a vaccine to a patient, what should the nurse assess? You selected: The patient's temperature Correct Explanation: The nurse should assess the patient's temperature, because vaccines and toxoids are usually contraindicated during febrile illnesses. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 3: (see full question) Middle aged adults and health care workers should receive which immunizations? You selected: Tetanus-diphtheria-pertussis; hepatitis B vaccine once and influenza vaccine annually Correct 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 ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 4: (see full question) A nurse should warn a client about which of the following adverse reactions that can occur after the administration of cytomegalovirus immune globulin (CytoGam)? Select all that apply: You selected: • Chills • Angioedema • Headache • Urticaria Correct Explanation: The most common adverse reactions to the administration of cytomegalovirus immune globulin (CytoGam) include urticaria, angioedema, erythema, malaise, nausea, diarrhea, headache, c ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 5: (see full question) 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? You selected: Immune globulins Correct Explanation: Immune globulins provide passive immunity to prevent organ rejection. The varicella virus vaccine and antivenins are not immune globulins. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 11: Drug Therapy to Suppress Immunity, p. 191-192. Question 6: (see full question) A nurse is presenting an educational event about vaccines at a local elementary school. What would the nurse tell the attendees of the event about the administration of live vaccines and when they are generally contraindicated? You selected: In people who are receiving immune globulin for immune deficiency Correct 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 a ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 7: (see full question) 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? You selected: People undergoing systemic, long-term corticosteroid therapy Correct Explanation: Systemic corticosteroid therapy may depress the immune system to such a degree that patients lack a sufficient number of antibodies to safely receive a live-virus vaccine. Patients ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 8: (see full question) A man who was working on his outside deck comes to the emergency department after sustaining a puncture wound of his hand from a large nail. Which would the nurse expect to administer? You selected: Tetanus toxoid Correct Explanation: Tetanus toxoid is used to provide passive immunization against tetanus as the result of an injury that could potentially precipitate a tetanus infection, such as a puncture wound b ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 175. Question 9: (see full question) To prevent meningococcal infections, the nurse would administer: You selected: Vaccine Correct 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 o ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 164. Question 10: (see full question) 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? You selected: 6 weeks Incorrect Correct response: 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. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172.

Question 1: (see full question) Which are used to produce active immunity? (Select all that apply.) You selected: • Antibodies • Vaccines • Toxoids • Antigens Incorrect Correct response: • Vaccines • Toxoids Explanation: The immunity produced by the administration of toxoids and vaccines is considered active immunity. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 2: (see full question) Which is an example of passive immunity? (Select all that apply.) You selected: • An individual who is exposed to chickenpox for the first time and has no immunity to the disease. Incorrect Correct response: • Administration of botulism immune globulin (BabyBIG) for the treatment of infant botulism. • Administration of crotalidae polyvalent immune Fab (CroFab) for the treatment of mild to moderate North American rattlesnake bite. Explanation: Administration of botulism immune globulin (BabyBIG) for the treatment of infant botulism or administration of crotalidae polyvalent immune Fab (CroFab) for the treatment of mild t ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 3: (see full question) A nurse is presenting an educational event about vaccines at a local elementary school. What would the nurse tell the attendees of the event about the administration of live vaccines and when they are generally contraindicated? You selected: In people who have hepatic failure Incorrect Correct response: In people who are receiving immune globulin for immune deficiency 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 a ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 4: (see full question) What type of modification may be necessary for a client with diabetes mellitus who requires immunizations? You selected: The client will require reduced doses of vaccines. Incorrect Correct response: The client will require increased doses of vaccines. Explanation: Clients who have diabetes mellitus may require increased dosage and more frequent administration of vaccines. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 5: (see full question) A nurse prepares to administer antithymocyte immune globulin. The nurse understands that this is used to: You selected: treat acute renal transplant rejection. Correct Explanation: Antithymocyte immune globulin is used to treat acute renal transplant rejection. The varicella virus vaccine would be used to prevent varicella (chickenpox). Hepatitis B immune glo ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 192. Question 6: (see full question) The difference between toxoids and vaccines is: You selected: Vaccines offer lifelong immunity, and toxoids do not. Incorrect Correct response: Vaccines induce antibody formation, which prevent the disease or cause a very mild form. Many vaccines produce long-lasting immunity. Toxoids are bacterial toxins or products modified to destroy toxicity. Toxoid immunization is not permanent; scheduled repeat doses (boosters) maintain immunity. Explanation: Vaccines are suspensions of microorganisms that have been killed or attenuated so that they can induce antibody formation while preventing or causing very mild forms of the disease ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 7: (see full question) A male client presents to the emergency department with an asthma attack. He is treated and sent home with prednisone 10 mg on a taper and is encouraged to see his physician within 1 week. During an assessment of the chart, the nurse notices that the client is overdue for his tetanus booster. What would the nurse expect the physician to do? You selected: Postpone the booster for 1 week Incorrect Correct response: Order the booster Explanation: Immunizations are not contraindicated with short-term use (less than 2 weeks) or low-to-moderate doses (less than 20 mg/d) of prednisone. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 8: (see full question) 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? You selected: Active immunity occurs when a client receives a killed or weakened antigen that stimulates antibodies. These antibodies fight the antigen (for example, chickenpox vaccine). Correct 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 ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 9: (see full question) What immunizations are recommended for older adults? (Select all that apply.) You selected: • A tetanus-diphtheria (Td) booster every 10 years • An annual influenza vaccine • A one-time administration of pneumococcal vaccine at 65 years of age Correct Explanation: Recommended immunizations for older adults have usually consisted of a tetanus- diphtheria (Td) booster every 10 years, annual influenza vaccine, and a one-time adminis ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 10: (see full question) The administration of vaccines and toxoids are contraindicated in which of the following? Select all that apply: You selected: • Leukemia • Clients over 70 years of age • Chronic prednisone therapy • HIV Incorrect Correct response: • Leukemia • Chronic prednisone therapy • HIV Explanation: Vaccines and toxoids are contraindicated during acute febrile illnesses, leukemia, lymphoma, immunosuppressive illness (HIV) or drug therapy (prednisone), and nonlocalized carcinom ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 11: (see full question) 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) You selected: 1 to 3 months Correct Explanation: While onset after immune globulin is raped the duration is short, only 1 to 3 months. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 169. Question 12: (see full question) To prevent meningococcal infections, the nurse would administer: You selected: Toxoid Incorrect 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 o ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 164. Question 13: (see full question) Based on your work as a nurse in a geriatric clinic, the nurse knows that older adults should receive a pneumococcal vaccine: You selected: once at 65 years of age and then again every 5 years. Incorrect Correct response: 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 admi ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 14: (see full question) 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? You selected: State that the booster is contraindicated at this time Incorrect Correct response: Order the booster Explanation: Long-term alternate-day therapy with short-acting corticosteroids; maintenance physiologic doses; and the use of topical, aerosol, or intra-articular injections are not contr ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 15: (see full question) 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? You selected: People with hepatic failure Incorrect Correct response: People undergoing systemic, long-term corticosteroid therapy Explanation: Systemic corticosteroid therapy may depress the immune system to such a degree that patients lack a sufficient number of antibodies to safely receive a live-virus vaccine. Patients ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 16: (see full question) A female client is living with HIV. She is exposed to measles. What is the treatment of choice in this case? You selected: Immune globulin Correct 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 glo ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 17: (see full question) A nurse is educating a group of nursing students about the contraindications of human immune globulin. Which among the following conditions are contraindications for human immune globin? Select all that apply. You selected: • Anemic disorder • Pregnancy • Preexisting renal disease Incorrect Correct response: • Preexisting renal disease • Age more than 65 years • Diabetes mellitus Explanation: Human immune globulin intravenous (IGIV) product can cause renal impairment, osmotic nephrosis, and death as its complications. Hence it is contraindicated in individuals with acut ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 18: (see full question) 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? (Choose one) You selected: 30 minutes Correct Explanation: The patient should be asked to stay in the physician's office for observation for about 30 minutes after the injection of immune globulin for any signs of hypersensitivity. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 19: (see full question) 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? You selected: The attenuated, live varicella virus vaccine Incorrect Correct response: Immune globulins Explanation: Immune globulins provide passive immunity to prevent organ rejection. The varicella virus vaccine and antivenins are not immune globulins. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 11: Drug Therapy to Suppress Immunity, p. 191-192. Question 20: (see full question) A 60-year-old male client received a dose of pneumococcal vaccine during a physician's visit. What would the nurse recommend? You selected: A second dose when he turns 70 Incorrect Correct response: 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. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172.

Question 1: (see full question) 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? You selected: 0.5 mL sub-q Correct Explanation: The nurse will administer 0.5 mL. This is the recommended dose for adults and children older than 15 months of age. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 165. Question 2: (see full question) Which statements best indicates the client understands recommended vaccines following the 65th birthday? You selected: A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age Correct Explanation: 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 pn ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 3: (see full question) A nurse should warn a client about which of the following adverse reactions that can occur after the administration of cytomegalovirus immune globulin (CytoGam)? Select all that apply: You selected: • Constipation • Urticaria • Headache • Chills Incorrect Correct response: • Urticaria • Angioedema • Headache • Chills Explanation: The most common adverse reactions to the administration of cytomegalovirus immune globulin (CytoGam) include urticaria, angioedema, erythema, malaise, nausea, diarrhea, headache, c ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 4: (see full question) 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? You selected: Reye syndrome Correct Explanation: When salicylates are administered along with the varicella vaccine, there is an increased risk of development of Reye syndrome. It is often associated with children who are given a ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 5: (see full question) A young mother asks the clinic nurse about the "chickenpox" vaccine. The mother states that she and her husband have both had chickenpox, but that she wants to protect her child if she can. What should the nurse tell the mother about the recommendation for the chickenpox vaccine? You selected: It is recommended for all children who have not been exposed to the varicella virus. Correct Explanation: Measles, mumps, rubella, varicella virus vaccine (ProQuad) 0.5 mL Sub-Q. Simultaneous immunization against measles, mumps, rubella, and varicella in children aged 12 months to 12 y ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 164. Question 6: (see full question) A male client is treated for his cancer of the 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. For when should the nurse schedule immunizations? You selected: Three months after his cancer treatment is completed Correct Explanation: For clients with active malignant disease, live vaccines should not be given. Although killed vaccines and toxoids may be given, antibody production may be inadequate to prov ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 7: (see full question) A 72-year-old client is brought to the clinic by her daughter. The daughter asks how often her mother should receive the influenza vaccine. What would be the nurse's best response? You selected: "Your mother needs the influenza vaccine yearly." Correct Explanation: Influenza vaccine should be administered annually prior to flu season. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunization, p. 166. Question 8: (see full question) A patient, aged 72, is brought to the clinic by her daughter. The daughter asks how often her mother should receive the influenza vaccine. What would be the nurse's best response? You selected: "Your mother needs the influenza vaccine yearly." Correct Explanation: Adults with chronic diseases are advised to be immunized yearly with an influenza vaccine and once with a pneumococcal pneumonia vaccine. The other options are incorrect informatio ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 166. Question 9: (see full question) 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? You selected: People with hepatic failure Incorrect Correct response: People undergoing systemic, long-term corticosteroid therapy Explanation: Systemic corticosteroid therapy may depress the immune system to such a degree that patients lack a sufficient number of antibodies to safely receive a live-virus vaccine. Patients ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 10: (see full question) 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? You selected: Every 10 years Correct Explanation: Following the initial booster injection, the tetanus toxoid should be administered to adults every 10 years. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 168. Question 11: (see full question) The nurse is teaching the parents of a child who has received immunizations and possible adverse effects. What would the nurse identify as common adverse effects? (Select all that apply.) You selected: • Fretfulness • Nodule at the injection site • Chills Incorrect Correct response: • Nodule at the injection site • Fretfulness • Chills • Anorexia Explanation: Common adverse effects include moderate fever, rash, malaise, chills, fretfulness, drowsiness, anorexia, vomiting, irritability, and pain, redness, swelling, and nodule formation a ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 12: (see full question) Which is an example of passive immunity? (Select all that apply.) You selected: • An individual who is exposed to petussis for the first time and has no immunity to the disease. • An individual who is exposed to chickenpox for the first time and has no immunity to the disease. Incorrect Correct response: • Administration of botulism immune globulin (BabyBIG) for the treatment of infant botulism. • Administration of crotalidae polyvalent immune Fab (CroFab) for the treatment of mild to moderate North American rattlesnake bite. Explanation: Administration of botulism immune globulin (BabyBIG) for the treatment of infant botulism or administration of crotalidae polyvalent immune Fab (CroFab) for the treatment of mild t ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 13: (see full question) A patient 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. What is the nurse referring to in this explanation? You selected: Toxin Correct 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 at ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 14: (see full question) A nurse is presenting an educational event about vaccines at a local elementary school. What would the nurse tell the attendees of the event about the administration of live vaccines and when they are generally contraindicated? You selected: In people who have hepatic failure Incorrect Correct response: In people who are receiving immune globulin for immune deficiency 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 a ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 15: (see full question) 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? You selected: The attenuated, live varicella virus vaccine Incorrect Correct response: Immune globulins Explanation: Immune globulins provide passive immunity to prevent organ rejection. The varicella virus vaccine and antivenins are not immune globulins. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 11: Drug Therapy to Suppress Immunity, p. 191-192. Question 16: (see full question) 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? You selected: Vaccines Correct Explanation: A vaccine is an active immunity agent. Immune globulins and antivenins are passive immunity agents. Herbal coffee is not an immunologic agent. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 17: (see full question) A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive? You selected: Immune globulin Correct Explanation: Hepatitis B immune globulin would be used for post-exposure prophylaxis for hepatitis B. This vaccine would be used to prevent herpes zoster (shingles) in persons over the age of 6 ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 169. Question 18: (see full question) To prevent meningococcal infections, the nurse would administer: You selected: Immune globulin Incorrect 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 o ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 164. Question 19: (see full question) What type of vaccine is contraindicated in clients who have active malignant disease? You selected: Killed vaccines Incorrect Correct response: 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) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 20: (see full question) A female client is receiving chemotherapy for breast cancer. She requires a vaccine booster. For when would the physician order the administration of the vaccine? You selected: 3 months after chemotherapy is completed Correct 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 immunoglobuli ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172.

Question 1: (see full question) 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? You selected: Epinephrine pen Correct Explanation: Health care providers who are administering vaccines should have aqueous epinephrine 1:1000 readily available to allow immediate treatment of any allergic reaction. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 2: (see full question) A female client is receiving chemotherapy for breast cancer. She requires a vaccine booster. For when would the physician order the administration of the vaccine? You selected: 3 months after chemotherapy is completed Correct 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 immunoglobuli ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 3: (see full question) A client is 50 years old. The client asks what, if any, vaccines the client should get. The nurse's best response is: You selected: Hepatitis B (one dose) and the flu vaccine. Incorrect Correct response: Tetanus-diphtheria-pertussis; hepatitis B vaccine once; influenza vaccine annually. Explanation: Middle-aged adults should maintain immunizations against tetanus-diphtheria-pertussis; health care providers should receive hepatitis B vaccine once (if not previously taken) and i ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, pp. 171-172. Question 4: (see full question) 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? You selected: I know that I do not need to worry about infection after getting this injection. Incorrect Correct response: I know that this booster is good for 10 years. Explanation: 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 pn ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 168. Question 5: (see full question) Your client is currently undergoing chemotherapy. She asks what type of immunizations that she should get at her annual physical, which is next week. Your best response is: You selected: She should not be given live vaccines and should wait for 3 months after stopping chemotherapy to get the vaccines. Correct Explanation: Patients 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 ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 6: (see full question) Which statements best indicates the client understands recommended vaccines following the 65th birthday? You selected: A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age Correct Explanation: 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 pn ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 7: (see full question) Which agent would the nurse expect to administer to a pregnant woman to prevent Rh factor sensitization? You selected: 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. Cytomegalo ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 170. Question 8: (see full question) A young mother asks the clinic nurse about the "chickenpox" vaccine. The mother states that she and her husband have both had chickenpox, but that she wants to protect her child if she can. What should the nurse tell the mother about the recommendation for the chickenpox vaccine? You selected: It is recommended for all children who have not been exposed to the varicella virus. Correct Explanation: Measles, mumps, rubella, varicella virus vaccine (ProQuad) 0.5 mL Sub-Q. Simultaneous immunization against measles, mumps, rubella, and varicella in children aged 12 months to 12 y ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 164. Question 9: (see full question) 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. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 166. Question 10: (see full question) A nurse is presenting an educational event about vaccines at a local elementary school. What would the nurse tell the attendees of the event about the administration of live vaccines and when they are generally contraindicated? You selected: In people who have hepatic failure Incorrect Correct response: In people who are receiving immune globulin for immune deficiency 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 a ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 11: (see full question) 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? You selected: Teach the client that the agent of choice is rabies immune globulin, used if the client has not been previously immunized. Correct 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 r ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 169. Question 12: (see full question) 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? You selected: Every 10 years Correct Explanation: Following the initial booster injection, the tetanus toxoid should be administered to adults every 10 years. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 168. Question 13: (see full question) A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive? You selected: Immune globulin Correct Explanation: Hepatitis B immune globulin would be used for post-exposure prophylaxis for hepatitis B. This vaccine would be used to prevent herpes zoster (shingles) in persons over the age of 6 ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 169. Question 14: (see full question) 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? You selected: 0.5 mL sub-q Correct Explanation: The nurse will administer 0.5 mL. This is the recommended dose for adults and children older than 15 months of age. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 165. Question 15: (see full question) 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) You selected: 7 to 14 days Incorrect Correct response: 1 to 3 months Explanation: While onset after immune globulin is raped the duration is short, only 1 to 3 months. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 169. Question 16: (see full question) A male client is treated for his cancer of the 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. For when should the nurse schedule immunizations? You selected: Three months after his cancer treatment is completed Correct Explanation: For clients with active malignant disease, live vaccines should not be given. Although killed vaccines and toxoids may be given, antibody production may be inadequate to prov ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 17: (see full question) 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? You selected: People with hepatic failure Incorrect Correct response: People undergoing systemic, long-term corticosteroid therapy Explanation: Systemic corticosteroid therapy may depress the immune system to such a degree that patients lack a sufficient number of antibodies to safely receive a live-virus vaccine. Patients ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 18: (see full question) What type of vaccine is contraindicated in clients who have active malignant disease? You selected: Live vaccines Correct 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) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 19: (see full question) A forest ranger arrives at a community clinic for prophylactic vaccination. Which vaccine would be most important to be administered to the ranger? You selected: Rabies vaccine Correct Explanation: The ranger has to be administered the rabies vaccine as prophylaxis as he is at high risk for contracting the virus. The MMR vaccine is used in treating measles, mumps, and rubella ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 167. Question 20: (see full question) What is the nurse's responsibility when obtaining a history from a new client? You selected: Assess the client's immunization status Correct Explanation: Health care providers need to assess and inform clients about recommended immunizations. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 175-176.

Question 1: (see full question) The nurse has just administered the measles, mumps, and rubella vaccine to female patient, how long should the nurse advise the patient to wait before trying to become pregnant? (Choose one) You selected: At least 3 months Correct Explanation: Women are instructed to avoid becoming pregnant at least 3 months after receiving the measles, mumps, rubella, and varicella vaccines. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 174. Question 2: (see full question) What is the best source of information for current recommendations regarding immunizations and immunization schedules? You selected: Centers for Disease Control and Prevention Correct Explanation: Recommendations regarding immunizations change periodically as additional information and new immunizing agents become available. Consequently, health care providers need to update ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 174. Question 3: (see full question) To prevent chickenpox, a patient would receive a viral vaccine. You selected: True Correct Explanation: Varicella virus vaccine is used for immunization against chickenpox infections in adults and children 12 months of age or older. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 168. Question 4: (see full question) 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: You selected: pain, redness, and swelling at site of injection. Correct Explanation: Normal reactions to immunizations include pain, redness, and swelling at the site of the injection. Vomiting, diarrhea, high fever, sweating, lethargy, or drowsiness would not be e ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 5: (see full question) When describing the use of vaccines to a local community group, what would the nurse include? You selected: Vaccines are used to provide active immunity. Correct Explanation: Vaccines provide active immunity. They promote the formation of antibodies against a specific disease. The person experiences an immune response without having to suffer the f ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 6: (see full question) 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? You selected: AST is within normal limits Incorrect Correct response: 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. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 165. Question 7: (see full question) 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? You selected: Tuberculosis Correct Explanation: Immunization for tuberculosis occurs worldwide, but it is not routinely used in the United States. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 163. Question 8: (see full question) 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. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 172. Question 9: (see full question) What would the nurse identify as a vaccine that is a toxoid? You selected: Hepatitis A Incorrect Correct response: 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. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 168. Question 10: (see full question) 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? You selected: Imogam is routinely administered for prevention of specific virus infections after organ transplant. Incorrect Correct response: 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. Imogam treat ... (more) Question 11: (see full question) 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? You selected: Infants and people at risk for contracting the disease Correct Explanation: Indications for receiving the vaccine are susceptible people and in infants born to mothers with hepatitis B. Indications for receiving the vaccine do not include children under th ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 165. Question 12: (see full question) For what group of adults is pre-exposure immunization against hepatitis B recommended? You selected: People with chronic illnesses Incorrect Correct response: People who are at risk for exposure to the disease 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, imm ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 165. Question 13: (see full question) 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? You selected: Temperature Correct 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 dang ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 14: (see full question) 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? You selected: Measles Incorrect Correct response: 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) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 168. Question 15: (see full question) A nursing instructor is discussing the intended populations for various vaccines. Which groups might the instructor mention when discussing the hepatitis B vaccine? You selected: Paramedics and emergency medical technicians Correct 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); ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 165. Question 16: (see full question) 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? You selected: Chills and fever Correct Explanation: Chills and fever are mild adverse reactions observed after administration of vaccines. Seizure, cardiac arrest, death, and brain damage are not considered mild adverse reactions. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 174. Question 17: (see full question) A male patient, age 78, presents in the emergency department after stepping on a nail. The patient tells the nurse that he had his last tetanus shot 12 years ago and asks the nurse about the recommended interval for the administration of tetanus toxoid to adults. What would be the nurse's most correct response? You selected: Every 10 years Correct Explanation: A tetanus booster every 10 years will also help to protect older adults from exposure to that illness. Ask the patient about any adverse reaction to previous tetanus boosters, and ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 168. Question 18: (see full question) Before administering a vaccine to a patient, what should the nurse assess? You selected: All the above Incorrect Correct response: The patient's temperature Explanation: The nurse should assess the patient's temperature, because vaccines and toxoids are usually contraindicated during febrile illnesses. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 19: (see full question) 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? You selected: Blood transfusion 3 weeks ago Incorrect Correct response: 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 vacci ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173. Question 20: (see full question) What is a contraindication to an MMR booster for an adolescent female? You selected: Pregnancy Correct Explanation: MMR is administered to adolescent females if they are not pregnant and their rubella titer is inadequate or proof of immunization is unavailable. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 10: Drug Therapy: Immunizations, p. 173.