Chapter 18 PrepU

A forest ranger arrives at a community clinic for prophylactic vaccination. Which vaccine would be most important to be administered to the ranger?

Rabies vaccine

A nurse is preparing a presentation to a local community group about biological weapons. The nurse would identify which disease as lacking an available vaccine?

Plague

What immunizations are recommended for older adults? (Select all that apply.)

-A tetanus-diphtheria (Td) booster every 10 years -An annual influenza vaccine -A one-time administration of pneumococcal vaccine at 65 years of age

Which is an example of artificially acquired active immunity? (Select all that apply.)

-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.

Antivenins are used for passive, transient protection from which bites? (Select all that apply.)

-Rattlesnake -Black widow -Copperhead

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?

3 months

A group of students are role playing various scenarios related to biological weapons. In one of the situations, an adult client develops botulism. What is the appropriate choice for treatment?

Antitoxin

The administration of immunizations to a patient is a form of what type of immunity?

Artificial active immunity

When describing the action of vaccines, the nurse identifies their action as primarily affecting:

B lymphocytes.

The nurse is preparing to administer a client's prescribed dose of immune sera. How should the nurse describe this treatment to the client?

Bacterial antibodies in serum

A patient has received a rubella immunization. The patient was unaware that she was pregnant. What risk is associated with the administration of the rubella immunization in this patient?

Birth defects in the newborn

The perinatal nurse recognizes that what vaccine can be safely given to a neonate?

Hepatitis B

A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive?

Immune globulin

When providing patient teaching to parents regarding measles, mumps, and rubella vaccine administration, which is most important regarding the schedule for administration?

It is administered at 12-15 months.

An infant is being administered an immunization. What provides an accurate description of an immunization?

It is the administration of an antigen for an antibody response.

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

A nursing instructor is discussing the intended populations for various vaccines. Which groups might the instructor mention when discussing the hepatitis B vaccine?

Paramedics and emergency medical technicians

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 agent of choice is rabies immune globulin, used if the client has not been previously immunized.

What would the nurse identify as a vaccine that is a toxoid?

Tetanus

Middle aged adults and health care workers should receive which immunizations?

Tetanus-diphtheria-pertussis; hepatitis B vaccine once and influenza vaccine annually

A client is 50 years old. The client asks what, if any, vaccines the client should get. The nurse's best response is:

Tetanus-diphtheria-pertussis; hepatitis B vaccine once; influenza vaccine annually.

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?

Tuberculosis

To prevent meningococcal infections, the nurse would administer:

Vaccine

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?

Vaccines

When describing the use of vaccines to a local community group, what would the nurse include?

Vaccines are used to provide active immunity.

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.

A group of students are reviewing class material about immunizations and vaccines. The students demonstrate understanding of the topic when they state that immunizations and vaccines:

promote the development of antigens for the disease.

Which is an example of naturally acquired active immunity? (Select all that apply.)

-An individual who is exposed to chickenpox for the first time and has no immunity to the disease. -An individual who is exposed to pertussis for the first time and has no immunity to the disease.

Which are used to produce active immunity? (Select all that apply.)

-Vaccines -Toxoids

What is the best source of information for current recommendations regarding immunizations and immunization schedules?

Centers for Disease Control and Prevention

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?

Chills and fever

A group of students are role-playing scenarios involving biological weapon exposure. Which medication would the students identify as using for a client with cutaneous anthrax?

Ciprofloxacin

The nurse is teaching the parents of a child who is receiving a vaccine about possible adverse effects. Which would the nurse include as necessitating an immediate call to the health care provider?

Difficulty breathing

A nurse is administering a mumps vaccine to an adolescent. Which medications should be available when administering an immunization?

Epinephrine

A client who was bitten by a pit viper is to receive antivenin. What is the nurse's best action?

Establish IV access

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?

Every 10 years

Serum sickness occurs more commonly with the use of vaccines than with immune sera.

False

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?

I know that this booster is good for 10 years.

A patient is scheduled to receive an immunization. In which patient is the administration of live vaccine contraindicated?

Patient taking steroid therapy

For what group of adults is pre-exposure immunization against hepatitis B recommended?

People who are at risk for exposure to the disease

A patient develops fever and arthralgia 4 days after the administration of tetanus toxoid. What reaction to the vaccine is this?

Serum sickness

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 physician to order?

Shingles vaccine

Before administering a vaccine to a patient, what should the nurse assess?

The patient's temperature

A client, 65 years of age, comes to the drugstore clinic after receiving the shingles vaccine two weeks ago. The client asks the nurse how long the immunity will last. The nurse would include which information in the immunity explanation?

The varicella virus (shingles) vaccine protects the recipient for several years or, in some cases, for life.

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?

Toxin

A 60-year-old patient is seen in the family practice clinic. Which vaccine should be administered to prevent herpes zoster?

Zoster vaccine