Immunization Exam
For healthy patients 65 years of age and older who are indicated to receive both PCV13 and PPSV23, what is the recommended time period for separation of administration of the two vaccines? A) 1 year B) 6 months C) 5 years D) No separation needed, simultaneous administration recommended
1 year
Which of the following is a candidate for the HPV9 vaccine? A) 11-year-old healthy male B) 27-year-old male on prednisone 10 mg daily C) 35-year-old healthy male D) 27-year-old healthy female
11-year-old healthy male
What strains of influenza are included in the quadrivalent inactivated influenza vaccine (IIV)? A) 2 A, 1 B, and 1 C B) 2 A and 2 B C) 1 A and 3 B D) 3 A and 1 B
2 A and 2 B
Temperature and freezer logs must be kept for a period of at least: A) 1 year B) 3 years C) 5 years D) 7 years
3 years
Which of the following patients is a candidate for varicella vaccine? A) 6-month-old who needs IIV3 simultaneously and again in 28 days B) 5-year-old who received DTaP four weeks ago C) 12-month-old who received MMR two weeks ago D) 37-year-old pregnant female
5-year-old who received DTaP four weeks ago
Which of the following individuals is a candidate for hepatitis A vaccine?A) A 45-year-old female daycare employee B) A 15-month-old male also receiving a 3rd dose of hepatitis B vaccine C) A 6-month-old female presenting to the pediatrician for the 6-month wellness exam D) A 25-year-old male college student preparing to study abroad in Canada
A 15-month-old male also receiving a 3rd dose of hepatitis B vaccine
For which of the following individuals is the human papillomavirus vaccine series indicated? A) A 30-year-old female who has a sister with cervical cancer B) A 16-year-old female who recently became sexually active C) A 5-year-old female who presents for a well child visit prior to entering school D) A 28-year-old male with a history of genital warts
A 16-year-old female who recently became sexually active
For which of the following individuals is inactivated influenza vaccine (IIV) NOT recommended? A) A 2-month-old healthy infant B) A 68-year-old male who received a heart transplant 6 years ago C) A 62-year-old female who sneezes when in contact with feathers D) A 28-year-old female who is in her first trimester of pregnancy
A 2-month-old healthy infant
For which of the following individuals is a mumps vaccine recommended? A) A 22-year-old female who received a single dose of MMR and just accepted a position as a nurse on a general surgery unit B) A 65-year-old who is healthy and has no record of every receiving a dose of MMR C) A 26-year-old female who received a single dose of MMR at age 12 months and is pregnant D) A 12-year-old who received a single dose of MMR at age 12 months and is taking prednisone 40 mg daily for inflammatory bowel disease
A 22-year-old female who received a single dose of MMR and just accepted a position as a nurse on a general surgery unit
For which of these individuals is pneumococcal polysaccharide vaccine recommended today? A) A 67-year-old with type 2 diabetes who received PPSV23 on her 65th birthday B) A 14-month-old child who completed the infant series for whom repair of a congenital heart defect is planned C) A medical student prior to her pediatric clerkship D) A 23-year-old healthy male who smokes
A 23-year-old healthy male who smokes
For which of the following patients should the trivalent recombinate hemagglutinin influenza vaccine (RIV3) be administered? A) A 50-year-old woman with asthma B) A 44-year-old man with diabetes C) A 24-year-old woman with no comorbidities D) A 30-year-old man with a history of anaphylaxis to eggs
A 30-year-old man with a history of anaphylaxis to eggs
Following the ACIP guidelines, for which of the following individuals is zoster vaccine recommended? A) A 58-year-old patient with analphylaxic reaction to neomycin B) A 45-year-old patient recovering from singles rash C) A 55-year-old patient with active shingles rash lesions D) A 65-year-old patient who had chicken pox at 7 years of age
A 65-year-old patient who had chicken pox at 7 years of age
Which of the following individuals has a risk factor for poor response to the hepatitis B vaccine series? A) A newborn infant who is apparently healthy B) A 16-year-old female with asthma C) A 21-year-old paramedic D) A 66-year-old male who is waiting for a cadaveric kidney transplant
A 66-year-old male who is waiting for a cadaveric kidney transplant
Which of the following patients can receive zoster vaccine? A) A 68-year-old with COPD treated with inhaled fluticasone/salmeterol B) A 78-year-old who had a kidney transplant two years ago C) A 48-year-old man recently diagnosed with cancer who will start chemotherapy in two weeks D) A 62-year-old female with autoimmune hepatitis controlled with prednisone 30 mg daily
A 68-year-old with COPD treated with inhaled fluticasone/salmeterol
Which of the following is a CDC best practice in regards to vaccine storage and handling? A) Refrigerated vaccines should be kept on the top shelf of the refrigerator B) A bio-safe glycol-based or buffered thermometer should be used to monitor the temperature of the refrigerator C) Refrigerator and freezer temperature logs should be monitored once daily in the morning D) One pharmacy employee should be designated to be in charge of storage and handling in case of a temperature related emergency
A bio-safe glycol-based or buffered thermometer should be used to monitor the temperature of the refrigerator
Which of the following is not a permanent contraindication to vaccination? A) For rotavirus vaccine, severe combined immunodeficiency or history of intussusception B) A condition which would compromise the ability of the vaccine to produce immunity or protection from infection C) Encephalopathy not due to another identifiable cause occurring within 7 days of pertussis vaccination D) Severe allergic reaction to a vaccine component or following a prior dose
A condition which would compromise the ability of the vaccine to produce immunity or protection from infection
Which is true about the incidence of measles in the United States? A) A majority of cases are a result of importation in unvaccinated populations B) A 2-dose series is required for anyone born before 1957 when traveling C) Measles incidence is usually around 200 cases annually D) When traveling internationally with an infant, do not worry about their vaccine status
A majority of cases are a result of importation in unvaccinated populations
Following the ACIP guidelines, for which of the following individuals is live attenuated influenza vaccine (LAIV) recommended? A) A 35-year-old pregnant patient B) A 10-year-old patient with a fear of needles C) A 6-month-old healthy infant D) ACIP does not recommend LAIV for any patients
ACIP does not recommend LAIV for any patients
Which of the following is NOT an example of active immunity? A) Administration of recombinant immunogenic protein B) Administration of a live attenuated viral vaccine C) Administration of high titer immune globulin D) Infection with natural disease
Administration of high titer immune globulin
Which of the following age groups with immunocompromising conditions should receive one dose of pneumococcal conjugate vaccine (PCV13)? A) Adults and children > 6 years of age B) Adults 19 to 64 years of age C) All adults D) Children < 5 years of age
Adults and children > 6 years of age
Which of the following is specifically listed as a VAERS reportable event for tetanus vaccine? A) Chronic arthritis B) Encephalopathy C) Thrombocytopenic purpura D) Brachial neuritis
Brachial neuritis
For which of the following individuals is Tdap recommended?A) All of the above B) A 12-year-old female who completed the childhood DTaP series C) A 30-year-old pregnant female of 32 weeks gestation D) A 65-year-old female caring for her newborn granddaughter
All of the above
HPV vaccine is currently indicated for females and males as young as 9 years old and up to age 26. A mother is considering vaccination for her young son, but some commercials that she recalls lead her to believe this vaccine is for prevention of cervical cancer, and does not see how this will benefit her son. How do you expain to this mother the importance of this vaccine for her son? A) All of the above B) Yes, this does prevent cervical, vulvar, and vaginal cancer in women; however it also protects against genital warts, anal cancer, as well as other cancer strains C) This is the most common sexually transmitted infection D) There are benefits for protection for him contracting strains of virus as well as spreading the virus to others
All of the above
Hepatitis B is a virus spread by parenteral routes including blood transfusions, sharing of needles, sexual contact, and mother to neonate. Which is true about hepatitis B? A) All of the above B) Renal failure will decrease response to hepatitis B vaccine C) Death commonly occurs as a result of cirrhosis and hepatocellular carcinoma D) Using needles which are not long enough will decrease response rates
All of the above
Which of the following is a contraindication to receiving a vaccine? A) Patient is breastfeeding B) Patient is taking an antibiotic C) Anaphylaxis to a previous dose D) Allergy to penicillin
Anaphylaxis to a previous dose
Which of the following vaccines is recommended for all healthcare workers? A) Pneumococcal vaccine B) Annual influenza vaccine C) Hepatitis A vaccine D) Zoster vaccine
Annual influenza vaccine
Which of the following scenarios are healthcare professionals encouraged to use VAERS for reporting? A) Serious adverse reactions for which causation is firmly established B) Only serious, life-threatening adverse reactions C) Only adverse reactions that have not been previously reported D) Any clinical significant adverse event after vaccination
Any clinical significant adverse event after vaccination
How should the disposal of sharps containers be handled? A) Arranged with the local waste management company B) Done when the container is full to the top C) Always taken care of with the regular garbage D) The are of little concern because of the puncture-proof nature of the containers
Arranged with the local waste management company
Which of the following skills is among the standards of practice among immunizing pharmacists? A) Basic life support (CPR) B) Advanced cardiac life support C) Emergency medical technician D) First aid training
Basic life support (CPR)
Which of the following is a meningococcal serogroup B vaccine? A) Boostrix B) Menveo C) Engerix-B D) Bexsero
Bexsero
The primary vaccine coordinator at a practice site should be responsible for: A) Administering all vaccines at the practice site B) Ensuring that vaccines are stored and handled correctly C) Ensuring that staff is adequately trained D) Both b and c
Both b and c
Which of the following is the appropriate schedule for polio immunization in the United States?A) Not used anymore because disease is almost eradicated B) Childhood immunization series with IPV at 2, 4, 6-18 months, and 4-6 years of age with a booster dose every 10 years C) Childhood immunization series with IPV at 2, 4, 6-18 months of age D) Childhood immunization series with IPV at 2, 4, 6-18 months, and 4-6 years of age
Childhood immunization series with IPV at 2, 4, 6-18 months, and 4-6 years of age
Which of the following is a likely benefit of annual influenza immunization of school-aged children? A) Causes school absenteeism around immunization time that will be offset by the decrease in absenteeism during peak influenza season B) Decreases the magnitudes of influenza epidemics in the community C) Changes resistance patterns in influenza viruses D) Dramatically decreases the high rates of mortality of influenza in this population
Decreases the magnitudes of influenza epidemics in the community
Which of the following statements is true? A) Employers must offer the hepatitis B vaccine series to immunizing employees free of charge B) Immunizers must finish the hepatitis B vaccine series prior to providing immunizations C) Employees do not have the right to decline hepatitis B vaccination D) All of the above
Employers must offer the hepatitis B vaccine series to immunizing employees free of charge
Which of the following is true regarding bloodborne pathogen exposure and immunizations? A) Providing immunizations is a high risk activity for exposure Correct! B) Every pharmacy providing immunizations must have a bloodborne pathogen exposure control plan C) No extra immunizations or training need to be offered to employees that provide immunizations D) The FDA is the main authority providing guidance on minimizing exposure
Every pharmacy providing immunizations must have a bloodborne pathogen exposure control plan
A 65-year-old female taking fluticasone MDI BID for asthma is not a candidate for the herpes zoster vaccine. A) True B) False
False
Anaphylaxis generally will not occur until 1-2 hours after administration of a vaccine. A) True B) False
False
If the date on the label of a vaccine or diluent has a specific month and year, the vaccine can be used only until the first day of the month listed. A) True B) False
False
Per OSHA (Occupational Safety and Health Administration), bloodborne pathogens training must be completed every 2 years for immunizers. A) True B) False
False
Polio is currently considered eradicated worldwide. A) True B) False
False
Which of the following influenza vaccines is produced using no eggs and no influenza virus? A) Flublok (RIV3) B) Flumist Quadrivalent (LAIV4) C) Flucelvax (ccIIV3) D) Fluvirin (IIV3)
Flublok (RIV3)
A 26-year-old female received the second dose in her series of varicella vaccine two weeks ago. Today she stepped on a rusty nail while working on her farm. Her last tetanus-diphtheria (Td) dose was 6 years ago. Which of the following immunization strategies is appropriate? A) Give Td in two weeks B) Give DTap now C) Give Tdap now D) No booster is necessary
Give Tdap now
Joe is a 28-year-old accountant who traveled to Bangkok for a two-month visit two years ago. As part of his preparations for that trip he received a dose of hepatitis A vaccine. He has received only a Tdap booster for a finger laceration since his return. He is now planning a trip to Beijing and seeks your advice regarding hepatitis A vaccination. What do you recommend? A) He should start the hepatitis A series over and receive a dose now and another dose in 6 months B) He should receive a double dose of hepatitis A vaccine prior to his departure C) He should receive a dose of hepatitis A vaccine now to complete the series D) He should receive a half dose of hepatitis A vaccine now and another dose in 6 months
He should receive a dose of hepatitis A vaccine now to complete the series
Which of the following is a contraindication to receipt of the rotavirus vaccine? A) History of intussusception B) History of anaphylaxis to eggs C) Receipt of another live attenuated vaccine on the same day D) History of Guillian-Barre Syndrome
History of intussusception
Which manifestation of anaphylaxis is epinephrine used to treat? A) Hypotension B) Arrhythmias C) Decreased oxygen saturation D) Hemorrhage
Hypotension
Which of the following are inactivated vaccines? A) Hepatitis B, Hib, Zoster B) LAIV, PCV13, Zoster C) IIV4, PPSV23, Tdap D) MMR, Tdap, IIV4
IIV4, PPSV23, Tdap
Joseph, a healthy 55-year-old male, is employed as a pharmacist at a chain pharmacy. The chain pharmacy will be implementing a corporate immunization program this October. Joseph wants to make sure he is up-to-date on his immunizations before the program begins. He has received no vaccinations since childhood. Which of the following vaccines are recommended for this patient? A) Zoster, LAIV, Hepatitis B B) IIV4, Tdap, Hepatitis B C) Td, 9vHPV, PPSV23 D) Zoster, Td, PPSV23, Hepatitis A
IIV4, Tdap, Hepatitis B
Which of the following antibody classes is the mediator of allergy and anaphylaxis? A) IgA B) IgG C) IgE D) IgM
IgE
Which of the following mediators is important for the development of analphylaxis? A) IgE B) IgG C) IgA D) IgD
IgE
Which of the following is an advantage of immunization in nontraditional settings, such as a pharmacy? A) Increased access and convenience for the patient B) Higher cost of immunization to the patient C) Consolidated immunization records for the patient D) Decreased public awareness regarding vaccinations
Increased access and convenience for the patient
Which of the following describes the benefits of using standing orders for immunization? A) Makes immunization less costly B) Increases immunization coverage among adults in a variety of practice settings C) Limits liability of all healthcare providers D) Is generally perceived as substandard practice by immunization policy making bodies
Increases immunization coverage among adults in a variety of practice settings
Which of the following is the appropriate timing for influenza vaccine administration? A) Influenza vaccine should be administered only from October 15 until December 31 B) Influenza vaccine should be administered as soon as the clinician has a vaccine supply but should stop no later than October 31 C) Live attenuated influenza vaccine (LAIV) can be administered as early as August, but inactivated influenza vaccine (IIV) should not be administered earlier than October 15 D) Influenza vaccine should be administered as soon as the clinician has a vaccine supply and if possible by October and should continue throughout the season
Influenza vaccine should be administered as soon as the clinician has a vaccine supply and if possible by October and should continue throughout the season
A US born 67-year-old was recently diagnosed with diabetes. His vaccine records indicate that he received his Tdap, PPSV23, and influenza vaccines in October 2015. What vaccines would you recommend for him? A) Influenza vaccine, zoster, PCV13, and hepatitis B vaccine series B) Influenza vaccine, zoster vaccine, and hepatitis B vaccine series C) Influenza vaccine, PCV13, varicella vaccine, and hepatitis B vaccine series D) Influenza vaccine and hepatitis B vaccine series
Influenza vaccine, zoster, PCV13, and hepatitis B vaccine series
Mary received a blood transfusion following a recent motor vehicle accident. Response to which of the following vaccines will be most affected by this event? A) Inactivated influenza vaccine (IIV) B) Tetanus-diphtheria C) Measles vaccine D) Pneumococcal polysaccharide vaccine (PPSV)
Measles vaccine
Which of the following vaccines is contraindicated for a pregnant woman? A) PPSV23 B) Measles, mumps, and rubella vaccine C) Tetanus, diphtheria, pertussis vaccine D) Inactivated influenza vaccine
Measles, mumps, and rubella vaccine
Which of the following most accurately describes the federally-mandated training for employees with blood and body fluid exposure? A) Initial training and annual retraining are required for bloodborne pathogens B) Use of safer injection devices may be included in initial training only C) A handout alone can be used for retraining D) A standardized training program can be used for all employees with exposure
Initial training and annual retraining are required for bloodborne pathogens
Most, but not all, states allow student pharmacist interns to administer vaccines. Which of the following is/are true in regards to student pharmacist immunization? A) Interns do not need to complete a certification course if the supervising pharmacist is certified B) An intern can delegate administration of a vaccine to a technician C) Interns who provide immunizations must be current in CPR and blood borne pathogens training D) None of the above are true
Interns who provide immunizations must be current in CPR and blood borne pathogens training
Which of the following is true regarding the use of Haemophilus influenzae type b vaccine? A) All of the above B) Is administered as a single dose to infants with a repeat dose prior to entering school C) Is a polysaccharide vaccine conjugated to a protein to improve immunogenicity in infants D) Is indicated in patients with COPD
Is a polysaccharide vaccine conjugated to a protein to improve immunogenicity in infants
The liquid diluent for the Zostavax vaccine: A) Is sterile water B) Should be stored in the freezer C) Is 0.9% sodium chloride D) Is distilled water
Is sterile water
The recommendations for prevention of vaccine preventable diseases made by the Advisory Committee on Immunization Practices (ACIP) are published in which of the following? A) The New England Journal of Medicine B) Morbidity and Mortality Weekly Report (MMWR) C) The Annals of Internal Medicine D) Immunofacts
Morbidity and Mortality Weekly Report (MMWR)
Refrigerator and freezer temperature(s): A) Must be checked three times daily B) Logs must be kept on hand for 7 years C) Logs should be posted near the pharmacist work station D) Must be maintained between +36 and +46 F and -58 and +5 F respectively
Must be maintained between +36 and +46 F and -58 and +5 F respectively
Which of the following describe appropriate storage conditions for inactivated vaccines? A) Must not be frozen B) Are stored at room temperature C) Are not affected by storage temperature D) Should be stored in the door of the refrigerator
Must not be frozen
Which of the following describes a limitation of the quadrivalent meningococcal conjugate vaccine? A) No protection from serogroup B B) Requires multiple doses to induce protection from infection C) Licensed only for use in young children up to 7 years D) Associated with a high risk of Guillain-Barre syndrome
No protection from serogroup B
The Countermeasures Injury Compensation Program (CICP): A) Provides benefits to seriously injured individuals that resulted from using certain antivirals B) Was established from the National Childhood Vaccine Injury Act C) Reimburses pharmacies the cost of expired or unused vaccines D) Reviews all of the adverse effects submitted through the VAERS program
Provides benefits to seriously injured individuals that resulted from using certain antivirals
All pregnant women should optimally receive one dose of Tdap when? A) After the birth of their first child B) Pregnant women should not receive the vaccine C) Optimally between 27 and 36 weeks gestation of their first child D) Optimally between 27 and 36 weeks gestation of each pregnancy
Optimally between 27 and 36 weeks gestation of each pregnancy
Which of the following is an appropriate response to a patient who tells you that she is concerned that she will get influenza from the inactivated influenza vaccine (IIV)?A) Injectable influenza vaccine rarely causes influenza in those who receive the vaccine, but the illness is very mild B) Although the injectable influenza vaccine is a live attenuated viral vaccine, it has never been known to cause influenza in a vaccinated individual C) Other than a higher incidence of sore arm, influenza vaccine has a side effect profile similar to placebo D) The influenza vaccine will not cause influenza if the circulating strain matches those contained in the current vaccine
Other than a higher incidence of sore arm, influenza vaccine has a side effect profile similar to placebo
Which of the following is an advantage to passive immunity compared to active immunity? A) Passive immunity is long-lasting B) Passive immunity does not interfere with the development immune responses from live vaccines C) Passive immunity protects almost immediately D) Passive immunity develops in response to infection or after giving a vaccine or toxoid
Passive immunity protects almost immediately
Which of the following can be done to prevent vaccine storage problems? A) Utilize a multi-outlet power strip to plug-in both the freezer and refrigerator B) Utilize extension cords to plug into an outlet that is rarely utilized C) Plug in both the refrigerator and freezer into one outlet D) Place containers of water labeled "do not drink" into refrigerator to stabilize temperatures
Place containers of water labeled "do not drink" into refrigerator to stabilize temperatures
Which of the following vaccines should NOT be stored frozen? A) Pneumococcal polysaccharide vaccine B) Varicella vaccine C) Zoster vaccine D) MMR vaccine
Pneumococcal polysaccharide vaccine
Which of the following is a contraindication to receiving live vaccines? A) Allergy to penicillin B) Chronic liver disease C) Prednisone 40 mg daily D) Diabetic patient
Prednisone 40 mg daily
Which process correctly describes cocooning against pertussis? A) Process of vaccinating close contacts including mother, father, siblings, grandparents, and out of home care providers B) Infant vaccine series begins at 2 months and continues at 4, 6, 15-18 months, and a booster at 4-6 years C) Wrapping infant tightly in a blanket to act as a protective barrier D) Taking long naps with a newborn
Process of vaccinating close contacts including mother, father, siblings, grandparents, and out of home care providers
Which of the following describes the role of helper T cells in mounting an immune response to a vaccine? A) Present antigen to antibodies B) Produce cytokines that stimulate B cells to produce antibodies C) Directly kills infected cells D) Produces large amounts of antigen-specific antibodies
Produce cytokines that stimulate B cells to produce antibodies
Which of the following describes the Vaccine Injury Compensation Program? A) Protects the immunization provider and vaccine manufacturer from personal liability B) Requires that the injured party prove negligence C) Absolves the immunization provider from personal negligence D) Covers all licensed vaccines
Protects the immunization provider and vaccine manufacturer from personal liability
Pharmacists are an integral part of increasing vaccination rates in the community. Which of the following would be the LEAST effective strategy for a pharmacist to employ? A) Encourage all pharmacy staff to be up to date on immunizations B) Recommend that a patient return for a vaccine at a later time when it is less busy C) Provide a strong recommendation to receive an eligible vaccine D) Call the patient to remind them of immunizations that are due
Recommend that a patient return for a vaccine at a later time when it is less busy
Which of the following methods describes how vaccines are covered under Medicare Part D? A) As a medical benefit B) With a universal copay of $10 for every patient enrolled C) Provider must submit a bill plus invoice documenting vaccine cost for reimbursement D) Reimbursement based on negotiated amount based on vaccine, dispensing fee, sales tax, and vaccine administration fee
Reimbursement based on negotiated amount based on vaccine, dispensing fee, sales tax, and vaccine administration fee
Rotavirus is a common childhood illness accounting for 1/3 of hospitalizations due to diarrhea. What is the appropriate vaccine recommendation for a 2-month-old child with a known history of latex allergy? A) Rotarix at age 2, 4, and 6 months B) Rotarix at age 2 and 4 months C) Rotateq at age 2 and 4 months D) Rotateq at age 2, 4, and 6 months
Rotateq at age 2, 4, and 6 months
For a post-kidney transplant patient on chronic immunosuppression with no history of pneumococcal vaccination, which of the following is correct? A) Single dose of PCV13 followed by a single dose of PPSV23 8 weeks later B) PCV13 alone is indicated when patients are 50 years of age or older C) PPSV23 alone is indicated when patients are 65 years of age or older D) Single dose of PPSV23 followed by a single dose of PCV13 8 weeks later
Single dose of PCV13 followed by a single dose of PPSV23 8 weeks later
Which of the following is true regarding the timing of immunization? A) Vaccinate premature infants based on gestational age rather than chronological age B) Vaccinate two weeks before elective splenectomy or after acute recovery from splenectomy C) Vaccinate cancer patients immediately upon completion of chemotherapy or radiation D) Vaccinate organ transplant patients three months after transplantation
Vaccinate two weeks before elective splenectomy or after acute recovery from splenectomy
How should you proceed if vaccine arrives from the manufacturer under questionable conditions? A) Repack the vaccine and return it to the manufacturer B) Store the vaccine as recommended separately from other stock and call the Centers for Disease Control and Prevention for advice C) Place the vaccine in stock and use it first D) Store the vaccine as recommended separately from other stock and call the manufacturer's quality control office for advice
Store the vaccine as recommended separately from other stock and call the manufacturer's quality control office for advice
Which of the following is true regarding vaccine preparation? A) For large flu clinics it is good practice to draw up large quantities (15 doses) at one time B) Manufacturer-filled syringes may be used for 48 hours once the sterile seal is broken C) Multi-dose vials may be used for 7 days once opened D) Syringes other than those filled by the manufacturer should be administered immediately
Syringes other than those filled by the manufacturer should be administered immediately
Which of the following describes a difference between Tdap and DTaP? A) Tdap should be used for all three doses of the primary tetanus-diphtheria series for adults B) Tdap has a lower dose of diphtheria toxoid for use in individuals aged 10-11 years and older C) DTaP is used in children and adults for primary series D) DTaP has a lower dose of diphtheria toxoid for use in individuals less than 7 years
Tdap has a lower dose of diphtheria toxoid for use in individuals aged 10-11 years and older
A 13-year-old male and his mother go to the community pharmacy for a refill on his ADHD medication. His mother notices the pharmacy's immunization clinic sign and realizes her son has not seen his primary care provider for several years. She wonders if he is up-to-date with immunizations. He was up-to-date at his 4 to 6-year-old well child visit and has received no immunizations since. Which of the following vaccines are recommended for this patient? A) IIV4, DTaP, Hepatitis B, MMR B) Tdap, 9vHPV, MCV4, IIV4 C) PCV13, IPV, MMR, Tdap D) LAIV, 9vHPV, Varicella, Td
Tdap, 9vHPV, MCV4, IIV4
Which of the following is the appropriate strategy for giving the Vaccine Information Statement (VIS) to patients? A) The VIS should be given to the patients 1 week prior to the immunization visit to allow time to review B) The VIS can be posted in the clinic for the patient to read while they wait C) The VIS should be given to the patient prior to immunization so the patient has time to review it and ask questions D) The VIS is required for only immunization of pediatric patients
The VIS should be given to the patient prior to immunization so the patient has time to review it and ask questions
Which of the following is/are true regarding live attenuated vaccines? A) Live attenuated vaccines generally have milder reactions versus inactivated vaccines B) The injectable live attenuated vaccines usually produce immunity with one dose C) They are stronger versions of the "wild" virus D) All of the above
The injectable live attenuated vaccines usually produce immunity with one dose
Which of the following is the reason that a second dose of measles vaccine is recommended for all college students? A) Vaccine-induced immunity wanes over ten years and reimmunization provides a boost B) Most children received a killed vaccine for their first dose C) The measles vaccine used a decade ago was much less effective than the current formulation D) The second dose provides another opportunity for seroconversion for those who failed to respond to the first dose
The second dose provides another opportunity for seroconversion for those who failed to respond to the first dose
Which of the following items should be included in immunization records for vaccines administered in the pharmacy? A) The vaccine and date administered, site of administration, vaccine manufacturer and lot number, VIS publication date with the date given to the patient/parent or guardian, and the identification of the person administering the vaccine B) The date administered, site of administration, vaccine manufacturer and lot number, and the VIS publication date with the date given to the patient/parent or guardian C) The vaccine and date administered, site of administration, site of vaccine storage, vaccine manufacturer and lot number, VIS publication date with the date given to the patient/parent or guardian D) The vaccine and date administered, vaccine manufacturer and lot number, and the VIS publication date with the date given to the patient/parent or guardian
The vaccine and date administered, site of administration, vaccine manufacturer and lot number, VIS publication date with the date given to the patient/parent or guardian, and the identification of the person administering the vaccine
Which of the following best describes immunization information systems? A) All immunization information systems are used exclusively for tracking childhood immunizations B) All children born in the United States have their immunizations recorded in an immunization information system C) The value of the immunization information system is that it allows healthcare providers to access immunization records to facilitate clinical decision making D) Immunization information systems are used only to measure immunization coverage rates
The value of the immunization information system is that it allows healthcare providers to access immunization records to facilitate clinical decision making
Why is the safety of vaccines held to a higher standard than for most medications? A) The diseases prevented by vaccination are generally not life threatening B) The public is willing to accept a high degree of risk to avoid most infectious diseases C) They are administered to healthy people to prevent disease rather than to sick people to cure disease D) The risks associated with vaccines are perceived by the individual to be voluntary risks
They are administered to healthy people to prevent disease rather than to sick people to cure disease
Which of the following is true regarding Vaccine Information Statements (VIS)? A) The VIS can serve as the "informed consent" for vaccination B) They are meant to prevent questions to healthcare providers regarding vaccines C) They are updated every month D) They are designed to provide information about vaccines, or, in the case of a minor, the child's parent or guardian about the risks and benefits of each vaccine
They are designed to provide information about vaccines, or, in the case of a minor, the child's parent or guardian about the risks and benefits of each vaccine
Which of the following is specifically listed as a VAERS reportable event for measles vaccine? A) Encephalopathy B) Brachial neuritis C) Chronic arthritis D) Thrombocytopenic purpura
Thrombocytopenic purpura
Which of the following should be completed in all pharmacies that provide immunizations? A) Recapping needles after immunizations are administered to prevent needlesticks B) Wearing gowns, masks, and goggles when giving vaccines C) Training employees about bloodborne pathogens and the pharmacy's bloodborne exposure control plan D) Posting an orange biohazard symbol on the refrigerator door that is used to store vaccines
Training employees about bloodborne pathogens and the pharmacy's bloodborne exposure control plan
Is the following statement true or false? Increasing the interval between doses of a multi-dose vaccine does not diminish the effectiveness of the vaccine. A) True B) False
True
Joe is a 20-year-old patient stating that he remembers having the chicken pox when he was young. He is a candidate for the varicella vaccine. A) True B) False
True
One of the Clinical Immunization Safety Assessment (CISA) project's main goal is to serve as a vaccine safety resource for consultation on clinical vaccine safety issues. A) True B) False
True
Which of the following describes the procedure for intramuscular administration of a vaccine to an adult patient? A) Use a 25 gauge, 1 inch needle B) Aspirate before injection of the vaccine C) Select a site on the outer aspect of the upper arm D) Insert the needle at a 45 degree angle to the skin
Use a 25 gauge, 1 inch needle
A vaccine-related error should be reported to which of the following programs? A) Medwatch (FDA) B) VAERS (FDA) C) VERP (ISMP) D) Immunization Information Systems (IIS)
VERP (ISMP)
Which of the following represents a true contraindication to measles vaccine? A) Moderate or severe acute illness with or without fever B) Vaccine candidate's mother is pregnant C) History of thrombocytopenia D) Vaccine candidate is pregnant
Vaccine candidate is pregnant
Martha is a 68-year-old female seeking your advice regarding immunization. Her son and daughter-in-law are expecting their first child in the next few months. She has received no vaccinations since childhood. Which of the following vaccines should she receive today? A) Td, 9vHPV, PPSV23 B) Zoster, IIV4, Tdap, PCV13 C) IIV4, MMR, MCV4, Hepatitis A D) LAIV, Zoster, Hepatitis B
Zoster, IIV4, Tdap, PCV13
Which of the following vaccines is administered via the subcutaneous route? A) IIV4 B) Hepatitis B C) Zoster D) Td
Zoster
Sam is a 48-year-old male, presenting to a pharmacy wondering if he would be able to get the zoster vaccine. You explain the guidelines to Sam, which explanation is correct? A) Zoster vaccine is effective in reducing incidence of shingles, decreasing burden of disease in 50-70% of patients vaccinated B) Zoster is a live vaccine and can only be administered alone at least 60 days between any other vaccine. C) Zoster vaccine is an intramuscular injection and one can expect muscle aches and pain for up to 2 weeks post-injection. D) Zoster vaccine is currently indicated only in patients over age 65 as that is what is covered by insurance.
Zoster vaccine is effective in reducing incidence of shingles, decreasing burden of disease in 50-70% of patients vaccinated
