Immunizations

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 she administer?

0.5 mL sub-q 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 years.

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? a) 30 days after chemotherapy is completed b) 6 months after chemotherapy is completed c) 1 year after chemotherapy is completed d) 3 months after chemotherapy is completed

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

if a nurse is administering immune globulin to a patient in the physician's office how long should the patient stay to be observed for hypersensitivity reactions? (Choose one)

30 minutes 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.

Which of the following statements best indicates your client understands recommended vaccines (following her 65th birthday)? a) A tetanus-diphtheria booster every 2 years, annual influenza vaccine, and a yearly administration of pneumococcal vaccine b) A tetanus-diphtheria booster every 2 years c) A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age d) An influenza vaccine booster every 10 years, annual tetanus-diphtheria vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age

A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age 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 pneumococcal vaccine at 65 years of age. A second dose of pneumococcal vaccine may be given at 65 years if the first dose was given 5 years previously.

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) a) At least 1 month b) At least 3 months c) At least 7 days d) At least 14 days

At least 3 months Explanation: Women are instructed to avoid becoming pregnant at least 3 months after receiving the measles, mumps, rubella, and varicella vaccines.

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

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? a) Antivenins b) The killed varicella virus vaccine c) Immune globulins d) The attenuated, live varicella virus vaccine

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

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? a) Infants and people at risk for contracting the disease b) Children under the age of 15 c) People over the age of 65 d) People with diabetes mellitus or renal disease

Infants and people at risk for contracting the disease 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 the age of 15, people with diabetes or renal disease or all children over the age of 65.

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? a) It is not recommended for children who have not been exposed to the Varicella virus. b) It is not recommended for children under the age of 6. c) It is recommended only for adults who have not had chickenpox. d) It is recommended for all children who have not been exposed to the Varicella virus.

It is recommended for all children who have not been exposed to the Varicella virus.

What type of vaccine is contraindicated in clients who have active malignant disease? a) Attenuated vaccines b) Killed vaccines c) Toxoids d) Live vaccines

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 received chemotherapy for at least 3 months.)

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

Paramedics and emergency medical technicians Explanation: Pre-exposure immunization against hepatitis B is recommended for people at high risk for exposure to the disease. This can include health care workers (e.g., paramedics and EMTs); patients with cancer, organ transplants, hemodialysis, immunosuppression drug therapy, or multiple infusions of blood products; male homosexuals; IV drug users; household contacts of HBV carriers; and residents and staff of institutions for mentally challenged people.

As a participant in an educational event at a local senior center, you are explaining the administration of vaccines. What group would you identify as being ineligible for live-virus vaccines? a) People over the age of 65 b) People with renal impairment c) People undergoing systemic, long-term corticosteroid therapy d) People with hepatic failure

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 receiving a systemic corticosteroid in high doses or for longer than 2 weeks should wait at least 3 months before being given a live-virus vaccine. Immunizations are not contraindicated with short-term use or low to moderate doses. Patients with renal or hepatic disorders who are not receiving immunosuppressant drugs are typically eligible for live attenuated and killed vaccines and toxoids.

For what group of adults is pre-exposure immunization against hepatitis B recommended? People with chronic illnesses b) People who are at risk for exposure to the disease c) People over the age of 70 d) None of the above

People who are at risk for exposure to the disease

A forest ranger arrives at a community clinic for prophylactic vaccination. Which of the following vaccines would be most important to be administered to the ranger? a) Rotavirus vaccine b) MMR vaccine c) Varicella vaccine d) Rabies vaccine

Rabies vaccine

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? a) Serum antibody levels b) Liver is not palpable c) AST is within normal limits d) Client does not develop hepatitis B

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

A group of students are reviewing information about immunizations. The students demonstrate a need for additional study when they identify which of the following as a component of an immunization? a) Weakened bacterial cell membrane b) Serum with bacterial antibodies c) Viral protein coat d) Chemically weakened actual virus

Serum with bacterial antibodies Explanation: The protein of an immunization could be an actual weakened bacterial cell membrane, the protein coat of a virus, or an actual virus (protein coat with the genetic fragment that makes up a virus) that has been chemically weakened and thus cannot cause disease. Immune sera refers to sera that contains antibodies to specific bacteria or viruses.

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: a) She should be given live vaccines, and she should speak with her health care provider about the flu vaccine. b) She should not be given live vaccines and should wait for 3 months after stopping chemotherapy to get the vaccines. c) There are no contraindications for getting or not getting vaccines while on chemotherapy. d) She should get the vaccines at the time of her physical and wait 2 months before resuming chemotherapy.

She should not be given live vaccines and should wait for 3 months after stopping chemotherapy to get the vaccines. 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 start of chemotherapy or 3 months after chemotherapy is completed. Passive immunity with immunoglobulins may be used in place of active immunit

You are a clinic nurse administering vaccines at well-baby check-ups. You know that before administering a DTP vaccine, you should check what vital sign? a) Respirations b) Temperature c) Pulse d) Blood pressure

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

Which of the following would the nurse identify as a vaccine that is a toxoid? a) Pneumococcal polyvalent b) Haemophilus influenza b c) Tetanus d) Hepatitis A

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.

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? a) Three months after his cancer treatment is completed b) 30 days after his cancer treatment is completed c) This appointment d) The next routine appointment

Three months after his cancer treatment is completed

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 of the following as common disease for which immunizations are given? a) Poliovirus b) Pertussis c) Tuberculosis d) Diphtheria

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

When describing the use of vaccines to a local community group, which of the following would the nurse include? a) Vaccines are used to provide active immunity. b) Vaccines can result in signs and symptoms of the full-blown disease. c) Vaccines are associated with severe reactions in children. d) Vaccines promote the development of antigens.

Vaccines are used to provide active immunity. 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 full course of the disease. Severe reactions are rare.

The difference between toxoids and vaccines is: a) Vaccines offer lifelong immunity, and toxoids do not. b) Only vaccines offer lifelong immunity. c) Vaccines and toxoids offer lifelong immunity. d) 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.

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. Many vaccines produce long-lasting immunity. Attenuated live vaccines produce immunity, usually lifelong, that is similar to that produced by natural infection. Toxoids are bacterial toxins or products that have been modified to destroy toxicity while retaining the ability to induce antibody formation. Immunization with toxoids is not permanent; scheduled repeat doses (boosters) are required to maintain immunity.

You are presenting an educational event about vaccines at a local elementary school. What would you tell the attendees of the event about the administration of live vaccines and when they are generally contraindicated? a) In people who have hepatic failure b) In people who have renal impairment c) In people who are over 65 d) In people who are receiving immune globulin for immune deficiency

You selected: 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 an immunodeficient state, during pregnancy because of potential effects on the fetus and on the success of the pregnancy, in patients with known allergies to any of the components of the vaccine (refer to each individual vaccine for specifics, sometimes including eggs, where some pathogens are cultured), or in patients who are receiving immune globulin or who have received blood or blood products within the last 3 months because a serious immune reaction could occur. Live vaccines are not contraindicated in people with renal impairment or who have hepatic failure nor are they contraindicated in people over the age of 65.

A 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. a) Age more than 65 years b) Pregnancy c) Diabetes mellitus d) Anemic disorder e) Preexisting renal disease

• 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 acute renal failure, preexisting renal disease, diabetes mellitus, individuals older than 65 years, or patients receiving nephrotoxic drugs. Human immune globulin is not contraindicated in pregnancy or anemic disorders, but should be administered with caution

Which of the following are used to produce active immunity? Select all that apply: a) Immune globulin b) Antibodies c) Antigens d) Toxoids e) Vaccines

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