NIP-IT Mods 1-6

A client tells the nurse that he is very anxious about getting this flu shot. To help prevent vasovagal response in this client during injection, the nurse should have the client: A. Sit down while receiving the injection B. Lay down while receiving the injection C. Hold their breath while receiving the injection D. Stand while receiving the injection

A. Sit down while receiving the injection Vasovagal syncope is fainting that can occur when the body over-reacts to extreme, emotional distress or triggers such as fear of getting an injection. When it occurs it causes the HR and BP to suddenly drop, limiting blood flow to the brain. To prevent injury, ask the patient to sit down while administering the injection. If they feel faint afterwards, have them put their head between their legs or lie down.

This disease is now considered eradicated from the world due to vaccination efforts but it is still of concern since it has been posed to be used as a biological weapon. A. Smallpox B. Polip C. Spanish Influenza D. HIV

A. Smallpox - Smallpox has been the only disease to be declared eradicated from the world. - Polio has been declared eradicated from the Americas but not in other countries. - Influenza strains continue to jump from animal to humans so yearly we see different strains occurring. - There is no vaccine for HIV so it continues to grow in epidemic proportions.

What happens when some in a community are immunized against a disease? A. Some get the disease B. Community immunity never works C. Everyone gets the disease D. Few get the disease

A. Some get the disease When some of the community are immunized, their immunity also protects some of the community.

Nearly 3-6% of the world's entire population died from this viral disease in the early twentieth century. A. Spanish Influenza B. Polio C. Bubonic Plague D. HIV

A. Spanish Influenza - SI was caused by a deadly virus between 1918-1920. - BP was caused by a bacterium. - The # of deaths from Polio were much smaller than those of SI but for those infected with Polio, they could have long-lasting effects of paralysis. - HIV is a late 20th century disease which is now occurring un epidemic proportions

Which nursing role is responsible for the following task? Review participant history for contraindications. A. Exit review B. Medical councilor C. First aid officer D. Vaccinator

B. Medical councilor The medical councilor is responsible for reviewing participants' histories for contraindications. This nursing role reports to the Screening Supervisor. The other nursing roles have different responsibilities.

Although relatively few died from this disease or even had symptoms of it, for a small percent of the population, this disease was serious, causing lifelong complete or partial paralysis. A. Smallpox B. Polio C. Spanish Influenza D. HIV

B. Polio - For 1% of those infected with Polio, they had to endure long-lasting effects of paralysis. - For those infected with SI, little long-lasting effects occurred. - For those infected with Smallpox, long-lasting effects of scarring, especially in the facial area. - HIV is a disease where larger #s die and those that are debilitated by it have multiple serious problems caused by immunosuppression.

Which of these statements most accurately describes the application of the National Incident Management System to a Mass Immunization/Prophylaxis Site (MIPS)? A. The MIPS does not have a command structure within the facility; the command is controlled off-site within the Command Center B. The MIPS has a clearly defined command structure that integrates seamlessly into the state and federal prophylaxis campaign command structure C. The MIPS has a unique, local command structure that functions independently of the state and federal command structures D. The MIPS has a clearly defined leadership structure that is created by the public health jurisdiction

B. The MIPS has a clearly defined command structure that integrates seamlessly into the state and federal prophylaxis campaign command structure The NIMS creates a command structure that allows local activities such as as a MIPS to integrate with local, state, federal, and private orgs using the same NIMS command structure. It is not a unique structure; it is not created by any one org. A MIPS would need to have a command structure w/in the facility and the ability to integrate with a higher level command.

A nurse teaches a new other about what to do in the event the child gets a fever after receiving an immunization. The best way to evaluate whether or not a parent understands what to do is: A. The RN asks if the parent has any further questions about what to do in the event of a fever B. The RN asks the parent to teach back how to identify fever and how to treat it C. The RN gives the parent a post-test with specific questions about how to identify and treat fever to see if the parent can answer correctly D. The RN asks the parent to complete an evaluation form of teaching effectiveness

B. The RN asks the parent to teach back how to identify fever and how to treat it - The teach back strategy asks the person to help evaluate effectiveness of teaching by teaching back what they have learned. - Having parents ask questions is one way to find out if they have other concerns, but does not evaluate if they know what to do. - Giving a post-test can put some pts on the spot, especially is they did not understand the materials. - Providing an evaluation form for the teaching session doesn't really provide information about what the parent learned

Which vaccines are contraindicated for pregnant women? A. Influenza B. Varicella C. Tetanus (Td) D. Hepatitis A

B. Varicella - Varicella is a live virus and is contraindicated in women who are pregnant or trying to become pregnant - Generally, live-virus vaccines are contraindicated for pregnant women because of the theoretical risk of transmission of the vaccine virus to the fetus - Influenza vaccination is recommended for pregnant women - Td can be administered during the 2nd and 3rd trimester - Pregnancy is not a contraindication for HepA admin

Which vaccines are administered via the subcutaneous route? A. Hepatitis B, Hepatitis A B. Varicella, Measles, Mumps, & Rubella (MMR) C. Meningococcal, HPV D. Influenza, pneumococcal

B. Varicella & MMR Varicella and the MMR vaccine and the combination MMRV vaccine are all administered subcutaneously. They are the only vaccines administered subcutaneously.

A one-year-old is being seen for his immunizations. His mother states, "I am concerned about the MMR because my sister had a reaction to it." When communicating with the parent, an example of reflection is: A. The MMR is much safer today than when your sister had it B. What happened after she took the MMR? C. "Your sister had a reaction to the MMR?" D. What are you concerns about the MMR?

C. "Your sister had a reaction to the MMR?" - Reflection is a communication technique where you repeat back what the person just said to you so they can hear what they said and add more information. - "What happened after she took the MMR?" is an open-ended question and "The MMR is much safer today than when your sister had it" is a probing question. Both of these strategies are also effective for getting more information from patients.

At what age should older adults receive a pneumococcal vaccine? A. 55 years B. 62 years C. 65 years D. 60 years

C. 65 years Pneumococcal vaccine is recommended one time for adults 65 years and older

What is the recommended immunization schedule for children ages 0-6 years for Hepatitis B? A. 2 months, 3 months, & 5 months B. Birth dose, 4-6 months, & 12-15 months C. Birth dose, 1-2 months, & 6-18 months D. Birth dose, 1 month, & 3 months

C. Birth dose, 1-2 months, & 6-18 months HepB is an inactivated fractional vaccine that requires dosing at set intervals in order to provide immunity. The 2nd dose should be administered 1-2 months after the first and the 3rd should be administered at 6-18 months. The final dose should be administered no earlier than 24 weeks.

Documentation which is required by law whenever vaccines are given is: A. Client's insurance billing information B. Needle size and length C. Edition of the VIS provided to the client D. Client's tolerance

C. Edition of the VIS provided to the client The federal government requires that we give VIS to clients and that we document the edition date of the VIS that was given to clients. Although documenting the client's tolerance, needle size, and length is important, none of these are required by the federal government. However, they may be required by the healthcare entity that is sponsoring the vaccination clinic.

Who is credited with discovering the first safe vaccination? He discovered that inoculation with cowpox would protect a person from smallpox. A. Albert Sabin B. Jonas Salk C. Edward Jenner D. Peter Jennings

C. Edward Jenner In 1796, Edward Jenner demonstrated that inoculation with material from a cowpox (vaccinia) lesion from a cowpox infected milkmaid would protect against subsequent exposure to smallpox. The success of his experiments began the vaccine era. Jonas Salk and Albert Sabin both developed polio vaccines and Peter Jennings was a well-known TV news anchor.

At a community flu clinic at a local church an adult client reports he is having difficulty breathing after receiving the flu vaccine. The priority action the nurse should take is: A. Administer medications B. Notify the supervisor C. Have someone call 911 D. Tell the patient to be calm and the symptoms will disappear

C. Have someone call 911 The first step to obtaining help in a serious situation for an adult, such as this, is calling 911. The nurse or someone else can call. The nurse should then begin administering medications and have someone call the supervisor to report the incident. When clients divulge to nurses that something may be wrong, it needs to be taken seriously.

Fears about the ingredients in vaccines, a belief that diseases are not longer a threat and mistrust of vaccine supply are all examples of: A. Social inequity barriers B. Healthcare system barriers C. Health Knowledge barriers D. Practitioner barriers

C. Health knowledge barriers - HK barriers include fears about the ingredients in vaccines, a belief that diseases are no longer a threat and mistrust of vaccine supply - The absence of Sat. or evening clinic hours, long waiting times, and an inefficient reminder system are all examples of HC system barriers - Poverty, single parent, and lack of access to transportation are examples of social inequity barriers - Practitioner barriers include lack of knowledge about current recommendations in the vaccine schedule and current precautions and contraindications

The absence of Saturday or evening clinic hours, long waiting times and an inefficient reminder system are all examples of: A. Social inequity barriers B. Health knowledge barriers C. Healthcare system barriers

C. Healthcare system barriers HC system barriers include the absence of Saturday or evening clinic hours, long waiting times, and an inefficient reminder system. Poverty, single parent, and lack of access to transportation are examples of Social inequity barriers. Practitioner barriers include lack of knowledge about current recommendations in the vaccine schedule current precautions and contraindications.

A severe allergic reaction to eggs is a contraindication for which vaccine? A. Inactivated poliovirus (IPV) B. Hepatitis B (HepB) C. Rotavirus (RV) C. Influenza (TIV)

C. Influenza The influenza vaccine is developed in eggs and therefore a severe allergic reaction to eggs is a contraindication for receiving the influenza vaccine (TIV). No other vaccine has a contraindication for anyone with a severe allergy to eggs

When implementing the immunization teach care plan, which activity is part of the evaluation? A. Discuss vaccine concerns, clarify misperceptions B. Provide follow up with physician if vaccine concerns persist C. Patient/parent will report their vaccine questions and concerns were addressed D. Assess their concerns, attitudes, and/or misperceptions about immunizations

C. Patient/parent will report their vaccine questions and concerns were addressed - You can evaluate effectiveness of the care plan if the pt or parent states their questions and concerns were addressed. - Provide follow-up is an assessment done during the early phase of the Teaching Care Plan - Discussing vaccine concerns and reporting are activities related to implementation

The nurse notices that when he goes to place the vaccine in the refrigerator, the door has been left open and the temperature of the refrigerator and its contents are warm. He should: A. Place the vaccine in the refrigerator and shut the door B. Check the vials and if no change has occurred in the medication he should shut the door C. Place the vaccine in an emergency backup refrigerator and immediately notify the supervisor D. Place the vaccine in the refrigerator but leave the door open since someone is defrosting the the refrigerator

C. Place the vaccine in an emergency backup refrigerator and immediately notify the supervisor When you notice problems with a refrigeration system, whatever they may be, you should notify your supervisor and begin detecting how the problem may have occurred. A backup fridge must always be in place in case of emergencies. Vaccines that are warm present a problem since they may not longer be potent. Remember that you will be unable to tell from the human eye if a vaccine has lost its potency.

Which of the vaccine given to infants between birth and 12 months is administered orally? A. Polio (IPV) and rotavirus (RV) B. Polio (IPV) C. Rotavirus D. Influenza (TIV)

C. Rotavirus - The only vaccine administered by mouth (PO) b/w birth and 12 mo. is rotavirus. - In 1999, a change in vaccination policy in the US from use of OPV (PO) to exclusive use of IPV (IM) resulted in the elimination of the 8-10 vaccine-associated paralytic poliomyelitis (VAPP) cases that had occurred annually since the intro of OPV in the 1960s - Influenza vaccine is not administered orally

Mass vaccination would be needed for an outbreak of a disease posing a maximum risk to the public health. What is that disease? A. Viral hemorrhagic fever B. Brucellosis C. Smallpox D. Anthrax

C. Smallpox - Smallpox is a disease that poses great risk for the public health and for which we have a vaccine with sufficient stockpile to vaccinate the US population - There is no vaccine for humans for brucellosis - There are many types of viral hemorrhagic fever and the only vaccine is for yellow fever - A protective vaccine has been developed for anthrax; however, it is primarily given to military personnel. With anthrax, the antibiotics used in post exposure prophylaxis are very effective in preventing anthrax disease from occurring after an exposure

The Vaccine Information Statement (VIS) is an important part of teaching vaccine recipients are parents about vaccines. Which statement is true about the VIS? A. If more than one vaccine is given at any one time, a combined VIS must be used B. The VIS is part of the chart and must be signed by the vaccine recipient or parent of child receiving vaccines C. The RN must document in the chart which VISs were given along with the VIS production date D. According to federal law, the nurse must provide the VIS after giving any vaccines

C. The RN must document in the chart which VISs were given along with the VIS production date The type of VIS given and production date of the VIS must be documented on the pt chart. The combined VIS is only used for vaccines for children from birth to 6 mo. of age. Federal law mandates the VIS is provided prior to giving the immunization so the person has time to read it over and ask questions. The VIS is not part of the pt chart and is designed to be taken home by the pt/family. Some states do require informed consent for immunizations which would be part of the chart.

Parents have voiced concerns about the number of reported adverse events in the VAERS. A critical element of understanding VAERS reporting is that: A. VAERS only accepts reports from health professionals and vaccine manufacturers who are qualified to determine causality B. VAERS only contains reports of adverse events that are related to the vaccine administration C. VAERS captured all medical events occurring post-vaccination, even if the reporter is not certain that the incident is vaccine related D. The primary purpose of VAERS is to determine the actual rate of side effects and adverse event associated with each vaccine.

C. VAERS captures all medical events occurring post-vaccination, even if the reporter is not certain that the incident is vaccine related. VAERS collects all reports of clinically significant adverse events. VAERS is a passive reporting system and accepts reports from health professionals, vaccine manufacturers, and the general public. Additional studies are always required to confirm if adverse events are related to the vaccine. The primary purpose of VAERS is to detect new or rare vaccine adverse events, increases in rates of known side effects, and patient risk factors for particular types of adverse events.

What is the CDC recommendation for influenza virus for health care personnel? A. Vaccinate health care personnel ages 50 or greater B. Routine annual administration of influenza is not recommended for healthy, non-pregnant health care personnel C. Vaccinate all health care personnel annually D. One time vaccination is recommended for health care personnel

C. Vaccinate all health care personnel annually The CDC recommendation is to vaccinate all HCP annually

Parents may have several vaccine concerns. Studies have demonstrated the core concept that parents are most concerned about is: A. Vaccine supply B. Vaccine development C. Vaccine safety D. Vaccine efficacy

C. Vaccine safety Vaccine safety has been shown in studies to be what parents are most concerned. Unfounded fears about the safety of vaccines have had extensive media exposure enhancing parental concerns. While there have been times when vaccine supply was problematic, it is rarely identified as a primary parent concern. Vaccine development has been a concern in the international vaccine community and HIV advocacy groups, but not mentioned often by parents. In the most recent focus groups, parents have voiced a concern that the risk of catching the disease is low, but do not fear the vaccine does not work.

The best site to give an IM vaccine to an infant is: A. Dorsogluteal B. Deltoid C. Vastus Lateralis D. The fatty tissue behind the arm

C. Vastus Lateralis

An appropriate needle length for an IM injection for a man who weighs 290 pounds is: A. 5/8 inch B. 2 inch C. 1 inch D. 1.5 inches

D. 1.5 inches There has been some research to indicate that IM injections given in larger-sized individuals may not reach the IM area but only the SQ area which results in lower titers of antibodies. For males over 260 pounds and females over 200 pounds, the CDC suggests giving in the deltoid with a 1.5 inch needle. All the other sizes would then be considered to be too short to give in the deltoid muscle for this individual.

Getting an annual flu vaccine is a professional responsibility of nurses because: A. Patients are less likely to take the flu vaccine if the doctor's office nurse has received it B. Nurses can show they are more responsible than other HCWs C. Nurses who refuse the flu vaccine are role models for the public for healthy behaviors D. An annual flu shot helps protect the nurse, patients, co-workers and the nurse's family

D. An annual flu shot helps protect the nurse, patients, co-workers and the nurse's family The annual flu vaccine protects the nurse and others who the nurse comes in contact with. When nurses get their flu vaccine each year, they are role models and exert social influence on others. One study reported that when the nurse in the doctor's office is updated with the annual flu vaccine, patients are more likely to be current with flu and PPV. All HCWs have a professional responsibility to get the annual flu vaccine.

Mass antibiotic prophylaxis would be needed for outbreaks of disease due to any of the three bacterial pathogens posing the maximum risk to public health. What are these diseases? A. Anthrax, smallpox, or influenza B. Viral hemorrhagic fever, plague, or tularemia C. Cholera, plague, or botulism D. Anthrax, plague, or tularemia

D. Anthrax, plague, or tularemia - Anthrax, plague, and tularemia are bacterial diseases are great risk to the public health. They are Category A high priority agents and are all treatable with antibiotics. - Smallpox and viral hemorrhagic fever are viruses, not bacteria. - Cholera is not a Category A disease.

Over time as vaccines have become available, the rate of disease incidence for vaccine-preventable diseases has: A. Increased B. Stayed the same C. Made no difference D. Decreased

D. Decreased Since the development of vaccines, the rate of diseases that we encounter on a daily basis has decreased dramatically. For those living today who have the opportunity for vaccination, living disease-free is relatively simple largely due to vaccines as compared to people living only a half century or more ago.

What happens when a critical portion of the community is immunized against a disease? A. Some get the disease B. Everyone gets the disease C. Community immunity never works D. Few get the disease

D. Few get the disease When a critical portion of the community is immunized, most members are protected from the disease.

Which nursing role is responsible for managing anaphylaxis, fainting and seizure emergencies per protocol at a MIPS? A. Exit review B. Vaccinator C. Medical councilor D. First aid officer

D. First aid officer - The FAO is responsible for managing reactions to immunization/vaccination and unrelated medical incidents during the operation of the MIPS - MCs are a part of the screening team - The ER team ensures that all questions are answered before people leave - The vaccinators administer vaccines

Which is the source people most often rely upon to answer questions about immunizations? A. The internet B. Nurses C. Physicians D. Friends and relatives

D. Friends and relatives A study by Gardner, Davies, McAteer & Mitchie (2010) reported people often ask their friends or relatives for advice about vaccines because they do not perceive they are getting the information they need from HCPs

One of the risk factors for not receiving immunization is the absence of health insurance. Which ethical principle do you see applied in the situation? A. Non-maleficence B. Beneficence C. Autonomy D. Justice

D. Justice Justice is the primary ethical principle applied to this situation; it is the principle of fairness. Justice addresses equitable access to vaccines for all patients, no matter what their ethnicity or socioeconomic status

The phrase "Do no harm" reflects which ethical principle? A. Justice B. Beneficence C. Autonomy D. Non-maleficence

D. Non-maleficence - NM means to prevent harm and beneficence is the principle meaning to do well - Autonomy is the right to make their own decisions or in the case of children, the parent's right to make decisions for their child - Justice is the principle of promoting fairness

Within the Incident Command System structure, nurses dispensing medications would be within which ICS function? A. Planning B. Logistics C. Command D. Operations

D. Operations Nurses dispensing meds are w/in the Operations function in an ICS structure. They represent the "doing." Logistics coordinates the provision of regulated services and materials. Planning section collects, evaluates, and disseminates information. Command is in charge and responsible for overall management.

Which of the following vaccine-preventable diseases is a common cause of serious illness in children and adults? A. Meningitis B. Influenza C. Shingles D. Pneumococcal

D. Pneumococcal - Pneumococcal disease is a leading cause of serious illness in children and adults - Influenza can lead to pneumococcal disease - Meningitis infects low numbers, therefore not a "leading" cause, but has serious consequences for those that are infected - Shingles can occur in adults who have had the chickenpox virus

Effective public health response to a bioterrorist attack or disease outbreak is dependent upon five response components. Which is the first component? A. Distribution B. Dispensing C. Supplies D. Surveillance

D. Surveillance - The first component is surveillance. - Surveillance includes monitoring pathogenic microbes in the environment and monitoring suspicious symptoms. - The trigger for a response is found by our surveillance system. - Other responses follow the detection of a problem by surveillance.

Many parents and organizations have voiced concerns about thimerosal. Which statement is accurate? A. Thimerosal is the preservative present in the MMR vaccine B. Thimerosal contains methylmercury, a known neurotoxin that accumulates in the body C. Thimerosal is the preservative present in the Varicella vaccine D. Thimerosal breaks down into ethylmercury and thiosalicylate, which are rapidly excreted from the body

D. Thimerosal breaks down into ethylmercury and thiosalicylate, which are rapidly excreted from the body

Which is a barrier to health literacy? A. Asking the person to teach back what has been taught B. Learning cultural preferences of the target population C. Use of multiple methods to provide immunization information D. Use of jargon, words with double meanings, or idioms

D. Use of jargon, words with double meanings, or idioms Use simple, plain language. To improve understanding of health information, use a variety of methods to teach. Learning the cultural preferences of the target group will help nurses understand some of the misperceptions that might be circulating in the community. The teach back method is an excellent way to evaluate if the health message was understood.

The nurse assesses a patient likes to learn by watching videos, viewing internet sites, and reading charts and graphs. This would indicate the patient's preferred learning style is: A. Verbal B. Auditory C. Kinesthetic D. Visual

D. Visual - This pt demonstrates they prefer visual learning - Auditory learners would prefer activities where they can listen to information or talk about information - A video is a mixed method of audio and visual - Kinesthetic learners would prefer learning by interacting in a hands-on approach with the materials or through playing games

Which is an example of the nurse acting as an immunization advocate? A. Placing handouts about vaccines in the waiting room B. Assuring vaccines are stored safely at the proper temperature C. Assessing patients for vaccine teaching needs D. Working for policies to make vaccines more accessible

D. Working for policies to make vaccines more accessible The nurse advocates for pts when trying to make vaccines more accessible. Placing handouts in the waiting room is part of the educator role. Assuring vaccines are stored safely at the proper temperature is a care coordinator role.

Before giving a vaccine, which information is essential to know? A. Client preference for site B. Emergency procedures C. Client insurance number D. Client preference for needle size

B. Emergency procedures Although it is important to consider the patient's preference for site to respect their wishes and their patient insurance number is important for billing purposes, they are not essential when compared to knowing the emergency procedures that are in place. Nurses make the decision on needle size based on their knowledge of the type of medication they are giving, the route and the side of the individual.

Why do infants need repeated doses of the same vaccines at regular intervals in the first year of life? A. Live vaccines have no interference with maternal antibodies and the protection they afford does not last very long B. Inactivated vaccines have less interference from maternal antibodies, but the protection they afford does not last very long C. The live viruses in these vaccines replicate in large numbers, but every two months the immune response kills them D. The infant immune system has a very robust response and vaccinations at regular intervals desensitize that response

B. Inactivated vaccines have less interference from maternal antibodies, but the protection they afford does not last very long Most of the vaccines that infants receive in the first year of life are developed from inactivated vaccines. Inactivated vaccines cannot replicate and have little interference from the circulating maternal antibodies, however; they generally are not as effective and require 3-5 doses to provide immunity. The exception is rotavirus, but because it is administered orally, it has a different effect.

Which of the following are vaccine preventable disease? A. Bubonic plague B. Influenza and polio C. Polio D. HIV E. Bubonic plague and influenza F. Influenza

B. Influenza and polio - Influenza and polio are the only two diseases in this list that are vaccine preventable - BP is a bacterium and is treated with antibiotics -- there is no vaccine to prevent it. Public health measures to decrease presence of rodents that carry fleas (which have been infected with the disease) have decreased the incidence of the plague. - HIV has no vaccine to prevent it

Which is a live attenuated viral vaccine? A. Human papillomavirus (HPV) B. Measles, Mumps, Rubella (MMR) C. Diphtheria, Tetanus (Td) D. Hepatitis B (HepB)

B. Measles, Mumps, Rubella (MMR) - MMR is a live attenuated vaccine. One of the distinguishing characteristics of a live attenuated vaccine is that it is not given in a series, nor do you need a booster - The HPV, HepB, and Td are inactivated vaccines. HPV and HepB are given as a series. Td is a booster that provides immunity for about 10 years

Identify the responsibility that every individual participating in the MIPS must fulfill regardless of role or level of responsibility. A. Check-in at the designated check-in location B. Use universal precautions to prevent exposure to bloodborne pathogens C. Insure gloves are worn D. Call 911 if emergency transport is necessary

A. Check-in at the designated check-in location - Each participant in the MIP event must check-in at the designated check-in location. - Not every individual needs to wear gloves or use universal precautions. Those tasks are dependent upon the type of event and are only for those in specific roles. - The FAO is responsible for calling 911 after evaluating the situation. The decision to call 911 requires the knowledge to determine the best recourse, for example, treat at the facility or transport

Which information is not important to collect and document prior to providing a flu vaccine? A. Current medications B. Medical illness C. Allergies D. Vaccine history

A. Current medications It is not important to know what current meds they are taking when giving the flu vaccine. However, it is important to collect and document allergies, such as past allergies to vaccines or their components like eggs. Nurses also need to collect medical information, such as pregnancy, and vaccine history, since they may have recently received the vaccine. All of these pieces of information would be important since they may preclude the client from being eligible to receive the vaccine.

Identify three functional areas within the Mass Immunization/Prophylaxis Site (MIPS). A. Forms distribution, medical evaluation, briefing B. Form distribution, command center, medical treatment C. Greeter, medical treatment, supply center D. Command center, supply center, first aid

A. Forms distribution, medical evaluation, briefing The three functional areas within the MIPS are forms distribution, medical evaluation, and briefing. Medical treatment, supply center, command center, and first aid would most likely not be located within the MIPS, but if necessary at an off-site location.

Which of the following is the most commonly sexually transmitted vaccine-preventable disease? A. HPV B. Influenza C. HIV D. Pneumococcal

A. HPV - Human papillomavirus is the most commonly sexually transmitted disease and causes 40% of all cervical cancers - HIV is a STD and, although occurring in epidemic proportions, there is no vaccine at this time - Flu and pneumococcal diseases are both vaccine-preventable, but are not sexually transmitted

A nurse is working at the health department and has been asked to put away a leftover multi-dose influenza vial that has not expired but was used in today's clinic. Temperature of the vial has been safely maintained. Where should the nurse place this vaccine? A. In the refrigerator, in a centrally located area far away from vents B. On the refrigerator's bottom shelf since the vaccine needs to be stored at a very low temperature C. In the refrigerator door since the temperature is more stable here D. The nurse should discard the vial since it has been opened and used even through the vaccine has not expired.

A. In the refrigerator, in a centrally located area far away from vents All vaccines have special temps at which they need to be stored. Nurses need to be aware of which vaccines need to be stored in the fridge and which need to be stored in the freezer. Also, nurses need to know which areas of the fridge where vaccines should not be stored due to temperature instability. These areas include areas near freezer air vents, in the door, or on the bottom shelf since the motor is located there. It is not necessary to discard a vial that is opened and used, if it is not expired.

Many parents and organizations have voiced concerns about a relationship between vaccines and autism. Which statement is accurate? A. Multiple large and well designed studies have shown no causal relationship between vaccines and autism

A. Multiple large and well designed studies have shown no causal relationship between vaccines and autism. In fact, the rate of autism is the same in children who have never received the MMR vaccines and those who have received the MMR vaccines. Since thimerosal was removed from childhood vaccines the incidence of autism has increased. Dr. Wakefield's research methods in his study of 12 children have been highly criticized. The journal in which his study and the vast majority of physicians affiliated with the study have retracted the study's interpretation.

Which of the following vaccine-preventable diseases is characterized by this whooping cough? A. Pertussis B. Hepatitis C. Tetanus D. Chicken Pox

A. Pertussis - Pertussis is characterized by a whooping cough. The disease is highly contagious. Early in the 20th century, it was the leading cause of childhood deaths. - CP is characterized by small pox-like formations on the skin - Hepatitis is characterized by jaundiced skin - Tetanus is characterized by lockjaw followed by stiffness in neck

The best approach for discussing vaccine risks is: A. Provide accurate information about both benefits and risks of vaccines B. Only discuss risks when parents ask about them C. Downplay risks so the vaccines are more acceptable D. Provide detailed statistics related to risks to back up safety of vaccines

A. Provide accurate information about both benefits and risks of vaccines A balanced approach discussing both benefits and risks of vaccines is more effective and builds trust. Many people do not understand how to use statistics so it is better to not use too many. Balance statistics with anecdotal stories to demonstrate vaccine benefits and risks.

The nurse arrives at a church as a volunteer for a flu clinic. The nurse observes hundreds of pre-filled syringes. She learns that there were no manufacturer pre-filled syringes available, so a pharmacist and a nurse prepared them that morning so that no one would need to fill syringes during the clinic. Which is correct? A. The CDC recommends only pre-filling a few syringes at a time and that the nurse who draws up the medication is the person who should give it. B. It is an acceptable practice to pre-fill the syringes since it was done by a nurse and a pharmacist C. When there are no manufacturer-filled syringes available, it is acceptable to pre-fill syringes for an entire day D. It is a common and acceptable practice when the flu clinic occurs at a c=place other than the health department

A. The CDC only recommends using pre-fill syringes if they are pre-filled by the manufacturer. They will allow the nurse that is administering the vaccine to fill a few at a time but not enough for the entire day. Using the pre-filled syringes by others can increased the likelihood of medication error. It also does not follow storage principles since the vaccine needs to be kept at a certain temperature. Pre-filled syringes can also contribute to waste since those that are not used must be discarded. These rules apply no matter where the vaccine is administered.

If an act of bioterrorism triggers a MIP response, people's lives depend on getting a right medication into as many people as possible. The traffic flow or patient flow becomes a critical part of response planning. The traffic flow for which group can adversely impact the overall patient flow rate? A. Uncomplicated cases B. Seriously ill individuals C. Specialized-care cases D. Mentally ill individuals

A. Uncomplicated cases - Since the majority of pts will most likely be uncomplicated cases, even small errors in traffic flow layout for this group may adversely impact overall pt flow rate - Specialized-care cases will be a smaller group but may require more time and resources - Seriously ill and mentally ill should be transported immediately to receive treatment

Many parents and organizations have voiced concerns about aluminum. Which statement is accurate? A. Aluminum is not excreted by the kidneys. It remains and accumulates in the body B. Aluminum is the most commonly found metal on the planet. It is in the water we drink and the food we eat. C. Aluminum is a known neurotoxin. It is not normally found in the human body. D. Aluminum is completely unnecessary to the function and efficacy of vaccines

B. Aluminum is the most commonly found metal on the planet. It is in the water we drink and the food we eat Al has been used to improve the immune system's response to vaccines for more than 70 years. Most of the Al that enters the body is eliminated quickly. The ability of the body to rapidly eliminate Al accounts for its excellent record of safety. Did you know that the average recommended dose of antacids has about 1,000 times more Al than a vaccine does?

Social factors have heightened vaccine concerns and impacted immunization coverage. Identify the two social factors that negatively impact the number of Americans immunized. A. Increasing prosperity for women and children and trust in the local government B. Complexity of the vaccine schedule and concerns about environmental hazards C. Rising employment rates and universal health insurance D. Diminishing social inequalities and understanding the cause of autism

B. Complexity of the vaccine schedule and concerns about environmental hazards ... are social factors that negatively impact immunization coverage. Poverty, especially children in poverty, is a barrier to immunizations. Therefore, rising employment rates, universal health insurance, and increasing prosperity for women and children would positively impact vaccination coverage. Ethnic discrepancies and diminishing social inequalities also positively impact our immunization rate. One of the unfounded fears is the concern about a relationship between vaccines and autism. A clear scientific understanding of the cause of autism would remove any doubt.