APhA Home Study Questions 1
(M5) At what age is the herpes zoster vaccine first recommended for immunocompetent adults?
50 years
(M5) Based on the adult immunization schedule, at what age is the live attenuated influenza vaccine (LAIV) no longer recommended? a. 50 years b. 19 years c. 65 years d. 27 years
50 years
(M18) When preparing vaccines for administration, pharmacists should do which of the following?
Always check the expiration dates on the vaccine and any diluent that is used, always use aseptic technique
(M4) What are the four steps set by NVAC as the standards for Adult Immunization Practice?
Assess, recommend, administer/refer, document
(M4) In the patient care process, how often should a pharmacist collect information a patient?
At every clinical encounter
(M6) Match the symptoms below with the corresponding most likely cause of cold or flu
Cold: gradual onset, sneezing Flu: fever, aches
(M8) What type of vaccine is meningococcal quadrivalent vaccine? a. Recombinant b. Conjugate c. Polysaccharide d. Viral vector
Conjugate
(M11) Which of the following is the most common type of tetanus? a. Cephalic b. Generalized c. Neonatal d. Local
Generalized
(M12) Post-vaccination testing for hepatitis B immunity is recommended for which of the following? a. IV drug users b. Adolescents c. Health-care workers d. Men who have sex with men
Health-care workers
(M5) Which vaccines are not to be given to a woman who is pregnant?
LAIV, MMR, HPV, VAR
(M3) What clinical factors need to be considered before administering a live attenuated vaccine?
Patients who currently are immunocompromised & live attenuated vaccines administered in the previous 28 days
(M10) Match the words together based on the correct transmission route:
Pertussis - respiratory droplets Tetanus - wound Diphtheria - nasopharynx and skin
(M18) What does SIRVA stand for?
Shoulder injury related to vaccine administration
(M1) Which of the following diseases have been eradicated worldwide, allowing vaccination to be discontinued? a) Polio b) Smallpox c) Mumps d) Tetanus
Smallpox
(M4) What is the name of the document published by the CDC that describes the risk and benefits of a vaccine in lay terms?
Vaccine Information Statement
(M4) What screening questions should be asked to any and all patients?
1. Are you sick today or how are you feeling? 2. Do you have any allergies to medications, food, any vaccine, or latex? 3. Have you ever had a serious reaction after receiving a vaccination? 4. Do you have a long-term health problem with heart disease, lunch disease, asthma, kidney disease, metabolic disease, anemia, or other blood disorder?
(M18) How does one prepare for IM injections?
1. Patient and provider seated 2. Expose patient upper arm and deltoid muscle 3. Wipe area with alcohol and let it dry 4. Help patient relax arm muscle
(M18) What angle should the needle be inserted for SC injections?
45 degrees
(M9) What percentage of HPV infections are cleared by the body and do not develop to CIN2 or CIN3? a. 38% b. 70% c. 54% d. 92%
70%
(M2) ______ evoke the immune response and bind to specific antibodies a) antigens b) antibodies c) phagocytes d) t-cells e) b-cells f) macrophages
Antigens
(M25) A pharmacy technician may perform which of the following roles? a. Determine whether a vaccine is appropriate for a patient. b. Educate patients about the risks of vaccines. c. Ask patients to complete screening questionnaires. d. Make clinical judgments about a patient's health.
Ask patients to complete screening questionnaires
(M1) What is the definition of collaboration, coordination, and communication among all those involved in meeting the immunization goals of patients and communities? a) Immunization Party b) Healthcare Team c) Prevention Task Force d) Immunization Neighborhood
Immunization Neighborhood
(M18) What is a good body landmark to know where to administer IM injections?
Near the same level as the armpit
(M12) Which of the following groups are at high risk for hepatitis A? Infants, adolescents, persons experiencing homelessness, illicit drug users, international travelers
Persons experiencing homelessness, illicit drug users, international travelers
(M13) What is the primary transmission route of MMR? a. Blood transfusions b. Gastrointestinal c. Respiratory d. Skin to skin contact
Respiratory
(M8) What is the youngest age that the meningococcal B vaccine is recommended for children at risk? a. 2 years b. 4 years c. 6 years d. 10 years
10 years
(M5) If a child is behind on the rotavirus vaccine, what is the interval of time between dose 1 and dose 2 to start getting the child caught up?
4 weeks
(M5) At what age is the influenza vaccine first recommended?
6 months
(M26) When promoting a mass immunization clinic it is helpful to: a. Share appointment scheduling instructions, if applicable. b. Explain how the cold chain will be maintained. c. Ask patients to bring their own first aid supplies.
Share appointment scheduling instructions, if applicable
(M1) In 2019, which of the following vaccine-preventable diseases had fewer than 100 cases in the United States? a) Diphtheria b) Measles c) Pertussis d) Polio
Diphtheria, polio
(M2) Vaccines contain antibodies which are recognized by the immune system. True or false?
False
(M12) Match the items below to the appropriate virus
Hepatitis A: RNA virus, fecal-oral transmission Hepatitis B: DNA virus, transmitted through body fluids
(M19) What are the local and system reactions that patients should expect after a vaccine?
Local: pain, swelling, redness Systemic: fever, myalgia, headache, rash
(M15) Which of the following vaccines are mRNA vaccines? a. Pfizer-BioNTech b. Moderna c. Janssen d. Pfizer-BioNTech (Comirnaty)
Pfizer-BioNTech, Moderna, Pfizer-BioNTech (Comirnaty)
(M18) What is the recommended needle selection for IM injection? Syringe size: Needle gauge: Length:
Syringe size: depends on the value of the vaccine (1ml or 3ml) Needle gauge: 22-25G Length: based on sex and weight
(M18) When reconstituting vaccines, pharmacists should do which of the following?
always refer to the vaccine's package insert for specific information
(M23) The Vaccine for Children (VFC) program pays for which of the following? a. The refrigerator needed to store the vaccine b. The vaccine administration supplies c. The administration fee d. The vaccine
The vaccine
(M24) Which of the following statements best illustrates the affirmation skill in motivational interviewing? a. "Can you tell me more about your concerns?" b. "What information do you have about this disease?" c. "It sounds like that was a really frustrating experience for you." d. "Thank you for sharing your concerns with me, I enjoyed speaking with you today"
"Thank you for sharing your concerns with me, I enjoyed speaking with you today"
(M9) Which of the below statements regarding Human papillomavirus (HPV) serotypes is true? a. There are only 9 known serotypes of HPV. b. High risk serotypes are estimated to cause 99% of cervical precancers c. HPV low risk serotypes, such as type 16, cause about 50% of all cervical cancer cases worldwide. d. HPV is a small RNA virus transmitted via sexual skin to skin contact.
High risk serotypes are estimated to cause 99% of cervical precancers
(M3) What are the two broad categories that vaccines are classified? a) Influenza vaccines b) Live attenuated vaccines c) Oral vaccines d) Injectable vaccines e) Inactivated vaccines
Live attenuated vaccines & inactivated vaccines
(M18) What needle length and gauge should be used for SC injections?
Needle length: 5/8-3/4 inch Gauge: 23-25G
(M29) Which of the following is a non-governmental organization that participates in disaster relief efforts? a. Public Health Department b. Red Cross c. World Health Organization d. Medical Reserve Corps
Red Cross
(M10) Which of the following vaccines are recommended for persons older than 10 years? a. Td b. DT c. Tdap d. DTap e. DTaP-IPV
Td, Tdap
(M13) What is another name for rubella? a. rubeola b. epidemic measles c. german measles d. scarlet fever
german measles
(M9) HPV or human papillomavirus infections that infect a non mucosal, cutaneous epithelium usually leads to which of the following? a. anal warts b. palmar warts c. plantar warts d. increased cervical cancer
palmar warts and plantar warts
(M14) What is the primary route that Haemophilus influenzae is transmited? a. fecal oral b. skin contact c. droplet inhalation/respiratory tract secretions d. blood transmission/puncture wound
droplet inhalation/respiratory tract secretions
(M15) Which of the following is a common side effect from COVID-19 vaccinations? a. injection site pain b. Guillain-Barre Syndrome (GBS) c. myocarditis d. death
injection site pain
(M2) Which vaccines are more susceptible to circulating antibodies in the system? a) inactive b) live-attenuated
live-attenuated
(M20) What should you do when asking a practitioner to sign a standing order or protocol?
1, 2, 3
(M19) What should pharmacists do when treating a patient for anaphylaxis?
1, 2, 3, 4
(M17) Which of the following statements about refrigerations and freezers for storing vaccines are true?
1, 2, 3, 6
(M18) Which of the following statements are true?
1, 2, 4
(M9) A 25-year old female comes to the pharmacy inquiring about the 9vHPV series. What would be the recommended vaccination series? a. 3 doses administered intramuscularly at 0, 1-2, 6 months b. 2 doses administered intramuscularly at 0 and 6-12 months c. Patient is not eligible to receive the vaccine due to age d. 1 dose administered intramuscularly
3 doses administered intramuscularly at 0, 1-2, 6 months
(M15) Which of the following patients is eligible to receive their first dose of the rotavirus vaccine? a. A newborn 3 days age before leaving the hospital b. An 8-month-old c. A 10-week-old presenting to the pediatrician for their 2-month well check. d. A 1-year-old with severe GERD
A 10-week old presenting to the pediatrician for their 2 month well check
(M8) The quadrivalent meningococcal conjugate vaccines contain which of the following serotypes? A, B, C, D, W, X, Y
ACWY
(M5) Which immunization schedule should be used to determine which vaccines are needed for each situation listed?
Adult immunization schedule by medical condition and other indications, child and adolescent immunization schedule by age, catch-up schedule for children and adolescents, adult immunization schedule by age group
(M5) How often are the CDC immunization schedules published?
Annually
(M2) Which of the following is found in vaccines to evoke an immune response? a. B cells b. Antigens c. Antibodies d. Macrophages
Antigens
(M6) Which of the following symptoms are usually associated with influenza? a. Normal temperature b. Sneezing c. Nausea/vomiting d. Chills
Chills
(M19) What is a first-line treatment for anaphylaxis and how do you use it?
Epinephrine 1. Administer intramuscularly into the anterolateral aspect of the thigh, may administer through clothing if necessary 2. Administer every 5-15 minutes as needed until EMS personnel arrive (no more than 2 epinephrine doses for normal patients, no more than 3 epinephrine doses for patients taking antihypertensive medication) ***Have at least 3 epinephrine doses at site!
(M1) Healthy People 2030 identified a goal of 100% for proportion of persons vaccinated annually with seasonal influenza vaccination. True or false?
False
(M11) True or False. Varicella is NOT transmitted by contact with the lesions?
False
(M14) True or false. Polio always results in paralysis that can be short or long term?
False
(M20) Which of the following organizations provides standing order templates? a. Public Health Institute b. Infectious Diseases Society of America c. National Institutes of Health d. Immunization Action Coalition
Immunization Action Coalition
(M7) A healthy 70-year old female who received PPSV23 at 65-years of age is inquiring about pneumococcal vaccination. Which of the following should you recommend? a. PPSV23 b. No pneumococcal vaccination is recommended. c. PCV13 now and then PPSV23 1 year later d. PCV13
No pneumococcal vaccination is recommended
(M1) Which of the following is one of the five guidelines identified by the APhA Board of Trustees in 2019 to assist pharmacists in incorporating immunization activities into their practice? a) Power b) Quantity c) Solidarity d) Prevention
Prevention
(M17) What temperature should refrigerated vaccines be kept at?
Range: 35-46F (2-8C) Optimal: 40F (5C)
(M17) Which of the following statements about vaccine storage are true?
1, 3
(M11) Which of the following patients should receive the varicella vaccination? a. 10 month old at their well check b. 65 year old who had chickenpox over 60 years ago c. 5 year old who received one dose at 12 months of age d. 12 year old who received doses at 15 months and 6 years of age
5 year old who received one dose at 12 months of age
(M6) Which of the following patient scenarios regarding influenza vaccination is correct? a. 65-year-old patient with thimerosal allergy would be eligible to receive adjuvanted inactivated Fluad or high dose inactivated Fluzone. b. A 5-year-old who received one dose of influenza vaccination when they were 3 years old, should receive only one dose this year. c. An annual influenza vaccination is recommended for 2 years and older due to being a polysaccharide vaccination. d. A 40-year-old who is allergic to eggs would be contraindicated to receive Flublock (RIV4).
A 65-year-old patient with thimerosal allergy would be eligible to receive adjuvanted inactivated Fluad or high dose inactivated Fluzone
(M7) Why do conjugated vaccines produce IgG but not polysaccharide vaccines?
A protein is required to trigger T-cell dependent B-cell activation, and only conjugated vaccines have proteins and not polysaccharide vaccines.
(M18) When reconstituting a vaccine for injection, pharmacists should: a. Always shake the vaccine prior to reconstitution. b. Always refer to the vaccine's package insert for specific information. c. Always shake the diluent prior to reconstitution. d. Always withdraw the entire contents from the reconstituted vial.
Always refer to the vaccine package insert for specific information
(M18) What age group is the deltoid muscle recommended for for IM inections?
Children ages 3 years and older and adults
(M19) An adverse event that is considered a systemic reaction to a vaccine is: a. Wheezing b. Angioedema c. Tenderness d. Fever
Fever
(M9) Which of the following factors does not need to be considered when utilizing shared decision making to evaluate the need to vaccinate an adult (27-45 years of age) with 9vHPV vaccine? a. Patient's sexual history, including lifetime sexual partners. b. Patient current relationship status c. HPV antibody test results d. Patient's immunocompetency
HPV antibody test results
(M24) Health literacy is considered a part of which domain of social determinants of health? a. Economic stability b. Health care access c. Neighborhood and built environment d. Social and community context
Health care access
(M3) Pneumococcal polysaccharide vaccine (PPSV23) is best categorized as what type of vaccine?
Inactivated polysaccharide vaccine
(M11) The whooping cough associated with pertussis occurs in this stage of disease: a. Convalescence b. Paroxysmal c. Initial d. Catarrhal
Paroxysmal
(M13) Which of the rare diseases prevented by the MMR vaccine is most rare in the U.S.? a. Marburg b. Measles c. Mumps d. Rubella
Rubella
(M11) Which of the following vaccines is used as a booster every 10 years? a. Td b. DTaP c. DTaP-IPV d. DT
Td
(M7) Which of the following is an invasive pneumococcal disease? a. pneumonia with bacteremia b. sinusitis c. otitis media d. meningitis
meningitis
(M16) Match the myth with the correct proof against it
1,2 2,3 3,1 4,4 5,5
(M9) The human papillomavirus 9-valent vaccine, recombinant, or 9vHPV, provides protection against how many HPV serotypes?
9 serotypes
(M22) The OSHA exposure control plan is used by employers to achieve what goal? a. Create a process of controls that aims to eliminate or minimize employee's potential exposure to bloodborne pathogens in the workplace. b. Creates a system for Human Resources to monitor employee health at the workplace. c. Develop a team-based environment that fosters creativity and collaboration. d. Improve employee health and wellness.
Create a process of controls that aims to eliminate or minimize employee's potential exposure to bloodborne pathogens in the workplace
(M4) An electronic prescription for glipizide 10mg is received by a pharmacist for a new patient. The prescription indicates a diagnosis of E11, Type 2 diabetes mellitus. In addition to filling the prescription, the pharmacist could assess the patient for potential immunizations to recommend. What form of assessment is the pharmacist utilizing? a. Diagnosis-based screening b. Occurrence-based screening c. Mass screening d. Procedure-based screening
Diagnosis-based screening
(M21) The National Childhood Vaccine Injury Act of 1986 established national vaccine documentation requirements which include: a. The patient/caregiver must be given a Vaccine Information Statement (VIS) for only the first dose in a series. b. Site of injection. c. Edition date of the Vaccine Information Statement (VIS) d. Documentation of informed consent.
Edition date of the Vaccine Information Statement (VIS)
(M17) Why is it important to preserve the cold chain for vaccines? a. Exposure to heat, cold, or light outside recommended ranges can reduce vaccine potency. b. Vaccines stored at temperatures outside the recommended range are more likely to cause systemic adverse events. c. Vaccines stored at temperatures outside the recommended range are more likely to cause localized adverse events. d. Maintaining the cold chain extends the shelf-life for vaccines.
Exposure to heat, cold, or light outside recommended ranges can reduce vaccine potency
(M27) Which of the following is considered a print marketing strategy? a. Radio announcements b. Social media advertising c. Voice response system messages d. Flyers and brochures
Flyers and brochures
(M16) A simple way to communicate information about risks and benefits of vaccines to all patients is to: a. Recommend patients do their own research online prior to their vaccine appointment b. Schedule a 10-minute counseling session prior to each vaccine c. Give them Vaccine Information Statements d. Offer town-hall style events for your community to ask questions about vaccines
Give them the Vaccine Information Statements
(M11) Which of the following statements are true regarding the recombinant zoster vaccine? a. It requires an adjuvant b. It requires reconstitution c. It is indicated starting at 60 years of age d. It requires two doses
It requires an adjuvant, it requires reconstitution, it requires two doses **indicated at 50 years old, not 60 years old
(M25) Which setting best facilitates the delivery of a mass vaccination clinic for the general population? a. Physician practice b. Community pharmacy c. On-site community event d. Long-term care facility
On-site community event
(M17) Pharmacists should do what when accepting a vaccine delivery?
Record the inventory, document and report any damage, label damaged vaccine "Do NOT Use" and store in appropriate conditions
(M7) How is the immune system broken up?
The immune system is divided into innate immunity (skin, stomach pH, mucous membranes, already have, general) and adaptive immunity (need to make, specific). Adaptive immunity is then divided into humoral (production of antibodies in a T-cell dependent (IgG) and T-cell independent (IgM) way) and cell-mediated immunity (direct attack, MHC). Both require B and T cells. In humoral immunity, B cells required to make antibodies and what type depends on whether T cells interact with it. In cell-mediated immunity, T cells rely on B cell's antibodies attaching to their MHC to know what antigen to target. Humoral immunity can range from natural-passive (maternal), natural-active (infection), artificial-passive (antibody transfer, Ig infusion), and artificial-active (immunization).
(M17) Why do vaccines need to be properly stored and handled?
To maintain their potency
(M13) Which of the following is the primary reason we have measles outbreaks in the U.S.? a. Low MMR vaccination rates nationally b. There is a shortage of MMR vaccine in the U.S. c. Low effectiveness of the MMR vaccine d. Unvaccinated people with measles coming to the U.S.
Unvaccinated people with measles coming to the U.S.
(M18) How do you locate the upper arm area for SC injection?
~Middle point between the elbow and armpit, just above the triceps muscle
(M20) What information is included in a standing order or protocol?
1, 3, 4
(M9) The Advisory Committee of Immunization Practices recommends that routine HPV vaccination be initiated for the 9vHPV at which age group?
11-12 years of age
(M13) A child received the MMR vaccine when he was 9 months of age before moving out of the country with his parents. He is now 4 years old and about to enter Kindergarten. How many, if any, doses of MMR should the child receive now? a. 1 b. 2 c. None d. 3
2
(M20) Which of the following best describes a standing order? a. A directive from a third-party payer indicating that pharmacists can be reimbursed for administering vaccines. b. The order of steps that must be followed when administering a vaccine. c. A preapproved document signed by a collaborating physician who authorizes the pharmacist to administer a vaccine. d. An order from the state board of pharmacy allowing pharmacists to administer vaccines.
A preapproved document signed by a collaborating physician who authorizes the pharmacist to administer a vaccine/
(M3) Which vaccine technology listed below is an ingredient added typically to inactivated vaccines to boost its immune response by targeting pathogen recognition receptors that are expressed on dendritic cells to trigger a pro-inflammatory response? Though this technology creates a more robust immune response, it can also increase local site reactions and systemic reactions, such as fevers, chills, and body aches. a. Conjugation b. Adjuvants c. Attenuation d. mRNA technology
Adjuvants
(M4) The community pharmacist, while filling discharge orders from the hospital, recognizes a patient's need for receiving the pneumococcal vaccine during a transition of care to a personal care home. This is an example of what part of the patient care process? a. Follow-up, Monitor, and Evaluate b. Access c. Assess d. Implement
Assess
(M24) Which of the following best describes how to roll with resistance? a. Explain to the patient the errors in their thinking. b. Tell patients that you believe in their ability to change. c. Use open-ended questions and reflective statements. d. Change strategies to avoid arguing with patients.
Change strategies to avoid arguing with patients.
(M18) What locations are used for subcutaneous injection?
Children age 3 years and older and adults: outer aspect of upper arm (posterolateral) Infants: Fatty area of anterior lateral thigh
(M4) Star Pharmacy has been providing influenza vaccines for years and is now implementing a Hepatitis B vaccine program in their pharmacy next month. A crucial step in the Pharmacists' Patient Care Process for this vaccine is: a. Review staffing levels. b. Purchase the hepatitis B vaccine. c. Plan a large marketing event. d. Create a reminder and recall
Create a reminder and recall system
(M12) Which of the following vaccines contains a synthetic adjuvant? a. Recombivax b. Engerix c. Heplisav d. Havrix
Heplisav
(M5) Which of the following vaccines is not recommended during pregnancy? a. Tdap b. HPV c. HepB d. IIV
Human papillomavirus vaccine (HPV)
(M7) What is the difference between the immunoglobulins IgM and IgG?
IgM (produced as a first response to new infection, short-term protection, produced initially but then declines as IgG are made, low affinity) IgG (produced after IgM, long-term protection, helps to prevent re-infection, high affinity)
(M16) Post-vaccination counseling for patients should include: a. A review of all steps in the shared decision-making process b. Information about adverse reactions that require contact with the health care system c. A discussion of the risks and benefits of the vaccine d/ Warnings to self-isolate for 48 hours so that the vaccine does not spread disease to others
Information about adverse reactions that require contact with the health care system
(M1) The National Vaccine Advisory Committee 2013 Standards for Adult Immunization Practice and the 2016 International Pharmaceutical Federation global report identify pharmacists as: a) Only facilitators b) Integral to increasing vaccination rates c) Not a member of the healthcare team d) Medication dispensers
Integral to increasing vaccination rates
(M17) The cold chain for vaccines a. Begins when the provider assumes responsibility when accepting delivery of the vaccine. b. Applies to vaccines but not to diluents. c. Requires that all vaccines be kept refrigerated until they are ready to be prepared for administration. d. Must be maintained from manufacture until the vaccine is administered to the patient.
Must be maintained from manufacture until the vaccine is administered to the patient
(M11) Which of the following is true regarding varicella zoster transmission? a. Covering the lesions will prevent chance of transmission to others. b. It is not respiratory transmitted c. The incidence of varicella disease has remained unchanged since vaccinations became available. d. Period of contagiousness: 1-2 days before rash to 4-7 days later.
Period of contagiousness: 1-2 days before rash to 4-7 days later
(M12) Which of the following is the reason for the most recent hepatitis A outbreaks? a. International travelers b. Person-to-person transmission c. Imported food d. Domestic food
Person-to-person transmission
(M15) Which disease state(s) can potentially lead to meningitis? a. Polio b. Haemophilus influenzae c. Polio and Haemophilus influenzae d. Rotavirus and Polio
Polio and Haemophilus influenzae
(M15) Which vaccination is NOT part of a combined antigen vaccine? a. Polio b. DTaP c. Haemophilus influenzae d. Rotavirus
Rotavirus
(M20) Which of the following statements about standing orders and protocols is true? a. Protocols, by definition, apply to all patients within a state. b. Standing orders and protocols must consider which vaccines may be administered by pharmacists according to state laws and regulations. c. Standing orders and protocols may be needed for nonprescription products. d. A standing order is similar to a protocol but is usually broader, authorizing the administration of multiple vaccines.
Standing orders and protocols must consider which vaccines may be administered by pharmacists according to state laws and regulations.
(M18) What are the four routes for vaccines approved in the U.S.?
Subcutaneous (SC) = administered into fatty tissue below the dermis Intramuscular (IM) = administered into the muscle beneath the subcutaneous tisssue Oral = administered through drops to the mouth Intranasal = sprayed into the nostrils
(M29) Which of the following issues affecting international access to vaccines is best aligned to efforts by pharmacist volunteers? a. Unstable governments b. Poor infrastructure c. Lack of clean drinking water d. Suboptimal levels of health care providers
Suboptimal levels of health care providers
(M25) After the routine administration of a vaccine, the pharmacy technician should send documentation of the vaccination to: a. The Vaccine Adverse Event Reporting System (VAERS). b. The National Vaccine Errors Reporting Program (VERP). c. All of the patient's prescribers in the pharmacy's records. d. The patient's primary care physician.
The patient's primary care physician
(M18) Why is it important to use the proper length needle for IM injections?
To avoid subcutaneous tissue administration
(M17) Which of the following vaccines must be frozen? a. Live attenuated influenza b. Tdap c. Zostavax d. Inactivated influenza
Zostavax
(M12) The combination hepatitis A and hepatitis B vaccine (Twinrix) is administered at which of the following monthly intervals? a. 0,1 b. 0,6 c. 0,1,6 d. 0,2,12
0,1,6
(M2) Match the terms together:
1,2 2,3 3,4 4,1
(M16) Which of the following statements are true?
1,2,4
(M19) What are some other pain-relieving options?
1. Pretreatment with topical lidocaine-prilocaine emulsion 2. Vapocoolant immediately prior to injection 3. Application of cold compress after injection 4. Comfort measures in infants (swaddling)
(M11) What is the recommended timing for Tdap during pregnancy ? a. 1-12 weeks b. 13-26 weeks c. Before pregnancy d. 27-36 weeks
27-36 weeks
(M17) Refrigerated vaccines should be maintained at temperatures between: a. 33°F and +40°F b. 32°F and +40°F c. 35°F and +46°F d. 34°F and +42°F
35ºF and +46ºF
(M4) What screening question should be asked to woman of child-bearing age?
Are you pregnant or is there a chance you could become pregnant during the next month?
(M19) In a patient experiencing anaphylaxis, pharmacists should administer epinephrine: a. Intramuscularly in the deltoid b. As a first-line treatment c. Every 2 minutes until EMS arrives d. Only in conjunction with diphenhydramine
As a first-line treatment
(M28) Which of the following activities should only be performed by a pharmacist? a. Document the vaccine in the pharmacy's electronic record. b. Gather information about a patient's vaccination history. c. Decide whether a patient needs a vaccine. d. Communicate information about the vaccination to the patient's primary care provider.
Decide whether a patient needs a vaccine.
(M19) Which of the following is considered a systemic symptom of anaphylaxis? a. Headache b. Fever c. Myalgia d. Diarrhea and vomiting
Diarrhea and vomiting
(M10) How often are Tdap boosters given?
Every 10 years
(M7) Using shared clinical decision-making, which of the following recommendation is most appropriate for a 65-year old living in a skilled nursing facility with multiple co-morbid conditions? This patient has no record of receiving either pneumococcal vaccine and is immune competent. a. PPSV23 now, 1 year later PCV13 b. PPSV23 only c. PCV13 only d. Give PCV13 now, then give PPSV23 one year later.
Give PCV13 now, then give PPSV23 one year later
(M25) A potential advantage of accommodating walk-in vaccines, compared with only scheduling appointments, is that: a. It allows the pharmacy to ensure that enough vaccine is on hand. b. It helps the patient receive multi-dose series vaccines according to the recommended schedule. c. It may allow greater flexibility and convenience for the patient. d. It allows the pharmacy to ensure adequate staffing to support demand.
It may allow greater flexibility and convenience for the patient
(M2) Which of the following is an example of passive immunity? a. Maternal antibodies b. Hepatitis B vaccine c. Contracting measles d. Skin barrier
Maternal antibodies
(M15) Which COVID-19 vaccination has 2 doses administered 28 days apart? a. Janssen b. Pfizer-BioNTech (Comirnaty) c. Moderna d. Pfizer-BioNTech
Moderna
(M13) A young adult presenting with swelling of the parotid glands most likely has which of the following diseases: a. Mumps b. Measles c. Congenital Rubella d. Rubella
Mumps
(M19) Which of the following over-the-counter medications may be recommended to treat systemic reactions after vaccination? a. Loperamide and bismuth subsalicylate b. Diphenhydramine and guaifenesin c. Dextromethorphan and cetirizine NSAIDs and acetaminophen
NSAIDs and acetaminophen
(M17) What temperature should frozen vaccines be kept at?
Range: -58F to 5F (-50C to -15C)
(M15) True or false. The incubation period for COVID-19 is usually around 5 days.
True
(M6) The period a person is most contagious with influenza can be as long as 5-10 days. True or false?
True (once symptoms begin, the influenza virus can shed in respiratory secretions for 5-10 days usually peaking around 1-3 days after symptoms begin. This is the time when people are most contagious and can spread the illness, however the virus can be spread at other times too)
(M18) When administering an intramuscular injection, pharmacists should: a. Insert the needle at a 45-degree angle. b. Tell patients to flex the muscle into which the vaccine will be injected. c. Administer the vaccine in the deltoid or gluteus maximus. d. Use a 22- to 25-gauge needle.
Use a 22- to 25- gauge needle
(M21) The program which collects data regarding errors of vaccine handling and administration is called: a. VICP b. VAERS c. VIT d. VERP
VERP
(M26) Which of the following vaccines are best suited to a mass immunization clinic? a. Vaccines for high-risk patient populations b. Travel health vaccine needs c. Vaccines to address a pandemic pathogen d. Childhood vaccines
Vaccines to address a pandemic pathogen
(M15) Which of the following is true regarding 3rd dose and booster doses for COVID-19? a. Booster doses must always be from the same product as the primary series. b. The third dose and booster dose recommendations for immunocompromised patients are only for mRNA vaccines. c. Booster doses for all COVID-19 vaccinations are given 6 months after completing the primary series. d. A homologous booster dose is a subsequent dose of the vaccine that is a different product than the primary series.
The third dose and booster dose recommendations for immunocompromised patients are only for mRNA vaccines
(M3) Which of the following vaccines listed is a live attenuated vaccine? a. Recombinant zoster vaccine (RZV) b. Hepatitis B c. Varicella (VAR) d. Hepatitis A
Varicella (VAR)
(M5) If an 11 year old child never got the hepatitis B vaccine series, what is the minimum amount of time that must occur between dose 1 and dose 3 when getting this child caught up? a. 4 weeks b. 16 weeks c. 8 weeks d. 6 months
16 weeks
(M8) An adolescent received his first meningococcal conjugate quadrivalent (MenACWY) vaccine at age 13 years, when should he receive his booster dose? a. 16 years b. No booster is needed c. 14 years d. 20 years
16 years
(M5) At what ages is the live attenuated influenza vaccine (LAIV) contraindicated if the child has asthma or wheezing?
2 to 4 years
(M2) Children less than what age do not mount an adequate immune response to t-cell independent immunity? a. 5 years b. 11 years c. 2 years d. 18 years
2 years
(M11) DTaP is recommended to be administered using which of the following schedules? a. 2, 4, 6, 12-15 months, 4-6 years b. 7-10 years c. 2, 4, 12-15 months d. 11-12 years
2, 4, 6, 12-15 months, 4-6 years
(M12) The ACIP recommends the hepatitis A vaccine be administered to all children starting at which age? a. 12 months b. 11 years c. 5 years d. 6 months
12 months
(M13) Which of the following individuals are contraindicated from receiving the MMR vaccine? a. 50-year-old with a low platelet count b. 75-year-old with COPD c. 23-year-old in her 3rd trimester d. 30-year-old with asplenia(M13)
23-year-old in her 3rd trimester
(M6) Recommendations for influenza vaccination include the following...
Administer to patients 6 months of age and older, adverse reactions tend to last no longer than 1-2 days, vaccination in July/August is likely to cause suboptimal immunity later in the season **You should not give influenza vaccination only to those that have had a Guillain-Barre episode in the past 6 weeks prior to the vaccine
(M8) Which of the following is a potential long term complication from meningococcal disease? a. Stiff neck b. Photophobia c. Amputations d. Headache
Amputations
(M23) According to the Affordable Care Act, which of the following must be covered without cost-share to the patient? a. An ACIP recommended travel vaccine b. A vaccine from an Out of Network provider. c. An ACIP routinely recommended vaccine. d. A vaccine using Medicare Part D
An ACIP routinely recommended vaccine
(M19) Generalized urticaria following a vaccine is considered: a. A reactogenicity symptom b. A localized reaction c. Unrelated to vaccine administration d. An allergic reaction
An allergic reaction
(M7) For which of the following conditions are both PCV13 and PPSV23 recommended? a. Chronic liver disease b. Asplenia c. Diabetes d. Alcoholism
Asplenia
(M21) IISs have been shown to increase immunization rates and reduce vaccine-preventable diseases by: a. All states reporting into the same vaccination registry. b. Assisting in vaccination status assessment. c. Tracking vaccine adverse events. d. Requiring all vaccines for pediatric, adolescent, and adults be entered.
Assisting in vaccination status assessment.
(M12) What is youngest age that hepatitis B vaccine is recommended in infants and children? a. 4 weeks b. 6 months c. At birth d. 1 year
At birth
(M11) Which of the following are true regarding vaccine efficacy and safety for the live varicella vaccine and the recombinant zoster vaccine? a. Postherpetic neuralgia was not reduced in patients >70 years of age receiving the recombinant zoster vaccine. b. Both vaccines have over 90% effectiveness in prevention of disease after two doses. c. Systemic grade 3 reactions (preventing normal activities) were lower after dose 2 for the recombinant zoster vaccine. d. Injection site pain for both vaccines was <5%.
Both vaccines have over 90% effectiveness in prevention of disease after two doses
(M4) What screening question should be asked to patients considering tetanus-containing vaccines?
Have you had a seizure, brain, or other nervous system problem?
(M6) Which of the following are true regarding the influenza virus? a. People exposed are contagious within minutes of exposure. b. It is transmitted through respiratory droplets that contain the virus. c. Only Type B influenza has surface antigens of hemagglutinin (HA) and neuraminidase (NA). d. It cannot be transmitted from surfaces.
It is transmitted through respiratory droplets that contain the virus.
(M19) When is it appropriate to take NSAIDs and acetaminophen to treat fever and pain?
Not prior to vaccination, only after the vaccination if tolerated and appropriate
(M26) Which of the following facility features is most important for maintaining the cold chain? a. Adequate seating in the waiting area b. Proximity to public transportation c. Access to high-speed internet service d. Space for vaccine storage and temperature monitoring
Space for vaccine storage and temperature monitoring
(M7) Which organ plays an important role in eliminating encapsulated bacteria, such as streptococcus pneumoniae? a. Kidneys b. Spleen c. Liver d. Pancreas
Spleen
(M16) ACIP offers shared decision-making recommendations for which vaccine(s)? a. Hepatitis B vaccine b. 9-valent HPV c. Meningococcal B d. Meningococcal ACWY e. Measles f. DTaP g. Zoster
hepatitis B vaccine, 9-valent HPV, meningococcal B
(M28) Which of the following statements would be appropriate for a pharmacy technician to make? a. You should receive the influenza vaccine." b. "After reviewing your records, I think you should receive the hepatitis B vaccine." c. "Because you are high risk, you should receive the pneumococcal vaccine." d. "We are now offering herpes zoster vaccines in the pharmacy."
"We are now offering herpes zoster vaccines in the pharmacy"
(M18) What preparation is needed for SC vaccines?
1. Patient and provider seated 2. Expose back of patient's arm 3. Wipe area with alcohol and let the alcohol dry 4. Help the patient relax the arm
(M5) According to the CDC's Adult Immunization Schedule, at what age does an adult start?
19 years
(M23) What are the three billing codes?
CPT (Current Procedural Terminology) Codes = billing to commercial insurance third-party payers HCPCS (Healthcare Common Procedure Coding System) Codes = billing to Medicare and Medicaid ICD-10 (International Classification of Diseases) Codes = billing for specific diseases (i.e. Z23, encounter for immunization)
(M22) Which statement is true regarding gloves and handwashing? a. Employers must make available to employees appropriately sized gloves and a hand washing facility or antiseptic hand cleansers for employees to use while providing immunizations. b. It is recommended to keep gloves on for the duration of a clinic and not change them between patients. c. Pharmacists do not need to wash or use antiseptic cleansers on their hands while providing immunizations if they are wearing gloves. d. Gloves are required to be worn while administering vaccines by the CDC and OSHA.
Employers must make available to employees appropriately sized gloves and a hand washing facility or antiseptic hand cleansers for employees to use while providing immunizations
(M23) What type of code is used to identify the diagnosis for a patient receiving a vaccine? a. ACIP b. ICD-10 c. NCPDP d. CPT
ICD-10
(M24) Which of the following best describes the preparation stage of the Transtheoretical Model of Health Behavior Change? a. Patients intend to take action in the next month to change their behavior. b. Patients are aware that a problem exists and are seriously thinking about overcoming it. c. Patients have no intention to change behavior. d. Patients modify their behavior.
Patients intend to take action in the next month to change their behavior.
(M5) A 9 year-old was just diagnosed with asplenia. This child is up to date on all routinely recommended vaccines. Which additional vaccine does this child need? a. MenACWY b. PCV13 c. Hib d. MenB
MenACWY
(M7) Which of the following is a group at high risk for complications from streptococcus pneumoniae? a. young children b. men who have sex with men c. healthcare providers d. college students
young children
(M13) When counseling the parent of a 1-year-old receiving the MMR vaccine, they should be told that their child may get a measles-like rash after how long from vaccination? a. 1 week b. 48 hours c. 6 weeks d. Immediately
1 week
(M4) What screening questions should be asked to patients taking live vaccines?
1. Do you have cancer, leukemia, AIDS, or any other immune system problem? 2. Do you have a parent, brother, or sister with an immune system problem? 3. In the past 3 months, have you taken medications that affect your immune system, such as prednisone, other steroids, or anticancer drugs; drugs for the treatment of rheumatoid arthritis, Crohn's disease, or psoriasis; or have you had a radiation treatment? 4. During the past year, have you received a transfusion of blood or blood products, or have been given a medicine called immune (gamma) globulin)? 5. Have you received any vaccinations in the past 4 weeks?
(M18) What is the technique for IM injections?
1. Insert needle at 90 degrees to skin in a smooth controlled motion while bracing against the arm (if needle contacts bone, pull back slightly until needle is in the muscle and proceed with injection) 2. Depress the plunger (if using a retractable device, activate it while in the arm) 3. Withdraw the needle swiftly 4. Activate safety device immediately 5. Dispose of syringe in sharps container 6. If patient is bleeding, apply cotton or gauze 7. Apply an adhesive bandage 8. Remove gloves and wash hands
(M18) What injection technique is used for SC injections?
1. Pinch fold of skin over the tricep muscle 2. Insert needle at 45 angle to skin 3. Depress plunger 4. Wait for 3 seconds to allow vaccine to absorb (if using a retractable device, activate it while in the arm) 5. Withdraw needle swiftly 6. Activate safety device immediately 7. Dispose of syringe in sharps container 8. If patient is bleeding, apply cotton or gauze 9. Apply an adhesive bandage 10. Remove gloves and wash hands
How to fill a syringe with a vaccine?
1. Remove rubber cap from the vaccine vial 2. Perform one swift swipe of the vial top with an alcohol pad 3. Draw up the syringe with air equal to the amount of vaccine you need 4. Hold vial upside down and insert needle and inject the air 5. With the vial still upside down, withdraw the correct volume (tap the needle to remove any large air bubbles) 6. Remove syringe from the vial and either inject patient or recap
(M8) The advisory committee on immunization practices (ACIP) recommends routine vaccination with the meningococcal conjugated quadrivalent vaccine (MenACWY) which of the following age groups? a. 2-3 years of age b. 7-8 years of age c. 4-6 years of age d. 11-12 years of age
11-12 years of age
(M15) Although the primary series for Hib varies between 2-3 doses, all vaccines are recommended to have a booster dose at age: a. booster is not recommended b. 12-15 months c. 4-6 years d. 2 years
12-15 months
(M2) How long does it take for the immune system to provide protection by producing disease-specific antibodies and memory cells? a. 21 days b. 7 days c. 14 days d. 5 days
14 days
(M4) Which of the following statements best meets the definition of precaution? a. The risk of vaccinating outweighs the benefits from the vaccine and the patient cannot be vaccinated. b. A condition that may alter or diminish the patient's response or may increase the patient's risk of a serious reaction to a vaccine. c. A compelling indication for the patient to receive a vaccine. d. Condition that will likely result in a severe, life-threatening event if the patient receives the vaccine.
A condition that may alter or diminish the patient's response or may increase the patient's risk of a serious reaction to a vaccine.
(M24) Which of the following best describes the definition of vaccine hesitancy? a. Patients who express a desire to receive a vaccine, but then refuse due to fear of needles. b. A delay in the acceptance of, or refusal of, a vaccination despite availability of vaccination services. c. Refusal to receive vaccinations due to religious beliefs. d. When patients do not receive vaccinations due to misinformation.
A delay in the acceptance of, or refusal of, a vaccination despite availability of vaccination services.
(M29) Which of the following best describes a public health department? a. A department which helps prevent the start and spread of disease. b. An international organization that provides resources for pharmacists in multiple countries. c. A volunteer-led organization that aims to improve vaccination rates. d. A department within a pharmacy's corporate office that focuses on population health.
A department which helps prevent the start and spread of disease
(M15) A contraindication to receiving a COVID-19 vaccination includes: a. A known (diagnosed) allergy to a component of a COVID-19 vaccine. b. People with a contraindication to mRNA COVID-19 vaccines who request the Janssen COVID-19 vaccine. c. Receipt of COVID-19 vaccine the same day the patient receives an influenza vaccination. d. Any immediate allergic reaction to other vaccines or injectable therapies.
A known (diagnosed) allergy to a component of a COVID-19 vaccine
(M18) When preparing vaccines for administration, pharmacists should: a. Prepare all vaccines in a multi-dose vial at the same time. b. Always use aseptic technique. c. Prepare enough vaccine for the entire shift at the beginning of the day. d. Reuse needles and syringes if multiple vaccines are administered to the same patient.
Always use aseptic technique
(M6) Options to increase influenza vaccine effectiveness include: a. Avoid vaccination in July and August to minimize chances of suboptimal immunity later in the season. b. Administer in combination with pneumococcal vaccination to boost titer levels. c. Receive one influenza vaccination in the fall and one in the spring. d. Administer high dose influenza vaccination to children ages 2-8 years to ensure appropriate immune response.
Avoid vaccination in July and August to minimize chances of suboptimal immunity later in the season
(M12) Which of the following is a clinical feature of hepatitis B but not hepatitis A? a. Chronic infection b. Dark urine c. Fulminant hepatitis d. Jaundice
Chronic infection
(M2) Why is spacing and timing of vaccines important? a. Memory t-cells interfere with the immune response b. Antibodies interfere with inactive vaccines c. Antigen load may interfere with immune response d. Circulating antibodies may interfere with immune response
Circulating antibodies may interfere with immune response
(M22) Westend Pharmacy is launching an immunization program next month. The pharmacy manager, John, has a list of items that still need to be completed. Which item below is not required by OSHA to be completed before implementing the program? a. Evaluate employees with potential exposure to bloodborne pathogens for Hepatitis B vaccination status and ensure immunizers have at least one dose prior to administering vaccines. b. Implement a method for sharps disposal, including having sharps containers available at the pharmacy and a system or vendor to dispose of full containers. c. Ensure safety devices are available for vaccinators to use while administering immunizations. d. Create a network with local physicians to refer patients to the new immunization program.
Create a network with local physicians to refer patients to the new immunization program.
(M28) Which of the following is true about the pharmacy technicians' role in managing vaccine inventory? a. Expiration dates and beyond use dates should be checked at least weekly. b. If vaccines are damaged when they arrive, they should immediately be thrown away. c. Pharmacy technicians are only allowed to check temperatures to maintain the cold chain in some states. d. After vaccines arrive within the pharmacy, they should be checked with 24 hours of arrival.
Expiration dates and beyond use dates should be checked at least weekly
(M6) Counseling on vaccine safety should include: a. A history of severe allergic reaction (anaphylaxis) to a previous dose or component of influenza vaccine is no longer a contraindication. b. Fever, chills, malaise could occur within 6-12 hours post vaccination and may last up to 1-2 days. c. Injection site pain should resolve within 5-10 minutes post vaccination. d. Nasal congestion is common with the influenza vaccine administered intramuscularly.
Fever, chills, malaise could occur within 6-12 hours post vaccination and may last up to 1-2 days.
(M5) A 10 year-old child received one dose of the hepatitis A vaccine at 1 year of age, but never returned for a second dose. Which of the following is true regarding the need for a second dose of the hepatitis A vaccine for this child? a. Wait until the child is 18 years of age and give the second dose if there are other risk factors b. Give 1 dose now as catch up c. No further doses of hepatitis A vaccine are required d. Restart the series and give 2 doses, 6 months apart
Give 1 dose now as catch up
(M8) Which of the following scenarios is an appropriate shared clinical decision making for meningococcal vaccine? a. Healthy 16 year old who received meningococcal B vaccine b. 25 year old microbiologist who receives MenACWY c. 2-year old with complement deficiency who received MenACWY d. 29 year old with asplenia who receives MenB vaccine
Healthy 16 year old who received meningococcal B vaccine
(M22) Which vaccine is required by OSHA to be offered to all employees with potential exposure to bloodborne pathogens? a. Hepatitis B vaccine b. Hepatitis A vaccine c. Influenza vaccine d. Tetanus containing vaccine per current ACIP recommendations (Td or Tdap)
Hepatitis B vaccine
(M15) A patient presents to the pediatric clinic for their 5-year-old well check before entering kindergarten. They received rotavirus at 2 and 4 months and Pentacel (DTaP/IPV/Hib) at 2 and 4 and 6 and 15 months. What vaccine should they need to receive today? a. Hib b. Another dose of Pentacel c. IPV d. Rotavirus
IPV
(M26) Which of the following statements is true when operating a mass vaccination clinic? a. If multiple vaccines are available, they should be administered at different stations. b. Patients do not need to be provided with Vaccine Information Stations. c. Patients do not need to be observed after vaccination. d. The clinic does not need to be able to accommodate patients with disabilities.
If multiple vaccines are available, they should be administered at different stations
(M18) Where does one perform IM injections in the deltoid muscle? Where do they not?
Imagine the deltoid muscle as a triangle. Immunizers should administer the vaccine in the thickest most central portion of the deltoid muscle at a 90 degree angle to the skin. Do not inject too high on the arm as it can lead to SIRVA as well as not too low or off the central line as it can hit bone or vessels.
(M20) An important benefit of standing orders and protocols is that they: a. Ensure that all members of a patient's health care team are informed of vaccines. b. Improve patient access to vaccines and efficiency of services. c. Allow for pharmacists to bill as providers for Medicare Part D. d. Provide education to patients about the risks and benefits of vaccines.
Improve patient access to vaccines and efficiency of services
(M22) Which of the following is not a benefit of a reminder and recall system? a. Complies with ACIP recommendations b. Helps improve immunization rates c. Incentivizes patients to make a primary care appointment. d. Provides continuity of care
Incentivizes patients to make a primary care appointment.
(M1) Under the direction of the U.S. Department of Health and Human Services, the Healthy People initiative has identified the following as a goal for 2030: a) Achieve 95% vaccination for all vaccines on the annual published vaccine schedule b) Maintain all goals from 2020 as all goals were achieved c) Develop a single system nationwide for vaccine tracking d) Increase the proportion of persons who are vaccinated annually against seasonal influenza
Increase the proportion of persons who are vaccinated annually against seasonal influenza
(M15) Which of the following is true regarding transmission of SARS-CoV-2? a. Infected individuals who may be presymptomatic, asymptomatic, or symptomatic can transmit the virus. b. Incubation period is 14 days (range 7-14 days) c. It is only spread through respiratory droplets d. Is not transmitted through contaminated surfaces or objects
Infected individuals who may be presymptomatic, asymptomatic, or symptomatic can transmit the virus.
(M27) Which of the following is a source of free print materials that can be used to market vaccination services? a. National Academy of Medicine b. Centers for Disease Control and prevention c. International Pharmaceutical Federation d. Infectious Diseases Society of America
Infectious Diseases Society of America
(M25) Which of the following vaccines would be best delivered in a mass vaccination clinic? a. Tetanus/diphtheria/pertussis vaccine b. Influenza vaccine c. Meningitis vaccines d. Herpes zoster vaccine
Influenza vaccine
(M27) Which of the following statements is true regarding forming relationships with other immunization stakeholders? a. It is a function best left to the pharmacy's sales and marketing team b. It can be risky if other providers feel threatened by competition c. It supersedes the need to create print marketing materials d. It can enhance your marketing efforts
It can enhance your marketing efforts
(M11) Which of the following is true regarding the recombinant herpes zoster vaccination? a.It cannot be given to someone who has had the varicella vaccine. b. It should not be given to someone who previously received the zoster vaccine live. c. It is approved as a treatment of herpes zoster if administered within 48 hours of onset of symptoms. d. It is indicated for prevention of herpes zoster and its complications in patients ≥50 years of age.
It is indicated for prevention of herpes zoster and its complications in patients ≥50 years of age
(M9) A 16-year old patient presents to the pharmacy for her first dose of 9vHPV. The patient is instructed to wait in the pharmacy for 15 minutes after receiving the dose. Three minutes after receiving the dose, the patient experiences syncope. What is the recommended response to treat the patient's syncope? a. Call the patient's emergency contact to take her to the emergency department. b. Call 9-1-1 and wait for emergency services to address the situation. c. Lay the patient flat on the ground and elevate her legs. Monitor the patient's vitals and initiate emergency services if the patient does not regain consciousness. d. Stand the patient up into a vertical position.
Lay the patient flat on the ground and elevate her legs. Monitor the patient's vitals and initiate emergency services if the patient does not regain consciousness
(M3) When administering measles, mumps, rubella (MMR) and pneumococcal conjugate vaccine (PCV13) to a patient at their 15-month appointment, what must be considered regarding vaccine spacing? a. MMR and PCV13 may be administered simultaneously or at any interval between doses. b. Vaccines should never be administered simultaneously. As such these vaccines should be separated by a 7-day minimum interval. c. MMR and PCV13 may be administered simultaneously or must be separated by a 28-day minimum interval. d. MMR and PCV13 should not be administered simultaneously. They must be separated by a 28-day minimum interval.
MMR and PCV13 may be administered simultaneously or at any interval between doses.
(M20) A standing order or protocol should include information about: a. A statement of indemnification for liability. b. Managing medical emergencies that may occur after administration of a vaccine. c. The pharmacy workflow and staffing needed to support the vaccination service. d. Details regarding any liability that the signing practitioner assumes as a result of the standing order or protocol.
Managing medical emergencies that may occur after administration of a vaccine
(M5) Which of the following is TRUE of the emergency use authorization process? a. Risks are not evaluated until long-term safety data is available b. Manufacturers must include a plan for safety monitoring c. Used when approved or licensed alternatives are too expensive d. Clinical trial data are not required
Manufacturers must include a plan for safety monitoring
(M3) What of the following is classified as a live vaccine? a) IIV4 b) Human papillomavirus vaccine (9vHPV) c) Recombinant zoster vaccine (RZV) d) Measles, mumps, rubella (MMR) e) DTap f) TdaP
Measles, mumps, rubella (MMR)
(M5) Which of the following vaccines is contraindicated for an adult patient with HIV and a CD4 count <200 mm2? a. RZV b. HPV c. MMR d. IIV
Measles, mumps, rubella (MMR)
(M29) Which of the following is a government-run volunteer organization for medical and public health professionals? a. Immunization Action Coalition b. Medical Reserve Corps c. Peace Corps d. National Guard
Medical Reserve Corps
(M23) Which of the following requires no cost-share for the patient and is mainly for those 65 years and older? a. Medicare Part D b. Medicare Part B c. Medicaid d. Medicare Part C
Medicare Part B
(M1) Opportunities for Advocacy and Collaboration include: a) There is no need for advocacy since the vaccine schedules dictate what people need to receive b) Discussion with other health care professionals on ways to set prices for vaccines to increase revenue c) Membership in state Immunization coalition to serve as an expert on policy and practice issues affecting pharmacy d) Replace services offered by the local health department so they don't have to offer immunizations
Membership in state immunization coalition to serve as an expert on policy and practice issues affecting pharmacy
(M27) Which of the following awareness campaigns is typically conducted in December? a. American Pharmacists Month b. National Influenza Vaccination Week c. National Immunization Awareness Month d. World Pneumonia Day
National Influenza Vaccination Week
(M23) Which of the following is the correct answer and reason for a 64-year old patient who asks you if it is better to get their shingles vaccine now or wait til it is covered by Medicare at 65 years? a. Now because it must be covered at no cost by commercial insurance. b. Now because it is not covered at 65 years or above. c. Wait till 65 years when it is covered by Medicare part B. d. Wait till 65 years as it is not indicated before 65 years.
Now, because it must be covered at no cost be commercial insurance
(M15) Which of the following is true regarding risk for COVID-19? a. There has not been an association between number of comorbid conditions and increase in death. b. In the workforce, only healthcare professionals are flagged as at high risk for exposure. c. Coronary atherosclerosis and other heart disease patients have the highest risk of death. d. Older adults and people with underlying medical conditions are some of the patients at highest risk for severe disease and complications.
Older adults and people with underlying medical conditions are some of the patients at highest risk for severe disease and complications
(M26) Which of the following functions should be performed prior to the mass vaccination clinic? a. Ordering of adequate inventory of vaccines and supplies b. Communication of wait-times c. Documentation of any adverse events and submission to the Vaccine Adverse Event Reporting System (VAERS) d. Continuous quality improvement activities
Ordering of adequate inventory of vaccines and supplies
(M27) Which of the following best describes immunization coalitions? a. Nongovernmental public health organizations b. Patient advocacy organizations c. Organizations that bring together vaccination stakeholders to improve vaccination rates d. Professional membership associations for health care providers who immunize
Organizations that bring together vaccination stakeholders to improve vaccination rates
(M7) A 3-yearmold child recently underwent a splenectomy. Previous to the surgery, the child was up to date on all pediatric vaccinations. According to the CDC, which of the following vaccines should be recommended? a. PCV15 b. PCV20 c. PPSV23 d. PCV13
PPSV23
(M7) Which of the following is true for the 23-valent pneumococcal polysaccharide vaccine (PPSV23)? a. PPSV23 is routinely recommended for all children b. PPSV23 should not be given to children less than 2 years of age c. PPSV23 relies on T-cell to mount an immune response d. PPSV23 is a live vaccine
PPSV23 should not be given to children less than 2 years of age
(M4) A male patient presents to the pharmacy for a shingles vaccine appointment. The patient is a new patient to the pharmacy. Which of the following information would be most appropriate to collect as part of the patient care process? a. Patient's age and vaccine history b. Patient's age, eye color, and allergies c. Patient's age, current health, vaccine history, and allergies d. Current health and allergies
Patient's age, current health, vaccine history, and allergies
(M21) Which of the following is true regarding professional liability? a. Only anaphylaxis needs to be reported to VAERS. b. Pharmacists should educate and inform patients and their caregivers about the benefits and risks of vaccination. c. Patients who accept awards from the VICP fund can still file malpractice claims. d. It is not necessary for a pharmacist to have individual insurance since their place of work would cover them.
Pharmacists should educate and inform patients and their caregivers about the benefits and risks of vaccination.
(M28) Which of the following statements is true regarding how pharmacy technicians can gather information about a patient's vaccination history? a. Pharmacy technicians can access Immunization Information Systems in all states. b. Pharmacy technicians can review information from immunization coalitions. c. Pharmacy technicians should not be involved in gathering information about a patient's vaccination history. d. Pharmacy technicians can review electronic health records.
Pharmacy technicians can review electronic health records
(M18) When administering a subcutaneous injection, pharmacists should a. Tell the patient to flex the muscle under the injection site. b. Pinch a fold of skin over the triceps muscle c. Insert the needle at a 90-degree angle. d. Use a 1 to 1-1/2 inch needle.
Pinch a fold of skin over the triceps muscle
(M7) Why are polysaccharide vaccines not given to children less than 2?
Polysaccharide vaccines induce poor responses in infants. Polysaccharide vaccines do not activate T-cells and only activate B-cells. Activating B-cells alone will not create enough of an immune response in infants, so these vaccines are not given to infants as there will be no booster effect.
(M2) A pharmacist refuses to get the hepatitis B vaccine. After giving a vaccination to a patient, he pokes himself with the needle. He finds out that his patient has hepatitis B. What should he do to reduce the risk of getting hepatitis B?
Post-exposure prophylaxis is needed right away. Then give both hepatitis B immune globulin and the hepatitis B vaccine. HBIG has antibodies that provide immediate protection via passive immunity while the vaccine, once fully vaccinated, will provide long-term protection.
(M11) Which of the following complications are correctly matched to the associated condition? a. Pneumonia-herpes zoster b. Postherpetic neuralgia-herpes zoster c. Ramsey hunt syndrome-varicella zoster d. Zoster ophthalmicus-varicella zoster
Postherpetic neuralgia-herpes zoster
(M15) Documentation requirements for COVID-19 vaccinations include: a. Report administration data to your jurisdiction's system (e.g., IIS) within 72 hours after administration. b. Only cases of COVID-19 that result in hospitalization or death after the recipient has received COVID-19 vaccine should be reported to VAERS. c. COVID-19 vaccination record cards can be redesigned by the pharmacy. d. Emergency Use Authorization (EUA) Fact Sheets should be provided after the patient receives the vaccine.
Report administration data to your jurisdiction's system (e.g. IIS) within 72 hours after administration
(M7) How is streptococcus pneumoniae primarily transmitted? a. Fecal-oral route b. Direct contact with an open wound c. Respiratory droplets or secretions d. Spores in the environment
Respiratory droplets or secretions
(M16) The first step in AHRQ's "SHARE" approach to vaccines is to: a. Assess your patient's values and preferences. b. Ask if your patient is ready to make a decision about getting the vaccine. c. Seek your patient's participation in a discussion. d. Ask if your patient has any questions about the vaccine.
Seek your patient's participation in a discussion
(M28) Preparing a vaccine for administration may include which of the following tasks? a. Disposing of the needle in a sharps container. b. Sterilizing the area for preparing the vaccine. c. Selecting the needle for administering the vaccine. d. Ensuring the vaccine is at room temperature before it is administered.
Selecting the needle for administering the vaccine
(M16) If patients believe that influenza vaccines can cause influenza because they were ill after receiving the vaccine last year, pharmacists should educate them that: a. Only immunocompromised individuals can become ill from inactivated vaccines. b. Influenza vaccine can cause mild influenza infections in some people. c. Some people experience systemic reactions to influenza vaccine that include mild flu-like symptoms d. It takes 3-4 weeks for the immune system to respond to the vaccine, so it is possible to become ill within that window.
Some people experience systemic reactions to influenza vaccine that include mild flu-like symptoms
(M16) Vaccine hesitancy is defined as: a. The perception that the risk of a disease is low and that vaccines are not necessary. b. A lack of trust in the safety and effectiveness of vaccines. c. Lack of confidence in the reliability and competence of the health system. d. The delay in acceptance or refusal of a vaccination despite the availability of vaccination services.
The delay in acceptance or refusal of a vaccination despite the availability of vaccination services
(M11) Which of the following correctly describes current ACIP recommendations? a. The herpes zoster vaccine should be given to patients ≥40 years. b. The varicella zoster vaccine should be given at birth. c. Patients ≥ 13 years without prior evidence of immunity should only receive one dose of varicella zoster vaccine. d. The varicella zoster vaccine should be given at 12-15 months and 4-6 years of age.
The varicella zoster vaccine should be given at 12-15 months and 4-6 years of age
(M7) What is the difference between T-cell independent and T-cell dependent antigen B-cell activation?
These are two types of humoral immunity. T-cell independent antigens activate B-cells without the help of T-cells. This leads to the direct stimulation of short-lived plasma cells (B cells) and the production of IgMs antibodies. The immune response is limited and limited with time. This is seen in polysaccharide vaccines (PPSV23). T-cell dependent antigens activate B-cells with the help of T-cells. The antigen first interacts with the T-cells that then activate both long-lived plasma and memory B-cells, which lead to the production of IgGs antibodies. This leads to an increased immune response that lasts with time. This is seen in conjugated vaccines (PCV13).
(M29) Which of the following is a law or program that may grant immunity from civil liability during emergencies for covered activities? a. NABP emergency passport b. Medical Reserve Corps c. U.S. Public Readiness and Emergency Preparedness Act d. Immunization Action Coalition
U.S. Public Readiness and Emergency Preparedness Act
(M17) When storing vaccines in the refrigerator, pharmacists should: a. Keep vaccines and food on separate shelves. b. Store vaccines on the bottom of the refrigerator. c. Use water bottles to help stabilize temperatures. d. Use dorm-style units.
Use water bottles to help stabilize temperatures
(M21) Which of the following is an example of a common vaccine administration error? a. Providing a vaccination while the patient is standing. b. Receiving a second dose of a vaccine in the opposite arm that the first dose was received in. c. Wrong vaccine, route, site, or dosage; or improperly prepared. d. Administering a vaccine 3 days after it was due.
Wrong vaccine, route, site, or dosage; or improperly prepared.
(M13) During a public health declared mumps outbreak, a 21-year old college student with a history of 2 MMR vaccine doses as a child wants to know if she needs a dose of MMR now. Which of the following is the best response? a. Yes, since there is a declared mumps outbreak. b. Yes, since all college students should have 3 doses of MMR. c. No, as a third dose of MMR is only for measles outbreaks. d. No, as a third dose of MMR is only for rubella outbreaks.
Yes, since there is a declared mumps outbreak
(M14) Which of the following are complications that result form diarrhea caused by rotavirus? a. electrolyte imbalance b. brain damage c. dehydration d. paralysis
electrolyte imbalance, dehydration
(M3) Which of the following is true regarding the use of mRNA in vaccine technology? a. mRNA vaccine technology elicits its immune response and protects the host by altering the host's DNA. b. mRNA is extremely stable in a host's body. c. mRNA is the genetic blueprint that tells your body how to make a particular protein subunit of a virus which, after being produced, will elicit an immune response. d. mRNA vaccine technology requires replication similar to a live attenuated vaccine.
mRNA is the genetic blueprint that tells your body how to make a particular protein subunit of a virus which, after being produced, will elicit an immune response.
(M8) Which of the following are examples of invasive meningococcal disease? a. urethritis b. pneumonia c. meningitis d. septicemia e. conjunctivitis
pneumonia, meningitis, septicemia
(M18) To prevent errors of vaccine administration, pharmacists should: a. Use the same diluent for all vaccines prepared in one sitting. b. Memorize vaccine schedules. c. Select the appropriate needle length. d. Prepare enough vaccine for the entire shift at the beginning of the day.
select the appropriate needle length