NU141- Chapter 18 Vaccines and Sera
Which response best demonstrates a nurse's understanding of the risk immunizations pose concerning the development of resulting illness?
"Immunizing agents are quite safe, and risks of the diseases they prevent are greater than the risks of the vaccines."
The parents of a two month-old infant have brought their child in to the clinic for the first scheduled immunizations. The parents appear anxious and the child's father says, "We keep hearing about the link between vaccinations and autism. Is there a risk that it could happen to our child?"
"There's been shown to be no genuine link between children receiving vaccinations and developing autism."
A primiparous woman tells the nurse that she and her partner are highly reluctant to have their infant vaccinated, stating, "We've read that vaccines can potentially cause a lot of harm, so we're not sure we want to take that risk." How should the nurse respond to this family's concerns?
"Vaccinations are not without some risks, but these are far exceeded by the potential benefits."
The nurse is working with the parents of an infant and has initiated a dialogue about immunizations. The infant's parent states, "We're not comfortable with immunizations because of the safety issue." What is the nurse's best response?
"What are some of the safety risks that most concern you?"
The nurse is preparing to administer a dose of the human papillomavirus vaccine to a middle school student. What assessment question should the nurse prioritize when interacting with the student?
"What's your understanding of why you're getting this vaccination?"
A mother brings her 18-month-old into the clinic for a well-baby check-up. A nurse will administer measles, mumps, and rubella vaccine (MMR) to the 18-month-old. What dosage will the nurse administer?
0.5 mL IM
The nurse at an ambulatory clinic has seen several clients with suspected or confirmed infectious diseases in recent days. Which client is most likely to benefit from the administration of an immune serum.
A client who is known to have contracted hepatitis B from sexual activity
Which statements best indicates the client understands recommended vaccines following the 65th birthday?
A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age
A client has been exposed to hepatitis A after eating at a restaurant. The client's care provider has prescribed a dose of hepatitis A immune globulin. the nurse learns that the client has a history of chronic renal failure and successfully received a donor kidney three years ago. What is the nurse's best action?
Administer the immune globulin as prescribed
A client has presented to the emergency department with a puncture wound suffered a few hours ago while demolishing an old house. The nurse's assessment reveals that the client is not in acute distress. The client's immunization status is unknown. What intervention should the nurse prioritize?
Administering tetanus immune globulin as prescribed
Which is an example of artificially acquired active immunity? (Select all that apply.)
Administration of the varicella vaccine to an individual who has no immunity to the disease. Administration of the influenza vaccine to an individual who has no immunity to the disease. Administration of the rubella vaccine to an individual who has no immunity to the disease.
Which is an example of naturally acquired active immunity? (Select all that apply.)
An individual who is exposed to chickenpox for the first time and has no immunity to the disease. An individual who is exposed to pertussis for the first time and has no immunity to the disease.
A client was bitten by a poisonous snake. Which treatment would be most appropriate to administer?
Antivenin
The administration of immunizations to a client is a form of what type of immunity?
Artificial active immunity
An adult client being treated for breast cancer inquired about required vaccinations. What information should the nurse provide to this client?
Avoid all live vaccines.
The nurse is preparing to administer a client's prescribed dose of immune sera. How should the nurse describe this treatment to the client?
Bacterial antibodies in serum
Antivenins are used for passive, transient protection from which bites? (Select all that apply.)
Black widow Rattlesnake Copperhead
It is important for the nurse to stay current with the recommendations for immunizations. Which source is most accurate regarding immunization guidelines?
Centers for Disease Control and Prevention
The nurse educator is teaching a class of community leaders about immunologic agents. To minimize the concern regarding adverse effects of vaccinations, the nurse should include which mild reactions in the teaching plan?
Chills and fever
A group of students are role-playing scenarios involving biological weapon exposure. Which medication would the students identify as using for a client with cutaneous anthrax?
Ciprofloxacin
A client who was bitten by a pit viper is to receive antivenin. What is the nurse's best action?
Establish IV access
Administration of the tetanus toxoid in adults involves two initial injections given four weeks apart, a booster injection given six months to a year later, and periodic injections thereafter. What is the recommended interval for the periodic injections for a 66 year old client ?
Every 10 years
The perinatal nurse recognizes that what vaccine can be safely given to a neonate?
Hepatitis B
An elderly client has been given a tetanus-diphtheria (Td) booster after stepping on a rusty nail. Which statements indicate an understanding of vaccine schedules?
I know that this booster is good for 10 years.
A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive?
Immune globulin
A group of nursing students are presenting information on the hepatitis B vaccine. What would the students prepare to tell others about the recommended population?
Infants and people at high risk for contracting the disease
When providing client teaching to parents regarding measles, mumps, and rubella vaccine administration, which is most important regarding the schedule for administration?
It is administered at 12 to 15 months.
A young mother asks the clinic nurse about the "chickenpox" vaccine. The mother states that she and her husband have both had chickenpox, but that she wants to protect her child if she can. What should the nurse tell the mother about the recommendation for the chickenpox vaccine?
It is recommended for all children who have not been exposed to the varicella virus.
An infant is being administered an immunization. Which statement provides an accurate description of an immunization?
It is the administration of an antigen for an antibody response.
A nursing instructor is discussing the intended populations for various vaccines. Which groups might the instructor mention when discussing the hepatitis B vaccine?
Paramedics and emergency medical technicians
The nursing instructor is discussing immunity with the clinical group. What statement would the instructor make that would be an accurate statement concerning immunity?
Passive immunity is limited.
For what group of adults is pre-exposure immunization against hepatitis B recommended?
People who receive hemodialysis
What is a contraindication to an MMR booster for an adolescent female?
Pregnancy
A forest ranger arrives at a community clinic for prophylactic vaccination. Which vaccine would be most important to be administered to the ranger?
Rabies vaccine
The school nurse is participating in a program to immunize students against human papillomavirus (HPV). What benefit should the nurse describe to students and their families?
Reduced risk for cervical cancer
A nurse is participating in an influenza vaccination clinic on a college campus. What action will best prepare the nurse for this role?
Review the procedure for intramuscular injection
A patient develops fever and arthralgia 4 days after the administration of tetanus toxoid. What reaction to the vaccine is this?
Serum sickness
A group of students are reviewing information about immunizations. The students demonstrate a need for additional study when they identify what as a component of an immunization?
Serum with bacterial antibodies
A 65-year-old male client lives in a long-term care facility. The infection control nurse identifies a cluster of clients on the unit diagnosed with shingles. What would the nurse expect the client's prescriber to order?
Shingles vaccine
A 65-year-old client is being seen in the emergency department for exposure to rabies. The nurse checks the electronic health record and discovers the client has had no history of allergic reactions to immunization agents. The client's history guides the nurse to take which action?
Teach the client that the agent of choice is rabies immune globulin
A clinic nurse is administering vaccines at well-baby check-ups. The nurse knows that before administering a DTP vaccine, the nurse should check what vital sign?
Temperature
What would the nurse identify as a vaccine that is a toxoid?
Tetanus
A client is 50 years old. The client asks what, if any, vaccines the client should get. The nurse's best response is:
Tetanus-diphtheria-pertussis; hepatitis B vaccine once; influenza vaccine annually.
A client has come to the clinic requesting a hepatitis A and B vaccination before leaving on a tropical vacation. After assessing the client, the nurse should prioritize what finding to communicate to the provider?
The client takes corticosteroids to treat rheumatoid arthritis
A nurse is teaching a group of clients about immunizations . What benefit of immunization should the nurse describe?
They provide the person with active immunity.
After teaching a group of students about the standard childhood immunizations given today, the instructor determines that the students need additional teaching when they identify which as a common disease for which immunizations are given?
Tuberculosis
To prevent meningococcal infections, the nurse would administer:
Vaccine
When describing the use of vaccines to a local community group, what would the nurse include?
Vaccines are used to provide active immunity.
Which statement best describes the recommended vaccination schedule for a 63-year-old client?
a tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age
After teaching a parent about common adverse effects associated with routine immunizations, which of the following, if stated by the parent, would indicate the need for additional teaching? a. Difficulty breathing and fainting b. Fever and rash c. Drowsiness and fretfulness d. Swelling and nodule formation at the site of injection
a. Difficulty breathing and fainting
A patient is to receive immune globulin after exposure to hepatitis A. The patient has a previous history of allergies to various drugs. Before giving the immune globulin, the nurse should a. have emergency equipment readily available. b. premedicate the patient with aspirin. c. make sure all of the patient's vaccinations are up to date. d. make sure the patient has a ride home.
a. Have emergency equipment readily available
A public education campaign to stress the importance of childhood immunizations should include which points? a. Prevention of potentially devastating diseases outweighs the discomfort and risks of immunization. b. Routine immunization is standard practice in the United States. c. The practice of routine immunizations has virtually wiped out many previously deadly or debilitating diseases. d. The risk of severe adverse reactions is on the rise and is not being addressed. e. If there is a family history of autism, that person should avoid immunizations. f. The temporary discomfort associated with the immunization can be treated with over-the-counter drugs.
a. Prevention of potentially devastating diseases outweighs the discomfort and risks of immunization b. Routine immunization is standard practice in the United States c. The practice of routine immunizations has virtually wiped out many previously deadly or debilitating diseases f. The temporary discomfort associated with the immunization can be treated with over-the-counter drugs.
A female health care worker has received her annual influenza vaccination and has remained at the clinic after administration so that the nurse may observe for adverse reactions. The worker reports pain at the site of IM injection. What should the nurse recommend?
acetaminophen
A client receives an immunization. The nurse interprets this as providing the client with which type of immunity?
artificially acquired active immunity
When preparing a presentation for a local parent group about vaccines, the nurse would describe vaccines as being used to stimulate a. passive immunity to a foreign protein. b. active immunity to a foreign protein. c. serum sickness. d. a mild disease in healthy people.
b. Active immunity to a foreign protein.
A nurse suffers a needlestick after injecting a patient with suspected hepatitis B. The nurse should a. have repeated titers to determine whether she was exposed to hepatitis B and if she was have hepatitis immune globulin. b. immediately receive hepatitis immune globulin and begin hepatitis B vaccines if she has not already received them. c. start antibiotic therapy immediately. d. go on sick leave until all screening tests are negative.
b. Immediately receive hepatitis immune globulin and begin hepatitis
It is now recommended that all people over the age of 6 months should receive a flu vaccine every fall based on the understanding that the vaccine is repeated because a. the immunity wears off after a year. b. the strains of virus predicted to cause the flu change every year. c. a booster shot will activate the immune system. d. flu shots do not produce good antibodies.
b. The strains of virus predicted to cause the flu change every year
When assessing the medical record of an older adult to evaluate the status of his immunizations, the nurse would be looking for evidence of which immunizations? a. Yearly pneumococcal vaccination b. Yearly flu vaccination c. Tetanus booster every 10 years d. Tetanus booster every 5 years e. Measles, mumps, rubella vaccine if the patient was born after 1957 f. Varicella vaccine only if there is evidence that the patient had chickenpox as a child
b. Yearly flu vaccination c. Tetanus booster every 10 years
A mother brings her child to his 18-month well-baby visit. The nurse would not give the child his routine immunizations in which situations? a. He cried at his last immunization. b. He developed a fever or rash after his last immunization. c. He currently has a fever and symptoms of a cold. d. He is allergic to aspirin. e. He is currently taking oral corticosteroids. f. His siblings are all currently being treated for a viral infection.
c. He currently has a fever and symptoms of a cold e. He is currently taking oral corticosteroids f. His siblings are all currently being treated for a viral infection
The nurse is preparing to administer a vaccine to a newborn. Before administering the vaccine, the nurse should:
check the infant's temperature.
A client is scheduled to receive an immunization. In which client may the administration of a live vaccine be contraindicated?
client taking steroid therapy
Which vaccine would the nurse be least likely to recommend for a 6-month-old child? a. Diphtheria, tetanus, pertussis vaccine b. Haemophilus influenzae b vaccine c. Poliovirus vaccine d. Chickenpox vaccine
d. Chickenpox vaccine
The nurse reviews a patient's record to make sure that tetanus booster shots have been given a. only with exposure to anaerobic bacteria. b. every 2 years. c. every 5 years. d. every 10 years.
d. Every 10 years.
A nurse is administering a mumps vaccine to an adolescent. Which medication should be available when administering an immunization?
epinephrine
Antitoxins
immune sera that contain antibodies to specific toxins produced by invaders; may prevent the toxin from adhering to body tissues and causing disease
Antivenins
immune sera that contain antibodies to specific venins produced by poisonous snakes or spiders; may prevent the venom from causing cell death
Vaccine
immunization containing weakened or altered protein antigens to stimulate a specific antibody formation against a specific disease; refers to a product used to stimulate active immunity
Immune sera
preformed antibodies found in immune globulin from animals or humans who have had a specific disease and developed antibodies to it
Serum sickness
reaction of a host to injected antibodies or foreign sera; host cells make antibodies to the foreign proteins, and a massive immune reaction can occur
A client has received a rubella immunization. The client was unaware that she was pregnant. What risk is associated with the administration of the rubella immunization in this client?
risk of birth defects
An infant is seen in the clinic for first immunizations. When providing client teaching to the parent, which is no longer recommended for administration?
smallpox vaccine
Active immunity
the formation of antibodies secondary to exposure to a specific antigen; leads to the formation of plasma cells, antibodies, and memory cells to immediately produce antibodies if exposed to that antigen in the future; imparts lifelong immunity
Passive immunity
the injection of preformed antibodies into a host at high risk for exposure to a specific disease; immunity is limited by the amount of circulating antibody
Immunization
the process of stimulating active immunity by exposing the body to weakened or less toxic proteins associated with specific disease-causing organisms; the goal is to stimulate immunity without causing the full course of a disease
Biological
vaccines, immune sera, and antitoxins that are used to stimulate the production of antibodies, to provide preformed antibodies to facilitate an immune reaction, or to react specifically with the toxins produced by an invading pathogen
A 70-year-old client is seen in the family practice clinic. Which vaccine should be administered to prevent herpes zoster?
zoster vaccine
