Immunization Final

Which of the following is the most appropriate injection site for administering Td to an adult patient?

Deltoid muscle

Which age group is appropriate to receive the 2-dose HPV9 vaccine series?

9 through 14 years.

Which of the following live vaccines is recommended to be administered prior to one year of age?

Rotavirus

Which of the following is the recommended dose of 1:1000 epinephrine for managing anaphylaxis?

0.01 ml per kg body weight, up to a maximum of 0.5 mg per dose.

Which of the following is the routine schedule for vaccinating adolescents with MCV4?

One dose at age 11 to 12 years, followed by a booster dose at age 16 years.

When preparing to offer a vaccination service, which document should be up-to-date and readily available anytime vaccines are given?

Exposure control plan.

A patient who reports an allergy to eggs but is able to eat lightly cooked eggs (e.g., scrambled eggs) without a reaction could receive which of the following influenza vaccines?

Any influenza vaccine.

With which entity should pharmacists collaborate to develop a standing order for vaccine administration?

Physicians.

Vaccines should be avoided or delayed for which of the following patients?

A patient ill enough for referral to a physician or hospital.

Which of the following statements is true about risks associated with vaccines and vaccine-preventable diseases?

International travelers import many cases of vaccine-preventable diseases into the United States each year.

Which of the following best describes IIV intradermal administration?

Place the syringe perpendicular to the skin over the deltoid muscle.

Which of these vaccines is an inactivated vaccine?

DTaP.

Larry is a 65-year-old man with heart disease who comes to the pharmacy to refill a prescription on October 21. His immunization record indicates that he has completed the primary series of DTaP, MMR, hepatitis B, and hepatitis A. His last Td booster dose was 12 years ago. In addition to influenza, which of the following vaccines should Larry receive?

PCV13 followed by PPSV23 12 months later, Tdap, and herpes zoster.

Which of the following best describes immunization coalitions?

Organizations that foster collaboration among stakeholders to increase immunization rates.

Missy is a 36-year-old woman with diabetes mellitus. She requests a refill of her insulin on November 1. She has completed the primary series of MMR, DTaP, and hepatitis A vaccines, and she received a dose of Tdap 2 years ago. She had a physician-confirmed case of chickenpox as a child. Missy is not pregnant. Which of the following vaccines should Missy receive?

PPSV23, Hepatitis B, and influenza.

Which of the following influenza vaccines would be appropriate to recommend for a 7-month-old girl?

Fluzone.

Lily is a 15-month-old girl who is up to date with her vaccinations. Which of the following tetanus toxoid-containing vaccines would be appropriate for Lily?

DTaP.

The majority of cases of vasovagal syncope occur within which of the following time frames following vaccination?

15 minutes.

Which of the following statements best describes the approach to take with patients regarding simultaneous administration of vaccines?

In immunocompetent people of any age, the immune system is fully capable of eliciting an appropriate immune response to multiple antigens administered on the same day through vaccination. In fact, a person’s immune system is exposed to more antigens every day from food or bacteria in the mouth and nose than from some vaccines. Delaying vaccination and using alternative schedules increases the time during which children are susceptible to diseases. With more unprotected children, the chance of an outbreak spreading increases.

Which of the following is the correct dose and route of administration for the high-dose influenza vaccine?

0.5 mL intramuscularly.

Five minutes after receiving a vaccine, a patient tells you that his face "feels funny" and he is starting to feel itchy all over. You notice that his lips are swollen. Which of the following would be the most appropriate action to take?

Tell a staff member to call 911 and administer a dose of epinephrine.

Which of the following vaccines should be administered subcutaneously?

MMR.

Which of the following is the recommended schedule for administration of the hepatitis A vaccine?

Two doses at least 6 months apart.

Which of these vaccines must replicate to stimulate an immune response?

MMR.

Liz, a 37-year-old woman, was diagnosed with HIV 2 months ago. She received one dose of MCV4 at that time and is now getting her 2nd dose. Which of the following would be an appropriate recommendation for MCV4 vaccination for Liz?

According to ACIP, adults with human immunodeficiency virus (HIV) infection who have not been previously vaccinated should receive a 2-dose primary series of MenACWY (MCV4) at least 2 months apart. Following the 2nd dose, they should be revaccinated every 5 years. Children who completed the primary series at ages 2 months through 6 years and remain at high risk for meningococcal disease should receive another dose after 3 years. Booster doses are given every 5 years after that.

Which of the following patients would be a candidate now for revaccination with PPSV23?

A 66-year-old woman who received the first dose of PPSV23 at 60 years of age.

Which of the following statements best describes appropriate administration of pneumococcal vaccines for adults 19 to 64 years of age who are immunocompromised?

Whenever both PCV13 and PPSV23 are recommended, PCV13 should ideally be given first. The body produces a better immune response to the vaccines when given in this order. For those with immunocompromising conditions at high-risk for pneumococcal disease, the interval between PCV13 and PPSV23 is at least 8 weeks. This 8-week interval also applies to those with asplenia, cochlear implants, and cerebrospinal fluid leaks. All others would wait at least one year between the two vaccines.

Which of the following is the youngest age at which a child should receive inactivated influenza vaccine?

6 months.

Which influenza vaccine is approved to be used with the jet injector needle-free system?

Afluria

A 63-year old woman arrives at your pharmacy for her herpes zoster vaccine. Which of the following is the appropriate dose and route of administration?

0.65 mL subcutaneously.

Albert is a 61-year-old man who wants to receive the herpes zoster vaccine. He is up to date on his other immunizations and reports receiving his inactivated influenza vaccine two weeks ago. Which of the following would be the best recommendation to make regarding the herpes zoster vaccine for Albert?

He can receive the herpes zoster vaccine today.

Among all states in the United States, which of the following is the youngest minimum patient age for vaccination by a pharmacist allowed by a state?

Newborn.

Which of the following is a requirement of the Occupational Safety and Health Administration (OSHA) bloodborne pathogens standard?

Use of universal precautions.

Which of the following would be an appropriate needle size and length for administering varicella vaccine to an adult woman who weighs 175 lbs?

25 gauge; 5/8 inch.

Which of the following vaccines should be administered to boys and young men aged 9 through 26 years to reduce their likelihood of acquiring genital warts?

HPV9.

Which of the following statements best describes recommendations for vaccine administration during pregnancy?

There are two vaccines recommended during pregnancy. Tdap should be given with each pregnancy in the beginning of the third trimester (27 to 36 weeks gestation). Influenza vaccine is recommended if the woman is pregnant during flu season. It can be given in any trimester. Live vaccines are a temporary contraindication during pregnancy. They should be administered after the woman gives birth. There is no risk to a pregnant woman who is in close contact with someone who received a live vaccine. There is also no risk if pregnant providers administer live vaccines.

Which of the following patients would be an appropriate candidate for the HPV vaccine?

A 12-year-old boy.

Which of the following should be one of the first steps involved in establishing a pharmacy-based immunization program?

Identify state laws and regulations that determine what activities are allowed in the state(s) in which you practice.

Angie is a 16-year-old high school student with no chronic medical conditions. She completed the primary series of DTaP, IPV, PCV, Hib, and MMR. She received the complete series of hepatitis A and hepatitis B vaccines before entering high school. Which of the following would be the most appropriate recommendation for Angie today?

Tdap, HPV, MCV, varicella, and influenza (if during influenza season).

Which of the following best describes how to administer hepatitis B vaccine to an adult man who weighs 225 lbs?

Intramuscularly at a 90-degree angle in the deltoid muscle.

Which of the following tetanus toxoid-containing vaccines would be most appropriate to recommend for Linda, a 67-year-old woman and grandmother of six with no record of receiving Tdap?

Tdap.

Within a few minutes after receiving a vaccine, a patient reports not feeling well and would like a drink of water. Which of the following would be the most appropriate action to take?

Ask the patient to sit down and begin to monitor the patient’s vital signs.

Which of the following patients would be a ACIP recommended candidate for PPSV23?

A 21-year-old man who smokes cigarettes.

Which of the following is a symptom of a true allergic reaction?

Hives.

Which of the following is a provider factor associated with low vaccination rates in adults?

Lack of effective reminder or recall systems.