Immunization Post Live Seminar – Certification for ACP

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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 intramuscular influenza vaccine three 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

Which of the following is recommended for storage of vaccines?

A stand-alone refrigerator and stand-alone freezer

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

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

Which of the following vaccines should be administered subcutaneously?

MMR

If a patient experiences symptoms of anaphylaxis, which of the following would be the first action to take?

Call 911 or have a staff member call

Which of the following statements/questions best demonstrates how pharmacists should ask permission to share information?

Would you mind if I share some information about this issue with you?

A 63-year old woman is a candidate for herpes zoster vaccine. Which of the following is the appropriate dose and route of administration?

0.65 mL subcutaneously

Vaccines evoke an immune response because they contain

Antigens that stimulate the production of antibodies

Hugh, a 56-year-old health care worker, has no laboratory evidence of immunity to measles or mumps and cannot confirm that he had either disease. Which of the following MMR vaccinations should Hugh receive?

two doses of MMR

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 6-12 months later, Tdap and herpes zoster

Before administering a vaccine covered by the Vaccine Injury Compensation Fund (VICP), the National Childhood Vaccine Injury Compensation Act requires vaccine providers to provide a vaccine information statement to all patients:

Regardless of age

Katy is a 12-year-old high school student with no chronic medical conditions who comes to your pharmacy on October 31. She completed the primary series of DTaP, IPV, hepatitis A, hepatitis B, and Hib, and had a physician-diagnosed case of chickenpox at 2 years of age. Which of the following would be the most appropriate recommendation for Katy today?

Tdap, HPV, MCV, MMR, and influenza

Which of the following best describes intranasal administration of LAIV

The tip of the applicator should be placed just inside the nostril

With regard to logistics, which of the following statements provides the best rationale for why pharmacists should offer herpes zoster vaccine?

The herpes zoster vaccine is billable to Medicare Part D rather than Part B

Which of the following statements best describes the administration of vaccines during the provision of Medication Therapy Management (MTM) services?

A review of patient vaccination needs should be part of every patient’s complete medication therapy review

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

HPV4

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

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.

Olivia, a 10-year-old girl, has no record of ever receiving an influenza vaccination. The only medication she receives on a regular basis is albuterol. Which of the following would be an appropriate recommendation for an influenza vaccination for Olivia?

Recommend one dose of IIV

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 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 influenza vaccines would be appropriate to recommend for Ella, a 7-month-old girl?

Fluzone

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

Use of universal precautions.

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

6 months.

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.

A patient experiences anaphylaxis after receiving an influenza vaccine in your pharmacy. A report should be filed using which of the following?

Vaccine Adverse Effects Reporting System (VAERS).

According to the American Pharmacists Association (APhA) Annual Immunization Surveys, which of the following sources provides the most referrals to pharmacy vaccination services?

Physicians.

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

Two doses at least 6 months apart.

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

A 12-year-old girl.

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

Deltoid muscle

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

PCV13 should be given first, followed by PPSV23 1 year later.

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

Which of the following best describes immunization coalitions?

Organizations that foster collaboration among stakeholders to increase immunization rates.

Theresa is a 23-year-old woman with rheumatoid arthritis who is treated with immunosuppressive therapies. Which of the following vaccines should be avoided for Theresa?

Varicella

Which of the following statements best describes vaccine scheduling?

A delay in the administration of vaccines increases the risks for infection and outbreaks.

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

Rotavirus

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

Ideally, Tdap should be administered during the second trimester.

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

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.

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

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).

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 is the correct dose and route of administration for LAIV for an 8 year old?

One spray in each nostril

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

A 21-year-old man who smokes cigarettes.

Liz, a 37-year-old woman, had a splenectomy after a car accident 5 years ago. She received one dose of MCV4 during her hospitalization and one dose 2 months after discharge. Which of the following would be an appropriate recommendation for MCV4 vaccination for Liz?

No additional doses of MCV4.

what is the minimum needle length for administering HepB vaccine to an adult patient weighing 130 lb

1 inch

after reconstitution, within what time frame must HZV be administered

30 minutes

Emily is a 16-year-old high-school student with no chronic medical conditions. Emily’s immunization record shows that she completed the primary series for IPV, HepA, Hib, DTaP, and MMR, and she had a physician-dignosed case of chickenpox at 2 years of age. which of the following would be the most appropriate recommendation for her today?

Tdap, HPV, MCV, HepB, and influenza (if during influenza season)

which of the following diseases has been successfully eradicated worldwide through vaccination efforts

smallpox

in 2014, which vaccination rate was lowest among adolescents 13-17 years of age

HPV

what is meant by the term "immunization neighborhood"

describes the collaboration, coordination, and communication among immunization stakeholder dedicated to meeting the immunization needs of the patients and protecting the community from vaccine-preventable diseases

what is the most common complication of pertussis

pneumonia

which entity determines the specific vaccines that a pharmacist may administer

states through laws and regulations

adolescents should be routinely vaccinated with MCV4 on the following schedule

1 dose at age 11-12 years, followed by a booster at age 16

Jackie is a 34-year-old woman who received an influenza vaccine from you today. she wants to know how long it will take for the vaccine to begin working to protect her from getting the flu. what would be the most appropriate response to this patient?

14 days

a health care provider who has not been vaccinated against hepatitis B is stuck by a contaminated needle after administering an immunization to a hepatitis B-positive patient. in addition to hepatitis B vaccine, the health care provider also should receive hepatitis B immunoglobulin (HBIG) as postexposure prophylaxis because the HBIG provides

active and passive immunity

how often are the healthy people targets for vaccination rates uploaded

every 10 years

which disease is characterized by the development of a membrane on the tonsils, pharynx, or larynx, leading to respiratory obstruction

diphtheria

which of the following statements about pharmacy-based vaccination programs is true

administratively, billing for vaccines covered by medicare part D may be easier for pharmacist than physicians

which of the following tetanus booster vaccines would be the most appropriate for administration to a 12-year-old boy who has completed a primary series with DTaP and has no known allergies

Tdap

arthus reactions, which are exaggerated local reactions that can occur if a patient is vaccinated too frequently, are most commonly reported after which vaccine

tetanus and diphtheria toxoids

according to the advisory committee on immunization practices (ACIP), which of the following would be considered adequate evidence of immunity to varicella, indicating that administration of varicella vaccine is unnecessary

diagnosis of chickenpox by a health care provider

in which publication does the CDC initially publish new or updated vaccine recommendations

morbidity and mortality weekly report (MMWR)

which of the following vaccines may be administered to boys and young men aged 9-26 years to reduce the likelihood of acquiring genital warts

HPV9

robert is a 48-year-old pharmacist who is preparing to provide immunizations in his pharmacy for the first time next fall. he has no documentation of receiving the hepatitis B vaccine and would like to be vaccinated before administering vaccines in his practice. what is the recommended routine schedule for vaccination against hepatitis B

0, 1, and 6 months

if a patient received the first dose of HepB but did not return for the remaining doses in the series, under what circumstanse should the HepB series be restarted

in it not necessary to start the series over oral typhoid is the one exception

for a patient who needs to receive IIV and HZV, which of the following best describes appropriate administration of the vaccines

there is no need to observe any minimum interval between doses of two different inactivated vaccines, nor between combinations of inactivated and live vaccines

which of the following is recognized by sociologists as a factor in patient’s decision whether to be vaccinated

perceived susceptibility to a disease, seriousness of a disease, vaccine benefits, vaccine barriers, and social influence

which disease is almost certain to cause death if infected patients do not receive prophylaxis

rabies

which vaccine does ACIP recommend for all college freshmen aged 21 years of younger living in dormitories who have no been previously vaccinated

MCV4

for a patient who needs to receive IV and HZV which of the following best describes appropriate administration of these vaccines

administer these 2 vaccines at the same visit

which of the following is a requirement of the occupational safety and health administration (OSHA’s) bloodborne pathogens standart

health care employers must provide safety devices to employees to reduce the risk of occupational exposure to bloodborne pathogens

in a vial of influenza vaccine is left out of the refrigerator on the pharmacy counter overnight, what should be done with the vaccine

the vaccine should be placed back in the refrigerator and marked do not use, contact the manufacture for further guidance documentation

which of the following patients would be a candidate for PPSV23

25-year-old man who smokes cigarretts

what is the standard dose of epinephrine for managing anaphylazis

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

the incubation period for influenza can range from

1-4 days

which of the following patients are appropriate candidates for the 2-dose schedule of HPV9

11 year-old girl with no medical conditions, series has not been started yet

if a patient is a candidate for revaccination with PPSV23 what is the ACIP-recommended interval between dose of this vaccine

5 years

olivia is a 9-year-old girl has no record of ever receiving an influenza vaccination she has a fear of needles the only medication she receives on a regular basis is albuterol which of the following would be an appropriate recommendation for the influenza vaccination for olivia

one dose of the inactivated influenza vaccine (IIV)

which of the following is a method to motivate patients to be vaccinated

acknowledge and have compassion when addressing their concerns

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

physicians

kate is a 24-year-old woman with asthma she requests a refill of her albuterol inhaler on November 1st kate’s immunization record indicated that she completed the primary series of MMR, varicella, DTaP, HepA, and HepB vaccines and she received a dose of Tdap 2 years ago for complete coverage which of the following vaccines should she receive

PPSV23, IIV, and HPV

at what point during pregnancy is it recommended to administer the influenza vaccine

anytime is safe

barbra is a 60-year-old woman who presents to the pharmacy for two vaccines HZV and IIV which of the following are the appropriate dose and routes for administering these vaccines to this patient

HZV 0.65 ml subcutaneously and IIV 0.5 ml intramuscularly

arthus reactions which are exaggerated local reactions that can occur if a patient is vaccinated too frequently, are most commonly reported after which vaccine

tetanus and diphtheria toxoid-containing vaccines

why was the live attenuated influenza vaccine (LAIV) removed from the ACIP’s influenza vaccine seasons

low effectiveness of this vaccine was seen during the 2013-2016 influenza season

which of the following is recognized by sociologists as a factor in a patient’s decision whether to be vaccinated

influence of health care provider

what is the time interval for which the development of guillain-barre syndrome following influenza vaccination would result in a precaution for future influenza vaccines

within 6 weeks

there should be a flat hard surface in the area where vaccines will be administered to ensure

there is room for the patient to lie down if fainting occurs or CPR is required

aiden is a 6-month-old healthy boy with no known allergies. he has received vaccinations in the past with no reported adverse reactions. aiden’s father asks about having his son vaccinated against influenza. the most appropriate response would be to inform the father that aiden

should receive 1 dose of IIV4 today followed by a second dose of IIV4 administered 4 weeks later

which of the following vaccines is recommended for infants to receive within 24 hours of birth

hepatitis B

why are adjuvants added to vaccines

to strengthen the immune response to the antigen

a history of anaphylaxis caused by gelatin would be a contraindication to receiving which of the following vaccines

varicella

health map vaccine is a free online tool that allows pharmacist to

list their vaccination services so patients can find them when searching the website for nearby immunizers

HZV should not be administered to a patient with a history of anaphylaxis to

gelatin

how is the live cholera vaccine administered

orally

which of the following key questions is important to ask a patient before administering IIV

are you sick today

which of the following statements would be accurate when responding to a patient’s concerns about the safety of vaccines

the immune system is capable of stimulating an immune response to multiple vaccines administered at the same time

kyle is a 5-year-old boy who is up to date with his vaccinaations he has never experienced any adverse effects from vaccinations at his well-child check-up kyle will be receiving the following vaccines IPV, MMR, varicella vaccine, and a tetanus-containing vaccine which of the following tetanus-containing vaccines would be appropriate for him

DTaP

Ava has arrived at the clinic for her well-child visit she is 4 months old ava’s immunization record reveals that she has received the following vaccines 2 doses of HepB, 1 dose of Hib, 1 dose of rotavirus, 1 dose of PCV13, 1 dose of DTaP, and 1 dose of IPV. which vaccines should ava receive at today’s visit

DTaP, Hib, PCV13, IPV, and rotavirus

john is a 46-year-old man with diabetes he requests a refill of his diabetes testing supplies on october 21st his immunization record indicates that he has completed the primary series of MMR, DTaP, HepA, and HepB vaccines john has a documented history of chickenpox, and his last Td booster dose was 19 years ago which of the following vaccines should he receive

PPSV23, Tdap, and IIV

which of the following patients should receive the MMR vaccine

a pharmacist born in 1975 with documentation of 1 dose of MMR vaccine

a history of anaphylaxis caused by neomycin would be a contraindication to receiving which of the following vaccines

IPV

which of the following is a requirement for the occupational safety and health administration’s OSHA’s bloodborne pathogens standard

health care providers must use safety devices when administering injectable vaccines

a health care provider who has not been vaccinated against hepatitis B is stuck by a contaminated needle after administering an immunization to a hepatitis B-positive patient in addition to hepatitis B vaccine the health care provider also should receive hepatitis B immunoglobulin (HBIG) as postexposure prophylaxis because the HBIG provides

prompt immunity

prior to the introduction of a vaccine what was the leading cause of bacterial meningitis in children younger than 5 years of age

Heamophilus influenzae type b

which of these vaccines is a live attenuated vaccine

zoster

which of the following is most likely to result in a influenza pandemic

antigenic shift in an influenza a virus

for which age group is the adjuvanted inactivated influenza vaccine approved

65 years and older

justin is a healthy 16-year-old boy who has no documentation of varicella vaccine or history of the disease he should receive

2 doses of varicella vaccine separated by at least 4 weeks

vaccines as well as exposure to natural disease are both examples of which type of immunity

active immunity

during which step of the pharmacist patient care process would a pharmacist analyze a patient’s need for certain vaccines

assess

according to ACIP recommendations which of the following needle lengths would be appropriate for administering HZV to an adult patient

5/8 inch

which of the following statements about establishing clinic for administering vaccines is true

technicians can administer screening questionnaires and distribute VISs

herd immunity refers to which of the following situations

vaccination of enough individuals in a community to protect those who cannnot be vaccinated

what is the type of immunity that occurs when a pregnant woman is vaccinated with Tdap to protect the infant from pertussis after birth

passive immunity

why should refrigerated vaccines be stored in the middle of the refrigerator

there are fewer temperature fluctuations

which of the following diseases are transmitted through mosquito bites

yellow fever and japanese encephalitis

tom is a 9-year-old boy who has never has an influenza vaccine tom’s mother shows you his up-to-date immunization record and reports that he has never had an adverse reactions to vaccinations what dose and schedule of IIV should be administered to tom

one dose during influenza season of 0.5 mL

with the exception of rotavirus the routinely recommended live vaccines are contraindicated in a patient who

is immunosuppressed

david is a health 5-year-old boy who is scheduled to see his pediatrician for a checkup in july prior to starting kindergarten david’s immunization reveals that he has received the following vaccines: 3 doses of HepB, 4 doses of PCV13, 2 doses of HepA, 3 doses of IPV, 2 doses of rotavirus, 1 dose of MMRV, 4 doses of DTaP’ and 4 doses of Hib which vaccines should david receive at this visit

DTaP, IPV, MMR, and varicella

even though state laws may have specific mandates, how long should pharmacists maintain records of immunizations

for the patients lifetime

Live Vaccines

live vaccines include: cholera, herpes zoster, live attenuated influenza vaccine (LAIV), MMR, MMRV, rotavirus (RV5), tuberculosis (BCG), typhoid (Ty21a), vaccinia (smallpox), varicella, and yellow fever

which of the following tetanus booster vaccines would be most appropriate for administration to a 12-year-old boy who has completed a primary series with DTaP and has no known allergies

Tdap

in the event that a young child is fussy following the receipt of a vaccine, pharmacists should advise parents to

comfort the child and engage in quiet activities

RotaTeq (RV5) should be administered as a

3-dose series to infants at 2, 4, and 6 months of age

a 69-year-old man received Td vaccination 4 years ago he is preparing to travel to see his newborn granddaughter next month which of the following vaccines containg teetanus, diphtheria, and or pertussis would be most appropriate for him

Tdap

which of the following best describes an opportunity for pharmacists to use diagnosis-based screening to identify people at risk for vaccine-preventable diseases

performing a medication review for a patient who has diabetes

which viruses are associated with the development of cancer

human papillomavirus and hepatitis B virus

if a patient with an egg allergy experiences hives following influenza vaccination, what is ACIP’s recommendation for vaccinating this patient against influenza

administer and age-appropriate inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV)

when mary turned 64 she was diagnosed with type 2 diabetes at that time she received PPSV23 which of the following represents appropriate pneumococcal coverage for mary

administer PCV13 at age 65, then PPSV23 at age 69

upon giving a VIS to a patient who is to receive a vaccine cover under the national childhood vaccine injury act what must be documented

the date the VIS was given to the patient or caregiver and the date printed on the VIS

the childhood/adolescent and adult immunization schedules are updated and published annually during which months

january or february

which of the following best describes how to administer MMR vaccine to an adult patient weighing 210 Ib

inject subcutaneously at a 45 degree angle in the outer aspect of the upper arm

federal law makes offering an annual influenza vaccination a requirement for continued federal funding in which setting

long-term care facilities

jackie is a 34-year-old woman who received an influenza vaccine from you today she wants to know how long it will take for the vaccine to begin working to protect her from getting the flu what would be the most appropriate response to this patient

14 days

when looking at the schedule for vaccines that might be indicated for children and adolescents aged 18 years or younger based on medical indications what does the orange bar represent

precautions for vaccination

which of the following best describes how to administer Tdap vaccines to an adult patient weighing 185 Ib

inject 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

1 dose of Tdap followed by a TB booster every 10 years

which of these vaccines is an inactivated vaccine

DTaP

which of the following patients would be an appropriate candidate for adjuvanted influenza vaccine (aIIV3)

anyone 65 and older, individual younger than 65 would need to receive either the trivalent or quadrivalent unadjuvanted standard-dose influenza vaccine but someone who has diabetes is higher risk for influenza-related complications

liz a 37-year-old woman was diagnosed with HIV 2 months ago she received 1 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

following the second dose they should be revaccinated every 5 years

which of the following patients would be a ACIP recommended condidate for PPSV23

all adults age 65 and older and those 2 years of age and older with high-risk for pneumococcal disease having cerebrospinal fluid leak or cochlear implants, diabetes, chronic heart disease, chronic lung disease, chronic liver disease, alcoholism, and people 19-64 with asthma or smoke cigarettes

which of the following best describes IIV intradermal administration

epinephrine is the first-line treatment choice for acute anaphylaxis 0.01mg/kg/dose/0.01mL up to a max of 0.5mg

theresa is a 23-year-old woman with rheumatoid arthritis who is treated with immunosuppressive therapies which of the following vaccines should be avoided for theresa

all live vaccines should be avoided in patients with altered immunocompetence ex. Varicella people with severe combined immunodeficiency (SCID) cannot receive herpes zoster or rotavirus vaccine

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

a written exposure control plan outlining how the employer intends to eliminate or minimize potential exposure to bloodborne pathogens

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 given subcutaneously

what could potentially happen if an intramuscular vaccine is administered too high

sever persistent shoulder pain and lack of function may occur

which of the following vaccines should be administered subcutaneously

MMR

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

Tdap with each pregnancy at the beginning of the 3rd trimester, influenza vaccine is recommended if the woman is pregnant during flu season

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

0.01mg/kg/dose/0.01mL up to 0.05mg per dose

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

rotavirus vaccine

why are water bottles recommended to be placed in refrigerators in which vaccines are stored

help stabilize the temperature in the event of a power failure or upon frequent opening and closing of the units

Hugh a 56-year-old health care worker has no laboratory evidence of immunity to measles or mumps and cannot confirm that he had either disease how many doses of MMR vaccine should Hugh receive

being born AFTER 1957, So he would need 2 doses of MMR

Allergic Reactions

True Allergic Rxn: itching, erythema, hives, urticarial, and anaphylaxis False Allergic Rxn: Fever, GI upset, red eyes w/ thimerosal, CNS events

larry is a 65-year old man with heart disease who comes to the pharmacy to refill a prescription on october 21st his immunization record indicated that she completed the primary series of MMR, DTaP, HepA, and HepB vaccines and he received a dose of Tdap 12 years ago, in addition to influenza which of the following vaccines should larry receive

PCV13 now and PPSV23 in 12 months, adults 65 and older need herpes zoster vaccine, since he was born before 1980 he does not need varicella vaccine

a patient who reports an allergy to eggs but is able to eat lightly cooked eggs (like scrambled eggs) without a reaction could receive which of the following influenza vaccines

any recommended influenza vaccine

katy is a 12-year-old middle school student with no chronic medical conditions who comes to your pharmacy on september 30th for her flu shot she completed the primary series of DTaP, IPV, HepA, HepB, and Hip and had a physician-diagnosed case of chickenpox at 2 years of age which of the following would be appropriate to recommend for katy today

influenza, Tdap, 1st does of MCV4 and 9vHPV, and 2 doses of MMR 4 weeks apart

before administering a vaccine covered by the vaccine injury compensation program (VICP) the national childhood vaccine injury compensation act requires vaccine providers to provide a vaccine information statement to all patients

regardless of age

if a patient experiences symptoms of anaphylaxis which of the following would be the first action to take

instruct a staff member to call 911 then prepare and administer epinephrine

which of the following is the minimum needle length recommended for intramuscular administration of the influenza vaccine to an adult woman weighing 215 lbs

1.5 inch needle intramuscularly (90 degrees)

vaccines evoke an immune response because the contain

antigens that stimulate an immune response and result in immunologic memory

lily is a 15-month-old girl who is up-to-date with he vaccinations which of the following tetanus toxoid containing vaccines would be appropriate for lily

DTaP and another one at age 4-6 years, at 11-12 years she would get Tdap followed by Td every 10 years

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

HPV

which of the following patients would be appropriate candidate for the HPV vaccine

ages 11-12 age 9 might if there is a history of sexual abuse

which of the following is the routine schedule for vaccinating adolescents with MCV4

1 dose at age 11-12 and a booster at age 16 if 21 years old have not gotten and is going to be living in the dorms at college then need one dose

angie is a 16-year-old high school student with no medical conditions she completed the primary series of DTaP, IPV, PCV, Hib, and MMR, she received the complete series of HepA and B vaccines before entering high school, which of the following would be the most appropriate recommendation for angie today

1 dose of Tdap, MCV4, 1 dose of varicella vaccine and another in 4 weeks, and the 1st of the 3 doses of 9vHPV also influenza vaccination if during flu season

among all states in the US which of the following is the youngest minimum patient age for vaccination by a pharmacist allowed by a state

newborn (ANY AGE)

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

instruct a staff member to call 911, prepare and administer epinephrine

which of the following types of vaccines represents an opportunity to collaborate with physicians to meet the needs of the community

vaccinations that needed to be done in series

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

immunocompetent males and females age 9-14 years, routinely recommended for ages 11-12

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

having high-risk for pneumococcal disease, revaccination need to be given 5 years apart (if a dose was given before age 65) a dose is to be given at the age 65

what is the most appropriate recommendation for administering Tdap to pregnant patients

should be given with each pregnancy during the 3rd trimester

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

15 minutes

vaccines should be avoided or delayed for which of the following patients

patients with moderate or acute illnesses that require additional care (hospitalization)

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

intramuscularly into the deltoid muscle

which of the following is recommended schedule for administration of the HepA vaccine

2 dose series at least 6 months apart 18 and younger 0.5 mL intramuscularly and 19 and older 1 mL intramuscularly

which of the following vaccines must replicate to stimulate an immune response

live attenuated vaccines must replicate in order for the body to produce an immune response (ex MMR)

olivia a 9-year-old girl has no record of ever receiving and influenza vaccination, she has a fear of needles, the only medication she receives on a regular basis is albuterol, which of the following would be an appropriate recommendation for olivia

1 dose of IIV

with which entity should pharmacist collaborate to develop a standing order for vaccine administration

physicians

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 intramuscular influenza vaccine three 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

Which of the following is recommended for storage of vaccines?

A stand-alone refrigerator and stand-alone freezer

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

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

Which of the following vaccines should be administered subcutaneously?

MMR

If a patient experiences symptoms of anaphylaxis, which of the following would be the first action to take?

Call 911 or have a staff member call

Which of the following statements/questions best demonstrates how pharmacists should ask permission to share information?

Would you mind if I share some information about this issue with you?

A 63-year old woman is a candidate for herpes zoster vaccine. Which of the following is the appropriate dose and route of administration?

0.65 mL subcutaneously

Vaccines evoke an immune response because they contain

Antigens that stimulate the production of antibodies

Hugh, a 56-year-old health care worker, has no laboratory evidence of immunity to measles or mumps and cannot confirm that he had either disease. Which of the following MMR vaccinations should Hugh receive?

two doses of MMR

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 6-12 months later, Tdap and herpes zoster

Before administering a vaccine covered by the Vaccine Injury Compensation Fund (VICP), the National Childhood Vaccine Injury Compensation Act requires vaccine providers to provide a vaccine information statement to all patients:

Regardless of age

Katy is a 12-year-old high school student with no chronic medical conditions who comes to your pharmacy on October 31. She completed the primary series of DTaP, IPV, hepatitis A, hepatitis B, and Hib, and had a physician-diagnosed case of chickenpox at 2 years of age. Which of the following would be the most appropriate recommendation for Katy today?

Tdap, HPV, MCV, MMR, and influenza

Which of the following best describes intranasal administration of LAIV

The tip of the applicator should be placed just inside the nostril

With regard to logistics, which of the following statements provides the best rationale for why pharmacists should offer herpes zoster vaccine?

The herpes zoster vaccine is billable to Medicare Part D rather than Part B

Which of the following statements best describes the administration of vaccines during the provision of Medication Therapy Management (MTM) services?

A review of patient vaccination needs should be part of every patient’s complete medication therapy review

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

HPV4

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

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.

Olivia, a 10-year-old girl, has no record of ever receiving an influenza vaccination. The only medication she receives on a regular basis is albuterol. Which of the following would be an appropriate recommendation for an influenza vaccination for Olivia?

Recommend one dose of IIV

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 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 influenza vaccines would be appropriate to recommend for Ella, a 7-month-old girl?

Fluzone

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

Use of universal precautions.

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

6 months.

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.

A patient experiences anaphylaxis after receiving an influenza vaccine in your pharmacy. A report should be filed using which of the following?

Vaccine Adverse Effects Reporting System (VAERS).

According to the American Pharmacists Association (APhA) Annual Immunization Surveys, which of the following sources provides the most referrals to pharmacy vaccination services?

Physicians.

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

Two doses at least 6 months apart.

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

A 12-year-old girl.

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

Deltoid muscle

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

PCV13 should be given first, followed by PPSV23 1 year later.

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

Which of the following best describes immunization coalitions?

Organizations that foster collaboration among stakeholders to increase immunization rates.

Theresa is a 23-year-old woman with rheumatoid arthritis who is treated with immunosuppressive therapies. Which of the following vaccines should be avoided for Theresa?

Varicella

Which of the following statements best describes vaccine scheduling?

A delay in the administration of vaccines increases the risks for infection and outbreaks.

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

Rotavirus

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

Ideally, Tdap should be administered during the second trimester.

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

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.

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

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).

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 is the correct dose and route of administration for LAIV for an 8 year old?

One spray in each nostril

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

A 21-year-old man who smokes cigarettes.

Liz, a 37-year-old woman, had a splenectomy after a car accident 5 years ago. She received one dose of MCV4 during her hospitalization and one dose 2 months after discharge. Which of the following would be an appropriate recommendation for MCV4 vaccination for Liz?

No additional doses of MCV4.

Youngest age for influenza vaccine (inactivated)

6 months

IM vaccine administered too high

Severe shoulder pain & injury

An appropriate HPV patient:

8 y.o. girl

12 y.o. boy

6 y.o. girl

30 y.o. woman

12 y.o. boy

PCV13/PPSV23 – Pneumococcal vaccine

General dose: Administer to immunocompetent 65 and up adults PCV13, 1 year later PPSV23. If PPSV23 was administered but not PCV13, then administer PCV13 1 year after PPSV23. ———————————————— Special Populations: Chronic Heart Disease, Chronic Lung Disease, Smokers, Chronic Liver Disease, Alcoholics, Diabetics. Dose–> *Ages 19-64: 1 dose PPSV23 with chronic conditions. *ages 65 and up: 1 dose of PCV13, 8 wks later PPSV23, 5 years later 2nd dose of PPSV23. Immunodeficiency disorders, HIV infections, Anatomical or functional asplenia, Chronic renal failure, nephrotic syndrome, cerebrospinal fluid leakage, cochlear implant. –> 1 dose of PCV13, 8 wks later PPSV23, 5 years later 2nd dose of PPSV23.

HPV9

2 dose series (9-14 y.o.) 0, 6-12 months 3 dose series (15-25 y.o.) 0, 1-2, 6 months. Immuncompromised do 3 doses

Influenza vaccine that is jet injector needle free system

Afluria (Ages 18-64)

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