Immunizing Drugs and Pandemic

Question 1

Two patients arrive at the clinic: a young boy with sickle-cell anemia and a 57-year-old woman with early-stage Hodgkin’s disease. Both patients require the same vaccine. What vaccine do they require?
a. Bacillus Calmette-Guérin (BCG) vaccine
b. Tetanus, diphtheria, and pertussis vaccine
c. Hepatitis B virus vaccine, inactivated
d. Haemophilus influenzae type b conjugate vaccine

Answer 1

ANS: D
H. influenzae type b conjugate vaccine is usually given to patients with sickle-cell anemia (an immunodeficiency syndrome) and with Hodgkin’s disease.

Question 2

Which type of immunity occurs when the body is exposed to a relatively harmless form of an antigen that imprints this information on the body’s memory bank and stimulates the body’s defences to resist any subsequent exposures?
a. Active immunity
b. Attenuating immunity
c. Naturally acquired passive immunity
d. Artificially acquired passive immunity

Answer 2

ANS: A
Active immunity causes an antigen–antibody response and stimulates the body’s defences to resist any subsequent exposures.

Question 3

A 45-year-old male has had a series of equine-derived immunizing drugs in preparation for a trip to an undeveloped country. His wife brings him to the emergency department because he has developed edema of the face, tongue, and throat and is having trouble breathing. What is he experiencing?
a. Serum sickness
b. Cross-sensitivity
c. An adverse effect
d. An anaphylactic reaction

Answer 3

ANS: A
Serum sickness sometimes occurs after repeated injections of equine-derived immunizing agents and is characterized by edema of the face, tongue, and throat; rash; urticaria; fever; flushing; dyspnea; and other conditions.

Question 4

A 12-month-old infant has received measles, mumps, and rubella virus (MMR) vaccine. Her mother calls the clinic to ask how she can help her infant to “feel better.” What is the nurse’s best suggestion to the mother?
a. Apply an ice pack to the injection site.
b. Give the infant pediatric Aspirin for the pain.
c. Apply warm compresses to the injection site.
d. Observe the site for further swelling and redness.

Answer 4

ANS: C
Applying warm compresses to the injection site and using acetaminophen (not Aspirin, which carries the risk of Reye’s syndrome) should help to relieve the infant’s discomfort. Contraindications to the administration of immunizing agents include active infections, pregnancy, febrile illnesses, and a history of reactions to or serious adverse effects of the drugs. Patients who are already immunosuppressed should not be given these agents.

Question 5

A health care employee has had a needle-stick injury from a contaminated needle. Which drug is used to provide passive immunity to hepatitis B infection?
a. Haemophilus influenzae type b (HIB) vaccine
b. Varicella zoster immune globulin (VariZIG®)
c. Hepatitis B immunoglobulin (H-BIG)
d. HB vaccine inactivated (Recombivax HB®)

Answer 5

ANS: C
H-BIG provides passive immunity in the prophylaxis and post exposure treatment of people exposed to hepatitis B virus or hepatitis B surface antigen–positive materials, such as blood, plasma, or serum. Recombivax HB promotes active immunity to hepatitis B infection in people considered at high risk for potential exposure to the virus. HIB vaccine is given to infants to prevent Haemophilus influenzae type B, and varicella zoster immune globulin is given for exposure to chicken pox.

Question 6

At what age is the first dose of DTaP-IPV (diphtheria, tetanus, and acellular pertussis [DTaP] and inactivated polio vaccine [IPV]) given?
a. 1 month
b. 2 months
c. 4 months
d. 6 months

Answer 6

ANS: B
The first dose of this series is given at the age of 2 months.

Question 7

A 14-month-old patient is to be vaccinated with measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a true statement about this vaccine?
a. It is given yearly to provide ongoing immunization.
b. It is given by deep intramuscular injection.
c. It is given by subcutaneous injection.
d. The patient will need a total of three injections by 18 months of age

Answer 7

ANS: C
Measles vaccine is available as measles, mumps, and rubella (MMR) vaccine or as MMRV vaccine. Children receive a single dose subcutaneously at 12 to 15 months of age and a second dose at 18 months of age or at 4 to 6 years of age.

Question 8

The human papilloma virus (HPV) vaccine can be given to males and females beginning at what age?
a. 3 years
b. 6 years
c. 9 years
d. 12 years

Answer 8

ANS: C
The HPV vaccine is recommended to be given to females and males beginning at 9 years of age and before the onset of sexual intercourse.