Vaccine questions from FItz

Question 1

27. Which of the following is true about the MMR vaccine?
    A. It contains inactivated virus.
    B. Its use is contraindicated in patients with a history
    of egg allergy.
    C. Revaccination of an immune person is associated
    with risk of significant systemic allergic reaction.
    D. Two doses given at least 1 month apart are
    recommended for adults who have not been
    previously immunized.

Answer 1

D. Two doses given at least 1 month apart are
recommended for adults who have not been
previously immunized.

Question 2

28. A 22-year-old man is starting a job in a college health center and needs proof of German measles, measles, and mumps immunity. He received childhood
    immunizations and supplies documentation of MMR
    vaccination at age 1.5 years.
    Your best response is to:
    A. obtain rubella, measles (rubeola), and mumps titers.
    B. give MMR immunization now.
    C. advise him to obtain immune globulin (IG) if he has
    been exposed to measles or rubella.
    D. advise him to avoid individuals with skin rashes.

Answer 2

B. give MMR immunization now.

Question 3

30. Assuming all of the following individuals are not immune to measles, mumps, and rubella, which of the following is not recommended to receive the MMR vaccination?

A. a 1-year-old boy with a history of hive-form reaction
egg ingestion
B. a 24-year-old woman who is 20 weeks pregnant
C. a 4-year-old girl who was born at 32 weeks of
gestation
D. a 32-year-old woman who is breastfeeding a
2-week-old

Answer 3

B. a 24-year-old woman who is 20 weeks pregnant

Question 4

Unclear immunization history

Answer 4

As with all vaccines, giving additional doses to patients with an unclear immunization history is safe.

Question 5

Contraindication to MMR vaccine

Answer 5

However, patients with a history of anaphylactic reaction to neomycin or gelatin should not receive MMR.

The MMR vaccine is safe to use during lactation, but its use during pregnancy is discouraged because of the theoretical but unproven risk of congenital
rubella syndrome from the live virus contained in the vaccine.

Question 6

PCV13

Answer 6

Use of PCV13 is associated with greater immunogenicity when compared with PPSV23, but it does not provide protection against as many pneumococcal serotypes, and is routinely
used in childhood

Question 7

40. Hepatitis B vaccine should not be given to a person with a history of anaphylactic reaction to:
A. egg.
B. baker’s yeast.
C. neomycin.
D. streptomycin.

Answer 7

B. baker’s yeast.

Question 8

42. Jason is a healthy 18-year-old who presents for
    primary care. According to his immunization record,
    he received two doses of HBV vaccine 1 month apart at age 14 years. Which of the following best describes his HBV vaccination needs?
    A. He should receive a single dose of HBV
    vaccine now.
    B. A three-dose HBV vaccine series should be started
    during today’s visit.
    C. He has completed the recommended HBV vaccine
    series.
    D. He should be tested for HBsAb and further
    immunization recommendations should be made
    according to the test results.

Answer 8

A. He should receive a single dose of HBV

vaccine now.

Question 9

HBV

Answer 9

Hepatitis B

Total doses: 3

Question 10

HBV: If the vaccine series was interrupted after the first dose

Answer 10

the second dose should be administered as soon as possible.

The second and third doses should be separated by an interval of at least 8 weeks.

Question 11

HBV: If only the third dose is delayed

Answer 11

it should be administered as soon as possible;

the entire three-dose series does not need to be repeated

Question 12

HBV: unvaccinated adults with diabetes mellitus who are aged 19 through 59 years

Answer 12

should also be encouraged to receive HBV vaccine

Question 13

HBV: booster doses

Answer 13

For patient receiving hemodialysis, based on HBsAg antibody levels less than 10 mlU/mL

Question 14

50. For which of the following patients should an NP order varicella antibody titers?
    A. a 14-year-old with an uncertain immunization
    history
    B. a healthcare worker who reports having had
    varicella as a child
    C. a 22-year-old woman who received two varicella
    immunizations 6 weeks apart
    D. a 72-year-old with shingles

Answer 14

B. a healthcare worker who reports having had

varicella as a child

Question 15

Varicalla Vaccine: Older children and adults with no history of varicella infection or previous immunization

Answer 15

should receive two immunizations 4 to 8 weeks apar

Question 16

54. An 18-year-old man without health problems has no primary tetanus immunization series documented.
    Which of the following represents the immunization
    needed?
    A. three doses of diphtheria, tetanus, and acellular
    pertussis (DTaP) vaccine 2 months apart
    B. tetanus IG now and two doses of tetanus-diphtheria
    (Td) vaccine 1 month apart
    C. tetanus, diphtheria, and acellular pertussis (Tdap) vaccine
    now with a dose of Td vaccine in 1 and 6 months
    D. Td vaccine as a single dose

Answer 16

C. tetanus, diphtheria, and acellular pertussis (Tdap) vaccine

Question 17

56. A 50-year-old man with hypertension and dyslipidemia presents for a primary care visit. He states, “It has been at least 10 years since my last tetanus shot.” He should be immunized with:
    A. Td.
    B. Tetanus IG.
    C. Tdap.
    D. none of the above, owing to his concomitant health
    problems.

Answer 17

C. Tdap.

Question 18

Tdap

Answer 18

A single dose of Tdap during adulthood provides

additional protection from pertussis

Question 19

Tetanus: For adults receiving initial immunization, a series of three vaccine doses is needed.

Answer 19

Two of the three can be Td, and one should be Tdap.