APhA Home Study 248 Questions with Verified Answers,100% CORRECT

APhA Home Study 248 Questions with Verified Answers (M1) Healthy People 2030 identified a goal of 100% for proportion of persons vaccinated annually with seasonal influenza vaccination. True or false? - CORRECT ANSW ...

APhA Home Study 248 Questions with Verified Answers (M1) Healthy People 2030 identified a goal of 100% for proportion of persons vaccinated annually with seasonal influenza vaccination. True or false? - CORRECT ANSWER False (M1) Under the direction of the U.S. Department of Health and Human Services, the Healthy People initiative has identified the following as a goal for 2030: a) Achieve 95% vaccination for all vaccines on the annual published vaccine schedule b) Maintain all goals from 2020 as all goals were achieved c) Develop a single system nationwide for vaccine tracking d) Increase the proportion of persons who are vaccinated annually against seasonal influenza - CORRECT ANSWER Increase the proportion of persons who are vaccinated annually against seasonal influenza (M1) The National Vaccine Advisory Committee 2013 Standards for Adult Immunization Practice and the 2016 International Pharmaceutical Federation global report identify pharmacists as: a) Only facilitators b) Integral to increasing vaccination rates c) Not a member of the healthcare team d) Medication dispensers - CORRECT ANSWER Integral to increasing vaccination rates (M1) Opportunities for Advocacy and Collaboration include: a) There is no need for advocacy since the vaccine schedules dictate what people need to receive b) Discussion with other health care professionals on ways to set prices for vaccines to increase revenue c) Membership in state Immunization coalition to serve as an expert on policy and practice issues affecting pharmacy d) Replace services offered by the local health department so they don't have to offer immunizations - CORRECT ANSWER Membership in state immunization coalition to serve as an expert on policy and practice issues affecting pharmacy (M1) Which of the following is one of the five guidelines identified by the APhA Board of Trustees in 2019 to assist pharmacists in incorporating immunization activities into their practice? a) Power b) Quantity c) Solidarity d) Prevention - CORRECT ANSWER Prevention (M1) Which of the following diseases have been eradicated worldwide, allowing vaccination to be discontinued? a) Polio b) Smallpox c) Mumps d) Tetanus - CORRECT ANSWER Smallpox (M1) What is the definition of collaboration, coordination, and communication among all those involved in meeting the immunization goals of patients and communities? a) Immunization Party b) Healthcare Team c) Prevention Task Force d) Immunization Neighborhood - CORRECT ANSWER Immunization Neighborhood (M1) In 2019, which of the following vaccine-preventable diseases had fewer than 100 cases in the United States? a) Diphtheria b) Measles c) Pertussis d) Polio - CORRECT ANSWER Diphtheria, polio (M2) How long does it take for the immune system to provide protection by producing disease-specific antibodies and memory cells? a. 21 days b. 7 days c. 14 days d. 5 days - CORRECT ANSWER 14 days (M2) Which of the following is found in vaccines to evoke an immune response? a. B cells b. Antigens c. Antibodies d. Macrophages - CORRECT ANSWER Antigens (M2) Why is spacing and timing of vaccines important? a. Memory t-cells interfere with the immune response b. Antibodies interfere with inactive vaccines c. Antigen load may interfere with immune response d. Circulating antibodies may interfere with immune response - CORRECT ANSWER Circulating antibodies may interfere with immune response (M2) Which of the following is an example of passive immunity? a. Maternal antibodies b. Hepatitis B vaccine c. Contracting measles d. Skin barrier - CORRECT ANSWER Maternal antibodies (M2) Children less than what age do not mount an adequate immune response to t-cell independent immunity? a. 5 years b. 11 years c. 2 years d. 18 years - CORRECT ANSWER 2 years (M2) Which vaccines are more susceptible to circulating antibodies in the system? a) inactive b) live-attenuated - CORRECT ANSWER live-attenuated (M2) A pharmacist refuses to get the hepatitis B vaccine. After giving a vaccination to a patient, he pokes himself with the needle. He finds out that his patient has hepatitis B. What should he do to reduce the risk of getting hepatitis B? - CORRECT ANSWER Post-exposure prophylaxis is needed right away. Then give both hepatitis B immune globulin and the hepatitis B vaccine. HBIG has antibodies that provide immediate protection via passive immunity while the vaccine, once fully vaccinated, will provide long-term protection. (M2) Vaccines contain antibodies which are recognized by the immune system. True or false? - CORRECT ANSWER False (M2) ______ evoke the immune response and bind to specific antibodies a) antigens b) antibodies c) phagocytes d) t-cells e) b-cells f) macrophages - CORRECT ANSWER Antigens (M2) Match the terms together: - CORRECT ANSWER 1,2 2,3 3,4 4,1 (M3) What are the two broad categories that vaccines are classified? a) Influenza vaccines b) Live attenuated vaccines c) Oral vaccines d) Injectable vaccines e) Inactivated vaccines - CORRECT ANSWER Live attenuated vaccines & inactivated vaccines (M3) What clinical factors need to be considered before administering a live attenuated vaccine? - CORRECT ANSWER Patients who currently are immunocompromised & live attenuated vaccines administered in the previous 28 days (M3) Pneumococcal polysaccharide vaccine (PPSV23) is best categorized as what type of vaccine? - CORRECT ANSWER Inactivated polysaccharide vaccine (M3) What of the following is classified as a live vaccine? a) IIV4 b) Human papillomavirus vaccine (9vHPV) c) Recombinant zoster vaccine (RZV) d) Measles, mumps, rubella (MMR) e) DTap f) TdaP - CORRECT ANSWER Measles, mumps, rubella (MMR) (M3) Which of the following is true regarding the use of mRNA in vaccine technology? a. mRNA vaccine technology elicits its immune response and protects the host by altering the host's DNA. b. mRNA is extremely stable in a host's body. c. mRNA is the genetic blueprint that tells your body how to make a particular protein subunit of a virus which, after being produced, will elicit an immune response. d. mRNA vaccine technology requires replication similar to a live attenuated vaccine. - CORRECT ANSWER mRNA is the genetic blueprint that tells your body how to make a particular protein subunit of a virus which, after being produced, will elicit an immune response. (M3) When administering measles, mumps, rubella (MMR) and pneumococcal conjugate vaccine (PCV13) to a patient at their 15-month appointment, what must be considered regarding vaccine spacing? a. MMR and PCV13 may be administered simultaneously or at any interval between doses. b. Vaccines should never be administered simultaneously. As such these vaccines should be separated by a 7-day minimum interval. c. MMR and PCV13 may be administered simultaneously or must be separated by a 28-day minimum - CORRECT ANSWER MMR and PCV13 may be administered simultaneously or at any interval between doses. (M3) Which vaccine technology listed below is an ingredient added typically to inactivated vaccines to boost its immune response by targeting pathogen recognition receptors that are expressed on dendritic cells to trigger a pro-inflammatory response? Though this technology creates a more robust immune response, it can also increase local site reactions and systemic reactions, such as fevers, chills, and body aches. a. Conjugation b. Adjuvants c. Attenuation d. mRNA technology - CORRECT ANSWER Adjuvants (M3) Which of the following vaccines listed is a live attenuated vaccine? a. Recombinant zoster vaccine (RZV) b. Hepatitis B c. Varicella (VAR) d. Hepatitis A - CORRECT ANSWER Varicella (VAR) (M4) What are the four steps set by NVAC as the standards for Adult Immunization Practice? - CORRECT ANSWER Assess, recommend, administer/refer, document (M4) In the patient care process, how often should a pharmacist collect information a patient? - CORRECT ANSWER At every clinical encounter (M4) What screening questions should be asked to any and all patients? - CORRECT ANSWER 1. Are you sick today or how are you feeling? 2. Do you have any allergies to medications, food, any vaccine, or latex? 3. Have you ever had a serious reaction after receiving a vaccination? 4. Do you have a long-term health problem with heart disease, lunch disease, asthma, kidney disease, metabolic disease, anemia, or other blood disorder? (M4) What screening questions should be asked to patients taking live vaccines? - CORRECT ANSWER 1. Do you have cancer, leukemia, AIDS, or any other immune system problem? 2. Do you have a parent, brother, or sister with an immune system problem? 3. In the past 3 months, have you taken medications that affect your immune system, such as prednisone, other steroids, or anticancer drugs; drugs for the treatment of rheumatoid arthritis, Crohn's disease, or psoriasis; or have you had a radiation treatment? 4. During the past year, have you received a transfusion of blood or blood products, or have been given a medicine called immune (gamma) globulin)? 5. Have you received any vaccinations in the past 4 weeks? (M4) What screening question should be asked to woman of child-bearing age? - CORRECT ANSWER Are you pregnant or is there a chance you could become pregnant during the next month? (M4) What screening question should be asked to patients considering tetanus-containing vaccines? - CORRECT ANSWER Have you had a seizure, brain, or other nervous system problem? (M4) What is the name of the document published by the CDC that describes the risk and benefits of a vaccine in lay terms? - CORRECT ANSWER Vaccine Information Statement (M4) Star Pharmacy has been providing influenza vaccines for years and is now implementing a Hepatitis B vaccine program in their pharmacy next month. A crucial step in the Pharmacists' Patient Care Process for this vaccine is: a. Review staffing levels. b. Purchase the hepatitis B vaccine. c. Plan a large marketing event. d. Create a reminder and recall - CORRECT ANSWER Create a reminder and recall system (M4) A male patient presents to the pharmacy for a shingles vaccine appointment. The patient is a new patient to the pharmacy. Which of the following information would be most appropriate to collect as part of the patient care process? a. Patient's age and vaccine history b. Patient's age, eye color, and allergies c. Patient's age, current health, vaccine history, and allergies d. Current health and allergies - CORRECT ANSWER Patient's age, current health, vaccine history, and allergies (M4) An electronic prescription for glipizide 10mg is received by a pharmacist for a new patient. The prescription indicates a diagnosis of E11, Type 2 diabetes mellitus. In addition to filling the prescription, the pharmacist could assess the patient for potential immunizations to recommend. What form of assessment is the pharmacist utilizing? a. Diagnosis-based screening b. Occurrence-based screening c. Mass screening d. Procedure-based screening - CORRECT ANSWER Diagnosis-based screening (M4) Which of the following statements best meets the definition of precaution? a. The risk of vaccinating outweighs the benefits from the vaccine and the patient cannot be vaccinated. b. A condition that may alter or diminish the patient's response or may increase the patient's risk of a serious reaction to a vaccine. c. A compelling indication for the patient to receive a vaccine. d. Condition that will likely result in a severe, life-threatening event if the patient receives the vaccine. - CORRECT ANSWER A condition that may alter or diminish the patient's response or may increase the patient's risk of a serious reaction to a vaccine. (M4) The community pharmacist, while filling discharge orders from the hospital, recognizes a patient's need for receiving the pneumococcal vaccine during a transition of care to a personal care home. This is an example of what part of the patient care process? a. Follow-up, Monitor, and Evaluate b. Access c. Assess d. Implement - CORRECT ANSWER Assess (M5) How often are the CDC immunization schedules published? - CORRECT ANSWER Annually (M5) At what age is the influenza vaccine first recommended? - CORRECT ANSWER 6 months (M5) If a child is behind on the rotavirus vaccine, what is the interval of time between dose 1 and dose 2 to start getting the child caught up? - CORRECT ANSWER 4 weeks (M5) At what ages is the live attenuated influenza vaccine (LAIV) contraindicated if the child has asthma or wheezing? - CORRECT ANSWER 2 to 4 years (M5) At what age is the herpes zoster vaccine first recommended for immunocompetent adults? - CORRECT ANSWER 50 years (M5) Which vaccines are not to be given to a woman who is pregnant? - CORRECT ANSWER LAIV, MMR, HPV, VAR (M5) According to the CDC's Adult Immunization Schedule, at what age does an adult start? - CORRECT ANSWER 19 years (M5) Which immunization schedule should be used to determine which vaccines are needed for each situation listed? - CORRECT ANSWER Adult immunization schedule by medical condition and other indications, child and adolescent immunization schedule by age, catch-up schedule for children and adolescents, adult immunization schedule by age group (M5) Which of the following vaccines is contraindicated for an adult patient with HIV and a CD4 count <200 mm2? a. RZV b. HPV c. MMR d. IIV - CORRECT ANSWER Measles, mumps, rubella (MMR) (M5) A 9 year-old was just diagnosed with asplenia. This child is up to date on all routinely recommended vaccines. Which additional vaccine does this child need? a. MenACWY b. PCV13 c. Hib d. MenB - CORRECT ANSWER MenACWY (M5) A 10 year-old child received one dose of the hepatitis A vaccine at 1 year of age, but never returned for a second dose. Which of the following is true regarding the need for a second dose of the hepatitis A vaccine for this child? a. Wait until the child is 18 years of age and give the second dose if there are other risk factors b. Give 1 dose now as catch up c. No further doses of hepatitis A vaccine are required d. Restart the series and give 2 doses, 6 months apart - CORRECT ANSWER Give 1 dose now as catch up (M5) If an 11 year old child never got the hepatitis B vaccine series, what is the minimum amount of time that must occur between dose 1 and dose 3 when getting this child caught up? a. 4 weeks b. 16 weeks c. 8 weeks d. 6 months - CORRECT ANSWER 16 weeks (M5) Which of the following vaccines is not recommended during pregnancy? a. Tdap b. HPV c. HepB d. IIV - CORRECT ANSWER Human papillomavirus vaccine (HPV) (M5) Based on the adult immunization schedule, at what age is the live attenuated influenza vaccine (LAIV) no longer recommended? a. 50 years b. 19 years c. 65 years d. 27 years - CORRECT ANSWER 50 years (M5) Which of the following is TRUE of the emergency use authorization process? a. Risks are not evaluated until long-term safety data is available b. Manufacturers must include a plan for safety monitoring c. Used when approved or licensed alternatives are too expensive d. Clinical trial data are not required - CORRECT ANSWER Manufacturers must include a plan for safety monitoring (M6) Match the symptoms below with the corresponding most likely cause of cold or flu - CORRECT ANSWER Cold: gradual onset, sneezing Flu: fever, aches (M6) The period a person is most contagious with influenza can be as long as 5-10 days. True or false? - CORRECT ANSWER True (once symptoms begin, the influenza virus can shed in respiratory secretions for 5-10 days usually peaking around 1-3 days after symptoms begin. This is the time when people are most contagious and can spread the illness, however the virus can be spread at other times too) (M6) Recommendations for influenza vaccination include the following... - CORRECT ANSWER Administer to patients 6 months of age and older, adverse reactions tend to last no longer than 1-2 days, vaccination in July/August is likely to cause suboptimal immunity later in the season **You should not give influenza vaccination only to those that have had a Guillain-Barre episode in the past 6 weeks prior to the vaccine (M6) Which of the following patient scenarios regarding influenza vaccination is correct? a. 65-year-old patient with thimerosal allergy would be eligible to receive adjuvanted inactivated Fluad or high dose inactivated Fluzone. b. A 5-year-old who received one dose of influenza vaccination when they were 3 years old, should receive only one dose this year. c. An annual influenza vaccination is recommended for 2 years and older due to being a polysaccharide vaccination. d. A 40-year-old who is - CORRECT ANSWER A 65-year-old patient with thimerosal allergy would be eligible to receive adjuvanted inactivated Fluad or high dose inactivated Fluzone (M6) Which of the following symptoms are usually associated with influenza? a. Normal temperature b. Sneezing c. Nausea/vomiting d. Chills - CORRECT ANSWER Chills (M6) Which of the following are true regarding the influenza virus? a. People exposed are contagious within minutes of exposure. b. It is transmitted through respiratory droplets that contain the virus. c. Only Type B influenza has surface antigens of hemagglutinin (HA) and neuraminidase (NA). d. It cannot be transmitted from surfaces. - CORRECT ANSWER It is transmitted through respiratory droplets that contain the virus. (M6) Options to increase influenza vaccine effectiveness include: a. Avoid vaccination in July and August to minimize chances of suboptimal immunity later in the season. b. Administer in combination with pneumococcal vaccination to boost titer levels. c. Receive one influenza vaccination in the fall and one in the spring. d. Administer high dose influenza vaccination to children ages 2-8 years to ensure appropriate immune response. - CORRECT ANSWER Avoid vaccination in July and August to minimize chances of suboptimal immunity later in the season (M6) Counseling on vaccine safety should include: a. A history of severe allergic reaction (anaphylaxis) to a previous dose or component of influenza vaccine is no longer a contraindication. b. Fever, chills, malaise could occur within 6-12 hours post vaccination and may last up to 1-2 days. c. Injection site pain should resolve within 5-10 minutes post vaccination. d. Nasal congestion is common with the influenza vaccine administered intramuscularly. - CORRECT ANSWER Fever, chills, malaise could occur within 6-12 hours post vaccination and may last up to 1-2 days. (M7) Which organ plays an important role in eliminating encapsulated bacteria, such as streptococcus pneumoniae? a. Kidneys b. Spleen c. Liver d. Pancreas - CORRECT ANSWER Spleen (M7) Which of the following is an invasive pneumococcal disease? a. pneumonia with bacteremia b. sinusitis c. otitis media d. meningitis - CORRECT ANSWER meningitis (M7) What is the difference between T-cell independent and T-cell dependent antigen B-cell activation? - CORRECT ANSWER These are two types of humoral immunity. T-cell independent antigens activate B-cells without the help of T-cells. This leads to the direct stimulation of short-lived plasma cells (B cells) and the production of IgMs antibodies. The immune response is limited and limited with time. This is seen in polysaccharide vaccines (PPSV23). T-cell dependent antigens activate B-cells with the help of T-cells. The antigen first interacts with the T-cells that then activate both long-lived plasma and memory B-cells, which lead to the production of IgGs antibodies. This leads to an increased immune response that lasts with time. This is seen in conjugated vaccines (PCV13). (M7) What is the difference between the immunoglobulins IgM and IgG? - CORRECT ANSWER IgM (produced as a first response to new infection, short-term protection, produced initially but then declines as IgG are made, low affinity) IgG (produced after IgM, long-term protection, helps to prevent re-infection, high affinity) (M7) How is the immune system broken up? - CORRECT ANSWER The immune system is divided into innate immunity (skin, stomach pH, mucous membranes, already have, general) and adaptive immunity (need to make, specific). Adaptive immunity is then divided into humoral (production of antibodies in a T-cell dependent (IgG) and T-cell independent (IgM) way) and cell-mediated immunity (direct attack, MHC). Both require B and T cells. In humoral immunity, B cells required to make antibodies and what type depends on whether T cells interact with it. In cell-mediated immunity, T cells rely on B cell's antibodies attaching to their MHC to know what antigen to target. Humoral immunity can range from natural-passive (maternal), natural-active (infection), artificial-passive (antibody transfer, Ig infusion), and artificial-active (immunization). (M7) Why do conjugated vaccines produce IgG but not polysaccharide vaccines? - CORRECT ANSWER A protein is required to trigger T-cell dependent B-cell activation, and only conjugated vaccines have proteins and not polysaccharide vaccines. (M7) Why are polysaccharide vaccines not given to children less than 2? - CORRECT ANSWER Polysaccharide vaccines induce poor responses in infants. Polysaccharide vaccines do not activate T-cells and only activate B-cells. Activating B-cells alone will not create enough of an immune response in infants, so these vaccines are not given to infants as there will be no booster effect. (M7) Which of the following is a group at high risk for complications from streptococcus pneumoniae? a. young children b. men who have sex with men c. healthcare providers d. college students - CORRECT ANSWER young children (M7) Which of the following is true for the 23-valent pneumococcal polysaccharide vaccine (PPSV23)? a. PPSV23 is routinely recommended for all children b. PPSV23 should not be given to children less than 2 years of age c. PPSV23 relies on T-cell to mount an immune response d. PPSV23 is a live vaccine - CORRECT ANSWER PPSV23 should not be given to children less than 2 years of age (M7) For which of the following conditions are both PCV13 and PPSV23 recommended? a. Chronic liver disease b. Asplenia c. Diabetes d. Alcoholism - CORRECT ANSWER Asplenia (M7) A healthy 70-year old female who received PPSV23 at 65-years of age is inquiring about pneumococcal vaccination. Which of the following should you recommend? a. PPSV23 b. No pneumococcal vaccination is recommended. c. PCV13 now and then PPSV23 1 year later d. PCV13 - CORRECT ANSWER No pneumococcal vaccination is recommended (M7) How is streptococcus pneumoniae primarily transmitted? a. Fecal-oral route b. Direct contact with an open wound c. Respiratory droplets or secretions d. Spores in the environment - CORRECT ANSWER Respiratory droplets or secretions (M7) A 3-yearmold child recently underwent a splenectomy. Previous to the surgery, the child was up to date on all pediatric vaccinations. According to the CDC, which of the following vaccines should be recommended? a. PCV15 b. PCV20 c. PPSV23 d. PCV13 - CORRECT ANSWER PPSV23 (M7) Using shared clinical decision-making, which of the following recommendation is most appropriate for a 65-year old living in a skilled nursing facility with multiple co-morbid conditions? This patient has no record of receiving either pneumococcal vaccine and is immune competent. a. PPSV23 now, 1 year later PCV13 b. PPSV23 only c. PCV13 only d. Give PCV13 now, then give PPSV23 one year later. - CORRECT ANSWER Give PCV13 now, then give PPSV23 one year later (M8) Which of the following are examples of invasive meningococcal disease? a. urethritis b. pneumonia c. meningitis d. septicemia e. conjunctivitis - CORRECT ANSWER pneumonia, meningitis, septicemia (M8) The quadrivalent meningococcal conjugate vaccines contain which of the following serotypes? A, B, C, D, W, X, Y - CORRECT ANSWER ACWY (M8) What is the youngest age that the meningococcal B vaccine is recommended for children at risk? a. 2 years b. 4 years c. 6 years d. 10 years - CORRECT ANSWER 10 years (M8) An adolescent received his first meningococcal conjugate quadrivalent (MenACWY) vaccine at age 13 years, when should he receive his booster dose? a. 16 years b. No booster is needed c. 14 years d. 20 years - CORRECT ANSWER 16 years (M8) Which of the following scenarios is an appropriate shared clinical decision making for meningococcal vaccine? a. Healthy 16 year old who received meningococcal B vaccine b. 25 year old microbiologist who receives MenACWY c. 2-year old with complement deficiency who received MenACWY d. 29 year old with asplenia who receives MenB vaccine - CORRECT ANSWER Healthy 16 year old who received meningococcal B vaccine (M8) What type of vaccine is meningococcal quadrivalent vaccine? a. Recombinant b. Conjugate c. Polysaccharide d. Viral vector - CORRECT ANSWER Conjugate (M8) The advisory committee on immunization practices (ACIP) recommends routine vaccination with the meningococcal conjugated quadrivalent vaccine (MenACWY) which of the following age groups? a. 2-3 years of age b. 7-8 years of age c. 4-6 years of age d. 11-12 years of age - CORRECT ANSWER 11-12 years of age (M8) Which of the following is a potential long term complication from meningococcal disease? a. Stiff neck b. Photophobia c. Amputations d. Headache - CORRECT ANSWER Amputations (M9) HPV or human papillomavirus infections that infect a non mucosal, cutaneous epithelium usually leads to which of the following? a. anal warts b. palmar warts c. plantar warts d. increased cervical cancer - CORRECT ANSWER palmar warts and plantar warts (M9) The human papillomavirus 9-valent vaccine, recombinant, or 9vHPV, provides protection against how many HPV serotypes? - CORRECT ANSWER 9 serotypes (M9) The Advisory Committee of Immunization Practices recommends that routine HPV vaccination be initiated for the 9vHPV at which age group? - CORRECT ANSWER 11-12 years of age (M9) What percentage of HPV infections are cleared by the body and do not develop to CIN2 or CIN3? a. 38% b. 70% c. 54% d. 92% - CORRECT ANSWER 70% (M9) Which of the below statements regarding Human papillomavirus (HPV) serotypes is true? a. There are only 9 known serotypes of HPV. b. High risk serotypes are estimated to cause 99% of cervical precancers c. HPV low risk serotypes, such as type 16, cause about 50% of all cervical cancer cases worldwide. d. HPV is a small RNA virus transmitted via sexual skin to skin contact. - CORRECT ANSWER High risk serotypes are estimated to cause 99% of cervical precancers (M9) Which of the following factors does not need to be considered when utilizing shared decision making to evaluate the need to vaccinate an adult (27-45 years of age) with 9vHPV vaccine? a. Patient's sexual history, including lifetime sexual partners. b. Patient current relationship status c. HPV antibody test results d. Patient's immunocompetency - CORRECT ANSWER HPV antibody test results (M9) A 16-year old patient presents to the pharmacy for her first dose of 9vHPV. The patient is instructed to wait in the pharmacy for 15 minutes after receiving the dose. Three minutes after receiving the dose, the patient experiences syncope. What is the recommended response to treat the patient's syncope? a. Call the patient's emergency contact to take her to the emergency department. b. Call 9-1-1 and wait for emergency services to address the situation. c. Lay the patient flat on the groun - CORRECT ANSWER Lay the patient flat on the ground and elevate her legs. Monitor the patient's vitals and initiate emergency services if the patient does not regain consciousness (M9) A 25-year old female comes to the pharmacy inquiring about the 9vHPV series. What would be the recommended vaccination series? a. 3 doses administered intramuscularly at 0, 1-2, 6 months b. 2 doses administered intramuscularly at 0 and 6-12 months c. Patient is not eligible to receive the vaccine due to age d. 1 dose administered intramuscularly - CORRECT ANSWER 3 doses administered intramuscularly at 0, 1-2, 6 months (M10) Match the words together based on the correct transmission route: - CORRECT ANSWER Pertussis - respiratory droplets Tetanus - wound Diphtheria - nasopharynx and skin (M10) How often are Tdap boosters given? - CORRECT ANSWER Every 10 years (M10) Which of the following vaccines are recommended for persons older than 10 years? a. Td b. DT c. Tdap d. DTap e. DTaP-IPV - CORRECT ANSWER Td, Tdap (M11) Which of the following is the most common type of tetanus? a. Cephalic b. Generalized c. Neonatal d. Local - CORRECT ANSWER Generalized (M11) Which of the following vaccines is used as a booster every 10 years? a. Td b. DTaP c. DTaP-IPV d. DT - CORRECT ANSWER Td (M11) What is the recommended timing for Tdap during pregnancy ? a. 1-12 weeks b. 13-26 weeks c. Before pregnancy d. 27-36 weeks - CORRECT ANSWER 27-36 weeks (M11) The whooping cough associated with pertussis occurs in this stage of disease: a. Convalescence b. Paroxysmal c. Initial d. Catarrhal - CORRECT ANSWER Paroxysmal (M11) DTaP is recommended to be administered using which of the following schedules? a. 2, 4, 6, 12-15 months, 4-6 years b. 7-10 years c. 2, 4, 12-15 months d. 11-12 years - CORRECT ANSWER 2, 4, 6, 12-15 months, 4-6 years (M11) True or False. Varicella is NOT transmitted by contact with the lesions? - CORRECT ANSWER False (M11) Which of the following patients should receive the varicella vaccination? a. 10 month old at their well check b. 65 year old who had chickenpox over 60 years ago c. 5 year old who received one dose at 12 months of age d. 12 year old who received doses at 15 months and 6 years of age - CORRECT ANSWER 5 year old who received one dose at 12 months of age (M11) Which of the following statements are true regarding the recombinant zoster vaccine? a. It requires an adjuvant b. It requires reconstitution c. It is indicated starting at 60 years of age d. It requires two doses - CORRECT ANSWER It requires an adjuvant, it requires reconstitution, it requires two doses **indicated at 50 years old, not 60 years old (M11) Which of the following is true regarding the recombinant herpes zoster vaccination? a.It cannot be given to someone who has had the varicella vaccine. b. It should not be given to someone who previously received the zoster vaccine live. c. It is approved as a treatment of herpes zoster if administered within 48 hours of onset of symptoms. d. It is indicated for prevention of herpes zoster and its complications in patients ≥50 years of age. - CORRECT ANSWER It is indicated for prevention of herpes zoster and its complications in patients ≥50 years of age (M11) Which of the following is true regarding varicella zoster transmission? a. Covering the lesions will prevent chance of transmission to others. b. It is not respiratory transmitted c. The incidence of varicella disease has remained unchanged since vaccinations became available. d. Period of contagiousness: 1-2 days before rash to 4-7 days later. - CORRECT ANSWER Period of contagiousness: 1-2 days before rash to 4-7 days later (M11) Which of the following are true regarding vaccine efficacy and safety for the live varicella vaccine and the recombinant zoster vaccine? a. Postherpetic neuralgia was not reduced in patients >70 years of age receiving the recombinant zoster vaccine. b. Both vaccines have over 90% effectiveness in prevention of disease after two doses. c. Systemic grade 3 reactions (preventing normal activities) were lower after dose 2 for the recombinant zoster vaccine. d. Injection site pain for both vac - CORRECT ANSWER Both vaccines have over 90% effectiveness in prevention of disease after two doses (M11) Which of the following complications are correctly matched to the associated condition? a. Pneumonia-herpes zoster b. Postherpetic neuralgia-herpes zoster c. Ramsey hunt syndrome-varicella zoster d. Zoster ophthalmicus-varicella zoster - CORRECT ANSWER Postherpetic neuralgia-herpes zoster (M11) Which of the following correctly describes current ACIP recommendations? a. The herpes zoster vaccine should be given to patients ≥40 years. b. The varicella zoster vaccine should be given at birth. c. Patients ≥ 13 years without prior evidence of immunity should only receive one dose of varicella zoster vaccine. d. The varicella zoster vaccine should be given at 12-15 months and 4-6 years of age. - CORRECT ANSWER The varicella zoster vaccine should be given at 12-15 months and 4-6 years of age (M12) Which of the following groups are at high risk for hepatitis A? Infants, adolescents, persons experiencing homelessness, illicit drug users, international travelers - CORRECT ANSWER Persons experiencing homelessness, illicit drug users, international travelers (M12) Match the items below to the appropriate virus - CORRECT ANSWER Hepatitis A: RNA virus, fecal-oral transmission Hepatitis B: DNA virus, transmitted through body fluids (M12) The combination hepatitis A and hepatitis B vaccine (Twinrix) is administered at which of the following monthly intervals? a. 0,1 b. 0,6 c. 0,1,6 d. 0,2,12 - CORRECT ANSWER 0,1,6 (M12) The ACIP recommends the hepatitis A vaccine be administered to all children starting at which age? a. 12 months b. 11 years c. 5 years d. 6 months - CORRECT ANSWER 12 months (M12) Which of the following vaccines contains a synthetic adjuvant? a. Recombivax b. Engerix c. Heplisav d. Havrix - CORRECT ANSWER Heplisav (M12) Which of the following is the reason for the most recent hepatitis A outbreaks? a. International travelers b. Person-to-person transmission c. Imported food d. Domestic food - CORRECT ANSWER Person-to-person transmission (M12) Post-vaccination testing for hepatitis B immunity is recommended for which of the following? a. IV drug users b. Adolescents c. Health-care workers d. Men who have sex with men - CORRECT ANSWER Health-care workers (M12) Which of the following is a clinical feature of hepatitis B but not hepatitis A? a. Chronic infection b. Dark urine c. Fulminant hepatitis d. Jaundice - CORRECT ANSWER Chronic infection (M12) What is youngest age that hepatitis B vaccine is recommended in infants and children? a. 4 weeks b. 6 months c. At birth d. 1 year - CORRECT ANSWER At birth (M13) What is the primary transmission route of MMR? a. Blood transfusions b. Gastrointestinal c. Respiratory d. Skin to skin contact - CORRECT ANSWER Respiratory (M13) What is another name for rubella? a. rubeola b. epidemic measles c. german measles d. scarlet fever - CORRECT ANSWER german measles (M13) Which of the rare diseases prevented by the MMR vaccine is most rare in the U.S.? a. Marburg b. Measles c. Mumps d. Rubella - CORRECT ANSWER Rubella (M13) A child received the MMR vaccine when he was 9 months of age before moving out of the country with his parents. He is now 4 years old and about to enter Kindergarten. How many, if any, doses of MMR should the child receive now? a. 1 b. 2 c. None d. 3 - CORRECT ANSWER 2 (M13) A young adult presenting with swelling of the parotid glands most likely has which of the following diseases: a. Mumps b. Measles c. Congenital Rubella d. Rubella - CORRECT ANSWER Mumps (M13) Which of the following individuals are contraindicated from receiving the MMR vaccine? a. 50-year-old with a low platelet count b. 75-year-old with COPD c. 23-year-old in her 3rd trimester d. 30-year-old with asplenia(M13) - CORRECT ANSWER 23-year-old in her 3rd trimester (M13) Which of the following is the primary reason we have measles outbreaks in the U.S.? a. Low MMR vaccination rates nationally b. There is a shortage of MMR vaccine in the U.S. c. Low effectiveness of the MMR vaccine d. Unvaccinated people with measles coming to the U.S. - CORRECT ANSWER Unvaccinated people with measles coming to the U.S. (M13) During a public health declared mumps outbreak, a 21-year old college student with a history of 2 MMR vaccine doses as a child wants to know if she needs a dose of MMR now. Which of the following is the best response? a. Yes, since there is a declared mumps outbreak. b. Yes, since all college students should have 3 doses of MMR. c. No, as a third dose of MMR is only for measles outbreaks. d. No, as a third dose of MMR is only for rubella outbreaks. - CORRECT ANSWER Yes, since there is a declared mumps outbreak (M13) When counseling the parent of a 1-year-old receiving the MMR vaccine, they should be told that their child may get a measles-like rash after how long from vaccination? a. 1 week b. 48 hours c. 6 weeks d. Immediately - CORRECT ANSWER 1 week (M14) Which of the following are complications that result form diarrhea caused by rotavirus? a. electrolyte imbalance b. brain damage c. dehydration d. paralysis - CORRECT ANSWER electrolyte imbalance, dehydration (M14) What is the primary route that Haemophilus influenzae is transmited? a. fecal oral b. skin contact c. droplet inhalation/respiratory tract secretions d. blood transmission/puncture wound - CORRECT ANSWER droplet inhalation/respiratory tract secretions (M14) True or false. Polio always results in paralysis that can be short or long term? - CORRECT ANSWER False (M15) Which vaccination is NOT part of a combined antigen vaccine? a. Polio b. DTaP c. Haemophilus influenzae d. Rotavirus - CORRECT ANSWER Rotavirus (M15) A patient presents to the pediatric clinic for their 5-year-old well check before entering kindergarten. They received rotavirus at 2 and 4 months and Pentacel (DTaP/IPV/Hib) at 2 and 4 and 6 and 15 months. What vaccine should they need to receive today? a. Hib b. Another dose of Pentacel c. IPV d. Rotavirus - CORRECT ANSWER IPV (M15) Although the primary series for Hib varies between 2-3 doses, all vaccines are recommended to have a booster dose at age: a. booster is not recommended b. 12-15 months c. 4-6 years d. 2 years - CORRECT ANSWER 12-15 months (M15) Which disease state(s) can potentially lead to meningitis? a. Polio b. Haemophilus influenzae c. Polio and Haemophilus influenzae d. Rotavirus and Polio - CORRECT ANSWER Polio and Haemophilus influenzae (M15) Which of the following patients is eligible to receive their first dose of the rotavirus vaccine? a. A newborn 3 days age before leaving the hospital b. An 8-month-old c. A 10-week-old presenting to the pediatrician for their 2-month well check. d. A 1-year-old with severe GERD - CORRECT ANSWER A 10-week old presenting to the pediatrician for their 2 month well check (M15) Which of the following vaccines are mRNA vaccines? a. Pfizer-BioNTech b. Moderna c. Janssen d. Pfizer-BioNTech (Comirnaty) - CORRECT ANSWER Pfizer-BioNTech, Moderna, Pfizer-BioNTech (Comirnaty) (M15) True or false. The incubation period for COVID-19 is usually around 5 days. - CORRECT ANSWER True (M15) Which of the following is a common side effect from COVID-19 vaccinations? a. injection site pain b. Guillain-Barre Syndrome (GBS) c. myocarditis d. death - CORRECT ANSWER injection site pain (M15) Which of the following is true regarding 3rd dose and booster doses for COVID-19? a. Booster doses must always be from the same product as the primary series. b. The third dose and booster dose recommendations for immunocompromised patients are only for mRNA vaccines. c. Booster doses for all COVID-19 vaccinations are given 6 months after completing the primary series. d. A homologous booster dose is a subsequent dose of the vaccine that is a different product than the primary series. - CORRECT ANSWER The third dose and booster dose recommendations for immunocompromised patients are only for mRNA vaccines (M15) Which COVID-19 vaccination has 2 doses administered 28 days apart? a. Janssen b. Pfizer-BioNTech (Comirnaty) c. Moderna d. Pfizer-BioNTech - CORRECT ANSWER Moderna (M15) Documentation requirements for COVID-19 vaccinations include: a. Report administration data to your jurisdiction's system (e.g., IIS) within 72 hours after administration. b. Only cases of COVID-19 that result in hospitalization or death after the recipient has received COVID-19 vaccine should be reported to VAERS. c. COVID-19 vaccination record cards can be redesigned by the pharmacy. d. Emergency Use Authorization (EUA) Fact Sheets should be provided after the patient receives the vacci - CORRECT ANSWER Report administration data to your jurisdiction's system (e.g. IIS) within 72 hours after administration (M15) Which of the following is true regarding risk for COVID-19? a. There has not been an association between number of comorbid conditions and increase in death. b. In the workforce, only healthcare professionals are flagged as at high risk for exposure. c. Coronary atherosclerosis and other heart disease patients have the highest risk of death. d. Older adults and people with underlying medical conditions are some of the patients at highest risk for severe disease and complications. - CORRECT ANSWER Older adults and people with underlying medical conditions are some of the patients at highest risk for severe disease and complications (M15) Which of the following is true regarding transmission of SARS-CoV-2? a. Infected individuals who may be presymptomatic, asymptomatic, or symptomatic can transmit the virus. b. Incubation period is 14 days (range 7-14 days) c. It is only spread through respiratory droplets d. Is not transmitted through contaminated surfaces or objects - CORRECT ANSWER Infected individuals who may be presymptomatic, asymptomatic, or symptomatic can transmit the virus. (M15) A contraindication to receiving a COVID-19 vaccination includes: a. A known (diagnosed) allergy to a component of a COVID-19 vaccine. b. People with a contraindication to mRNA COVID-19 vaccines who request the Janssen COVID-19 vaccine. c. Receipt of COVID-19 vaccine the same day the patient receives an influenza vaccination. d. Any immediate allergic reaction to other vaccines or injectable therapies. - CORRECT ANSWER A known (diagnosed) allergy to a component of a COVID-19 vaccine (M16) Match the myth with the correct proof against it - CORRECT ANSWER 1,2 2,3 3,1 4,4 5,5 (M16) ACIP offers shared decision-making recommendations for which vaccine(s)? a. Hepatitis B vaccine b. 9-valent HPV c. Meningococcal B d. Meningococcal ACWY e. Measles f. DTaP g. Zoster - CORRECT ANSWER hepatitis B vaccine, 9-valent HPV, meningococcal B (M16) Which of the following statements are true? - CORRECT ANSWER 1,2,4 (M16) Post-vaccination counseling for patients should include: a. A review of all steps in the shared decision-making process b. Information about adverse reactions that require contact with the health care system c. A discussion of the risks and benefits of the vaccine d/ Warnings to self-isolate for 48 hours so that the vaccine does not spread disease to others - CORRECT ANSWER Information about adverse reactions that require contact with the health care system (M16) If patients believe that influenza vaccines can cause influenza because they were ill after receiving the vaccine last year, pharmacists should educate them that: a. Only immunocompromised individuals can become ill from inactivated vaccines. b. Influenza vaccine can cause mild influenza infections in some people. c. Some people experience systemic reactions to influenza vaccine that include mild flu-like symptoms d. It takes 3-4 weeks for the immune system to respond to the vaccine, so i - CORRECT ANSWER Some people experience systemic reactions to influenza vaccine that include mild flu-like symptoms (M16) A simple way to communicate information about risks and benefits of vaccines to all patients is to: a. Recommend patients do their own research online prior to their vaccine appointment b. Schedule a 10-minute counseling session prior to each vaccine c. Give them Vaccine Information Statements d. Offer town-hall style events for your community to ask questions about vaccines - CORRECT ANSWER Give them the Vaccine Information Statements (M16) The first step in AHRQ's "SHARE" approach to vaccines is to: a. Assess your patient's values and preferences. b. Ask if your patient is ready to make a decision about getting the vaccine. c. Seek your patient's participation in a discussion. d. Ask if your patient has any questions about the vaccine. - CORRECT ANSWER Seek your patient's participation in a discussion (M16) Vaccine hesitancy is defined as: a. The perception that the risk of a disease is low and that vaccines are not necessary. b. A lack of trust in the safety and effectiveness of vaccines. c. Lack of confidence in the reliability and competence of the health system. d. The delay in acceptance or refusal of a vaccination despite the availability of vaccination services. - CORRECT ANSWER The delay in acceptance or refusal of a vaccination despite the availability of vaccination services (M17) Pharmacists should do what when accepting a vaccine delivery? - CORRECT ANSWER Record the inventory, document and report any damage, label damaged vaccine "Do NOT Use" and store in appropriate conditions (M17) What temperature should refrigerated vaccines be kept at? - CORRECT ANSWER Range: 35-46F (2-8C) Optimal: 40F (5C) (M17) What temperature should frozen vaccines be kept at? - CORRECT ANSWER Range: -58F to 5F (-50C to -15C) (M17) Which of the following statements about refrigerations and freezers for storing vaccines are true? - CORRECT ANSWER 1, 2, 3, 6 (M17) Which of the following statements about vaccine storage are true? - CORRECT ANSWER 1, 3 (M17) Why do vaccines need to be properly stored and handled? - CORRECT ANSWER To maintain their potency (M17) The cold chain for vaccines a. Begins when the provider assumes responsibility when accepting delivery of the vaccine. b. Applies to vaccines but not to diluents. c. Requires that all vaccines be kept refrigerated until they are ready to be prepared for administration. d. Must be maintained from manufacture until the vaccine is administered to the patient. - CORRECT ANSWER Must be maintained from manufacture until the vaccine is administered to the patient (M17) Refrigerated vaccines should be maintained at temperatures between: a. 33°F and +40°F b. 32°F and +40°F c. 35°F and +46°F d. 34°F and +42°F - CORRECT ANSWER 35ºF and +46ºF (M17) Which of the following vaccines must be frozen? a. Live attenuated influenza b. Tdap c. Zostavax d. Inactivated influenza - CORRECT ANSWER Zostavax (M17) Why is it important to preserve the cold chain for vaccines? a. Exposure to heat, cold, or light outside recommended ranges can reduce vaccine potency. b. Vaccines stored at temperatures outside the recommended range are more likely to cause systemic adverse events. c. Vaccines stored at temperatures outside the recommended range are more likely to cause localized adverse events. d. Maintaining the cold chain extends the shelf-life for vaccines. - CORRECT ANSWER Exposure to heat, cold, or light outside recommended ranges can reduce vaccine potency (M17) When storing vaccines in the refrigerator, pharmacists should: a. Keep vaccines and food on separate shelves. b. Store vaccines on the bottom of the refrigerator. c. Use water bottles to help stabilize temperatures. d. Use dorm-style units. - CORRECT ANSWER Use water bottles to help stabilize temperatures (M18) When preparing vaccines for administration, pharmacists should do which of the following? - CORRECT ANSWER Always check the expiration dates on the vaccine and any diluent that is used, always use aseptic technique (M18) When reconstituting vaccines, pharmacists should do which of the following? - CORRECT ANSWER always refer to the vaccine's package insert for specific information (M18) What are the four routes for vaccines approved in the U.S.? - CORRECT ANSWER Subcutaneous (SC) = administered into fatty tissue below the dermis Intramuscular (IM) = administered into the muscle beneath the subcutaneous tisssue Oral = administered through drops to the mouth Intranasal = sprayed into the nostrils (M18) What age group is the deltoid muscle recommended for for IM inections? - CORRECT ANSWER Children ages 3 years and older and adults (M18) Where does one perform IM injections in the deltoid muscle? Where do they not? - CORRECT ANSWER Imagine the deltoid muscle as a triangle. Immunizers should administer the vaccine in the thickest most central portion of the deltoid muscle at a 90 degree angle to the skin. Do not inject too high on the arm as it can lead to SIRVA as well as not too low or off the central line as it can hit bone or vessels. (M18) What is a good body landmark to know where to administer IM injections? - CORRECT ANSWER Near the same level as the armpit (M18) What does SIRVA stand for? - CORRECT ANSWER Shoulder injury related to vaccine administration (M18) What is the recommended needle selection for IM injection? Syringe size: Needle gauge: Length: - CORRECT ANSWER Syringe size: depends on the value of the vaccine (1ml or 3ml) Needle gauge: 22-25G Length: based on sex and weight (M18) Why is it important to use the proper length needle for IM injections? - CORRECT ANSWER To avoid subcutaneous tissue administration (M18) How does one prepare for IM injections? - CORRECT ANSWER 1. Patient and provider seated 2. Expose patient upper arm and deltoid muscle 3. Wipe area with alcohol and let it dry 4. Help patient relax arm muscle (M18) What is the technique for IM injections? - CORRECT ANSWER 1. Insert needle at 90 degrees to skin in a smooth controlled motion while bracing against the arm (if needle contacts bone, pull back slightly until needle is in the muscle and proceed with injection) 2. Depress the plunger (if using a retractable device, activate it while in the arm) 3. Withdraw the needle swiftly 4. Activate safety device immediately 5. Dispose of syringe in sharps container 6. If patient is bleeding, apply cotton or gauze 7. Apply an adhesive bandage 8. Remove gloves and wash hands (M18) What locations are used for subcutaneous injection? - CORRECT ANSWER Children age 3 years and older and adults: outer aspect of upper arm (posterolateral) Infants: Fatty area of anterior lateral thigh (M18) How do you locate the upper arm area for SC injection? - CORRECT ANSWER ~Middle point between the elbow and armpit, just above the triceps muscle (M18) What angle should the needle be inserted for SC injections? - CORRECT ANSWER 45 degrees (M18) What needle length and gauge should be used for SC injections? - CORRECT ANSWER Needle length: 5/8-3/4 inch Gauge: 23-25G (M18) What preparation is needed for SC vaccines? - CORRECT ANSWER 1. Patient and provider seated 2. Expose back of patient's arm 3. Wipe area with alcohol and let the alcohol dry 4. Help the patient relax the arm (M18) What injection technique is used for SC injections? - CORRECT ANSWER 1. Pinch fold of skin over the tricep muscle 2. Insert needle at 45 angle to skin 3. Depress plunger 4. Wait for 3 seconds to allow vaccine to absorb (if using a retractable device, activate it while in the arm) 5. Withdraw needle swiftly 6. Activate safety device immediately 7. Dispose of syringe in sharps container 8. If patient is bleeding, apply cotton or gauze 9. Apply an adhesive bandage 10. Remove gloves and wash hands (M18) Which of the following statements are true? - CORRECT ANSWER 1, 2, 4 (M18) When administering an intramuscular injection, pharmacists should: a. Insert the needle at a 45-degree angle. b. Tell patients to flex the muscle into which the vaccine will be injected. c. Administer the vaccine in the deltoid or gluteus maximus. d. Use a 22- to 25-gauge needle. - CORRECT ANSWER Use a 22- to 25- gauge needle (M18) When preparing vaccines for administration, pharmacists should: a. Prepare all vaccines in a multi-dose vial at the same time. b. Always use aseptic technique. c. Prepare enough vaccine for the entire shift at the beginning of the day. d. Reuse needles and syringes if multiple vaccines are administered to the same patient. - CORRECT ANSWER Always use aseptic technique (M18) When reconstituting a vaccine for injection, pharmacists should: a. Always shake the vaccine prior to reconstitution. b. Always refer to the vaccine's package insert for specific information. c. Always shake the diluent prior to reconstitution. d. Always withdraw the entire contents from the reconstituted vial. - CORRECT ANSWER Always refer to the vaccine package insert for specific information (M18) When administering a subcutaneous injection, pharmacists should a. Tell the patient to flex the muscle under the injection site. b. Pinch a fold of skin over the triceps muscle c. Insert the needle at a 90-degree angle. d. Use a 1 to 1-1/2 inch needle. - CORRECT ANSWER Pinch a fold of skin over the triceps muscle (M18) To prevent errors of vaccine administration, pharmacists should: a. Use the same diluent for all vaccines prepared in one sitting. b. Memorize vaccine schedules. c. Select the appropriate needle length. d. Prepare enough vaccine for the entire shift at the beginning of the day. - CORRECT ANSWER select the appropriate needle length (M19) What are the local and system reactions that patients should expect after a vaccine? - CORRECT ANSWER Local: pain, swelling, redness Systemic: fever, myalgia, headache, rash (M19) What is a first-line treatment for anaphylaxis and how do you use it? - CORRECT ANSWER Epinephrine 1. Administer intramuscularly into the anterolateral aspect of the thigh, may administer through clothing if necessary 2. Administer every 5-15 minutes as needed until EMS personnel arrive (no more than 2 epinephrine doses for normal patients, no more than 3 epinephrine doses for patients taking antihypertensive medication) ***Have at least 3 epinephrine doses at site! (M19) What should pharmacists do when treating a patient for anaphylaxis? - CORRECT ANSWER 1, 2, 3, 4 (M19) When is it appropriate to take NSAIDs and acetaminophen to treat fever and pain? - CORRECT ANSWER Not prior to vaccination, only after the vaccination if tolerated and appropriate (M19) What are some other pain-relieving options? - CORRECT ANSWER 1. Pretreatment with topical lidocaine-prilocaine emulsion 2. Vapocoolant immediately prior to injection 3. Application of cold compress after injection 4. Comfort measures in infants (swaddling) (M19) In a patient experiencing anaphylaxis, pharmacists should administer epinephrine: a. Intramuscularly in the deltoid b. As a first-line treatment c. Every 2 minutes until EMS arrives d. Only in conjunction with diphenhydramine - CORRECT ANSWER As a first-line treatment (M19) Generalized urticaria following a vaccine is considered: a. A reactogenicity symptom b. A localized reaction c. Unrelated to vaccine administration d. An allergic reaction - CORRECT ANSWER An allergic reaction (M19) An adverse event that is considered a systemic reaction to a vaccine is: a. Wheezing b. Angioedema c. Tenderness d. Fever - CORRECT ANSWER Fever (M19) Which of the following is considered a systemic symptom of anaphylaxis? a. Headache b. Fever c. Myalgia d. Diarrhea and vomiting - CORRECT ANSWER Diarrhea and vomiting (M19) Which of the following over-the-counter medications may be recommended to treat systemic reactions after vaccination? a. Loperamide and bismuth subsalicylate b. Diphenhydramine and guaifenesin c. Dextromethorphan and cetirizine NSAIDs and acetaminophen - CORRECT ANSWER NSAIDs and acetaminophen (M20) What information is included in a standing order or protocol? - CORRECT ANSWER 1, 3, 4 (M20) What should you do when asking a practitioner to sign a standing order or protocol? - CORRECT ANSWER 1, 2, 3 (M20) An important benefit of standing orders and protocols is that they: a. Ensure that all members of a patient's health care team are informed of vaccines. b. Improve patient access to vaccines and efficiency of services. c. Allow for pharmacists to bill as providers for Medicare Part D. d. Provide education to patients about the risks and benefits of vaccines. - CORRECT ANSWER Improve patient access to vaccines and efficiency of services (M20) Which of the following best describes a standing order? a. A directive from a third-party payer indicating that pharmacists can be reimbursed for administering vaccines. b. The order of steps that must be followed when administering a vaccine. c. A preapproved document signed by a collaborating physician who authorizes the pharmacist to administer a vaccine. d. An order from the state board of pharmacy allowing pharmacists to administer vaccines. - CORRECT ANSWER A preapproved document signed by a collaborating physician who authorizes the pharmacist to administer a vaccine/ (M20) Which of the following organizations provides standing order templates? a. Public Health Institute b. Infectious Diseases Society of America c. National Institutes of Health d. Immunization Action Coalition - CORRECT ANSWER Immunization Action Coalition (M20) A standing order or protocol should include information about: a. A statement of indemnification for liability. b. Managing medical emergencies that may occur after administration of a vaccine. c. The pharmacy workflow and staffing needed to support the vaccination service. d. Details regarding any liability that the signing practitioner assumes as a result of the standing order or protocol. - CORRECT ANSWER Managing medical emergencies that may occur after administration of a vaccine (M20) Which of the following statements about standing orders and protocols is true? a. Protocols, by definition, apply to all patients within a state. b. Standing orders and protocols must consider which vaccines may be administered by pharmacists according to state laws and regulations. c. Standing orders and protocols may be needed for nonprescription products. d. A standing order is similar to a protocol but is usually broader, authorizing the administration of multiple vaccines. - CORRECT ANSWER Standing orders and protocols must consider which vaccines may be administered by pharmacists according to state laws and regulations. (M21) IISs have been shown to increase immunization rates and reduce vaccine-preventable diseases by: a. All states reporting into the same vaccination registry. b. Assisting in vaccination status assessment. c. Tracking vaccine adverse events. d. Requiring all vaccines for pediatric, adolescent, and adults be entered. - CORRECT ANSWER Assisting in vaccination status assessment. (M21) The program which collects data regarding errors of vaccine handling and administration is called: a. VICP b. VAERS c. VIT d. VERP - CORRECT ANSWER VERP (M21) The National Childhood Vaccine Injury Act of 1986 established national vaccine documentation requirements which include: a. The patient/caregiver must be given a Vaccine Information Statement (VIS) for only the first dose in a series. b. Site of injection. c. Edition date of the Vaccine Information Statement (VIS) d. Documentation of informed consent. - CORRECT ANSWER Edition date of the Vaccine Information Statement (VIS) (M21) Which of the following is an example of a common vaccine administration error? a. Providing a vaccination while the patient is standing. b. Receiving a second dose of a vaccine in the opposite arm that the first dose was received in. c. Wrong vaccine, route, site, or dosage; or improperly prepared. d. Administering a vaccine 3 days after it was due. - CORRECT ANSWER Wrong vaccine, route, site, or dosage; or improperly prepared. (M21) Which of the following is true regarding professional liability? a. Only anaphylaxis needs to be reported to VAERS. b. Pharmacists should educate and inform patients and their caregivers about the benefits and risks of vaccination. c. Patients who accept awards from the VICP fund can still file malpractice claims. d. It is not necessary for a pharmacist to have individual insurance since their place of work would cover them. - CORRECT ANSWER Pharmacists should educate and inform patients and their caregivers about the benefits and risks of vaccination. (M22) Which statement is true regarding gloves and handwashing? a. Employers must make available to employees appropriately sized gloves and a hand washing facility or antiseptic hand cleansers for employees to use while providing immunizations. b. It is recommended to keep gloves on for the duration of a clinic and not change them between patients. c. Pharmacists do not need to wash or use antiseptic cleansers on their hands while providing immunizations if they are wearing gloves. d. Gloves a - CORRECT ANSWER Employers must make available to employees appropriately sized gloves and a hand washing facility or antiseptic hand cleansers for employees to use while providing immunizations (M22) Westend Pharmacy is launching an immunization program next month. The pharmacy manager, John, has a list of items that still need to be completed. Which item below is not required by OSHA to be completed before implementing the program? a. Evaluate employees with potential exposure to bloodborne pathogens for Hepatitis B vaccination status and ensure immunizers have at least one dose prior to administering vaccines. b. Implement a method for sharps disposal, including having sharps contai - CORRECT ANSWER Create a network with local physicians to refer patients to the new immunization program. (M22) Which of the following is not a benefit of a reminder and recall system? a. Complies with ACIP recommendations b. Helps improve immunization rates c. Incentivizes patients to make a primary care appointment. d. Provides continuity of care - CORRECT ANSWER Incentivizes patients to make a primary care appointment. (M22) The OSHA exposure control plan is used by employers to achieve what goal? a. Create a process of controls that aims to eliminate or minimize employee's potential exposure to bloodborne pathogens in the workplace. b. Creates a system for Human Resources to monitor employee health at the workplace. c. Develop a team-based environment that fosters creativity and collaboration. d. Improve employee health and wellness. - CORRECT ANSWER Create a process of controls that aims to eliminate or minimize employee's potential exposure to bloodborne pathogens in the workplace (M22) Which vaccine is required by OSHA to be offered to all employees with potential exposure to bloodborne pathogens? a. Hepatitis B vaccine b. Hepatitis A vaccine c. Influenza vaccine d. Tetanus containing vaccine per current ACIP recommendations (Td or Tdap) - CORRECT ANSWER Hepatitis B vaccine (M23) What are the three billing codes? - CORRECT ANSWER CPT (Current Procedural Terminology) Codes = billing to commercial insurance third-party payers HCPCS (Healthcare Common Procedure Coding System) Codes = billing to Medicare and Medicaid ICD-10 (International Classification of Diseases) Codes = billing for specific diseases (i.e. Z23, encounter for immunization) (M23) According to the Affordable Care Act, which of the following must be covered without cost-share to the patient? a. An ACIP recommended travel vaccine b. A vaccine from an Out of Network provider. c. An ACIP routinely recommended vaccine. d. A vaccine using Medicare Part D - CORRECT ANSWER An ACIP routinely recommended vaccine (M23) The Vaccine for Children (VFC) program pays for which of the following? a. The refrigerator needed to store the vaccine b. The vaccine administration supplies c. The administration fee d. The vaccine - CORRECT ANSWER The vaccine (M23) What type of code is used to identify the diagnosis for a patient receiving a vaccine? a. ACIP b. ICD-10 c. NCPDP d. CPT - CORRECT ANSWER ICD-10 (M23) Which of the following is the correct answer and reason for a 64-year old patient who asks you if it is better to get their shingles vaccine now or wait til it is covered by Medicare at 65 years? a. Now because it must be covered at no cost by commercial insurance. b. Now because it is not covered at 65 years or above. c. Wait till 65 years when it is covered by Medicare part B. d. Wait till 65 years as it is not indicated before 65 years. - CORRECT ANSWER Now, because it must be covered at no cost be commercial insurance (M23) Which of the following requires no cost-share for the patient and is mainly for those 65 years and older? a. Medicare Part D b. Medicare Part B c. Medicaid d. Medicare Part C - CORRECT ANSWER Medicare Part B (M24) Which of the following best describes how to roll with resistance? a. Explain to the patient the errors in their thinking. b. Tell patients that you believe in their ability to change. c. Use open-ended questions and reflective statements. d. Change strategies to avoid arguing with patients. - CORRECT ANSWER Change strategies to avoid arguing with patients. (M24) Which of the following best describes the preparation stage of the Transtheoretical Model of Health Behavior Change? a. Patients intend to take action in the next month to change their behavior. b. Patients are aware that a problem exists and are seriously thinking about overcoming it. c. Patients have no intention to change behavior. d. Patients modify their behavior. - CORRECT ANSWER Patients intend to take action in the next month to change their behavior. (M24) Which of the following best describes the definition of vaccine hesitancy? a. Patients who express a desire to receive a vaccine, but then refuse due to fear of needles. b. A delay in the acceptance of, or refusal of, a vaccination despite availability of vaccination services. c. Refusal to receive vaccinations due to religious beliefs. d. When patients do not receive vaccinations due to misinformation. - CORRECT ANSWER A delay in the acceptance of, or refusal of, a vaccination despite availability of vaccination services. (M24) Which of the following statements best illustrates the affirmation skill in motivational interviewing? a. "Can you tell me more about your concerns?" b. "What information do you have about this disease?" c. "It sounds like that was a really frustrating experience for you." d. "Thank you for sharing your concerns with me, I enjoyed speaking with you today" - CORRECT ANSWER "Thank you for sharing your concerns with me, I enjoyed speaking with you today" (M24) Health literacy is considered a part of which domain of social determinants of health? a. Economic stability b. Health care access c. Neighborhood and built environment d. Social and community context - CORRECT ANSWER Health care access (M25) Which setting best facilitates the delivery of a mass vaccination clinic for the general population? a. Physician practice b. Community pharmacy c. On-site community event d. Long-term care facility - CORRECT ANSWER On-site community event (M25) After the routine administration of a vaccine, the pharmacy technician should send documentation of the vaccination to: a. The Vaccine Adverse Event Reporting System (VAERS). b. The National Vaccine Errors Reporting Program (VERP). c. All of the patient's prescribers in the pharmacy's records. d. The patient's primary care physician. - CORRECT ANSWER The patient's primary care physician (M25) A potential advantage of accommodating walk-in vaccines, compared with only scheduling appointments, is that: a. It allows the pharmacy to ensure that enough vaccine is on hand. b. It helps the patient receive multi-dose series vaccines according to the recommended schedule. c. It may allow greater flexibility and convenience for the patient. d. It allows the pharmacy to ensure adequate staffing to support demand. - CORRECT ANSWER It may allow greater flexibility and convenience for the patient (M25) Which of the following vaccines would be best delivered in a mass vaccination clinic? a. Tetanus/diphtheria/pertussis vaccine b. Influenza vaccine c. Meningitis vaccines d. Herpes zoster vaccine - CORRECT ANSWER Influenza vaccine (M25) A pharmacy technician may perform which of the following roles? a. Determine whether a vaccine is appropriate for a patient. b. Educate patients about the risks of vaccines. c. Ask patients to complete screening questionnaires. d. Make clinical judgments about a patient's health. - CORRECT ANSWER Ask patients to complete screening questionnaires (M26) When promoting a mass immunization clinic it is helpful to: a. Share appointment scheduling instructions, if applicable. b. Explain how the cold chain will be maintained. c. Ask patients to bring their own first aid supplies. - CORRECT ANSWER Share appointment scheduling instructions, if applicable (M26) Which of the following functions should be performed prior to the mass vaccination clinic? a. Ordering of adequate inventory of vaccines and supplies b. Communication of wait-times c. Documentation of any adverse events and submission to the Vaccine Adverse Event Reporting System (VAERS) d. Continuous quality improvement activities - CORRECT ANSWER Ordering of adequate inventory of vaccines and supplies (M26) Which of the following vaccines are best suited to a mass immunization clinic? a. Vaccines for high-risk patient populations b. Travel health vaccine needs c. Vaccines to address a pandemic pathogen d. Childhood vaccines - CORRECT ANSWER Vaccines to address a pandemic pathogen (M26) Which of the following facility features is most important for maintaining the cold chain? a. Adequate seating in the waiting area b. Proximity to public transportation c. Access to high-speed internet service d. Space for vaccine storage and temperature monitoring - CORRECT ANSWER Space for vaccine storage and temperature monitoring (M26) Which of the following statements is true when operating a mass vaccination clinic? a. If multiple vaccines are available, they should be administered at different stations. b. Patients do not need to be provided with Vaccine Information Stations. c. Patients do not need to be observed after vaccination. d. The clinic does not need to be able to accommodate patients with disabilities. - CORRECT ANSWER If multiple vaccines are available, they should be administered at different stations (M27) Which of the following best describes immunization coalitions? a. Nongovernmental public health organizations b. Patient advocacy organizations c. Organizations that bring together vaccination stakeholders to improve vaccination rates d. Professional membership associations for health care providers who immunize - CORRECT ANSWER Organizations that bring together vaccination stakeholders to improve vaccination rates (M27) Which of the following awareness campaigns is typically conducted in December? a. American Pharmacists Month b. National Influenza Vaccination Week c. National Immunization Awareness Month d. World Pneumonia Day - CORRECT ANSWER National Influenza Vaccination Week (M27) Which of the following statements is true regarding forming relationships with other immunization stakeholders? a. It is a function best left to the pharmacy's sales and marketing team b. It can be risky if other providers feel threatened by competition c. It supersedes the need to create print marketing materials d. It can enhance your marketing efforts - CORRECT ANSWER It can enhance your marketing efforts (M27) Which of the following is considered a print marketing strategy? a. Radio announcements b. Social media advertising c. Voice response system messages d. Flyers and brochures - CORRECT ANSWER Flyers and brochures (M27) Which of the following is a source of free print materials that can be used to market vaccination services? a. National Academy of Medicine b. Centers for Disease Control and prevention c. International Pharmaceutical Federation d. Infectious Diseases Society of America - CORRECT ANSWER Infectious Diseases Society of America (M28) Which of the following activities should only be performed by a pharmacist? a. Document the vaccine in the pharmacy's electronic record. b. Gather information about a patient's vaccination history. c. Decide whether a patient needs a vaccine. d. Communicate information about the vaccination to the patient's primary care provider. - CORRECT ANSWER Decide whether a patient needs a vaccine. (M28) Which of the following statements would be appropriate for a pharmacy technician to make? a. You should receive the influenza vaccine." b. "After reviewing your records, I think you should receive the hepatitis B vaccine." c. "Because you are high risk, you should receive the pneumococcal vaccine." d. "We are now offering herpes zoster vaccines in the pharmacy." - CORRECT ANSWER "We are now offering herpes zoster vaccines in the pharmacy" (M28) Preparing a vaccine for administration may include which of the following tasks? a. Disposing of the needle in a sharps container. b. Sterilizing the area for preparing the vaccine. c. Selecting the needle for administering the vaccine. d. Ensuring the vaccine is at room temperature before it is administered. - CORRECT ANSWER Selecting the needle for administering the vaccine (M28) Which of the following is true about the pharmacy technicians' role in managing vaccine inventory? a. Expiration dates and beyond use dates should be checked at least weekly. b. If vaccines are damaged when they arrive, they should immediately be thrown away. c. Pharmacy technicians are only allowed to check temperatures to maintain the cold chain in some states. d. After vaccines arrive within the pharmacy, they should be checked with 24 hours of arrival. - CORRECT ANSWER Expiration dates and beyond use dates should be checked at least weekly (M28) Which of the following statements is true regarding how pharmacy technicians can gather information about a patient's vaccination history? a. Pharmacy technicians can access Immunization Information Systems in all states. b. Pharmacy technicians can review information from immunization coalitions. c. Pharmacy technicians should not be involved in gathering information about a patient's vaccination history. d. Pharmacy technicians can review electronic health records. - CORRECT ANSWER Pharmacy technicians can review electronic health records (M29) Which of the following best describes a public health department? a. A department which helps prevent the start and spread of disease. b. An international organization that provides resources for pharmacists in multiple countries. c. A volunteer-led organization that aims to improve vaccination rates. d. A department within a pharmacy's corporate office that focuses on population health. - CORRECT ANSWER A department which helps prevent the start and spread of disease (M29) Which of the following issues affecting international access to vaccines is best aligned to efforts by pharmacist volunteers? a. Unstable governments b. Poor infrastructure c. Lack of clean drinking water d. Suboptimal levels of health care providers - CORRECT ANSWER Suboptimal levels of health care providers (M29) Which of the following is a law or program that may grant immunity from civil liability during emergencies for covered activities? a. NABP emergency passport b. Medical Reserve Corps c. U.S. Public Readiness and Emergency Preparedness Act d. Immunization Action Coalition - CORRECT ANSWER U.S. Public Readiness and Emergency Preparedness Act (M29) Which of the following is a government-run volunteer organization for medical and public health professionals? a. Immunization Action Coalition b. Medical Reserve Corps c. Peace Corps d. National Guard - CORRECT ANSWER Medical Reserve Corps (M29) Which of the following is a non-governmental organization that participates in disaster relief efforts? a. Public Health Department b. Red Cross c. World Health Organization d. Medical Reserve Corps - CORRECT ANSWER Red Cross How to fill a syringe with a vaccine? - CORRECT ANSWER 1. Remove rubber cap from the vaccine vial 2. Perform one swift swipe of the vial top with an alcohol pad 3. Draw up the syringe with air equal to the amount of vaccine you need 4. Hold vial upside down and insert needle and inject the air 5. With the vial still upside down, withdraw the correct volume (tap the needle to remove any large air bubbles) 6. Remove syringe from the vial and either inject patient or recap