APhA Immunization Exam 103 Questions with Verified Answers,100% CORRECT

APhA Immunization Exam 103 Questions with Verified Answers What is the minimum needle length recommended for administering HepB vaccine to an adult patient weighing 130 lb? - CORRECT ANSWER Fixed 1-inch needles are ac ...

APhA Immunization Exam 103 Questions with Verified Answers What is the minimum needle length recommended for administering HepB vaccine to an adult patient weighing 130 lb? - CORRECT ANSWER Fixed 1-inch needles are acceptable for patients weighing 60 kg (132 lb) or less. HZV, MMR, rabies, typhoid, varicella, or yellow fever vaccine should not be administered to a patient with a history of anaphylaxis to: - CORRECT ANSWER Gelatin Alan is a 47-year-old man who has no documentation of a primary series of tetanus-containing vaccine. Which of the following would be an appropriate primary series for Alan? - CORRECT ANSWER 1) Tdap 2) Td 4 weeks later 3) Td 6-12 months later Td booster every 10 years after 3rd dose Candidate for PPSV23? - CORRECT ANSWER All adults 65+ years Immunocompromised (alcoholism, chronic liver; heart; lung disease, diabetics, cochlear implants, CSF leak) patients ages 19-64 Children with asthma only if theyre treated with high dose corticosteriods Name the vaccine-preventable disease that may be contracted by unimmunized children from adults serving as reservoirs for the disease, which causes a paroxysmal cough and potentially can result in pneumonia, seizures, encephalopathy, hypoxia, and death. - CORRECT ANSWER Pertussis Which of the following vaccines may be administered to males and females aged 9 through 26 years to reduce the likelihood of acquiring genital warts? - CORRECT ANSWER 9vHPV Which of the following key questions is important to ask a patient before administering IIV? - CORRECT ANSWER Are you sick today? *Mild illness is okay, but moderate to severe acute illness need to be resolved before getting vaccine. Live attenuated vaccines.. - CORRECT ANSWER produced by weakening the virus or bacteria to reduce the likelihood that it can cause disease end to produce more persistent, longer-lasting immunity than inactivated vaccines must replicate in order for the body to produce an immune response could cause disease in immunocompromised patients Circulating antibodies may interfere with a live attenuated vaccine's ability to replicate. Inactivated vaccines... - CORRECT ANSWER are produced by killing the virus/bacteria includes polysaccharide vaccines (conjugated [protein altered] or unconjugated), toxoids, or cellular vaccines Which type of vaccine involves stimulation of B cells without the assistance of T helper cells? - CORRECT ANSWER A pure polysaccharide *not recommended for children <2 because of their immature immune system Conjugated vaccines.. - CORRECT ANSWER provide longer lasting protection the immune response that changes to a T cell mediated response allows children <2 to form an immune response T/F Both live attenuated vaccines and recombinant vaccines mimic natural infection and involve T cells in the immune response. - CORRECT ANSWER True The incubation period for influenza can range from: - CORRECT ANSWER 1-4 days What is the time interval for which the development of Guillain-Barré syndrome following influenza vaccination would result in a precaution for future influenza vaccines? - CORRECT ANSWER 6 weeks The monitoring system that health care providers should use to report serious adverse events after vaccination is: - CORRECT ANSWER VAERS Which of the following patients are appropriate candidates for the 2-dose schedule of HPV9? - CORRECT ANSWER 11 or 12 year olds *if series has not been started by age 15, then a 3 dose series is needed *3 dose series recommended for immunocompromised patients *1st/2nd dose- given at 0 and 6-12 months *if 2nd dose is given sooner than 5 months after the first dose then a 3rd dose is needed Why should refrigerated vaccines be stored in the middle of the refrigerator? - CORRECT ANSWER because the temperature in the middle does not fluctuate as much. A history of anaphylaxis caused by neomycin would be a contraindication to receiving which of the following vaccines? - CORRECT ANSWER Hep A, IPV, MMR, Rabies, smallpox, varicella, zoster, influenza 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? - CORRECT ANSWER Orange-indicates theres a precaution for the vaccine * Yellow-vaccine recommended according to routine schedule Purple-recommended for people with an additional risk factor for which the vaccine would be indicated Yellow/black- vaccine recommended, additional doses may be necessary based on medical condition White-no recommendation Red-vaccine is contraindicated 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: - CORRECT ANSWER Immediate protection *its passive immunity so its short-lived, but provides protection right away Contraindication of HZV - CORRECT ANSWER HZV is a live vaccine so its contraindicated in immunocompromised patients, pregnant women, and those who have experienced a severe allergic reaction to the vaccine components (neomycin, gelatin) Viruses associated with the development of cancer: - CORRECT ANSWER HPV and Hep B There should be a flat hard surface in the area where vaccines will be administered to ensure: - CORRECT ANSWER there is space to perform CPR If pharmacists are called upon to assist with vaccination efforts following a natural disaster, which vaccine is likely to be needed by many of the victims? - CORRECT ANSWER Td or Tdap According to ACIP recommendations, which of the following needle lengths would be appropriate for administering HZV to an adult patient? - CORRECT ANSWER 5/8 in needle at 45 degrees in the outer upper arm (SC) How often are the Healthy People targets for vaccination rates updated? - CORRECT ANSWER every 10 years Which of the following patients is a candidate for both MenACWY and MenB vaccines? - CORRECT ANSWER A 10 year old who just had his spleen removed *MenA can be administered at 2months, MenB not recommended until 10 yrs HIV infection and being in the military are risk factors for MenA What must be documented for VIS? - CORRECT ANSWER -patient name -date vaccine was administered -vaccine manufacturer, lot number -name, address, title of the administer -date printed on VIS -date VIS was given to patient or guardian *signatures of patient/guardian not required by federal law, but some employers/companys may require signatures Who should receive MMR vaccine? - CORRECT ANSWER 2 dose series at 12-15 months and 4-6 years *no additional doses needed MMR is a live vaccine, not recommended until 12 months old Adults w/o immunity evidence (being born before 1957, documentation of MMR vaccine, lab evidence of disease) should receive one dose Healthcare professionals should receive 2 doses If a patient received the first dose of HepB but did not return for the remaining doses in the series, under what circumstances should the HepB series be restarted? - CORRECT ANSWER Do not have to start series over (oral typhoid is the exception) *Increasing the interval between doses of a multi-dose vaccine series does not diminish the ultimate effectiveness of the vaccine, but it does delay protection for the patient. Which of the following best describes how to administer MMR vaccine to an adult patient weighing 210 lb? - CORRECT ANSWER SC at 45 degree angle *weight of patient does not matter in regards to route of administration HPV vaccine is recommended for.. - CORRECT ANSWER Both males and females ages 9-26 years *routinely recommended for 11 or 12 years of age Tom is a 9-year old boy who has never had an influenza vaccine. Tom's mother shows you his up-to-date immunization record and reports that he has never had any adverse reactions to vaccinations. What dose and schedule of IIV should be administered to Tom? - CORRECT ANSWER One dose during flu season *influenza vaccine can be given beginning at 6 months 6 months-8 years who have not previously been vaccinated need 2 doses, 4 weeks apart 9 years-one dose during flu season 6 months-2 years 0.25mL dose 3+ years- 0.5mL dose 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-diagnosed case of chickenpox at 2 years of age. Which of the following would be the most appropriate recommendation for her today? - CORRECT ANSWER Tdap MCV4 HPV Hep B influenza vaccine if flu season True regarding varicella-containing vaccines: - CORRECT ANSWER HZV (Zostavax) contains 14 times more antigen than varicella vaccine the greater potency is necessary for an adequate immune response in older patients who have immunity to varicella because they had chicken pox Which disease is almost certain to cause death if infected patients do not receive postexposure prophylaxis? - CORRECT ANSWER Rabies *it affects the CNS If a patient with an egg allergy experiences hives following influenza vaccination, what is ACIP's recommendation for vaccinating this patient against influenza? - CORRECT ANSWER Hives only-can receive vaccine If patient experienced anaphylaxis or required an epi pen -CAN still receive vaccine but it must be in a medical setting where they can be supervised by medical professionals to assist with any complications The childhood/adolescent and adult immunization schedules are updated and published annually during which months? - CORRECT ANSWER once a year at the end of January or early February How is the live, cholera vaccine administered? - CORRECT ANSWER single oral dose at least 10 days prior to potential exposure *should not eat/drink for 1 hour before or after vaccine RotaTeq (RV5) should be administered as a: - CORRECT ANSWER 3-dose series at 2,4,6 months Rotarix (RV1) should be administered as a: - CORRECT ANSWER 2 dose oral series at 2 and 4 months Diagnosis-based screening to identify people at risk for vaccine-preventable diseases: - CORRECT ANSWER identifies patients in need of vaccines based on the presence of a particular diagnosis. ex: diabetes Procedure based screening to identify people at risk for vaccine-preventable diseases: - CORRECT ANSWER involves assessing vaccine needs based on a patient's receipt of a surgical, medical, or pharmacy-based procedure. ex: splenectomy Occurrence based screening to identify people at risk for vaccine-preventable diseases: - CORRECT ANSWER takes advantage of an event, such as a hospital admission, clinic visit, or emergency department visit to identify people who need to be vaccinated ex: discharge counseling Live attenuated vaccines (11) - CORRECT ANSWER Cholera HZV LAIV MMR MMRV Rotavirus TB (BCG) Typhoid (Ty21a) Vaccinia (smallpox) Varicella Yellow Fever *all others are inactivated For a patient who needs to receive IIV and HZV, which of the following best describes appropriate administration of these vaccines? - CORRECT ANSWER No minimum interval between doses *IIV is inactivated HZV is live inactivated do not interfere with live Interval between 2 live vaccines NOT given simultaneously: - CORRECT ANSWER 4 weeks Why was the live attenuated influenza vaccine (LAIV) removed from the ACIP's influenza vaccine recommendations? - CORRECT ANSWER Lower than expected efficacy in 2013-2016 Epi doses: - CORRECT ANSWER 1:1000 w/v 1mg/mL based on weight: 0.01mg/kg/dose max dose: 0.5mg/dose dose 5-15min for up to 3 doses The majority of vasovagal syncope cases occur withinin: - CORRECT ANSWER 15min of vaccination Which of the following diseases has been successfully eradicated worldwide through vaccination efforts? - CORRECT ANSWER smallpox In 2014, which vaccination rate was lowest among adolescents 13 through 17 years of age? - CORRECT ANSWER HPV How do vaccines evoke an immune response? - CORRECT ANSWER The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells. *Pure polysaccharide vaccines do not activate B cells. What to do in case of anaphylaxis: - CORRECT ANSWER Do not offer water (do not want anything in the throat) check BP and pulse to see if it is decreasing (decreasing means less blood flow and more likely to faint) Administer epi pen when patient is wheezing and difficulty in breathing, give second dose if wheezing continues IM is more prompt than SC True allergic reaction: - CORRECT ANSWER immediate hypersensitivity with itching, hives, redness, or symptoms of anaphylaxis False allergic reaction: - CORRECT ANSWER fever, GI upset, red eyes, neurological events Can a women receive the flu vaccine if she is pregnant? - CORRECT ANSWER Yes, but it has to be the inactivated flu vaccine only during flu season What vaccine should women get every pregnancy? - CORRECT ANSWER Tdap, after 20 weeks of pregnancy What individuals are at an increased risk of adverse effects from live vaccines - CORRECT ANSWER Immunocompromised Minimum interval when a PPD skin test is followed by a live vaccine - CORRECT ANSWER Administer vaccine after PPD skin test has been read Minimum interval when a live vaccine is followed by a PPD skin test - CORRECT ANSWER 28 days Minimum interval when blood product is given before live vaccine - CORRECT ANSWER minimum varies (have to look up) Minimum interval for live vaccines followed by blood products - CORRECT ANSWER 2 weeks Minimum interval for inactivated vaccines and antibodies - CORRECT ANSWER no minimum Minimum interval for two live vaccines, if not simultaneous - CORRECT ANSWER 28 days David is a healthy 5-year-old boy who is scheduled to see his pediatrician for a checkup in July prior to starting kindergarten. David's immunization record 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 4 doses of Hib Which vaccines should David receive at this visit? - CORRECT ANSWER 5th dose of DTaP 4th dose of IPV 2nd dose of MMR 2nd dose of varicella PCV13 Hib Hep A Hep B Purpose of adjuvants - CORRECT ANSWER it strengthens the response to the antigen and the immune response is much greater because the adjuvant results in an inflammatory response *adjuvants are added to recombinant vaccines The presence of fever, diffuse maculopapular rash, and Koplik spots are characteristic of which of the following diseases? - CORRECT ANSWER MMR Which of the following is recognized by sociologists as a factor in a patient's decision whether to be vaccinated? - CORRECT ANSWER 1) perceived susceptibility to a disease 2) perceived seriousness of a disease 3) perceived vaccine benefits 4) perceived vaccine barriers (e.g., adverse effects, access) 5) social influence (e.g., recommendation from a health care provider) In the event that a young child is fussy following the receipt of a vaccine, pharmacists should advise parents to: - CORRECT ANSWER quiet activites and comfort them *Can use acetaminophen/ibuprofen for discomfort Aspirin is not recommended During which step of the Pharmacists' Patient Care Process would a pharmacist analyze a patient's need for certain vaccines? - CORRECT ANSWER Assess After completion of a primary vaccine series and documentation of a one-time dose of Tdap, Td booster doses are recommended every: - CORRECT ANSWER every 10 years 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? - CORRECT ANSWER one dose of Tdap 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 1 dose of IPV Which vaccines should Ava receive at today's visit? - CORRECT ANSWER 2nd Hib Rotavirus DTaP PCV13 IPV *3rd Hep B at 6 months too young for flu vaccine MMR/varicella are live and recommend at 1 year 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? - CORRECT ANSWER 3 dose series at 0, 1, and 6 months At what point during pregnancy is it recommended to administer the influenza vaccine? - CORRECT ANSWER Any trimester Which of the following statements about pharmacy-based vaccination programs is true? Feedback - CORRECT ANSWER Administratively, billing for vaccines covered by Medicare Part D may be easier for pharmacists than physicians. Which of the following is the best example of a group with which individual pharmacists can collaborate to increase immunization rates in their communities? - CORRECT ANSWER Local Health Departments 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 containing tetanus, diphtheria, and/or pertussis would be most appropriate for him? - CORRECT ANSWER Tdap if he has not received that and a Td booster every 10 years Kate is a 24-year-old woman with asthma. She requests a refill of her albuterol inhaler on November 1st. Kate's immunization record indicates 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? - CORRECT ANSWER PPSV23 HPV Influenza if flu season *PCV13 is for immunocompromised not asthma What is the type of immunity that occurs when a pregnant woman is vaccinated with Tdap to protect the infant from pertussis after birth? - CORRECT ANSWER Passive Immunity *antibodies are provided from another source Acquired immunity: - CORRECT ANSWER immunological memory *can be active or passive Active immunity: - CORRECT ANSWER an antigen from an invading pathogen triggers an immune response Which of the following statements would be accurate when responding to a patient's concerns about the safety of vaccines? - CORRECT ANSWER Inactivated is killed so cannot cause influenza intranasal is live but modified so cannot cause disease No vaccine is 100% effective If illness does occur its often less severe in those who were vaccinated No evidence that Thimerosal has caused any short or long term harm Several vaccines on the same day in immunocompetent people will not overload their immune system people are exposed . to more antigens every day from food or bacteria than from vaccines If a patient is a candidate for revaccination with PPSV23, what is the ACIP-recommended interval between doses of this vaccine? - CORRECT ANSWER 1-3 doses with 5 years between under age of 65 who are immunocompromised or asplenia-2 doses with 5 years apart Which disease is characterized by the development of a membrane on the tonsils, pharynx, or larynx, leading to respiratory obstruction? - CORRECT ANSWER Diphtheria Which of the following best describes how to administer Tdap vaccine to an adult patient weighing 185 lb? - CORRECT ANSWER IM at 90 degrees *weight of patient is irrelevant in regards to route of administration Alex is a 32-year-old man who is scheduled to travel to a country where hepatitis A is endemic. He leaves in 3 weeks and will be gone a month. He received his first dose of hepatitis A vaccine today. Alex should be counseled to return for his second dose of hepatitis A vaccine: - CORRECT ANSWER 2nd dose given at least 6 months after the first dose Adolescents should be routinely vaccinated with MCV4 on the following schedule: - CORRECT ANSWER 1 dose at 11 or 12 years booster at 16 years Kyle is a 5-year-old boy who is up to date with his vaccinations. He has never experienced any adverse effects from vaccinations. At his next 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? - CORRECT ANSWER 5th dose DTaP *one time dose of Tdap at 7 years Td booster every 10 years Barbara is a 60-year-old woman who presents to the pharmacy for two vaccines: HZV and IIV. Which of the following are the appropriate doses and routes for administering these vaccines to this patient? - CORRECT ANSWER HZV-SC, 0.65mL dose IIV-IM, 0.5mL What is meant by the term "immunization neighborhood"? - CORRECT ANSWER Immunization stakeholders collaborate to meet community immunization needs. Even though state laws may have specific mandates, how long should pharmacists maintain records of immunizations? - CORRECT ANSWER Immunizations should become part of the patient's permanent record and should be kept for the patient's lifetime. All Medicare Part B enrollees are covered for which vaccines? - CORRECT ANSWER both pneumococcal vaccines influenza vaccine All Medicare Part D enrollees are covered for which vaccines? - CORRECT ANSWER Td/Tdap HZV Arthus reactions, which are exaggerated local reactions that can occur if a patient is vaccinated too frequently, are most commonly reported after which vaccine? - CORRECT ANSWER Td or Tdap 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: - CORRECT ANSWER If he has not had 2 doses of the flu vaccine then he needs 2 doses, 4 weeks apart According to the ACIP, which of the following would be considered adequate evidence of immunity to varicella, indicating that administration of varicella vaccine is unnecessary? - CORRECT ANSWER Diagnosis of chickenpox/shingles by a health care provider. Born in U.S. before 1980 2 doses of varicella at least 4 weeks apart Vaccines as well as exposure to natural disease are both examples of which type of immunity? - CORRECT ANSWER Active immunity How vaccines evoke an immune response: - CORRECT ANSWER The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells. *Pure polysaccharide vaccines do not activate B cells. If a vial of influenza vaccine is left out of the refrigerator on the pharmacy counter overnight, what should be done with the vaccine? - CORRECT ANSWER Should be quarantined in fridge/freezer and marked "do not use" and contact manufacturer for further instructions *RPh should document each step anytime theres a break in the cold chain Which vaccine does ACIP recommend for all college freshmen, aged 21 years or younger, living in dormitories, who have not been previously vaccinated? - CORRECT ANSWER One dose of MCV4 Prior to the introduction of a vaccine, what was the leading cause of bacterial meningitis in children younger than 5 years of age? - CORRECT ANSWER Hib