APhA Immunization Exam 89 Questions with Verified Answers,100% CORRECT

APhA Immunization Exam 89 Questions with Verified Answers The National Vaccine Advisory Committee 2013 Standards for Adult Immunization Practice and the 2016 International Pharmaceutical Federation global report ident ...

APhA Immunization Exam 89 Questions with Verified Answers The National Vaccine Advisory Committee 2013 Standards for Adult Immunization Practice and the 2016 International Pharmaceutical Federation global report identify pharmacists as: - CORRECT ANSWER Integral to increasing vaccination rates 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: - CORRECT ANSWER Increase the proportion of persons who are vaccinated annually against seasonal influenza Opportunities for Advocacy and Collaboration include: - CORRECT ANSWER Membership in state Immunization coalition to serve as an expert on policy and practice issues affecting pharmacy Which of the following diseases have been eradicated worldwide, allowing vaccination to be discontinued? - CORRECT ANSWER Smallpox - eradicated in 1980 by WHO 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? - CORRECT ANSWER Prevention, Partnership, Quality, Documentation and Empowerment Active Immunity - CORRECT ANSWER Long-term protection but takes 2 weeks to work Innate Immunity - CORRECT ANSWER Barrier defense mechanism Adaptive Immunity - CORRECT ANSWER Also known as acquired Passive Immunity - CORRECT ANSWER Antibodies from an external source Antigens - CORRECT ANSWER Evoke the immune response and bind to specific antibodies T/F: Vaccines contain antibodies which are recognized by the immune system. - CORRECT ANSWER False What can a pharmacist do to reduce the risk of getting hepatitis B after exposure? - CORRECT ANSWER 1. Post-exposure prophylaxis is needed right away 2. Give both Hep B immune globulin (HBIG) and Hepatitis B vaccine 3. HBIG contains antibodies that provide immediate protection via passive immunity 4. When a person is fully vaccinated, the hepatitis B vaccine provides long-term protection. Live Vaccines are: - CORRECT ANSWER 1. Attenuated 2. Stimulates both humoral and cell-mediated immune response 3. May be interfered with by circulating antibodies 4. Not given to children less than 12 months of age due to presence of maternal antibodies Inactivated Vaccines are: - CORRECT ANSWER 1. Killed virus or bacteria 2. Does not replicate 3. Stimulates humoral immunity (antibodies) 4. May be given to people who have received blood products or live vaccines, regardless of timing. 5. Predominantly given to infants (less than 12 months) because they may have circulating maternal antibodies which could reduce the effectiveness of a live vaccines. T/F: Inactivated vaccines do NOT have minimum intervals between administered vaccines - CORRECT ANSWER True T/F: Inactivated vaccines are not affected by live vaccines and visa versa. - CORRECT ANSWER True If two live vaccines are given simultaneously sly on the same day, then you must wait _____ minimum interval. - CORRECT ANSWER 28-day minimum interval so that each vaccine can replicate properly. Live vaccines followed by blood products (contain antibodies) require ______minimum interval. - CORRECT ANSWER 2 weeks. Which of the following is an example of passive immunity? a.) Contracting measles b.) Hep B Vaccine c.) Skin Barrier d.) Maternal antibodies - CORRECT ANSWER d.) Maternal antibodies Why is spacing and timing of vaccines important? - CORRECT ANSWER Circulating antibodies may interfere with immune response How long does it take for the immune system to provide protection by producing disease-specific antibodies and memory cells? - CORRECT ANSWER 14 days When does Active Immunity occur? - CORRECT ANSWER When a patient is exposed to an antigen that triggers the body's immune system to produce it's own disease-specific antibodies and memory cells. Children less than what age do not mount an adequate immune response to t-cell independent immunity? - CORRECT ANSWER 2 years. Which of the following is found in vaccines to evoke an immune response? - CORRECT ANSWER Antigens What does attenuated mean? - CORRECT ANSWER weakened LAIV4 is the abbreviation for: - CORRECT ANSWER Live Attenuated Influenza Vaccine RV1, RV5 is the abbreviation for: - CORRECT ANSWER Rotavirus VAR is the abbreviation for: - CORRECT ANSWER Varicella MMR is the abbreviation for: - CORRECT ANSWER Measles, mumps, rubella MMRV is the abbreviation for: - CORRECT ANSWER Measles, mumps, rubella, varicella Can inactivated vaccines replicate? - CORRECT ANSWER No. It does not cause disease. What are two broad categories that vaccines are classified as? - CORRECT ANSWER 1. Live attenuated vaccines 2. Inactivated vaccines Cellular Vaccines - CORRECT ANSWER 1. Inactivated Vaccines 2. Whole viruses or bacteria 3. Known as Subunits (fractions) 4. DTP/DTaP Toxoid Vaccines - CORRECT ANSWER 1. Inactivated Vaccine 2. Subunit (fractions) 3. Inactive or biological toxin 4. Tetanus toxoid Recombinant Vaccine - CORRECT ANSWER 1. Produced by genetic engineering 2. May contain no actual virus or a modified strain of a virus 3. HepB, HPV, RZV, RIV4 What clinical factors need to be considered before administering a lie attenuated vaccine? - CORRECT ANSWER 1. Patients who currently are immunocompromised 2. Live attenuated vaccines administered in the previous 28 days. T/F: MMR is a live attenuated vaccine. - CORRECT ANSWER True Which of the following vaccines listed is a live attenuated vaccine? a.) Hep B b.) Hep A c.) RZV d.) VAR - CORRECT ANSWER d.) VAR Pneumococcal polysaccharide vaccine (PPSV23) is best categorized as what type of vaccine? - CORRECT ANSWER Inactivated Polysaccharide Vaccine Which of the following is true regarding the use of mRNA in vaccine technology? a.) mRNA is extremely stable in a host's body. b.) 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. c.) mRNA vaccine technology requires replication similar to a live attenuated vaccine. d.) mRNA vaccine technology elicits its immune response and protects the host by altering the host's DNA. - CORRECT ANSWER b.) 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. Which vaccine technol 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. - CORRECT ANSWER Adjuvants (manufactured to produce a more robust immune response to the vaccine) 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? - CORRECT ANSWER MMR and PCV13 may be administered simultaneously or at any interval between doses. NVAC - CORRECT ANSWER National Vaccine Advisory Committee established standards for adult immunization practice: ASSESS, RECOMMEND, ADMINISTER & DOCUMENT Which of the following are part of the four steps set by NVAC as the standards for Adult Immunization Practice? - CORRECT ANSWER ASSESS, RECOMMEND, ADMINISTER & DOCUMENT PPCP - CORRECT ANSWER Pharmacist Patient Care Process PPCP Step 1 - CORRECT ANSWER COLLECT information to determine which vaccine and screen for any contraindications/precautions at every clinical encounter PPCP Step 2 - CORRECT ANSWER ASSESS after collecting information and analyzing the need for vaccines following ACIP recommendations. PPCP Step 2 - Mass Screening - CORRECT ANSWER Mass Screening can help identify candidates for vaccines based on a common factor, review child's vaccination status prior to school entry PPCP Step 2 - Diagnosis Based Screening - CORRECT ANSWER Diagnosis Based Screening is when certain medical conditions may be indications for certain vaccines PPCP Step 2 - Procedure Based Screening - CORRECT ANSWER Procedure Based screening is when certain procedures might indicate the need for specific vaccines PPCP Step 2 - Occurrence Based Screening - CORRECT ANSWER Occurrence-Based Screening is when Patients who may have health conditions that warrant vaccination at a hospital visit PPCP Step 3 - CORRECT ANSWER Plan - pharmacists creates an individualized patient-centered care plan with clear and strong evidence based recommendations PPCP Step 4 - CORRECT ANSWER Implement - communicate and collaborate with other providers as part of the immunization neighborhood, VIS form to educate patients about the vaccine they might be getting and counseling patients on risks and benefits to all patients receiving vaccinations. PPCP Step 5 - CORRECT ANSWER Follow-up with Patients, monitor and manage potential adverse events and schedule appt's for follow-up doses In the patient care process, how often should a pharmacist collect information on a patient? - CORRECT ANSWER At every clinical encounter Screening Questions for All Patients - CORRECT ANSWER 1. Current Health Status 2. Allergies and Past Reactions 3. Long-term Illness Screening Questions: Live Vaccines in immunocompromised - CORRECT ANSWER Immunocompromised - Cancer, Leukemia, AIDS These individuals may be a contraindication for live vaccines such as MMR, VAR, LAIV4 Screening Questions: Live Vaccines, Family history - CORRECT ANSWER Parent, brother/sister with immune system problem? Heredity immunodeficiency should be screened Screening Questions: Live Vaccines, Immunosuppressive Therapy - CORRECT ANSWER In the past 3 months, have you taken medications that affect your immune system like Prednisone or other steroids, anticancer drugs or treatment of rheumatoid arthritis, Crohn's disease or psoriasis, or radiation treatments? Immunosuppression may reduce vaccine efficacy or pose a risk for disseminated infection Screening Questions: Live Vaccines, Blood Products - CORRECT ANSWER Past year, have you received transfusion of blood/blood products or given Immune (gamma) globulin Blood or blood products may contain antibodies that reduce vaccine efficacy. Screening Questions: Live Vaccines, Vaccine Timing - CORRECT ANSWER Received vaccinations in the last 4 weeks? Vaccines should be given BEFORE initiation of immunosuppressive therapies Screening Questions: Pregnant Women - CORRECT ANSWER Pregnant women should receive IIV4 and Tdap vaccinations Some live vaccines may be contraindicated in pregnancy Screening Questions: Patients considering tetanus-containing vaccines - CORRECT ANSWER Seizure, brain or other nervous system problem Guillain-Barre syndrome (GBS) may be a precaution What is the name of the document published by the CDC that describes the risks and benefits of a vaccine in lay terms? - CORRECT ANSWER VIS - Vaccine Information Statement 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? - CORRECT ANSWER Diagnosis-based screening 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? - CORRECT ANSWER Assess 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? - CORRECT ANSWER Patient's age, current health, vaccine history, and allergies Which of the following statements best meets the definition of precaution? - 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. 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: - CORRECT ANSWER Create a reminder and recall system. EUA - CORRECT ANSWER Emergency Use Authorizations - allow for medical countermeasures, such as medications or vaccines to be made available during a public health emergency ex: COVID-19 EUA Process - CORRECT ANSWER Phase 1/2 have to be completed Phase 3 - long term so monitor safety and FDA may allow it to move forward. ACIP - CORRECT ANSWER Advisory Committee on Immunization Practices: -housed within the CDC -15 voting/30 nonvoting medical health experts -7 domains of framework that examines the vaccine At what age can the 2-dose schedule of the human papillomavirus (HPV) Vaccine be given? - CORRECT ANSWER A 2 dose schedule is recommended for girls and boys who initiate the vaccination series at ages 9 through 14 years. CDC Immunization Schedules - CORRECT ANSWER age, # of doses, time between doses, indications, precautions - UPDATED ANNUALLY How often are the CDC immunization schedules published? - CORRECT ANSWER Annually Precautions vs. Contraindications - CORRECT ANSWER Precautions - conditions that may diminish response to vaccine and increases risk of serious reaction Contraindications - when a conditions exists that will result in a severe, life-threatnening event if patient receives this vaccine. ex: severe allergy/reaction to previous dose or vaccine component. Schedule for Children up to 18 years - CORRECT ANSWER Table 1 - Age Table 2 - Catch-up schedule for pts. behind on vaccines Table 3 - Medical indication If a child is behind on the rotavirus vaccine, what is the interval of time between dose 1 & 2 to start getting the child caught up? - CORRECT ANSWER At least 4 weeks LAIV is contraindicated if child has asthma or wheezing for what age? - CORRECT ANSWER Children ages 2-4 with heart disease or chronic disease should still be vaccinated against influenza using INACTIVATED The herpes zoster vaccine is first recommended what age for immunocompetent adults - CORRECT ANSWER 50 If patient is pregnant then which vaccines should be avoided? - CORRECT ANSWER MMR, VAR, HPV but can be given immediately after she gives birth. Influenza should be inactivated. Steps when using Immunization schedules - CORRECT ANSWER 1. start with patients age, which vaccines should they have and are they behind? 2. If patient has medical condition, check for precautions and contraindications 3. Refer to vaccine notes for types, frequencies, intervals and special considerations Based on the adult immunization schedule, at what age is the live attenuated influenza vaccine (LAIV) no longer recommended? - CORRECT ANSWER 50 years Which of the following vaccines is contraindicated for an adult patient with HIV and a CD4 count <200 mm2? - CORRECT ANSWER MMR 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? - CORRECT ANSWER Give 1 dose now as catch up Which of the following is TRUE of the emergency use authorization process? - CORRECT ANSWER Manufacturers must include a plan for safety monitoring Which of the following vaccines is not recommended during pregnancy? - CORRECT ANSWER Human papillomavirus vaccine (HPV) 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? - CORRECT ANSWER 16 weeks 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? - CORRECT ANSWER MenACWY - Meningococcal ACWY