AANP: Immunizations + practice Questions with 100% Correct Answers | Verified | Updated 20, Exams of Nursing

Download AANP: Immunizations + practice Questions with 100% Correct Answers | Verified | Updated 20 and more Exams Nursing in PDF only on Docsity! AANP: Immunizations + practice Questions with 100% Correct Answers | Verified | Updated 2025 What is the best time interval for giving vaccines? - ✔✔6 weeks When is 1st HepB vaccine given - ✔✔Within 12 hours of birth What is the appropriate schedule for HepB vaccine? - ✔✔0-2-6 mo. Treatment for babies born to HBsAg positive mothers? When are they tested for HBsAg? - ✔✔1. Hepatitis B vaccine series at 0, 2, 6 2. Immune globulin within 12 hours of birth. 3. Test for HepB after hepatitis series is completed When is Rotavirus vaccine (Rota) given- How many vaccines are in the series? - ✔✔3 doses from 6 weeks-32 weeks When must the last dose of Rotavirus vaccine be given by? - ✔✔32 weeks (8 mo.) When are the DTaP vaccines given in the first year? - ✔✔2-4-6 What is the upper limit of age for DTaP vaccine? - ✔✔7 years old. When are the two boosters of DTaP given? - ✔✔15 mo 6 years When is TDaP given? Initial and Booster? - ✔✔1. 11 years old 2. every 10 years for life What is HIB schedule for initial 3 series? Booster? - ✔✔2-4-6 When in influenza vaccine started? - ✔✔6 mo. How is first round of influenza vaccine different from subsequent yearly vaccines? - ✔✔< 9 y.o.= two doses @ 1 mo apart If infant exposed to MMR, how can vaccine schedule be ammended? - ✔✔Can give as early as 6 mo. but needs to continue with regular schedule of 3 after that. Who is varicella NOT recommended for? - ✔✔Immunocompromised. When is Varicella vaccine given? Booster? - ✔✔between 12mo-12 years (two doses, three months apart) (*Ideally, 12 months and 4-6 y.o.) How should varicella and MMR be given - ✔✔Separated by one month Who gets the Hep A vaccine? - ✔✔All children What is schedule for Hep A vaccine? - ✔✔Series of two I year 2 years *give at least 6 months apart What is schedule for Meningococcal vaccine? - ✔✔Series of two: 1. First at 11-12 years old, 2. Second at 16. How are those >16 years old dosed for meningococccal vaccine? - ✔✔If they haven't had it before 16 y.o, one dose, no booster What is the HPV vaccine schedule? - ✔✔Series of 3: 1. First:11-12 yo, 2. Second, one month later 3. Third, 6 months after the initial dose. Which HPV preparation has coverage for 4 strains? - ✔✔Guardasil: 6,11, 16, 18. Who can get the guardasil? - ✔✔Boys and girls Who can get the cervarix? - ✔✔Girls Cation with administering HPV vaccine to adolescents - ✔✔Have them lie down x 15 minutes after vaccine. When should adverse vaccine reactions be reported? - ✔✔Within 48 hours lifestyle risk factors - ✔✔there is evidence that brief primary care-based interventions to modify risk behaviors are effective. This is particularly important in tobacco and alcohol misuse and includes the "5 A's" model for brief counseling. The "5 R's" model can be used for smokers unwilling to quit and includes: relevance (for the smoker to quit), risks (negative consequences of smoking), rewards (benefits of cessation), roadblocks (barriers to quit), and repetition (repeat motivational counseling at future visits). 5 A's" model for brief counseling and 5 Rs for those unwilling to quit - ✔✔assess (the behavior), advise (clear behavior change advice), agree (mutual collaboration to set goals), assist (aid patient to reach goals), and arrange (schedule follow-up to provide ongoing support). The "5 R's" model can be used for smokers unwilling to quit and includes: relevance (for the smoker to quit), risks (negative consequences of smoking), rewards (benefits of cessation), roadblocks (barriers to quit), and repetition (repeat motivational counseling at future visits). Screening - ✔✔an evaluation to detect a disease at an asymptomatic stage. It is appropriate when the population to be screened is accessible and willing to undergo testing, the disease causes burden to patients or society, and the test used is sensitive and specific enough to detect disease without undue false- positives or -negatives. Screening should result in a decrease in mortality. However, screening can also result in significant morbidity to the patient. False- positives tests can generate anxiety, and unnecessary tests and procedures. They can also lead to false-negatives, which gives a false sense of reassurance. Pneumococcal polysaccharide (Pneumovax): - ✔✔This 23-valent vaccine is approved for prevention of pneumococcal pneumonia and pneumococcal invasive disease (bacteremia and meningitis). Pneumovax should be given to all adults ≥65 years of age. It is also indicated for younger adults with some of the following conditions: chronic cardiovascular or pulmonary disease (eg, CHF, asthma, COPD), chronic liver disease, immunocompromising conditions including HIV, functional or anatomical asplenia including sickle cell disease, and chronic renal failure, and also for all nursing home residents, all smokers, alcoholics, and all diabetics. One- time revaccination 5 years after the first dose is only indicated in patients with renal failure, asplenia, and immunosuppression. Adults who received the vaccine more than 5 years before they turned 65 should also receive a 1-time booster. Influenza vaccination - ✔✔indicated for all persons 6 months of age and older. It is available in 3 forms: intranasally administered live attenuated (LAIV), intramuscularly or intradermally administered standard-dose trivalent inactivated vaccine (TIV), and high-dose TIV. LAIV should not be given to patients older than 50, pregnant women, immunocompromised patients, or health care personnel who care for severely immunocompromised persons. The new high-dose TIV is an option for adults older than 65 years. Influenza vaccine is contraindicated if patients have had an anaphylactic reaction to the vaccine or any of its components. Mild allergy to eggs (hives) is not a contraindication for the TIV, but these patients should be observed by health care personnel for 30 minutes after administration. Tdap - ✔✔Pertussis is underdiagnosed and underreported in all age groups. The CDC estimates that the actual burden of pertussis in adults ≥65 years old is at Hepatitis A and B vaccination - ✔✔Although there are multiple indications for these 2 vaccines, it is important to remember that patients with chronic liver disease should be immunized against both hepatitis A and B and screened for hepatitis C. This is for the purpose of protecting the liver from a second "hit." Hepatitis A and B vaccines are also indicated for drug users, men who have sex with men, and anybody who wants to be protected despite a lack of risk factors. Hepatitis B vaccine is indicated for patients with HIV, those with chronic renal failure on hemodialysis, health care workers, and persons with sexually transmitted diseases or risk factors for them, among others. In the 2012 immunization schedule from the ACIP, there is a new recommendation to vaccinate all diabetic patients younger than 60 years of age as soon as possible after the diagnosis. Diabetics older than 60 years may be vaccinated at the discretion of the health care provider. Varicella vaccination - ✔✔All adults without evidence of immunity should be vaccinated. Varicella is a live vaccine; therefore, it is contraindicated in immunocompromised patients and pregnant women. Pregnant women without immunity should receive the vaccine in the postpartum period before hospital discharge. MMR - ✔✔Adults born before 1957 are considered immune to measles and mumps. Adults born after 1957 should receive at least 1 dose of MMR if there is no laboratory evidence of immunity or documentation of a dose given on or after the first birthday. For all women of childbearing age immunity against rubella should be determined. If not immune, they should be vaccinated. Pregnant women without immunity should be vaccinated in the postpartum period before discharge from the hospital. MMR is a live vaccine and is thus contraindicated in pregnant women or those who are immunocompromised (except HIV patients with CD-4 above 200 cells/μL). Meningococcal vaccination - ✔✔Two vaccines are available for adults, the conjugate quadrivalent (MCV4) and the polysaccharide quadrivalent (MPSV4). The meningococcal vaccine is recommended for patients with anatomical or functional asplenia, those with persistent complement component deficiencies, people who travel to or reside in hyperendemic or epidemic areas (the meningitis belt of sub-Saharan Africa), microbiologists exposed to N. meningitidis, and first- year college students through age 21 who live in residence halls. Adults with persistent risk factors should receive a booster every 5 years. Selected Preventive Services for Adults Healthful diet counseling: The USPSTF recommends intensive behavioral dietary counseling for adults with hyperlipidemia or other risk factors for cardiovascular disease and diet-related chronic disease. The USPSTF found only a small benefit for routine counseling about a healthy diet and exercise for adults with no risk factors for cardiovascular disease. Tobacco use and cessation counseling: The USPSTF recommends screening for all adults and cessation counseling interventions. Use the "5 A's" model for brief counseling and the "5 R's" model for those unwilling to quit. Alcohol misuse screening: The USPSTF recommends screening and behavioral counseling to reduce alcohol misuse in all adults. (Misuse is defined as >7 drinks per week or >3 drinks/occasion for women and >14 drinks per week or >4/occasion for men or any physical, social, or psychological harm from alcohol use.) She should start the HPV vaccine series if not previously done, and given her risky sexual behavior, a pap smear is also recommended. B She has probably been exposed to HPV and vaccination is less likely to be effective; therefore, HPV vaccine is not recommended. She is not 21 years of age yet; therefore, a pap smear is not indicated. C She has probably been exposed to HPV and vaccination is less likely to be effective; however, given her age, she should still receive the HPV vaccine. She is not 21 years of age yet; therefore, a pap smear is not indicated. D She has probably been exposed to HPV and therefore vaccina - ✔✔The correct answer is C. Explanation: HPV vaccine is indicated in all women between the ages of 11 and 26 regardless of previous sexual history, HPV status, or other risk factors. It is true that this patient probably has been exposed to the HPV and that the vaccine might be less effective than in women never exposed. However, she is likely to benefit because there are different serotypes that can cause cervical cancer. Regarding a pap smear, the current recommendation is to start screening at the age of 21 years regardless of sexual history, so a pap is not indicated at this time. A 58-year-old man comes to your office for his annual Medicare visit. He has no complaints. He has a history of diabetes mellitus type 2, dyslipidemia, and hypertension. His social history is positive for a remote 5 pack year history of smoking during his young adult years. His family history is only positive for diabetes and CHD in his father. He has refused immunizations in the past due to a fear of their side effects. He had a normal colonoscopy 5 years ago and a normal PSA 2 years ago. His last HbA1C was 6% 3 months ago. Which of the following statements regarding preventive services for this man is true? A He should be offered a PSA for prostate cancer screening, a repeat colonoscopy for colon cancer screening, and pneumococcal and Tdap vaccines. B He should be offered a pneumococcal vaccine, hepatitis B vaccine, Tdap, and zoster vaccine and should be screened for colon cancer with colonoscopy. There is no in - ✔✔The correct answer is D. Explanation: All diabetic patients should receive the pneumococcal vaccine, and all diabetic patients younger than 60 should start the series of hepatitis B soon after diagnosis. A 1-time Tdap is indicated for all adults. This patient has no symptoms or risk factors for prostate cancer, as well as a previously normal PSA. The USPSTF recommends against PSA-based screening. This patient had a normal colonoscopy 5 years ago and current guidelines recommend colonoscopy every 10 years for average-risk adults with previously normal results. A 24-year-old woman comes for her annual physical examination. She has no pertinent medical history. She takes no medications. She reports no allergies. She is sexually active with a stable partner. She denies a history of STDs. Her last menstrual period was 7 days ago. She denies any symptoms and her physical examination is normal. You review her immunization record and see that she received all the appropriate vaccines during childhood but has not received any immunizations in the last 10 years. Which immunizations should you offer to this patient? 2. What antibody titers (related to immunizations) would it be important to check on this patient? - ✔✔This patient is a candidate for multiple vaccines. She should be offered the influenza vaccine recommended for all adults. She should start the series of human papillomavirus (HPV) vaccines to prevent cervical cancer and genital warts, as she is within the recommended age group. She should receive the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine that will replace the 10-year tetanus booster. This patient is at risk of becoming pregnant, so it is important to determine immunity against rubella and varicella and vaccinate if appropriate. Women should have rubella titers tested and if negative, should receive the measles, mumps, and rubella (MMR) vaccine.