Question 1

A sanitation worker has experienced a needle stick by a contaminated needle that was placed in a trash can. The employee health nurse expects that which drug will be used to provide passive immunity to hepatitis B infection?

A) Haemophilus influenzae type b (Hib)
B) Varicella virus vaccine (Varivax)
C) Hepatitis B immunoglobulin (BayHep B)
D) Hepatitis B virus vaccine (inactivated) (Recombivax HB)

Accepted Answer

Recombivax HB promotes active immunity to hepatitis B infection in people who are considered to be at high risk for potential exposure to the virus, whereas hepatitis B immunoglobulin provides passive immunity for the prophylaxis and postexposure treatment of people exposed to hepatitis B virus or HBs-Ag-positive materials, such as blood, plasma, or serum. Hib and Varivax vaccines are not appropriate for this situation.

Question 2

The nurse is reviewing principles of immunization. What type of immunization occurs when antibodies pass from mother to infant during breastfeeding or through the placenta during pregnancy?&#10;A) Artificial active immunization&#10;B) Attenuating immunization&#10;C) Natural passive immunization&#10;D) Artificial passive immunization

Accepted Answer

Natural passive immunization occurs when antibodies are transferred from the mother to her infant in breast milk or through the bloodstream via the placenta during pregnancy. Artificial active immunization causes an antigen-antibody response and stimulates the body's defenses to resist any subsequent exposures. Passive immunization is conferred by bypassing the host's immune system and injecting the person with antiserum or concentrated antibodies obtained from other humans or animals; this gives the host direct means of fighting off an invading microorganism. The host's immune system therefore does not have to manufacture these antibodies.

Question 3

A patient is in the urgent care center after experiencing a black widow spider bite. The nurse prepares to give which product to treat this injury?&#10;A) Live vaccine&#10;B) Antivenins or antisera&#10;C) Tetanus immune globulin&#10;D) Active immunizing drug

Accepted Answer

Antivenins, also known as antisera, are used to prevent or minimize the effects of poisoning by poisonous snakes and spiders. They provide the person who has been bitten with the substance needed to overcome the effects of the venom.

Question 4

The nurse is reviewing the health history of a new patient who may need immunizations. Active immunizations are usually contraindicated in which patients?&#10;A) Patients with a febrile illness&#10;B) Children younger than 1 year of age&#10;C) Elderly patients&#10;D) Patients who are immunosuppressed&#10;E) Those receiving cancer chemotherapy

Accepted Answer

Contraindications to the administration of immunizing drugs include a history of reactions to or serious adverse effects resulting from the drugs, and patients who are already immunosuppressed (patients with AIDS and patients receiving chemotherapy). Immunizations are best deferred until after a febrile illness. Children younger than 1 year of age and the elderly may receive immunizing drugs.

Question 5

A health care worker will be receiving hepatitis B immunoglobulin (BayHep B), 0.06 mL/kg IM now and repeated in 30 days as part of hepatitis B prophylaxis after a needle stick accident. The patient weighs 264 pounds. Identify how many milliliters the patient will receive for each dose. (record answer using one decimal place) _______

Accepted Answer

The answer of A health care worker will be receiving...

Question 6

The nurse is reviewing the information about the herpes zoster vaccine (Zostavax) before administering the dose. Which statements about the vaccine are true?&#10;A) It is a one-time vaccine.&#10;B) The vaccine is recommended for patients 50 years of age and older.&#10;C) The vaccine is given to children to prevent chickenpox.&#10;D) It is used to prevent postherpetic neuralgia.&#10;E) It is contraindicated in patients who have already had shingles.&#10;F) The vaccine is used to prevent reactivation of the zoster virus that causes shingles.

Accepted Answer

Zoster vaccine (Zostavax) is used to prevent shingles; it also prevents reactivation of the zoster virus that causes shingles. It is given to patients 50 years of age and older, and it is a one-time vaccine. It is not given to prevent chickenpox or given to children. It does not prevent postherpetic neuralgia, and it can be given to patients who have already had shingles.

Question 7

Two patients arrive at the clinic; one is a young boy with sickle cell anemia, and another is a 57-year-old woman with early stages of Hodgkin's disease. The nurse notices that both patients need the same vaccine. What vaccine would that be?

A) Varicella virus vaccine (Varivax)
B) Herpes zoster vaccine (Zostavax)
C) Hepatitis B virus vaccine, inactivated (Recombivax HB)
D) Haemophilus influenzae type b (Hib) vaccine

Accepted Answer

H. influenzae type b conjugate vaccine is usually given to patients with one of these disorders: sickle cell anemia, an immunodeficiency syndrome, Hodgkin's disease, and others. The other options are incorrect.

Question 8

A 30-year-old woman is in the clinic for her yearly gynecologic exam and asks the nurse about the "new vaccine that prevents HPV." She wants to receive the papillomavirus vaccine (Gardasil). Which response by the nurse is most appropriate?

A) "For women, the recommended age for this vaccine is 13 to 26 years of age."
B) "We will need to make sure you are not pregnant first."
C) "There will be a total of three injections."
D) "I will check with your health care provider and then get the first dose of the vaccine ready."

Accepted Answer

It is important to make sure that a patient receiving Gardasil is not pregnant and that the patient knows that there are a total of three injections, but this particular patient is too old to receive the vaccine. The guidelines recommend the vaccine for women 13 to 26 years of age.

Question 9

A 45-year-old man has received a series of immunizing drugs in preparation for a trip to a developing country. Within hours, his wife brings him to the emergency department because he has developed edema of the face, tongue, and throat and is having trouble breathing. The nurse suspects that, based on the patient's history and symptoms, he is experiencing which condition?

A) Serum sickness
B) Cross-sensitivity
C) Thrombocytopenic purpura
D) Adenopathy

Accepted Answer

Serum sickness sometimes occurs after repeated injections of equine (horse)-made immunizing drugs and is characterized by edema of the face, tongue, and throat; rash; urticaria; fever; flushing; dyspnea; and other symptoms.

Question 10

A 12-month-old infant has received an MMR II (measles, mumps, and rubella virus vaccine), and her mother calls the clinic that afternoon to ask about helping her fussy infant to "feel better." What will the nurse suggest?

A) Apply an ice pack to the injection site.
B) Apply warm compresses to the injection site.
C) Observe the site for further swelling and redness.
D) Bring the infant in to the emergency department for an immediate examination.

Accepted Answer

Applying warm compresses to the injection site and using acetaminophen (not aspirin, which carries the risk for Reye's syndrome) should help to relieve the discomfort. The other options are incorrect.

Question 11

A nurse is working in an immunization clinic. A new colleague asks, "When is the first dose of the diphtheria, tetanus, and acellular pertussis (DtaP, Daptacel) given?" The nurse knows that this series is started at what age?

A) At birth
B) 6 weeks
C) 3 months
D) 1 year

Accepted Answer

The answer of A nurse is working in an immunization...

Deck 49: Immunizing Drugs