Nokea
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) vaccine given?' The nurse knows that this series is started at what age?
- A. At birth
- B. 6 weeks
- C. 3 months
- D. 1 year
Correct Answer: B
Rationale: The first dose of the DTaP vaccine series is given at 6 weeks of age. The other options are incorrect.
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A health care worker will be receiving hepatitis B immunoglobulin, 0.6 mL/kg IM now and repeated in 30 days as part of hepatitis B prophylaxis after a needle stick accident. The patient weighs 242 pounds. Identify how many milliliters the patient will receive for each dose. (Record answer using one decimal place.)
Correct Answer: 6.6 Ml
Rationale: Convert pounds to kilograms: 242 ?· 2.2 = 110 kg. Calculate mL/kg: 0.6 mL/kg/dose ?? 110 kg = 6.6 mL/dose.
The nurse is reviewing the health history of a new patient who may need immunizations. Active immunizations are usually contraindicated in which patients? (Select all that apply.)
- A. Patients with a febrile illness
- B. Children younger than 1 year of age
- C. Elderly patients
- D. Patients who are immunosuppressed
- E. Those receiving cancer chemotherapy
Correct Answer: A,D,E
Rationale: 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.
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. 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.
Correct Answer: A
Rationale: The guidelines recommend the HPV vaccine (Gardasil) for women 13 to 26 years of age. It is important to ensure the patient is not pregnant and that the vaccine involves three injections, but the patient's age of 30 years makes her ineligible for the vaccine.
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?
- A. Artificial active immunization
- B. Attenuating immunization
- C. Natural passive immunization
- D. Artificial passive immunization
Correct Answer: C
Rationale: 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. Artificial 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.
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
- B. Herpes zoster vaccine
- C. Hepatitis B virus vaccine, inactivated
- D. Haemophilus influenzae type b (Hib) vaccine
Correct Answer: D
Rationale: 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.