Nokea
Several clients have come to the clinic for immunizations. When reviewing their medical records, the nurse identifies which of the following as a contraindication for the administration of vaccines and toxoids? Select all that apply.
- A. Acute nonfebrile illness
- B. Leukemia
- C. Chronic prednisone therapy
- D. HIV
- E. Clients older than 70 years of age
Correct Answer: B,C,D
Rationale: Vaccines and toxoids are contraindicated in leukemia, immunosuppressive conditions like HIV, and chronic prednisone therapy.
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Vaccines containing live organisms are not administered to clients taking which of the following drugs as insufficient numbers of antibodies are produced to prevent the disease because these drugs suppress the immune system? Select all that apply.
- A. Methylprednisolone (Medrol)
- B. Ciprofloxacin (Cipro)
- C. Prednisolone (Orapred)
- D. Paclitaxel (Taxol)
- E. Vincristine (Oncovin)
Correct Answer: A,C,D,E
Rationale: Live vaccines are contraindicated with corticosteroids (methylprednisolone, prednisolone) and antineoplastic drugs (paclitaxel, vincristine) due to immune suppression.
A nurse is reviewing a client's medical record and determines that the client has naturally acquired active immunity. Which of the following would most likely apply? Select all that apply.
- A. The client who is exposed to chickenpox for the first time and has no immunity to the disease
- B. Administration of the varicella vaccine to an individual who has no immunity to the disease
- C. An individual who is exposed to pertussis for the first time and has no immunity to the disease
- D. Administration of the influenza vaccine to an individual who has no immunity to the disease
- E. Administration of the rubella vaccine to an individual who has no immunity to the disease
Correct Answer: A,C
Rationale: Naturally acquired active immunity occurs when the person is exposed to and experiences a disease and the body manufactures antibodies to provide future immunity to the disease.
A nurse identifies a nursing diagnosis of Acute Pain for a client receiving a vaccine. Which of the following would the nurse include in the client's plan of care to address this problem? Select all that apply.
- A. Administering acetaminophen every 4 hours
- B. Providing for adequate rest periods
- C. Ensuring that the environment is stimulating
- D. Applying compresses to the injection site
- E. Limiting the client's access to funds
Correct Answer: A,B,D
Rationale: Acetaminophen, rest, and compresses help manage vaccine-related pain.
After teaching a group of nursing students about the various immunologic drugs, the instructor determines that the teaching was successful when the students identify which of the following as a viral vaccine? Select all that apply.
- A. Haemophilus influenza type B conjugate
- B. Typhoid
- C. Mumps
- D. Avian influenza
- E. Rabies
Correct Answer: C,D,E
Rationale: Mumps, avian influenza, and rabies are viral vaccines.
A nurse should screen clients of childbearing age for pregnancy as the administration of which of the following vaccines is contraindicated during pregnancy? Select all that apply.
- A. Influenza
- B. Varicella
- C. Measles
- D. Mumps
- E. Rubella
Correct Answer: B,C,D,E
Rationale: Measles, mumps, rubella, and varicella vaccines are contraindicated during pregnancy due to potential birth defects.