Nokea
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.
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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. Anaphylaxis
Correct Answer: D
Rationale: The symptoms of edema of the face, tongue, and throat along with difficulty breathing suggest an anaphylactic reaction, which is a severe allergic response that can occur after receiving immunizing drugs. Serum sickness is characterized by symptoms like fever, rash, and joint pain, typically appearing days to weeks after exposure. Cross-sensitivity refers to allergic reactions to related substances, and thrombocytopenic purpura involves bleeding issues due to low platelet counts, neither of which match the described symptoms.
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.
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.
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.