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APhA Immunization Self-Study Assessment | 90
Questions with 100% Correct Answers
Which of the following key questions is important to ask a patient before administering IIV? A. Are you sick today? B. During the past year, have you received a blood transfusion or immune (gamma) globulin? C. Have you received any vaccinations in the past 4 weeks? D. Do you have cancer, leukemia, AIDS, or any other immune system problem? Correct Answer: A What is the most common complication of pertussis? Correct Answer: pneumonia Which disease is characterized by the development of a membrane on the tonsils, pharynx, or larynx, leading to respiratory obstruction? A. Pertussis. B. Diphtheria. C. Haemophilus influenzae type b. D. Meningitis. Correct Answer: B At what point during pregnancy is it recommended to administer the influenza vaccine? A. Anytime is safe B. During the 1st trimester C. 27 to 36 weeks D. Wait until after the baby is delivered Correct Answer: A Influenza vaccination during pregnancy not only decreases the risks for influenza- related complications during pregnancy, but has also been shown to reduce influenza-related hospitalizations in newborns. Which of the following best describes how to administer Tdap vaccine to an adult patient weighing 185 lb? A. Inject subcutaneously at a 45° angle in the outer aspect of the upper arm. B. Inject intramuscularly at a 45° angle in the deltoid muscle.
C. Inject subcutaneously at a 90° angle in the outer aspect of the upper arm. D. Inject intramuscularly at a 90° angle in the deltoid muscle. Correct Answer: D Vaccines that are given subcutaneously are administered at a 45 degree angle into the outer aspect of the upper arm. Name the vaccine-preventable disease that may be contracted by unimmunized children from adults serving as reservoirs for the disease, which causes a paroxysmal cough and potentially can result in pneumonia, seizures, encephalopathy, hypoxia, and death. A. Pneumococcal disease. B. Pertussis. C. Varicella. D. Influenza. Correct Answer: B Bordetella pertussis is highly contagious and symptoms progress through stages over several weeks. Adolescents and adults tend to present with more mild symptoms and serve as reservoirs capable of transmitting pertussis to young children who have not yet been vaccinated. Which of the following diseases are transmitted through mosquito bites? A. Typhoid fever and Haemophilus influenzae type b. B. Hepatitis A and typhoid fever. C. Yellow fever and Japanese encephalitis. D. Hepatitis A and measles. Correct Answer: C Robert is a 48-year-old pharmacist who is preparing to provide immunizations in his pharmacy for the first time next fall. He has no documentation of receiving the hepatitis B vaccine and would like to be vaccinated before administering vaccines in his practice. What is the recommended routine schedule for vaccination against hepatitis B? A. 0 and 2 months. B. 0 and 6 months. C. 0, 1, and 2 months. D. 0, 1, and 6 months. Correct Answer: D If pharmacists are called upon to assist with vaccination efforts following a natural disaster, which vaccine is likely to be needed by many of the victims? A. Tetanus B. Pneumococcal C. MMR
Which of the following is a requirement of the Occupational Safety and Health Administration's (OSHA's) Bloodborne Pathogens Standard? A. All persons employed by the pharmacy must be offered hepatitis A and hepatitis B vaccines. B. Health care providers must use safety devices when administering injectable vaccines. C. All needles should be clipped or recapped before placing in the biohazard container. D. All employees of the pharmacy must attend an OSHA training course every 5 years. Correct Answer: B Which type of vaccine involves stimulation of B cells without the assistance of T helper cells? A. Live attenuated vaccines B. Conjugated vaccines C. Pure polysaccharide vaccines D. Recombinant vaccines Correct Answer: C A pure polysaccharide vaccine does not require T-helper cells to produce an immune response. It is mediated solely through B cells. As such, they are T cell- independent. Which disease is almost certain to cause death if infected patients do not receive postexposure prophylaxis? A. Hepatitis B. B. Measles. C. Meningococal disease. D. Rabies. Correct Answer: D The childhood/adolescent and adult immunization schedules are updated and published annually during which months? A. January or February B. April or May C. September or October D. November or December Correct Answer: A Alan is a 47-year-old man who has no documentation of a primary series of tetanus-containing vaccine. Which of the following would be an appropriate primary series for Alan? A. DTaP today; Td in 4 weeks; Td 6 months after the second dose.
B. Tdap today; Tdap in 4 weeks; Tdap 6 months after the second dose. C. DTaP today; DTaP in 4 weeks, DTaP 6 months after the second dose. D. Tdap today; Td in 4 weeks; Td 6 months after the second dose. Correct Answer: D Why was the live attenuated influenza vaccine (LAIV) removed from the ACIP's influenza vaccine recommendations? A. It was shown to cause influenza in children and adolescents. B. Low effectiveness of this vaccine was seen during the 2013-2014 and 2015- 2016 influenza seasons. C. Serious adverse events were reported with LAIV. D. There was concern about vaccine supply issues. Correct Answer: B Aiden is a 6-month-old healthy boy with no known allergies. He has received vaccinations in the past with no reported adverse reactions. Aiden's father asks about having his son vaccinated against influenza. The most appropriate response would be to inform the father that Aiden: A. Is too young to be vaccinated against influenza B. Should receive 1 dose of IIV4 today followed by a second dose of IIV4 administered 4 weeks later C. Should receive 1 dose of LAIV today followed by a second dose of LAIV administered 4 weeks later D. Should receive 1 dose of IIV3 or IIV4 today followed by a second dose 1 year later Correct Answer: B Which of the following statements about establishing clinics for administering vaccines is true? A. Clinics can only be held within the pharmacy. B. Technicians can administer screening questionnaires and distribute VISs. C. In all states, student pharmacists can administer vaccines during a clinic under appropriate supervision. D. Clinics are better-suited to year-round vaccines than to influenza vaccines. Correct Answer: B According to ACIP, which of the following is a contraindication to receiving HZV? A. Current treatment for lymphoma. B. Age 59 years or younger. C. Past history of herpes zoster. D. Has never received the varicella zoster vaccine (VAR). Correct Answer: A
D. A 22 year-old military recruit. Correct Answer: A Which of the following vaccines is recommended for infants to receive within 24 hours of birth? A. IIV3, if during influenza season. B. Hepatitis A. C. Hepatitis B. D. MMR Correct Answer: C In which publication does the CDC initially publish new or updated vaccine recommendations? A. Epidemiology and Prevention of Vaccine-Preventable Diseases B. Needle Tips C. Morbidity and Mortality Weekly Report (MMWR) D. Vaccine Correct Answer: C Kimberly is a 34 year-old woman who is 30 weeks pregnant. She received a Td booster dose 1 year ago when she cut her hand while working in the kitchen. She has no documentation of receiving a Tdap vaccine. The most appropriate recommendation would be to administer: A. Tdap as soon as possible. B. Tdap immediately postpartum. C. DTaP as soon as possible. D. Td in 9 years. Correct Answer: A Prior to the introduction of a vaccine, what was the leading cause of bacterial meningitis in children younger than 5 years of age? A. Haemophilus influenzae type b. B. Diphtheria. C. Varicella. D. Streptococcus pneumoniae. Correct Answer: A Which vaccine does ACIP recommend for all college freshmen, aged 21 years or younger, living in dormitories, who have not been previously vaccinated? A. PPSV23. B. MCV4. C. 9vHPV. D. Varicella. Correct Answer: B
According to the Advisory Committee on Immunization Practices (ACIP), which of the following would be considered adequate evidence of immunity to varicella, indicating that administration of varicella vaccine is unnecessary? A. Patient self-reported case of chickenpox. B. Patient self-reported case of herpes zoster. C. Birth in the United States after 1990. D. Diagnosis of chickenpox by a health care provider. Correct Answer: D Which of the following statements about live attenuated vaccines is true? A. They should generally be avoided in immunocompromised individuals. B. Their effectiveness wanes faster than inactivated vaccines. C. They can be either whole cell, fractional, or toxoids. D. Circulating antibodies have no impact on their effectiveness. Correct Answer: A A history of anaphylaxis caused by gelatin would be a contraindication to receiving which of the following vaccines? A. Varicella. B. Tdap. C. Pneumococcal. D. Hepatitis B. Correct Answer: A Which of the following statements is true regarding varicella-containing vaccines? A. The potency of HZV is greater than that of varicella vaccine. B. The potency of varicella vaccine is greater than that of HZV. C. The potency of varicella vaccine is the same as HZV. D. The vaccines are interchangeable. Correct Answer: A Herpes zoster vaccine (Zostavax) contains 14 times more antigen than varicella vaccine. This greater potency is necessary to elicit an adequate immune response in older patients who have immunity to varicella because they previously had chicken pox. After completion of a primary vaccine series and documentation of a one-time dose of Tdap, Td booster doses are recommended every: A. 1 year. B. 2 years. C. 5 years. D. 10 years. Correct Answer: D The incubation period for influenza can range from: A. 1 to 4 days
C. 12-year-old boy. D. 8-year-old girl. Correct Answer: C Arthus reactions, which are exaggerated local reactions that can occur if a patient is vaccinated too frequently, are most commonly reported after which vaccine? A. Inactivated influenza vaccine (IIV). B. Tetanus and diphtheria toxoid-containing vaccines. C. Pneumococcal polysaccharide vaccine (PPSV). D. Hepatitis B vaccine. Correct Answer: B RotaTeq (RV5) should be administered as a: A. 2-dose series to infants at 2 and 4 months of age. B. 2-dose series to infants at 0 and 6 months of age. C. 3-dose series to infants at 2, 4, and 6 months of age. D. 3-dose series to infants at 1, 2, and 6 months of age. Correct Answer: C Kyle is a 5-year-old boy who is up to date with his vaccinations. He has never experienced any adverse effects from vaccinations. At his next well-child check- up, Kyle will be receiving the following vaccines: IPV, MMR, varicella vaccine, and a tetanus-containing vaccine. Which of the following tetanus-containing vaccines would be appropriate for him? A. DTaP. B. DT. C. Td. D. Tdap. Correct Answer: A DTaP is a five-dose series given at ages 2, 4, 6, 15 through 18 months, and 4 through 6 years. Kyle is due for his 5th and final dose of DTaP. DTaP is appropriate for children less than 7 years of age. DT is only reserved for children who have a contraindication to the pertussis component in DTaP. Children, adolescents, and adults 7 years of age and older who require protection against tetanus, diphtheria, and pertussis would receive Tdap. Following the one-time dose of Tdap, a Td booster should be given every 10 years. Which viruses are associated with the development of cancer? A. Human papillomavirus and hepatitis B virus. B. Varicella virus and hepatitis A virus. C. Hepatitis A and herpes zoster. D. Rubella and varicella virus. Correct Answer: A With the exception of rotavirus, the routinely recommended live vaccines are contraindicated in a patient who:
A. Is finishing a course of antibiotics. B. Is breastfeeding. C. Is immunosuppressed. D. Received another live vaccine 6 weeks ago. Correct Answer: C If a patient with an egg allergy experiences hives following influenza vaccination, what is ACIP's recommendation for vaccinating this patient against influenza? A. Administer the recombinant influenza vaccine (RIV) only B. Administer the cell culture-based (ccIIV) or recombinant influenza vaccine (RIV) C. Administer any age-appropriate inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV) D. Refer the patient to a medical setting with the resources to recognize and manage severe allergic reactions Correct Answer: C Which of the following patients should receive the MMR vaccine? A. A 6-month-old infant with no documentation of MMR vaccine. B. An adolescent with documentation of 2 doses of MMR vaccine. C. An adult (who is not a health care provider) born in 1955 with no documentation of MMR vaccine. D. A pharmacist born in 1975 with documentation of 1 dose of MMR vaccine. Correct Answer: D MMR is a live vaccine and is not generally recommended until 12 months of age. A 2-dose series should be administered at 12 through 15 months and 4 through 6 years. No additional doses are needed. Adults who do not have evidence of immunity should receive one dose. Evidence of immunity includes being born before 1957, documentation of MMR vaccination, or laboratory evidence of disease. However, health care personnel should receive two doses. John is a 46-year-old man with diabetes. He requests a refill of his diabetes testing supplies on October 21st. His immunization record indicates that he has completed the primary series of MMR, DTaP, HepA, and HepB vaccines. John has a documented history of chickenpox, and his last Td booster dose was 19 years ago. Which of the following vaccines should he receive? A. Td and influenza. B. PCV13, Td, and IIV. C. PPSV23, Tdap, and IIV. D. PCV13 and IIV. Correct Answer: C Because John has diabetes both the recommended immunization schedule for adults aged 19 years or older by age group and the recommended immunization schedule for adults aged 19 years or older by medical condition and other indications should be used to determine
The monitoring system that health care providers should use to report serious adverse events after vaccination is: A. VAERS. B. OSHA. C. CMS-1500. D. VICP. Correct Answer: A According to ACIP recommendations, which of the following needle lengths would be appropriate for administering HZV to an adult patient? A. ½ inch. B. ⅝ inch. C. 1 inch. D. 1½ inch. Correct Answer: B herpes zoster vaccine is administered subcutaneously at a 45 degree angle into the outer aspect of the upper arm Which of the following immunization strategies is preferred for adults under the age of 65 years with immunocompromising conditions who require both PCV and PPSV23? A. PCV13 first, followed by PPSV23 at least 8 weeks later. B. PCV13 first, followed by PPSV23 at least 1 year later. C. PPSV23 first, followed by PCV13 at least 8 weeks later. D. PPSV23 first, followed by PCV13 at least 6 months later. Correct Answer: A munocompromising conditions at high-risk for pneumococcal disease, the interval between PCV13 and PPSV23 is at least 8 weeks. This 8-week interval also applies to those with asplenia, cochlear implants, and cerebrospinal fluid leaks. All others would wait at least one year between the two vaccines. Alex is a 32-year-old man who is scheduled to travel to a country where hepatitis A is endemic. He leaves in 3 weeks and will be gone a month. He received his first dose of hepatitis A vaccine today. Alex should be counseled to return for his second dose of hepatitis A vaccine: A. In 4 weeks. B. In 6 months. C. In 2 years. D. Immediately after travel. Correct Answer: B During which step of the Pharmacists' Patient Care Process would a pharmacist analyze a patient's need for certain vaccines? A. Collect
B. Assess C. Plan D. Implement Correct Answer: B If a patient received the first dose of HepB but did not return for the remaining doses in the series, under what circumstances should the HepB series be restarted? A. If more than 2 months have passed since the second dose was due. B. If more than 1 year has passed since the second dose was due. C. If more than 5 years have passed since the second dose was due. D. The series should not be restarted; resume the series where it was interrupted. Correct Answer: D What is the minimum needle length recommended for administering HepB vaccine to an adult patient weighing 130 lb? A. ½ inch. B. ⅝ inch. C. 1 inch. D. 1½ inch. Correct Answer: C There should be a flat hard surface in the area where vaccines will be administered to ensure: A. The pharmacist has an area to prepare the vaccines. B. The supply cart can be easily moved. C. There is room for the patient to lie down if fainting occurs or CPR is required. D. The pharmacy is in compliance with OSHA standards. Correct Answer: C According to ACIP recommendations, HZV is indicated for the prevention of herpes zoster in adults aged: A. 18 years and older. B. 50 years and older. C. 60 years and older. D. 65 years and older. Correct Answer: C Federal law makes offering an annual influenza vaccination a requirement for continued federal funding in which setting? A. Patient-centered medical homes B. Accountable care organizations C. Long-term care facilities D. Home health care Correct Answer: C
D. CMS-855B. Correct Answer: B Why are adjuvants added to vaccines? A. To minimize the adverse reactions of the vaccine. B. To strengthen the immune response to the antigen. C. To extend the vaccines expiration date. D. To provide immediate protection from disease. Correct Answer: B A history of anaphylaxis caused by neomycin would be a contraindication to receiving which of the following vaccines? A. IPV. B. Tdap. C. PCV13. D. HPV. Correct Answer: A For a patient who needs to receive IIV and HZV, which of the following best describes appropriate administration of these vaccines? A. Administer IIV and wait 4 weeks before administering HZV. B. Administer these 2 vaccines at the same visit. C. Mix the 2 vaccines together in the same syringe before administration to minimize the number of injections. D. Administer the HZV now, then wait 3 months before administering IIV. Correct Answer: B IIV is the inactivated influenza vaccine and HZV is the live, attenuated herpes zoster vaccine. Inactivated vaccines do not interfere with the immune response to other vaccines, live or inactivated. Adolescents should be routinely vaccinated with MCV4 on the following schedule: A. 1 dose at age 11 to 12 years. B. 1 dose at age 16 years. C. 1 dose at age 11 to 12 years, followed by a booster dose at age 16 years. D. 1 dose at age 16 years, followed by a booster dose at age 18 years. Correct Answer: C Which of the following statements would be accurate when responding to a patient's concerns about the safety of vaccines? A. In recent years, several hot lots of the vaccine have been known to cause severe adverse events. We do not stock these vaccines. B. Thimerosal in vaccines poses a risk for autism—we can use a vaccine that is thimerosal-free.
C. The immune system is capable of stimulating an immune response to multiple vaccines administered at the same time. D. While influenza vaccines may cause the flu, the extent of the illness and risk for hospitalization are greatly reduced. Correct Answer: C Which of the following statements about pharmacy-based vaccination programs is true? A. Pharmacists in any state can administer a vaccine under a collaborative practice agreement. B. All states require pharmacists to have a signed standing order or protocol to administer vaccines. C. Administratively, billing for vaccines covered by Medicare Part D may be easier for pharmacists than physicians. D. Influenza vaccine programs are less likely to have initial high demand than other vaccine programs. Correct Answer: C Even though state laws may have specific mandates, how long should pharmacists maintain records of immunizations? A. 5 years. B. 10 years. C. 20 years. D. For the patient's lifetime. Correct Answer: D According to ACIP recommendations, what is the maximum number of doses of PPSV23 a patient should receive in his or her lifetime? 1 dose. 2 doses. 3 doses. Unlimited. Correct Answer: 3 doses. Emily is a 16-year-old high-school student with no chronic medical conditions. Emily's immunization record shows that she completed the primary series for IPV, HepA, Hib, DTaP, and MMR, and she had a physician-diagnosed case of chickenpox at 2 years of age. Which of the following would be the most appropriate recommendation for her today? A. Tdap, HPV, MCV, HepB, and influenza, if during influenza season. B. DTaP, HPV, MCV, HepB, and influenza, if during influenza season. C. Tdap, HPV, MCV, and influenza, if during influenza season.
A. Administer PPSV23 at age 65, then PCV13 at age 66. B. Administer PPSV23 at age 69, then PCV13 at age 70 C. Administer PCV13 at age 65, then PPSV23 at age 69. D. Administer PCV13 at age 65, then PPSV23 at age 66. Correct Answer: C How is the live, cholera vaccine administered? A. Intramuscularly. B. Orally. C. Subcutaneously. D. Intranasally. Correct Answer: B Which of these vaccines is a live attenuated vaccine? A. IIV4. B. Zoster. C. PPSV23. D. Td. Correct Answer: B The live attenuated vaccines include cholera, herpes zoster, live attenuated influenza vaccine (LAIV), MMR, MMRV, rotavirus, tuberculosis (BCG), typhoid (Ty21a), vaccinia (smallpox), varicella, and yellow fever. All other vaccines are inactivated. When looking at the schedule for vaccines that might be indicated for children and adolescents aged 18 years or younger based on medical indications, what does the orange bar represent? A. Contraindicated. B. Precautions for vaccination. C. Recommended if an additional risk factor is present. D. Additional doses may be needed based on condition. Correct Answer: B Why should refrigerated vaccines be stored in the middle of the refrigerator? A. To keep them separated from food on the bottom shelf. B. To be at eye level. C. There are fewer temperature fluctuations. D. They are easier to reach. Correct Answer: C After reconstitution, within what time frame must HZV be administered? A. 30 minutes. B. 1 hour. C. 24 hours.
D. 72 hours. Correct Answer: A Which of the following is the best example of a group with which individual pharmacists can collaborate to increase immunization rates in their communities? A. Local health departments B. Advisory Committee on Immunization Practices C. Centers for Disease Control and Prevention D. National Vaccine Advisory Committee Correct Answer: A Vaccines as well as exposure to natural disease are both examples of which type of immunity? A. Innate immunity B. Temporary immunity C. Active immunity D. Passive immunity Correct Answer: C Barbara is a 60-year-old woman who presents to the pharmacy for two vaccines: HZV and IIV. Which of the following are the appropriate doses and routes for administering these vaccines to this patient? A. HZV 0.50 mL intramuscularly; IIV 0.65 mL subcutaneously. B. HZV 0.65 mL intramuscularly; IIV 0.5 mL subcutaneously. C. HZV 0.50 mL subcutaneously; IIV 0.65 mL intramuscularly. D. HZV 0.65 mL subcutaneously; IIV 0.5 mL intramuscularly. Correct Answer: D
