Chapter 31: Vaccines

Chapter 31: Vaccines

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is discussing vaccines with the mother of a 4-year-old child who attends a day care center that requires the diphtheria, tetanus, acellular pertussis (DTaP) vaccine. The mother, who is pregnant, tells the nurse that she does not want her child to receive the pertussis vaccine because she has heard that the disease is “not that serious” in older children. What information will the nurse include when discussing this with the mother?

a.	If she gets the vaccine, both she and her 4-year-old child will be protected.
b.	If the 4-year-old child contracts pertussis, it can be passed on to her newborn.
c.	The vaccine will not be given to her child while she is pregnant.
d.	Vaccinating the 4-year-old will provide passive immunity for her unborn child.

 

 

ANS:   B

Even though pertussis is not as serious in older children, it is important to vaccinate children to prevent the spread of the disease to infants and others who are not immunized and who are at risk for significant morbidity and mortality from this disease. Vaccinating the mother will not protect the 4-year-old from getting pertussis. The DTaP vaccine may be given to children whose mothers are pregnant. Vaccinating the child does not confer passive immunity to the unborn child.

 

DIF:    Cognitive Level: Understanding (Comprehension)               REF:    p. 438

TOP:    Nursing Process: Assessment/Nursing Intervention

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A woman who is pregnant tells the nurse she has not had any vaccines but wants to begin so that she can protect her unborn child. Which vaccine(s) may be administered to this patient?

a.	Human papillomavirus (HPV) quadrivalent vaccine (Gardasil)
b.	Trivalent influenza vaccine
c.	Measles–mumps–rubella (MMR) vaccine
d.	Varicella vaccine

 

 

ANS:   B

The influenza vaccine is recommended for pregnant women and should be given. Gardasil is given to young women who are not yet sexually active. The MMR is contraindicated because rubella can cause serious teratogenic effects. Varicella is contraindicated during pregnancy.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 433

TOP:    Nursing Process: Assessment/Planning

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. A 4-year-old child is receiving amoxicillin (Amoxil) to treat otitis media and is in the clinic for a well-child checkup on the last day of antibiotic therapy. The provider orders varicella (Varivax); measles–mumps–rubella (MMR); inactivated polio (IPV); and diphtheria, tetanus, and acellular pertussis (DTaP) vaccines to be given. Which action by the nurse is correct?

a.	Administer the vaccines as ordered.
b.	Discuss giving the MMR vaccine in 4 weeks.
c.	Hold all vaccines until 2 weeks after antibiotic therapy.
d.	Recommend aspirin for fever and discomfort.

 

 

ANS:   A

Antibiotic therapy is not generally a contraindication to the use of vaccines. Vaccines may be given in cases of mild acute illness or during the convalescent phase of an illness. All four vaccines may be given. If the MMR or other live virus vaccine is not given the same day as the varicella vaccine, administration of the two vaccines should be separated by at least 4 weeks. Aspirin should not be given because of the increased risk of Reye syndrome.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 436

TOP:    Nursing Process: Nursing Intervention

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A patient is preparing to travel with a 4-year-old child to India in 10 days and is in the clinic to receive typhoid vaccines. Which vaccines will be given to the parent and the child?

a.	Four capsules of live, oral vaccine to both patients
b.	Four capsules of live, oral vaccine for the parent and the intramuscular (IM) polysaccharide vaccine for the child
c.	Four capsules of live, oral vaccine for the child and the IM polysaccharide vaccine for the parent
d.	IM polysaccharide for both patients

 

 

ANS:   D

While the live, oral vaccine may be given to patients older than 6 years, each capsule must be taken 48 hours apart with the last capsule given 1 week prior to travel. There would not be enough time to complete the regimen since the patients leave in 10 days. Children under age 6 cannot receive the oral vaccine.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 436

TOP:    Nursing Process: Nursing Intervention

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies