Chapter 49: Immunizing Drugs

Chapter 49: Immunizing Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. 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 (Varivax)
b.	Herpes zoster vaccine (Zostavax)
c.	Hepatitis B virus vaccine, inactivated (Recombivax HB)
d.	Haemophilus influenzae type b (Hib) vaccine

 

 

ANS:  D

1. 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.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 788

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. 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

 

 

ANS:  C

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. 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; this gives the host direct means of fighting off an invading microorganism. The host’s immune system therefore does not have to manufacture these antibodies.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   p. 784

TOP:   NURSING PROCESS: Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. 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.	Adenopathy

 

 

ANS:  A

Serum sickness sometimes occurs after repeated injections of equine (horse)-made immunizing drugs and is characterized by edema of the face, tongue, and throat; rash; urticaria; fever; flushing; dyspnea; and other symptoms.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 787

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A 12-month-old infant has received an MMR II (measles, mumps, and rubella virus vaccine), and her mother calls the clinic that afternoon to ask about helping her fussy infant to “feel better.” What will the nurse suggest?

a.	Apply an ice pack to the injection site.
b.	Apply warm compresses to the injection site.
c.	Observe the site for further swelling and redness.
d.	Bring the infant in to the emergency department for an immediate examination.

 

 

ANS:  B

Applying warm compresses to the injection site and using acetaminophen (not aspirin, which carries the risk for Reye’s syndrome) should help to relieve the discomfort. The other options are incorrect.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 794

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort

 

5. A sanitation worker has experienced a needle stick by a contaminated needle that was placed in a trash can. The employee health nurse expects that which drug will be used to provide passive immunity to hepatitis B infection?

a.	Haemophilus influenzae type b (Hib)
b.	Varicella virus vaccine (Varivax)
c.	Hepatitis B immunoglobulin (BayHep B)
d.	Hepatitis B virus vaccine (inactivated) (Recombivax HB)

 

 

ANS:  C

Recombivax HB promotes active immunity to hepatitis B infection in people who are considered to be at high risk for potential exposure to the virus, whereas hepatitis B immunoglobulin provides passive immunity for the prophylaxis and postexposure treatment of people exposed to hepatitis B virus or HBs-Ag–positive materials, such as blood, plasma, or serum. Hib and Varivax vaccines are not appropriate for this situation.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 791

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Health Promotion and Maintenance