Chapter 70: The Immune System and Immunizations

Chapter 70: The Immune System and Immunizations

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The parents of a 2-month-old infant ask the primary care nurse practitioner (NP) if they can immunize their child by giving one or two immunizations per month instead of following the recommended immunization schedule for vaccines at 2, 4, 6, 12, and 15 months of age. The NP should:

ANS:  C

Young infants are the most vulnerable to serious outcomes of vaccine-preventable disease. Vaccination providers should adhere as closely as possible to recommended vaccination schedules. Protection may not occur until all doses have been given. Parents should be counseled about the risks and benefits of vaccines. Longer than recommended intervals between doses do not reduce final antibody concentrations. With the exception of oral typhoid, an interruption in the schedule does not require restarting the entire series.

DIF:    Cognitive Level: Applying (Application)                           REF:   756

2. The primary care NP sees a 5-year-old child for a prekindergarten physical examination. The child’s parents do not have immunization records, and a local record search does not provide proof of vaccinations, although the parent thinks the child may have had some vaccines several years ago. The NP’s initial action will be to:

ANS:  B

Persons without documentation of vaccine receipt should be considered nonimmunized if a reasonable effort to locate records is unsuccessful and should be started on age-appropriate vaccines. The Hib and rotavirus vaccines are not given after age 5, or 60 months of age. Serologic testing for immunity may be done for certain antigens, but this does not include tetanus.

DIF:    Cognitive Level: Applying (Application)                           REF:   756

3. The primary care NP sees a 6-month-old infant for a routine physical examination and notes that the infant has a runny nose and a cough. The parents report a 2-day history of a temperature of 99° F to 100° F and two to three loose stools per day. Other family members have similar symptoms. The infant has had two sets of immunizations at 2 and 4 months of age. The NP should:

ANS:  A

Minor upper respiratory infection or gastroenteritis, with or without fever, is not an indication for withholding a scheduled vaccine dose.

DIF:    Cognitive Level: Applying (Application)                           REF:   757

4. A woman who is pregnant and is planning to breastfeed tells the primary care NP that she has never had chickenpox. The NP should:

ANS:  C

Live vaccines are usually contraindicated in pregnancy but are usually safe when the mother is breastfeeding.

DIF:    Cognitive Level: Applying (Application)                           REF:   758