APhA Immunization Certification exam questions and answers

APhA Immunization Certification exam 15. The monitoring system that health care providers should use to report serious adverse events after vaccination is:: VAERS 16. Which of the following patients are appropriate candidates for the 2-dose schedule of HPV9?: 11 or 12 year olds *if series has not been started by age 15, then a 3 dose series is needed *3 dose series recommended for immunocompromised patients *1st/2nd dose- given at 0 and 6-12 months *if 2nd dose is given sooner than 5 months after the first dose then a 3rd dose is needed 17. Why should refrigerated vaccines be stored in the middle of the refriger- ator?: because the temperature in the middle does not fluctuate as much. 18. A history of anaphylaxis caused by neomycin would be a contraindication to receiving which of the following vaccines?: Hep A, IPV, MMR, Rabies, smallpox, varicella, zoster, influenza 19. When looking at the schedule for vaccines that might be indicated for children and adolescents aged 18 years or younger based on medical in- dications, what does the orange bar represent?: Orange-indicates theres a precaution for the vaccine * Yellow-vaccine recommended according to routine schedule Purple-recommended for people with an additional risk factor for which the vaccine would be indicated 24. 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?: Td or Tdap 25. According to ACIP recommendations, which of the following needle lengths would be appropriate for administering HZV to an adult patient?: 5/8 in needle at 45 degrees in the outer upper arm (SC) 26. How often are the Healthy People targets for vaccination rates updated?- : every 10 years 27. Which of the following patients is a candidate for both MenACWY and MenB vaccines?: A 10 year old who just had his spleen removed *MenA can be administered at 2months, MenB not recommended until 10 yrs HIV infection and being in the military are risk factors for MenA 28. What must be documented for VIS?: -patient name -date vaccine was administered -vaccine manufacturer, lot number -name, address, title of the administer -date printed on VIS -date VIS was given to patient or guardian *signatures of patient/guardian not required by federal law, but some employ- ers/companys may require signatures 29. Who should receive MMR vaccine?: 2 dose series at 12-15 months and 4-6 years *no additional doses needed MMR is a live vaccine, not recommended until 12 months old Adults w/o immunity evidence (being born before 1957, documentation of MMR vaccine, lab evidence of disease) should receive one dose Healthcare professionals should receive 2 doses 30. 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?: Do not have to start series over (oral typhoid is the exception) *Increasing the interval between doses of a multi-dose vaccine series does not diminish the ultimate effectiveness of the vaccine, but it does delay protection for the patient. 31. Which of the following best describes how to administer MMR vaccine to an adult patient weighing 210 lb?: SC at 45 degree angle *weight of patient does not matter in regards to route of administration 32. HPV vaccine is recommended for..: Both males and females ages 9-26 years *routinely recommended for 11 or 12 years of age 33. Tom is a 9-year old boy who has never had an influenza vaccine. Tom's mother shows you his up-to-date immunization record and reports that he has never had any adverse reactions to vaccinations. What dose and schedule of IIV should be administered to Tom?: One dose during flu season *influenza vaccine can be given beginning at 6 months 6 months-8 years who have not previously been vaccinated need 2 doses, 4 weeks apart 9 years-one dose during flu season 6 months-2 years 0.25mL dose 3+ years- 0.5mL dose 34. Emily is a 16-year-old high-school student with no chronic medical con- ditions. 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?: Tdap MCV4 HPV Hep B influenza vaccine if flu season 35. True regarding varicella-containing vaccines:: HZV (Zostavax) contains 14 times more antigen than varicella vaccine the greater potency is necessary for an adequate immune response in older patients who have immunity to varicella because they had chicken pox 36. Which disease is almost certain to cause death if infected patients do not receive postexposure prophylaxis?: Rabies *it affects the CNS 37. If a patient with an egg allergy experiences hives following influenza vaccination, what is ACIP's recommendation for vaccinating this patient against influenza?: Hives only-can receive vaccine If patient experienced anaphylaxis or required an epi pen -CAN still receive vaccine but it must be in a medical setting where they can be supervised by medical professionals to assist with any complications 38. The childhood/adolescent and adult immunization schedules are updat- ed and published annually during which months?: once a year at the end of January or early February 39. How is the live, cholera vaccine administered?: single oral dose at least 10 days prior to potential exposure *should not eat/drink for 1 hour before or after vaccine 40. RotaTeq (RV5) should be administered as a:: 3-dose series at 2,4,6 months 41. Rotarix (RV1) should be administered as a:: 2 dose oral series at 2 and 4 months 42. Diagnosis-based screening to identify people at risk for vaccine-pre- ventable diseases:: identifies patients in need of vaccines based on the presence of a particular diagnosis. ex: diabetes 43. Procedure based screening to identify people at risk for vaccine-pre- ventable diseases:: involves assessing vaccine needs based on a patient's re- ceipt of a surgical, medical, or pharmacy-based procedure. ex: splenectomy 44. Occurrence based screening to identify people at risk for vaccine-pre- ventable diseases:: takes advantage of an event, such as a hospital admission, clinic visit, or emergency department visit to identify people who need to be vaccinated ex: discharge counseling 45. Live attenuated vaccines (11): Cholera HZV LAIV MMR MMRV Rotavirus TB (BCG) Typhoid (Ty21a) Vaccinia (smallpox) Varicella Yellow Fever *all others are inactivated 46. For a patient who needs to receive IIV and HZV, which of the following best describes appropriate administration of these vaccines?: No minimum interval between doses *IIV is inactivated HZV is live inactivated do not interfere with live 47. Interval between 2 live vaccines NOT given simultaneously:: 4 weeks 48. Why was the live attenuated influenza vaccine (LAIV) removed from the ACIP's influenza vaccine recommendations?: Lower than expected efficacy in 2013-2016 49. Epi doses:: 1:1000 w/v 1mg/mL based on weight: 0.01mg/kg/dose max dose: 0.5mg/dose dose 5-15min for up to 3 doses 50. The majority of vasovagal syncope cases occur withinin:: 15min of vacci- nation 51. Which of the following diseases has been successfully eradicated world- wide through vaccination efforts?: smallpox 52. In 2014, which vaccination rate was lowest among adolescents 13 through 17 years of age?: HPV 53. How do vaccines evoke an immune response?: The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells. *Pure polysaccharide vaccines do not activate B cells. 54. What to do in case of anaphylaxis:: Do not offer water (do not want anything in the throat) check BP and pulse to see if it is decreasing (decreasing means less blood flow and more likely to faint) Administer epi pen when patient is wheezing and difficulty in breathing, give second dose if wheezing continues IM is more prompt than SC 55. True allergic reaction:: immediate hypersensitivity with itching, hives, red- ness, or symptoms of anaphylaxis 56. False allergic reaction:: fever, GI upset, red eyes, neurological events 57. Can a women receive the flu vaccine if she is pregnant?: Yes, but it has to be the inactivated flu vaccine only during flu season 58. What vaccine should women get every pregnancy?: Tdap, after 20 weeks of pregnancy 59. What individuals are at an increased risk of adverse effects from live vaccines: Immunocompromised 60. Minimum interval when a PPD skin test is followed by a live vaccine: Ad- minister vaccine after PPD skin test has been read 61. Minimum interval when a live vaccine is followed by a PPD skin test: 28 days 62. Minimum interval when blood product is given before live vaccine: mini- mum varies (have to look up) 63. Minimum interval for live vaccines followed by blood products: 2 weeks 64. Minimum interval for inactivated vaccines and antibodies: no minimum 65. Minimum interval for two live vaccines, if not simultaneous: 28 days 66. David is a healthy 5-year-old boy who is scheduled to see his pediatrician for a checkup in July prior to starting kindergarten. David's immunization record reveals that he has received the following vaccines: 3 doses of HepB 4 doses of PCV13 2 doses of HepA 3 doses of IPV 2 doses of rotavirus 1 dose of MMRV 4 doses of DTaP 4 doses of Hib Which vaccines should David receive at this visit?: 5th dose of DTaP 4th dose of IPV 2nd dose of MMR 2nd dose of varicella PCV13 Hib Hep A Hep B 67. Purpose of adjuvants: it strengthens the response to the antigen and the immune response is much greater because the adjuvant results in an inflammatory response *adjuvants are added to recombinant vaccines 68. The presence of fever, diffuse maculopapular rash, and Koplik spots are characteristic of which of the following diseases?: MMR 69. Which of the following is recognized by sociologists as a factor in a patient's decision whether to be vaccinated?: 1) perceived susceptibility to a disease 2) perceived seriousness of a disease 3) perceived vaccine benefits 4) perceived vaccine barriers (e.g., adverse effects, access) 5) social influence (e.g., recommendation from a health care provider) 70. In the event that a young child is fussy following the receipt of a vaccine, pharmacists should advise parents to:: quiet activites and comfort them *Can use acetaminophen/ibuprofen for discomfort Aspirin is not recommended 71. During which step of the Pharmacists' Patient Care Process would a pharmacist analyze a patient's need for certain vaccines?: Assess 72. After completion of a primary vaccine series and documentation of a one-time dose of Tdap, Td booster doses are recommended every:: every 10 years 73. Which of the following tetanus booster vaccines would be most appro- priate for administration to a 12-year-old boy who has completed a primary series with DTaP and has no known allergies?: one dose of Tdap 74. Ava has arrived at the clinic for her well-child visit. She is 4 months old. Ava's immunization record reveals that she has received the following vaccines: 2 doses of HepB 1 dose of Hib 1 dose of rotavirus 1 dose of PCV13 1 dose of DTaP 1 dose of IPV Which vaccines should Ava receive at today's visit?: 2nd Hib Rotavirus DTaP PCV13 IPV *3rd Hep B at 6 months too young for flu vaccine MMR/varicella are live and recommend at 1 year 75. Robert is a 48-year-old pharmacist who is preparing to provide immuniza- tions 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?: 3 dose series at 0, 1, and 6 months 76. At what point during pregnancy is it recommended to administer the influenza vaccine?: Any trimester 77. Which of the following statements about pharmacy-based vaccination programs is true? Feedback: Administratively, billing for vaccines covered by Medicare Part D may be easier for pharmacists than physicians. 78. Which of the following is the best example of a group with which indi- vidual pharmacists can collaborate to increase immunization rates in their communities?: Local Health Departments 79. A 69 year-old man received Td vaccination 4 years ago. He is preparing to travel to see his newborn granddaughter next month. Which of the following vaccines containing tetanus, diphtheria, and/or pertussis would be most appropriate for him?: Tdap if he has not received that and a Td booster every 10 years 80. Kate is a 24-year-old woman with asthma. She requests a refill of her albuterol inhaler on November 1st. Kate's immunization record indicates that she completed the primary series of MMR, varicella, DTaP, HepA, and HepB vaccines, and she received a dose of Tdap 2 years ago. For complete coverage, which of the following vaccines should she receive?: PPSV23 HPV Influenza if flu season *PCV13 is for immunocompromised not asthma 81. What is the type of immunity that occurs when a pregnant woman is vaccinated with Tdap to protect the infant from pertussis after birth?: Passive Immunity *antibodies are provided from another source 82. Acquired immunity:: immunological memory *can be active or passive 83. Active immunity:: an antigen from an invading pathogen triggers an immune response 84. Which of the following statements would be accurate when responding to a patient's concerns about the safety of vaccines?: Inactivated is killed so cannot cause influenza intranasal is live but modified so cannot cause disease No vaccine is 100% effective If illness does occur its often less severe in those who were vaccinated No evidence that Thimerosal has caused any short or long term harm Several vaccines on the same day in immunocompetent people will not overload their immune system people are exposed . to more antigens every day from food or bacteria than from vaccines 85. If a patient is a candidate for revaccination with PPSV23, what is the ACIP-recommended interval between doses of this vaccine?: 1-3 doses with 5 years between under age of 65 who are immunocompromised or asplenia-2 doses with 5 years apart 86. Which disease is characterized by the development of a membrane on the tonsils, pharynx, or larynx, leading to respiratory obstruction?: Diphtheria 87. Which of the following best describes how to administer Tdap vaccine to an adult patient weighing 185 lb?: IM at 90 degrees *weight of patient is irrelevant in regards to route of administration 88. 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:: 2nd dose given at least 6 months after the first dose 89. Adolescents should be routinely vaccinated with MCV4 on the following schedule:: 1 dose at 11 or 12 years booster at 16 years 90. 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?: 5th dose DTaP *one time dose of Tdap at 7 years Td booster every 10 years 91. 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?: HZV-SC, 0.65mL dose IIV-IM, 0.5mL 92. What is meant by the term "immunization neighborhood"?: Immunization stakeholders collaborate to meet community immunization needs. 93. Even though state laws may have specific mandates, how long should pharmacists maintain records of immunizations?: Immunizations should be- come part of the patient's permanent record and should be kept for the patient's lifetime. 94. All Medicare Part B enrollees are covered for which vaccines?: both pneumococcal vaccines influenza vaccine 95. All Medicare Part D enrollees are covered for which vaccines?: Td/Tdap HZV 96. Arthus reactions, which are exaggerated local reactions that can occur if a patient is vaccinated too frequently, are most commonly reported after which vaccine?: Td or Tdap 97. 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:: If he has not had 2 doses of the flu vaccine then he needs 2 doses, 4 weeks apart 98. According to the ACIP, which of the following would be considered ad- equate evidence of immunity to varicella, indicating that administration of varicella vaccine is unnecessary?: Diagnosis of chickenpox/shingles by a health care provider. Born in U.S. before 1980 2 doses of varicella at least 4 weeks apart 99. Vaccines as well as exposure to natural disease are both examples of which type of immunity?: Active immunity 100. How vaccines evoke an immune response:: The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells. *Pure polysaccharide vaccines do not activate B cells. 101. If a vial of influenza vaccine is left out of the refrigerator on the phar- macy counter overnight, what should be done with the vaccine?: Should be quarantined in fridge/freezer and marked "do not use" and contact manufacturer for further instructions *RPh should document each step anytime theres a break in the cold chain 102. Which vaccine does ACIP recommend for all college freshmen, aged 21 years or younger, living in dormitories, who have not been previously vaccinated?: One dose of MCV4 103. Prior to the introduction of a vaccine, what was the leading cause of bacterial meningitis in children younger than 5 years of age?: Hib