MSN 624 FINAL EXAM ACTUAL QUESTIONS AND
SOLUTIONS GRADED A+
✔✔Zoster: - ✔✔Shingrix age > 50, 2 doses given 2-6 months apart). Shingrix is a
recombinant zoster vaccine (RZV) regardless of past episode of zoster or receipt of live
zoster vaccine (ZVL)
If ZVL (live vaccine) previously received, administer 2 doses of RZV 2-6 months apart at
least 2 months after ZVL vaccine
Adults > 60 or older, give either RZV or ZVL (RZV preferred)
Contraindicated in pregnancy and anyone with severe immunodeficiency
✔✔Catch up vaccines or if at risk:
Hep A (2 doses) - ✔✔). If given HepA-HepB, 3 dose series (0, 1 and 6 mos)
✔✔Catch up vaccines or if at risk:
Hep B (3 doses): - ✔✔dosing regimen varies depending upon what given
✔✔Catch up vaccines or if at risk:
MMR - ✔✔1 dose if no evidence of immunity
✔✔varicella - ✔✔2 doses given 4-8 weeks apart. If no immunity, give 1 dose.
✔✔meningococcal - ✔✔1 or 2 doses, depending upon reason for vaccination
✔✔haemophilus influenza type B (Hib) - ✔✔1-3 doses depending upon reasoning
✔✔Ages 25-64 Chemoprophylaxis - ✔✔Multi-vitamin with folic acid if child-bearing
Discuss hormone therapy with women in peri / post menopause
Low dose aspirin for those at cardio-vascular risk
Vitamin D
A number of factors decrease the amount of vitamin D a person will synthesize from
sunlight. These factors include
Living at high latitudes (closer to the polar regions), particularly during winter months
Air quality conditions: high levels of air pollution
Weather conditions: dense cloud covering
The degree to which clothing covers the skin
Use of sunscreen
Skin pigmentation: darker skin types
✔✔Ages 65+ Screening - ✔✔Screening
Blood Pressure
, Height & weight
FOB / colonoscopy through age 75
Mammogram: q 1-2 years until age 75, then discuss pro & cons
Pap test if sexually active and have a cervix
Osteoporosis
Vision screening
Assess hearing
Assess for alcohol abuse and depression
✔✔Ages 65+ Counseling - ✔✔Counseling
Substance Abuse: Tobacco, alcohol, drugs
Diet and Exercise
Limit fat, maintain caloric balance, increase fruit, vegetables, grains
Calcium for women
Regular physical activity
Heal Maintenance/Injury Prevention
Seatbelts
Helmets
Fall prevention
Secure firearms
Smoke & carbon monoxide detectors
Set hot water heater to < 120 degrees
CPR training
Dental Health: regular visits, brush with fluoride, floss
Sexual Behavior: STD prevention, condoms, avoid high risk behavior, PrEP (senior
living communities are hot beds for STD's
✔✔Ages 65+ Immunizations
Tetanus-Diphtheria-Pertusis booster (Tdap) vs Tetanus-Diphtheria (Td): - ✔✔): (q 10
years)
✔✔Ages 65+ Immunizations zoster - ✔✔(Shingrix age 50 and greater; 2 doses, 2-6 mos
apart)
✔✔ages 65+ immunizations pneumococcal - ✔✔(1 dose of 13-valent for unvaccinated
followed by PCV 23 booster 1 year later for those previously vaccinated at least 5 years
after last dose)
✔✔65+ Immunizations, Continued - ✔✔Catch up vaccines generally speaking:
Hep A (2 doses)
Hep B (3 doses)
SOLUTIONS GRADED A+
✔✔Zoster: - ✔✔Shingrix age > 50, 2 doses given 2-6 months apart). Shingrix is a
recombinant zoster vaccine (RZV) regardless of past episode of zoster or receipt of live
zoster vaccine (ZVL)
If ZVL (live vaccine) previously received, administer 2 doses of RZV 2-6 months apart at
least 2 months after ZVL vaccine
Adults > 60 or older, give either RZV or ZVL (RZV preferred)
Contraindicated in pregnancy and anyone with severe immunodeficiency
✔✔Catch up vaccines or if at risk:
Hep A (2 doses) - ✔✔). If given HepA-HepB, 3 dose series (0, 1 and 6 mos)
✔✔Catch up vaccines or if at risk:
Hep B (3 doses): - ✔✔dosing regimen varies depending upon what given
✔✔Catch up vaccines or if at risk:
MMR - ✔✔1 dose if no evidence of immunity
✔✔varicella - ✔✔2 doses given 4-8 weeks apart. If no immunity, give 1 dose.
✔✔meningococcal - ✔✔1 or 2 doses, depending upon reason for vaccination
✔✔haemophilus influenza type B (Hib) - ✔✔1-3 doses depending upon reasoning
✔✔Ages 25-64 Chemoprophylaxis - ✔✔Multi-vitamin with folic acid if child-bearing
Discuss hormone therapy with women in peri / post menopause
Low dose aspirin for those at cardio-vascular risk
Vitamin D
A number of factors decrease the amount of vitamin D a person will synthesize from
sunlight. These factors include
Living at high latitudes (closer to the polar regions), particularly during winter months
Air quality conditions: high levels of air pollution
Weather conditions: dense cloud covering
The degree to which clothing covers the skin
Use of sunscreen
Skin pigmentation: darker skin types
✔✔Ages 65+ Screening - ✔✔Screening
Blood Pressure
, Height & weight
FOB / colonoscopy through age 75
Mammogram: q 1-2 years until age 75, then discuss pro & cons
Pap test if sexually active and have a cervix
Osteoporosis
Vision screening
Assess hearing
Assess for alcohol abuse and depression
✔✔Ages 65+ Counseling - ✔✔Counseling
Substance Abuse: Tobacco, alcohol, drugs
Diet and Exercise
Limit fat, maintain caloric balance, increase fruit, vegetables, grains
Calcium for women
Regular physical activity
Heal Maintenance/Injury Prevention
Seatbelts
Helmets
Fall prevention
Secure firearms
Smoke & carbon monoxide detectors
Set hot water heater to < 120 degrees
CPR training
Dental Health: regular visits, brush with fluoride, floss
Sexual Behavior: STD prevention, condoms, avoid high risk behavior, PrEP (senior
living communities are hot beds for STD's
✔✔Ages 65+ Immunizations
Tetanus-Diphtheria-Pertusis booster (Tdap) vs Tetanus-Diphtheria (Td): - ✔✔): (q 10
years)
✔✔Ages 65+ Immunizations zoster - ✔✔(Shingrix age 50 and greater; 2 doses, 2-6 mos
apart)
✔✔ages 65+ immunizations pneumococcal - ✔✔(1 dose of 13-valent for unvaccinated
followed by PCV 23 booster 1 year later for those previously vaccinated at least 5 years
after last dose)
✔✔65+ Immunizations, Continued - ✔✔Catch up vaccines generally speaking:
Hep A (2 doses)
Hep B (3 doses)
