Chapter 47: Vaccines Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. A nurse is prepared to administer a varicella vaccine to a female client planning to start a family. How long after the vaccination should the nurse instruct the client to wait before getting pregnant? a. 2 weeks b. 4 weeks c. 8 weeks d. 12 weeks Answer: D Rationale: The nurse should instruct the client to wait at least 12 weeks (3 months) before getting pregnant after receiving measles, mumps, rubella, and varicella vaccines. Measles, mumps, rubella, and varicella vaccines are contraindicated in pregnancy, especially in the first trimester, because of the danger of birth defects in the infant. Following vaccination with these agents, the client is advised to wait for 12 weeks before getting pregnant. Question format: Multiple Choice Chapter: 47 Learning Objective: 6 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Teaching/Learning Reference: p. 637, Vaccines and Toxoids 2. A child is brought to the health care center for MMR vaccination. On assessment, the nurse discovers that the child had received an antivenin injection for a snake bite 2 days before. When should the nurse instruct the caregivers to return for this vaccine for this child? a. After 1–2 weeks b. After 3–4 weeks c. After 4–5 weeks d. After 6–8 weeks Answer: D Rationale: Live attenuated vaccines should be administered to clients after 6–12 weeks of administration of immune globulin preparation. MMR vaccine, being a live attenuated vaccine, should be administered to the child after 6–12 weeks, as the child has received immune globulin for a snake bite. Vaccinations containing live organisms are not administered within 6–12 weeks of immune globulin administration because antibodies in the globulin preparation may interfere with the immune response to the vaccination. To obtain an effective immune response to vaccination, the live vaccine has to be administered 14–30 days before or 6– 12 weeks after immune globulin administration. Question format: Multiple Choice Chapter: 47 Learning Objective: 4 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 638, Immune Globulins and Antivenins 3. The caregivers of a child who is recovering from chickenpox tell the nurse the child was given aspirin for a fever. The nurse would prioritize the assessment for indications of which adverse reaction? a. Lymphoma b. Angioneurotic edema c. Acute renal failure d. Reye syndrome Answer: D Rationale: When salicylates are administered along with the varicella vaccine, there is an increased risk of development of Reye syndrome. It is often associated with children who are given aspirin-containing medicines while they have chickenpox (varicella). Lymphoma, angioneurotic edema, and acute renal failure do not develop with the simultaneous administration of salicylates and the varicella vaccine. Lymphoma is a contraindication for receiving some vaccines. Angioneurotic edema is a sign of hypersensitivity to a substance. IGIV products have been associated with acute renal failure and should be used cautiously in clients with renal disease. Question format: Multiple Choice Chapter: 47 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 637, Vaccines and Toxoids 4. A nursing instructor is teaching a session illustrating the various forms of immunity utilized by the human body. The instructor determines the session is successful when the students correctly choose which type of immunity as developing after the use of ready-made antibodies from animals? a. Active immunity b. Cell-mediated immunity c. Humoral immunity d. Passive immunity Answer: D Rationale: The nurse is referring to passive immunity. The injection of ready-made antibodies found in the serum of immune individuals or animals is called passive immunity. When a person is exposed to antigens, the body begins to form antibodies. This is called active immunity. Humoral and cell-mediated immunity involve the action by B lymphocytes and T lymphocytes. Question format: Multiple Choice Chapter: 47 Learning Objective: 2 Cognitive Level: Understand Client Needs: Physiological Integrity: Physiological Adaptation Integrated Process: Teaching/Learning Reference: p. 637, Passive Immunity 5. A client comes to the clinic and tells the nurse that close family members are suspected of having pulmonary tuberculosis. Which vaccine would the nurse predict the health care provider will prescribe as a preventative measure? a. MMR vaccine b. DPT vaccine c. BCG vaccine d. IPV vaccine Answer: C Rationale: For the prevention of pulmonary tuberculosis (TB) in high-risk populations such as health care workers, infants, and children in endemic areas, a BCG vaccination is given. The MMR vaccine is used for preventing measles, mumps, and rubella. The DPT vaccine is used for preventing diphtheria, pertussis, and tetanus. IPV is an inactivated poliovirus used to prevent polio. Question format: Multiple Choice Chapter: 47 Learning Objective: 6 Cognitive Level: Understand Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 644, Summary Drug Table 6. A forest ranger arrives at a community clinic for prophylactic vaccination. The nurse predicts the health care provider will prescribe which vaccine for this client? a. MMR vaccine b. Varicella vaccine c. Rotavirus vaccine d. Rabies vaccine