FNP ANCC BOARDS EXAM 2025
QUESTIONS AND ANSWERS
Dose of Tetanus Immune Globulin (TIG) - ANS 250 units IM
How many doses of Tdap or Td IM needed for protection after clean minor wounds. -
ANS Three doses needed. If <3, unknown, or >10 years since last dose give dose of Tdap or
Td for clean minor wounds. No need to give TIG.
Non-"clean" minor wounds given both of these if unknown tetanus hx or <3 doses of Tdap/Td. -
ANS Tdap or Td IM & TIG
Dirty wounds (puncture, crush injury, soil, saliva, feces, dirt, avulsions, missiles, burns, frostbite)
- ANS If <3 doses Tdap or Td give both Tdap and TIG 250 units. If 3 doses in past, but none in
the last 5 years then given Tdap or Td. No need to give TIG If 3 or > doses in the past
When to switch from DTap to Tdap in children - ANS Age 7 or > given Tdap
A woman becomes pregnant and received Tdap during her last pregnancy 1 year ago. When
should she receive her next dose. - ANS Tdap is recommended for each pregnancy.
"Getting Tdap between 27 through 36 weeks of pregnancy is 78% more effective at preventing
whooping cough in babies younger than 2 months old (CDC)".
A person with a hx of anaphylaxis to neomycin should avoid which immunizations (IZ)? -
ANS IPV, MMR, varicella
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,A person with a hx of anaphylaxis to neomycin should avoid which immunizations (IZ)? -
ANS IPV, vaccinia (smallpox)
A person with a hx of anaphylaxis to bakers yeast should avoid which immunizations (IZ)? -
ANS Hepatitis B
A person with a hx of anaphylaxis to gelatin should avoid which immunizations (IZ)? -
ANS varicella zoster (zostavax) and MMR
Epinephrine needs to be on hand for potential anaphylaxis r/t immunization rxn. What other
interventions/meds should be considered during anaphylaxis? - ANS Supine, 911, give
epinephrine:
7.5-15kg: give 0.1 mg IM x1
15 to <30 kg: give 0.15mg IM; may repeat in 5-15 min x1
>30 kg or Adult: Epipen 0.3mg/0.3mL IM; may repeat in 5-15 min
H1/H2 blocker po (diphenhydramine, ranitidine)
IV access for fluids, Oxygen.
Anticipate ED might give glucagon (if on beta blocker), systemic corticosteroids, bronchodilators
s/s anaphylaxis - ANS Skin: pruritus, urticaria, angioedema
Resp: dyspnea, wheezing (bronchospasm), stridor
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, End-organ dysfunction: hypotension, collapse, syncope, incontinence
PCV-13 - ANS Prevnar. Greater protection, Narrower coverage. Pneumococcal conjugate.
PCV23 - ANS lesser protection, broader coverage
Which type of vaccine boosts immune response better? conjugate vs. polysaccharide -
ANS conjugate (example: prevnar)
Live attenuated (weaned) vaccines - ANS MMR, Varicella and intranasal Flu-mist. Zostavax is
also live. Shingrix is NOT live.
When is rotavirus vaccine contraindicated? - ANS SCID (severe combined immunodeficiency)
or hx intussusception
Precautions after rotavirus - ANS hand washing!; viral shed in stool in first week post-
vaccination
Shingrix: timing and dosing - ANS =/> 50 y/o, 2 doses, 2nd dose two to six months after 1st
dose.
Under age 50 y/o gets shingles; think immunocompromise vs. stress.
What month does the CDC release a new vaccination schedule each year? - ANS Feb
What s/s are associated with leukemia? - ANS fever, wt loss, fatigue, bone pain, bleeding,
bruising.
COPYRIGHT © 2025 FYNDLAY ALL RIGHTS RESERVED 3
QUESTIONS AND ANSWERS
Dose of Tetanus Immune Globulin (TIG) - ANS 250 units IM
How many doses of Tdap or Td IM needed for protection after clean minor wounds. -
ANS Three doses needed. If <3, unknown, or >10 years since last dose give dose of Tdap or
Td for clean minor wounds. No need to give TIG.
Non-"clean" minor wounds given both of these if unknown tetanus hx or <3 doses of Tdap/Td. -
ANS Tdap or Td IM & TIG
Dirty wounds (puncture, crush injury, soil, saliva, feces, dirt, avulsions, missiles, burns, frostbite)
- ANS If <3 doses Tdap or Td give both Tdap and TIG 250 units. If 3 doses in past, but none in
the last 5 years then given Tdap or Td. No need to give TIG If 3 or > doses in the past
When to switch from DTap to Tdap in children - ANS Age 7 or > given Tdap
A woman becomes pregnant and received Tdap during her last pregnancy 1 year ago. When
should she receive her next dose. - ANS Tdap is recommended for each pregnancy.
"Getting Tdap between 27 through 36 weeks of pregnancy is 78% more effective at preventing
whooping cough in babies younger than 2 months old (CDC)".
A person with a hx of anaphylaxis to neomycin should avoid which immunizations (IZ)? -
ANS IPV, MMR, varicella
COPYRIGHT © 2025 FYNDLAY ALL RIGHTS RESERVED 1
,A person with a hx of anaphylaxis to neomycin should avoid which immunizations (IZ)? -
ANS IPV, vaccinia (smallpox)
A person with a hx of anaphylaxis to bakers yeast should avoid which immunizations (IZ)? -
ANS Hepatitis B
A person with a hx of anaphylaxis to gelatin should avoid which immunizations (IZ)? -
ANS varicella zoster (zostavax) and MMR
Epinephrine needs to be on hand for potential anaphylaxis r/t immunization rxn. What other
interventions/meds should be considered during anaphylaxis? - ANS Supine, 911, give
epinephrine:
7.5-15kg: give 0.1 mg IM x1
15 to <30 kg: give 0.15mg IM; may repeat in 5-15 min x1
>30 kg or Adult: Epipen 0.3mg/0.3mL IM; may repeat in 5-15 min
H1/H2 blocker po (diphenhydramine, ranitidine)
IV access for fluids, Oxygen.
Anticipate ED might give glucagon (if on beta blocker), systemic corticosteroids, bronchodilators
s/s anaphylaxis - ANS Skin: pruritus, urticaria, angioedema
Resp: dyspnea, wheezing (bronchospasm), stridor
COPYRIGHT © 2025 FYNDLAY ALL RIGHTS RESERVED 2
, End-organ dysfunction: hypotension, collapse, syncope, incontinence
PCV-13 - ANS Prevnar. Greater protection, Narrower coverage. Pneumococcal conjugate.
PCV23 - ANS lesser protection, broader coverage
Which type of vaccine boosts immune response better? conjugate vs. polysaccharide -
ANS conjugate (example: prevnar)
Live attenuated (weaned) vaccines - ANS MMR, Varicella and intranasal Flu-mist. Zostavax is
also live. Shingrix is NOT live.
When is rotavirus vaccine contraindicated? - ANS SCID (severe combined immunodeficiency)
or hx intussusception
Precautions after rotavirus - ANS hand washing!; viral shed in stool in first week post-
vaccination
Shingrix: timing and dosing - ANS =/> 50 y/o, 2 doses, 2nd dose two to six months after 1st
dose.
Under age 50 y/o gets shingles; think immunocompromise vs. stress.
What month does the CDC release a new vaccination schedule each year? - ANS Feb
What s/s are associated with leukemia? - ANS fever, wt loss, fatigue, bone pain, bleeding,
bruising.
COPYRIGHT © 2025 FYNDLAY ALL RIGHTS RESERVED 3
