NCLEX RN Vaccine Exam Bank: Age-Based Guidelines, Contraindications & Safety Q&A

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NCLEX RN Exam Bank on Vaccination Guidelines by
Age Group & Contraindication Safety




Table of Contents
Subtopic 1: Infant and Toddler Immunization Schedule (Birth to 24 Months) ...................... 2
Subtopic 2: Preschool and School-Age Vaccine Guidelines (2–12 Years) ......................... 10
Subtopic 3: Adolescent Vaccination Updates (13–18 Years) ............................................ 19
Subtopic 4: Adult Immunization Guidelines (19–64 Years) .............................................. 28
Subtopic 5: Adolescent Vaccination Strategies & Risk-Based Recommendations (Ages 11–
18) ............................................................................................................................. 37
Subtopic 6: Vaccination Guidelines for Pregnant and Lactating Individuals ..................... 45
Subtopic 7: Pregnancy and Immunization—Maternal & Fetal Considerations .................. 53
Subtopic 8: Immunization in Immunocompromised and Medically Complex Patients (HIV,
Oncology, Transplant).................................................................................................. 61
Subtopic 9: Vaccination Schedules for Immunocompromised Patients ........................... 70
Subtopic 10: Vaccine Administration Errors, Emergency Responses & Legal Reporting..... 77

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Subtopic 1: Infant and Toddler Immunization Schedule
(Birth to 24 Months)
Question 1:

At what age should the first dose of the Hepatitis B vaccine be administered to a healthy
full-term newborn?

A. At 4 weeks

B. At 2 months

C. Within 24 hours of birth

D. At 6 weeks



Correct Answer: C. Within 24 hours of birth

Rationale: The CDC recommends that all medically stable infants weighing ≥2,000 grams
receive the first dose of the Hepatitis B vaccine within 24 hours of birth to prevent perinatal
transmission.



Question 2:

Which vaccine is contraindicated in an infant with a known allergy to neomycin and
streptomycin?

A. DTaP

B. IPV (Inactivated Polio Vaccine)

C. Hib

D. Hepatitis B



Correct Answer: B. IPV (Inactivated Polio Vaccine)

Rationale: IPV is contraindicated in individuals with a history of anaphylactic reactions to
neomycin, streptomycin, or polymyxin B, which may be residual in the vaccine formulation.

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Question 3:

The nurse is preparing to administer the first dose of the MMR vaccine. Which is the
appropriate minimum age for this vaccine?

A. 6 months

B. 9 months

C. 12 months

D. 18 months



Correct Answer: C. 12 months

Rationale: The MMR vaccine is typically administered at 12–15 months because the
maternal antibodies may interfere with earlier immunogenicity.



Question 4:

Which of the following vaccine schedules is correct for the rotavirus vaccine?

A. 2 months, 4 months, 6 months

B. Birth, 1 month, 6 months

C. 2 months, 3 months

D. 4 months, 6 months, 9 months



Correct Answer: A. 2 months, 4 months, 6 months

Rationale: The rotavirus vaccine is administered orally at 2, 4, and optionally at 6 months
depending on the brand used.



Question 5:

Which vaccine is administered subcutaneously rather than intramuscularly in infants?

A. DTaP

B. MMR

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C. Hib

D. Hepatitis B



Correct Answer: B. MMR

Rationale: The MMR vaccine is given subcutaneously to allow optimal absorption and
minimize local reactions.



Question 6:

Which vaccine provides protection against whooping cough in infants?

A. Hib

B. IPV

C. DTaP

D. PCV13



Correct Answer: C. DTaP

Rationale: The pertussis component of DTaP protects against whooping cough, which can
be fatal in young infants.



Question 7:

An infant is scheduled for the third DTaP dose. At what age is this typically administered?

A. 4 months

B. 8 months

C. 6 months

D. 12 months



Correct Answer: C. 6 months