What interventions would you propose? What would be some realistic and measureable projected outcomes?
March 4, 2019
Discuss the implication if the goals are fully, partially or not achieved and what action you would take
March 4, 2019

Suzie, age 5, comes to the clinic for a well-child visit. She has not been in since she was 2. Her immunizations are up to date. What immunizations would you give her today?

Suzie, age 5, comes to the clinic for a well-child visit. She has not been in since she was 2. Her immunizations are up to date. What immunizations would you give her today?

1. A 55 y/o woman with Type 2 DM is leaving in 3 days for a 10-day trip to a developing country and is planning a return trip in 6 months. She request protection from Hepatitis A. You advise her to:
* A. Receive hepatitis A immunization
* B. Receive immune globulin
* C. Receive hepatitis A vaccine and immune Globulin
* D. Avoid exposure to blood and body fluids

2.Which of the following wounds represents the greatest risk for tetanus injection?
* A. A 2cm deep wound obtained while gardening
* B. A 1.5cm laceration obtained while trimming beef
* C. A human bite
* D. A 4cm circular abrasion from a fall on pavement

3.Which of the following represents the most appropriate immunizations for a 45 y/o adult with asthma
* A. Tetanus-diphtheria toxoid
* B. Varicella vaccine
* C. Influenza vaccine
* D. Hepatitis B series

4.When advising a patient about antipneumococcal vaccine, you report that it is:
* A. Protective against most pneumonia-causing pathogens
* B. Contraindicated in immunosuppresion
* C. Able to cause significant adverse reaction with both polysaccharide and conjugate forms
* D. Able to be given during antimicrobial therapy

5.Carol, a nursing student, is at your office for her nursing school admittance physical exam and immunizations. On reviewing Carol’s allergies, you find that she is allergic to baker’s yeast. What would tell Carol regarding the hepatitis B vaccine?
* A. You recommend that she receive the first Hep B vaccine today
* B. You advise her to wait until she is starting her clinical rotation to get the first Hep B injection
* C. You advise her that she can’t receive the Hep B vaccine because of her allergy to baker’s yeast
* D. You instruct her to receive the first Hep B vaccine today, the second injection in 6 months, and the third injection in 1 year.

6.Suzie, age 5, comes to the clinic for a well-child visit. She has not been in since she was 2. Her immunizations are up to date. What immunizations would you give her today?
* A. None; wait until she is 6 yrs old to give her booster shoots
* B. Diphtheria, tetanus, pertussis (DTaP); Haemophilusinfluenzae Type B (Hib); and measles, mumps, and rubella (MMR)
* C. DTaP and IPV
* D. DTaP, IPV, and MMR
*
7.Which of the following is a true contraindication to immunizations?
* A. Mild-to-moderate local reactions to a previous immunizations
* B. Mild acute illness with a low-grade fever
* C. Moderate or severe illness with or without a fever
* D. Recent exposure to an infectious disease
8.Which immunization may prevent meningitis?
* A. Hepatitis B
* B. Haemophilus Influenza Type B (Hib)
* C. MMR
* D. Varicella
9.Gerald, a 67-year old male retired maintenance worker, comes to your office for a physical. On reviewing Gerald’s history, you discover that he had pneumonia twice in the past 5 years. When you question Gerald about his immunization history, he reveals that his last tetanus and diphtheria (Td) immunization was 6 years ago, and his last flu shot was 8 months ago during the last flu season. He denies ever having had a pneumonia vaccination. Which immunizations should you offer to Gerald today?
* A. Td
* B. Pneumococcal vaccine
* C. Influenza
* D. Td and pneumococcal vaccine

10.Molly, age 48, is healthy except for her well-controlled asthma. She asks if she should get an annual flu vaccination. You tell her that she should
* A. get it only after she reaches age 65
* B. get it only during the fall season when her asthma is bothering her
* C. get it on an annual basis
* D. not get it because she has a respiratory problem (asthma)
11.Andrea, a 20 y/o nursing student, never had her second measles, mumps, rubella (MMR) immunization. What test must you do before giving Andrea her second MMR?
* A. CBC
* B. Complete metabolic panel
* C. Lipid profile
* D. Urinary Pregnancy test
12.In which of following situations would you NOT administer the HPV vaccination?
* A. Susie, age 11 who has not had sex yet
* B. Janice, age 17, who had a baby 6 months ago and is breastfeeding
* C. Alice, age 18, who is an immunocompromised state
* D. Jull, age 19, who is pregnant
13.True or false?
* A 55 y/o woman with asthma is an ideal candidate for live-attenuated influenza vaccine against seasonal influenza (LAIV, Flumist)
* Influenza and antipneumoccocal immunizations cannot be given on the same day
* Injectable influenza vaccine is contraindicated in the person with a history of anaphylactic reaction to penicillin
14.True or false?
* Immune globulin is a concentrated solution of antibodies derived from pooled donated blood
* A woman with a history of genital warts, abnormal Papanicolaou test, or positive HPV DNA test should not receive HPV vaccine
* Tdap (tetanus, diphtheria, acellular pertussis {Adacel, Boostrix}) vaccine should replace a single dose of Td vaccine for adults age <65 years who have not previously received a dose of Tdap in order to provide additional protection against pertussis


 

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