What are the answers to the Project Immune Readiness Competency Post Test?

Answer 1

Vaccine Healthcare Centers Network

Competency Course Module Post Test

ANTHRAX

Primary vaccination with anthrax vaccine consists of six doses.

The first three are given at 0 weeks, weeks, The next three doses

are given at months, months, and months.

4, 6, 12, 18

A person who is hospitalized with acute pneumonia. (anthrax)

No

A person who is receiving long-term immunosuppressant

therapy after a transplant. (routine anthrax vaccination today)

No

A multidose vial of anthrax vaccine is removed from the freezer.

After thawing, the vial is shaken thoroughly to evenly suspend the

vaccine during withdrawal. After administering the needed doses

of anthrax vaccine, the vial is labeled with the date, refrozen, and

discarded after 30 days.

NO

Which statement would be most correct to give a woman who

has just received her first routine anthrax vaccination?

Up to 50% of people develop minor local reactions, but these

reactions generally last only a few days.

HEP A/B TWINRIX HAVRIX HIB VAQTA RECOMBIVAX

You are giving Havrix to a 17 month old

720, 0.5

People who receive hepatitis B vaccine in the deltoid muscle

No

You are giving Vaqta to an 18 year old

25, 0.5 =

You are giving Vaqta to a 25 year old.

50, 1

A 44-year-old man receives a 0.5 mL booster dose of

Vaqta 50 units intramuscularly into a dorsogluteal site

NO

How many doses of single-antigen hepatitis A vaccine will he need

to receive to complete his primary series for hepatitis A?

2

How many doses of single-antigen hepatitis B vaccine will

he need to complete his primary series for hepatitis B?

2

For which person is Hib vaccine LEAST likely to be recommended?

A pediatrician who does volunteer work in developing countries.

What is the recommended dose and route of administration for Hib

vaccination of most adolescents and adults for whom the vaccine

is indicated?

One 0.5 mL dose administered intramuscularly into the deltoid.

Children who receive their first dose of Hib vaccine when they are

7 months of age or older still need at least four doses of vaccine.

False

Children who receive their first dose of Hib vaccine when they are

7 months of age or older still need at least four doses of vaccine.

False

Recombivax HB for a 52 year old.

Yes

Recombivax HB for a 15 year old receiving 2 doses.

10, 1

You are giving Havrix to a 32 year old.

1440, 1

For which family members is routine vaccination

for hepatitis A recommended?

Only the 12 year old and the 17 year old.

INFLUENZIA FLU LAIV

Fill in the number of milliliters (mL) in one dose of intramuscular

inactivated influenza vaccine for people 3 years of age or older,

and click on "Submit".

0.5

Which statement is correct about inactivated influenza vaccine

according to its Vaccine Information Statement (VIS)?

Influenza vaccine is kept up-to-date each year by replacing at least one of the vaccine virus strains with a strain currently causing illness.

The most common adverse reaction following LAIV vaccination

a mild systemic reaction, such as cough and chills.

True

A healthy 29-year-old emergency medical technician. (inactivated influenza)

LAIV/IV

What is the correct dose and route for administering LAIV?

0.1 mL intranasally into each nostril.

Multidose vials of inactivated influenza vaccine arrive at the

administration site in an insulated container.

The multidose vials that are not used

are transported back to the administration site in the insulated

container, which contains chilled coolant packs. Open vials are

dated and all vials are placed back into the refrigerator.

Yes

Fill in the number of influenza vaccine doses that should be given

each year to an adolescent or adult, and click on "Submit".

1

IXIARO JEV

A woman from the United States who will be spending three

weeks in a rural Southeast Asian village in August.

Yes

What is the recommended schedule for Ixiaro?

Days 0 and 28.

What is the correct dose and route for Ixiaro?

0.5 mL intramuscularly

A patient calls and reports that she has a headache and muscle pain.

She received her first dose of Ixiaro 2 days ago.

You should advise her that

this is a common side effect and an over-the-counter

medication can be taken relieve the discomfort.

How effective are 2 doses of Ixiaro at preventing Japanese

encephalitis when the doses are administered according to

the recommended schedule?

About 95%.

MMR MEASLES MUMBS RUBELLA

The Advisory Committee on Immunization Practices (ACIP)

recommends that combined measles, mumps, and rubella

vaccine be given whenever a person needs mumps vaccine.

TRUE

A man born in March of 1969 who, according to his medical record,

was vaccinated with a single dose of rubella-containing vaccine in

January of 1970.

NO

MMRV (ProQuad) vaccine is licensed for use in children

1 through 12 years of age.

True

Which person has a valid contraindication to receiving rubella

vaccine today?

An 18 year old who just found out she is pregnant.

Which modern vaccine contains weakened virus?

MMR

Human papillomavirus vaccine for an adolescent who received

MMR vaccine two weeks ago.

Yes

How many doses of rubella vaccine or MMR vaccine are

recommended for children 1 year of age and older?

Two

A single-dose vial of MMRV vaccine is stored in the

refrigerator with the diluent. It is then reconstituted

and placed back in the refrigerator. Six hours later,

the vial is removed and the dose is drawn up and

administered.

No

A man is beginning work in the housekeeping department of

a medical facility. During screening the following information

is obtained:

The man was born in 1952.

The man says his mother told him he had measles as a

child.

His PPD done 3 days ago was negative.

His wife is immune suppressed because of chemotherapy

treatments.

Vaccine administration personnel give him one dose of MMR

vaccine.

Yes

Which person does not need two doses of MMR vaccine?

30-year-old man who is a computer programmer

Fill in the number of milliliters (mL) in one dose

of MMR vaccine, and click on "Submit."

0.5

What type of adverse reaction are you most likely to see in

adolescent and adult men after injection of rubella vaccine?

Fever and rash.

What type of adverse reaction are you most likely to see

in adolescent and adult women after injection of measles

vaccine?

Fever and rash.

Which person should not receive mumps vaccine today?

A 16 year old who received antibody-containing blood products

4 weeks ago.

The recommended dose for M-M-R II is:

0.5 mL.

In the Armed Forces, which personnel are required

to have measles immunity?

All personnel

MENINGOCOCCAL

A 38-year-old college professor who teaches freshman English.

No

A healthy 12-year-old girl. (meningococcal)

YES

Which person has a valid contraindication to receiving

meningococcal vaccine today?

Someone hospitalized with acute bronchitis.

Which person should not receive meningococcal conjugate vaccine?

A 60-year-old woman traveling to West Africa.

What type of vaccine are Menveo and Menactra?

Conjugate polysaccharide.

An 11-year-old boy needs to receive meningococcal vaccine.

He has HIV infection. What is the correct schedule?

Two doses given 2 months apart and a booster dose at age 16.

A 5 year old who had his spleen removed last year

following an automobile accident.

YES

A single-dose vial of meningococcal polysaccharide vaccine is

reconstituted using the diluent provided and then placed back

in the refrigerator. Four hours later, the vial is removed and the

dose is drawn up and administered.

NO

Which is the correct dose for subcutaneous administration of

meningococcal polysaccharide vaccine?

0.5 mL.

MULTIPLE DOSES

A man needs MMR, varicella vaccine, and poliovirus vaccine. He

would like to receive all three today. Which statement is accurate?

All three vaccines can be given today at different injection sites.

PAPILLOMAVIRUS

A vial of human papillomavirus vaccine is removed from the freezer.

The vial is shaken well to evenly suspend the vaccine during

withdrawal. After administering the vaccine the vial is disposed of

in the sharps container.

YES

Human papillomavirus vaccine for an adolescent who received

MMR vaccine two weeks ago.

Yes

PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV)PNEUMOVAX PCV13 PPV23

For each person described, click on Yes if the person should be

vaccinated with PPV23 today, or on No if the person should

not be vaccinated with PPV23 today. In all cases, assume that

there are no valid contraindications to vaccine administration

Yes

(PCV13) A healthy 6-month-old.

Yes

Which statement is correct about pneumococcal polysaccharide

vaccine (PPV23)?

PPV23 vaccine is inactivated.

A 4 year old who is HIV positive. (PVC13)

Yes

A healthy 23 year old who is works in a long term

care facility for older adults and who smokes cigarettes.

YES

A 25 year old who will be receiving a cochlear implant in 3 weeks

YES

POLIO IPV

Which is the correct dose of IPV to administer

to a child, adolescent, or adult?

0.5 mL.

An adult who received two doses of polio vaccine as a child will be

leaving to travel to a country in which exposure to wild poliovirus

remains a threat. What additional IPV doses should this person receive before leaving?

Administer only one dose of vaccine.

Which person has a valid contraindication or precaution

to receiving polio vaccine today?

A woman with diarrhea and a high fever.

47. A healthy 2-year-old child. (polio)

Yes

A man had poliomyelitis disease as a child. What

type of immunity does he have against polio?

ACTIVE

A previously unvaccinated adult will be traveling to a country

in which exposure to wild poliovirus remains a threat. What is

the minimum interval between which doses can be given if an

accelerated schedule of IPV administration is needed?

4 weeks.

RABIES

If rabies is treated early and correctly, what

percentage of people will still die?

almost 100%.

Which person is LEAST likely to need

pre-exposure vaccination for rabies?

A man taking a business trip to Singapore and Hong Kong

A woman who received her first dose of pre-exposure rabies

vaccine yesterday calls to report redness and swelling at the

vaccine injection site. She should be told that this is

common and will go away, and that she can take an over-the-

counter pain reliever for the discomfort.

What is the recommended dose of rabies vaccine

when it is given intramuscularly?

1 mL.

Engerix-B for a 5 year old

10, 0.5

What percent of healthy people develop protective antibodies

against rabies when rabies vaccine is administered correctly?

100%

ROTAVIRUS

Rotavirus vaccine for a 3-month old who has

a high fever and severe diarrhea.

No

SHIPPING HANDLING STORAGE

A shipment of vaccine has been delivered to your vaccine

administration site. What would be the correct initial action

to take?

Check the condition of the vaccine and make sure the cold chain

has been maintained during shipping.

Expressed as degrees Centigrade, type in the temperature

at which vaccine storage freezers should be maintained.

-15

At a minimum, how many times a day should the temperature

in a vaccine storage unit be checked and logged?

Twice

Which statement about vaccine inventory and storage is correct?

Place extra water bottles in the refrigerator door and coolant

packs in the freezer to provide additional insulation.

SMALLPOX VACCINIA IMMUNE GLOBULIN (VIG)

As part of a pre-outbreak vaccination program, which Service

Member presenting for smallpox vaccination today should not

be given the vaccine? One who

is of childbearing age and who has had unprotected intercourse

since her last period.

As part of a pre-outbreak smallpox vaccination program, for which

person would smallpox vaccine most likely be contraindicated? A

person who answers "yes" to the question:

Have you ever had an itchy rash in the creases of your elbows or knees?

Which person has the most significant risk factor for a severe

immune system-related smallpox vaccine complication? A person

who

has had sexual contact with a person who is HIV-positive.

What is the correct action to take if, after dipping the bifurcated

needle into the smallpox vaccine vial, you do not see a droplet of

vaccine between the prongs?

Re-dip the needle perpendicularly into the vial.

Which person would be at greatest risk for development

of myopericardiditis following smallpox vaccination?

55-year-old woman with congestive heart failure.

Which measure is most important in preventing the most

frequent adverse event following smallpox vaccination?

Hand washing.

As part of a pre-outbreak smallpox vaccination program, for which

person would smallpox vaccine most likely be contraindicated? A

person who answers "yes" to the question:

Have you ever had an itchy rash in the creases of your elbows or knees?

Vaccinia immune globulin (VIG) use would

be indicated for a person with

progressive vaccinia.

There are an estimated 27 million people in the United States

who have atopic dermatitis. Why should these people not receive

smallpox vaccine, unless they have been exposed to smallpox virus

or are a contact of a person with smallpox? These people are at

risk for eczema vaccinatum, a severe reaction to smallpox vaccine

What is the correct action to take if, after dipping the bifurcated

needle into the smallpox vaccine vial, you do not see a droplet of

vaccine between the prongs?

Re-dip the needle perpendicularly into the vial

TD TDAP

What is recommended schedule for giving ACTHib vaccine

to an infant?

2, 4, 6, and 12-15 months of age

A 30-year-old Service Member has a deep cut that is

contaminated with dirt. He completed the primary Td

series six years ago. The wound is cleaned and sutured.

What additional treatment is needed to prevent tetanus?

Tdap booster dose today.

What is Td?

A toxoid vaccine made from altered tetanus and diphtheria toxins

In which person is Tdap contraindicated? Assume all people

are due for a Td booster dose.

41 year old who had encephalopathy 3 days after a dose of DTP

with no known cause.

A 24-year-old woman is 4 months pregnant. She has never

received Td or DTaP. What would be the recommended

schedule for her?

Td today, Td in 1 month, and Tdap 6 months after Td-2.

Which statement about Tdap is accurate?

Tdap should be given as a single-booster dose to people 10 - 64 years

of age.

Td vaccine for a woman who has not had a booster dose in 5 years.

NO

Pediarix can be used for infants and children 6 weeks to 7 years of age.

TRUE

Which vaccine requires multiple doses

before active immunity results?

Tetanus.

A woman cut her hand with a knife while slicing an apple. She

cannot recall whether she ever had a tetanus shot, but thinks

she may have had one dose. The wound is cleaned and sutured.

What additional treatment is needed to prevent tetanus?

Td primary series, with first dose today.

Which statement about Tdap is accurate?

Tdap should be given as a single-booster dose to people 10 - 64 years of age.

TYPHOID TY21A VICPS PEDIARIX

What type of vaccine is Ty21a?

A live attenuated bacterial vaccine.

What is the correct dose, schedule, and

route of administration for Ty21a?

Four capsules taken by mouth on alternate days, each dose

taken one hour before a meal.

Which adverse reactions are most common following vaccination with ViCPS?

Pain and swelling at the injection site.

What is the correct dose, schedule, and route

of administration for ViCPS vaccine?

One 0.5 mL dose administered intramuscularly.

Pediarix can be used for infants and children 6 weeks to 7 years of age.

True

What is Td?

A toxoid vaccine made from altered tetanus and diphtheria toxins

For which person would typhoid fever vaccine be indicated?

A person traveling to the Indian subcontinent.

If he plans to continue this type of travel in the future, when is it

recommended that he be revaccinated against typhoid fever?

In five years.

For which person would ViCPS be the preferred

type of typhoid vaccine? One who

is taking an antibiotic.

VARICELLA

An 18-year-old Armed Forces recruit needs varicella vaccination

and a PPD. What is a correct way to administer these injections?

Administer the PPD and varicella vaccine simultaneously.

Which person should have varicella vaccination delayed?

A 40 year old who received a blood transfusion 10 days ago.

Varicella vaccine for a man who completed chemotherapy and

radiation treatment for testicular cancer 9 months ago.

Yes

A healthy teen received her second dose of varicella vaccine two

days ago. She calls the vaccine administration center complaining

of redness, soreness, and swelling at the injection site. She has no

fever and otherwise feels well. Which recommendation would be appropriate to include in your response to the woman about this adverse reaction?

Expect these symptoms to go away by themselves in a few days

Which person has a valid contraindication to receiving varicella vaccine today?

An HIV-infected 2 year old with a very low CD4+T-lymphocyte count

A healthy, 40-year-old man who is susceptible to varicella was

exposed to VZV 3 days ago. What action is recommended to

prevent or reduce the severity of varicella illness if this man is

infected with VZV?

Administer a dose of varicella vaccine today, followed by a second dose in 4 to 8 weeks.

YF-VAX/YELLOW FEVER

Which statement accurately represents information

contained in the yellow fever VIS?

Nursing mothers should avoid or postpone travel to a yellow

fever area, if possible.

After vaccination with YF-VAX, two groups of people have

demonstrated lower rates of immunity to yellow fever than

other people.

Pregnant women and people with impaired immunity.

Which response would be most correct? "For healthy

men in their 40s, the vaccine has been shown to be (yellow fever)

99% to 100% effective after one dose."

What is the recommended dose of YF-VAX?

0.5 mL.

Which person has a valid contraindication to receiving yellow

fever vaccine or should check with his or her healthcare provider

prior to receiving yellow fever vaccine today?

A 20 year old who had his thymus removed last year.

Which susceptible person should receive

yellow fever vaccine today?

An Armed Forces member being deployed to West Africa.

ZOSTER

A single-dose vial of zoster vaccine is stored in the freezer.

It is then reconstituted with room temperature diulent

and placed in the refrigerator. The next day, the vial is

removed and the dose is drawn up and administered.

No

Which person should not receive zoster vaccine today?

48-year-old woman who will be undergoing chemotherapy in two week

Zoster vaccine for a man who uses

a corticosteroid inhaler for asthma.

YES

OTHER

A 29-year-old nurse who works in a Naval hospital.

Yes

Which person most likely will fail to develop active immunity

following vaccination? The person who was given

hepatitis B immune globulin 2 months ago and MMR vaccine given today.

Answer 2

A previously unvaccinated adult will be traveling to a country

in which exposure to wild poliovirus remains a threat. What is

the minimum interval between which doses can be given if an

accelerated schedule of IPV administration is needed?