NRNP 6540 MIDTERM EXAM LATEST 2023/NRNP6540 MIDTERM EXAM QUESTIONS AND ANSWERS (VERIFIED ANSWERS)|WALDEN UNIVERSITY

1

Correct

Answer: A previous severe allergic reaction to influenza vaccine, regardless of the

component suspected of being responsible for the reaction, is a

contraindication to future receipt of the vaccine.

NRNP 6540 MIDTERM EXAM LATEST

2023/NRNP6540 MIDTERM EXAM

QUESTIONS AND ANSWERS (VERIFIED

ANSWERS)|WALDEN UNIVERSITY

1. When would the influenza vaccine be absolutely contraindicated?

2. You see a 69-year-old patient who recently moved to town and does not remember his last

tetanus shot. What would you do?

3. E. D. is a 78-year-old woman who does not remember if she has ever had the immunization for

herpes zoster. She does remember having chicken pox as a child. What would you recommend for

her?

Correct

Answer: You could do one of two strategies: perform serologic testing for tetanus and

diphtheria antitoxin to see if they are immune, or give one dose of Tdap, followed

by Td at least 4 weeks later, followed by another dose of Td 6–12 months later.

Tetanus/Tdap:

In older adults, if the recommended childhood series was not done at all, the

recommendation is one dose of Tdap, followed by Td at least 4 weeks later,

followed by another dose of Td 6–12 months later. If vaccination documentation

is incomplete, the provider can either consider serologic testing for tetanus and

diphtheria antitoxin or assume that no vaccinations have been received and

administer vaccine as directed above for patients who have not been vaccinated.

2

Correct

Answer: Discuss the risks of herpes zoster and SE of vaccination with the patient and

decide on whether to immunize.

Herpes Zoster

Recombinant zoster vaccine (RZV) was approved by the U.S. Food and Drug

Administration in 2017 and recommended by the ACIP in 2017 for use in adults

aged 50 years and older. RZV has a significantly higher efficacy than Zoster

vaccine live ZVL, with rates of 90% to 97% for the prevention of herpes zoster

and rates of 89% for prevention of PHN.

Zoster vaccine live (ZVL) became available in 2006 and was recommended by

the ACIP in 2008 for use in adults aged 60 years and older. It is a one-dose live

attenuated strain of varicella zoster virus. ZVL has an overall vaccine efficacy of

49.1%.

RZV is recommended by the ACIP to be given to adults aged 50 years or older. It

is a two-dose vaccine series with the second dose given 2 to 6 months after the

first. The ACIP recommends using RZV in preference to ZVL.

Neither the Centers for Disease Control and Prevention (CDC) nor the World