HESI Immunization and Vaccination
Exam (2026 Edition)||
questions and answers with
rationales/graded A+/2026
update/100% correct /instant
download
Section 1: General Principles & Schedules (Questions 1–20)
1. A 2-month-old infant is brought to the clinic for routine vaccines. Which
immunizations are recommended at this visit according to the 2026 CDC schedule?
a) DTaP, IPV, HepB, Hib, PCV13, RV
b) DTaP, IPV, HepB, Hib, PCV13, RV, MenB
c) DTaP, IPV, HepB, Hib, PCV13, RV
d) DTaP, IPV, HepB, Hib, MMR, Varicella
Rationale: At 2 months, CDC recommends DTaP, IPV, HepB (if not given at
birth), Hib, PCV13, and RV. MMR and varicella start at 12 months. MenB is given
at 16–18 years or high-risk infants.
2. A 65-year-old patient with no underlying conditions is due for vaccines. Which
of the following is recommended annually?
a) PCV20
b) Tdap
c) High-dose influenza vaccine (Fluzone High-Dose)
d) PPSV23
Rationale: Annual influenza vaccine is recommended for all adults ≥6 months.
High-dose or adjuvanted is preferred for ≥65 years. PCV20 is one-time; Tdap
every 10 years; PPSV23 only with PCV13 in certain cases.
,3. The nurse is educating a pregnant patient at 28 weeks gestation. Which vaccine
is recommended during EVERY pregnancy regardless of trimester?
a) Hepatitis A
b) Tdap
c) MMR
d) HPV
Rationale: Tdap is recommended at 27–36 weeks each pregnancy to pass pertussis
antibodies to the newborn. MMR and HPV are contraindicated in pregnancy.
4. A child received MMR #1 at 12 months. When is MMR #2 due?
a) 15 months
b) 4–6 years (before kindergarten entry)
c) 18 months
d) 11–12 years
Rationale: CDC schedule: MMR #1 at 12–15 months, MMR #2 at 4–6 years. It
can be given earlier (≥28 days after dose 1) but routinely at 4–6 years.
5. Which vaccine is contraindicated in an egg-allergic child with a history of
anaphylaxis?
a) Varicella
b) MMR
c) LAIV (FluMist)
d) Hepatitis B
Rationale: LAIV is contraindicated in severe egg allergy. IIV (injectable flu) is
safe even with egg allergy per 2023 ACIP guidelines. MMR is egg-free.
6. A 70-year-old receives PCV20. When should they get PPSV23?
a) 1 year later
b) Not needed
c) 5 years later
d) Immediately
Rationale: PCV20 covers all 23 serotypes in PPSV23 plus more. If PCV20 is
given, PPSV23 is not recommended.
7. Which immunization is contraindicated in a patient receiving high-dose
corticosteroids (prednisone 40 mg/day for 2 weeks)?
, a) Live vaccines (MMR, Varicella, LAIV, Zoster live)
b) Inactivated polio
c) Tdap
d) Hepatitis B
Rationale: High-dose systemic steroids (>2 weeks) suppress immunity; live
vaccines deferred for ≥1 month after stopping.
8. A 6-month-old infant traveling to a measles-endemic country has not yet
received MMR. What is the recommendation?
a) Delay until 12 months
b) Give MMR now, then repeat at 12 months and 4–6 years
c) Give only IG (immune globulin)
d) Give MMR at 9 months and no further doses
Rationale: For international travel, MMR can be given at 6–11 months, then
repeat at 12–15 months and 4–6 years.
9. Which of the following provides the best herd immunity protection?
a) High vaccination coverage (>95%) with MMR
b) Natural infection
c) Delayed vaccination schedule
d) Only vaccinating high-risk groups
Rationale: Herd immunity requires >95% coverage for highly contagious diseases
like measles.
10. A healthcare worker has no documentation of varicella infection or vaccination.
What should they receive?
a) One dose of varicella vaccine
b) Two doses of varicella vaccine 4 weeks apart
c) Varicella titer alone
d) No vaccine if no high-risk contact
Rationale: ACIP recommends 2 doses for all susceptible HCP.
11. A patient asks if they can get influenza and COVID-19 vaccines on the same
day. Correct response:
a) No, must wait 14 days
b) Yes, co-administration is safe and effective
Exam (2026 Edition)||
questions and answers with
rationales/graded A+/2026
update/100% correct /instant
download
Section 1: General Principles & Schedules (Questions 1–20)
1. A 2-month-old infant is brought to the clinic for routine vaccines. Which
immunizations are recommended at this visit according to the 2026 CDC schedule?
a) DTaP, IPV, HepB, Hib, PCV13, RV
b) DTaP, IPV, HepB, Hib, PCV13, RV, MenB
c) DTaP, IPV, HepB, Hib, PCV13, RV
d) DTaP, IPV, HepB, Hib, MMR, Varicella
Rationale: At 2 months, CDC recommends DTaP, IPV, HepB (if not given at
birth), Hib, PCV13, and RV. MMR and varicella start at 12 months. MenB is given
at 16–18 years or high-risk infants.
2. A 65-year-old patient with no underlying conditions is due for vaccines. Which
of the following is recommended annually?
a) PCV20
b) Tdap
c) High-dose influenza vaccine (Fluzone High-Dose)
d) PPSV23
Rationale: Annual influenza vaccine is recommended for all adults ≥6 months.
High-dose or adjuvanted is preferred for ≥65 years. PCV20 is one-time; Tdap
every 10 years; PPSV23 only with PCV13 in certain cases.
,3. The nurse is educating a pregnant patient at 28 weeks gestation. Which vaccine
is recommended during EVERY pregnancy regardless of trimester?
a) Hepatitis A
b) Tdap
c) MMR
d) HPV
Rationale: Tdap is recommended at 27–36 weeks each pregnancy to pass pertussis
antibodies to the newborn. MMR and HPV are contraindicated in pregnancy.
4. A child received MMR #1 at 12 months. When is MMR #2 due?
a) 15 months
b) 4–6 years (before kindergarten entry)
c) 18 months
d) 11–12 years
Rationale: CDC schedule: MMR #1 at 12–15 months, MMR #2 at 4–6 years. It
can be given earlier (≥28 days after dose 1) but routinely at 4–6 years.
5. Which vaccine is contraindicated in an egg-allergic child with a history of
anaphylaxis?
a) Varicella
b) MMR
c) LAIV (FluMist)
d) Hepatitis B
Rationale: LAIV is contraindicated in severe egg allergy. IIV (injectable flu) is
safe even with egg allergy per 2023 ACIP guidelines. MMR is egg-free.
6. A 70-year-old receives PCV20. When should they get PPSV23?
a) 1 year later
b) Not needed
c) 5 years later
d) Immediately
Rationale: PCV20 covers all 23 serotypes in PPSV23 plus more. If PCV20 is
given, PPSV23 is not recommended.
7. Which immunization is contraindicated in a patient receiving high-dose
corticosteroids (prednisone 40 mg/day for 2 weeks)?
, a) Live vaccines (MMR, Varicella, LAIV, Zoster live)
b) Inactivated polio
c) Tdap
d) Hepatitis B
Rationale: High-dose systemic steroids (>2 weeks) suppress immunity; live
vaccines deferred for ≥1 month after stopping.
8. A 6-month-old infant traveling to a measles-endemic country has not yet
received MMR. What is the recommendation?
a) Delay until 12 months
b) Give MMR now, then repeat at 12 months and 4–6 years
c) Give only IG (immune globulin)
d) Give MMR at 9 months and no further doses
Rationale: For international travel, MMR can be given at 6–11 months, then
repeat at 12–15 months and 4–6 years.
9. Which of the following provides the best herd immunity protection?
a) High vaccination coverage (>95%) with MMR
b) Natural infection
c) Delayed vaccination schedule
d) Only vaccinating high-risk groups
Rationale: Herd immunity requires >95% coverage for highly contagious diseases
like measles.
10. A healthcare worker has no documentation of varicella infection or vaccination.
What should they receive?
a) One dose of varicella vaccine
b) Two doses of varicella vaccine 4 weeks apart
c) Varicella titer alone
d) No vaccine if no high-risk contact
Rationale: ACIP recommends 2 doses for all susceptible HCP.
11. A patient asks if they can get influenza and COVID-19 vaccines on the same
day. Correct response:
a) No, must wait 14 days
b) Yes, co-administration is safe and effective
