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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
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
, 2
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
