Exam Prep & Comprehensive Practice Review
Primary prevention - correct answerprevent the onset or acquisition of a given disease.
education and counseling
the most effective form of healthcare.
Secondary prevention - correct answerto identify and treat asymptomatic persons who
have risk factors for a given disease or in preclinical disease.
screening,
BP for HTN
Lipid Profile for HLD
Tertiary prevention - correct answermanagement of an established disease.
minimize disease
medications and lifestyle modification to normalize
aimed at improving or minimizing disease-related symptoms.
Active immunity is defined as - correct answerresistance developed in response to an
antigen.
Which of the following statements best describes zanamivir (Relenza) or oseltamivir
(Tamiflu) use in the care of patients with or at risk for influenza? - correct
answerInitiation of therapy early in acute influenza illness can help minimize the severity
of disease when the illness is caused by a nonresistant viral strain.
Preventive Services Recommended by the USPSTF - correct answer
Preventive Services Recommended by the USPSTF 2 - correct answer
In an immunocompetent adult, the length of incubation for the influenza virus is on
average: - correct answer1-4 days
Adults pass the illness on 1 day before the onset of symptoms and continue to remain
infectious for approximately 5 days after the onset of the illness. Children remain
infectious for 10 or more days after the onset of symptoms and can shed the virus
before the onset of symptoms. People who are immunocompromised can remain
infectious for up to 3 weeks.
,Influenza protection options for a 62-year-old man with hypertension, dyslipidemia, and
type 2 diabetes mellitus include receiving: - correct answertrivalent inactivated vaccine
(TIV) in standard dose via intramuscular injection.
This is the typical "flu shot." A quadrivalent inactivated vaccine is also available.
injected is not live but the nasal spray is
Which of the following should not receive vaccination against influenza?
A. a 19 year-old with a history of hive-form reaction to eating eggs
B. a 24-year-old woman who is 8 weeks pregnant
C. a 4-month-old infant who was born at 32 weeks of gestation
D. a 28-year-old woman who is breastfeeding a 2 week old. - correct answerc
all members of the population age 6 months and older should receive annual
immunization against seasonal influenza.
those with an egg allergy that is only hives should be given the vax
A healthy 6-year-old girl presents for care. Her parents request that she receive
vaccination for influenza and report that she has not received this vaccine in the past.
How many doses of influenza vaccine should she receive this flu season?
A.1 B.2 C.3 D.4 - correct answerb
All children aged 6 months to 8 years who receive a seasonal influenza vaccine for the
first time should receive 2 doses spaced ≥4 weeks apart.
high risk populations that need flu vax - correct answer• All children aged 6 through 59
months.
• Adults and children who have chronic pulmonary (including asthma) or cardiovascular
(except isolated hypertension), renal, hepatic, neurological, hematologic, or metabolic
disorders (including diabetes mellitus). Individuals age 50 years of age and older.
• Persons who have immunosuppression (including immunosuppression caused by
medications or by HIV infection).
• Women who are or will be pregnant during the influenza season.
• Children and adolescents (aged 6 months - 18 years) who are receiving long-term
aspirin therapy and who might be
at risk for experiencing Reye's syndrome after influenza virus infection.
• Residents of nursing homes and other long-term care facilities.
• American Indians/Alaska Natives.
• Persons who are morbidly obese (BMI ≥40) kg/m2.
• People who live with or care for those at high risk for complications from flu, including:
• Healthcare workers.
• Household contacts of persons with medical conditions that put them at high risk for
complications from the flu.
,• Household contacts and out of home caregivers of children aged ≤59 months and
adults aged ≥50 years, with par-
ticular emphasis on vaccinating contacts of children less than 6 months of age. (These
children are too young to be vaccinated.)
LAIV is approved for___ - correct answerLAIV is approved for use in healthy people
ages 2 to 49 years old
It is not for patients with a health condition that places them at high risk for
complications from influenza, including chronic heart disease, chronic lung dis- ease
such as asthma or reactive airways disease, diabetes or kidney failure, and
immunosuppression; children or adolescents receiving long-term high-dose aspirin
therapy; people with a history of Guillain-Barré syndrome; pregnant women; and people
with a history of allergy to any of the components of LAIV. Adverse effects of LAIV
include nasal irritation and discharge, muscle aches, sore throat, and fever.
FDA approved antiviral drugs for flu - correct answerIn the United States, four antiviral
drugs are approved by the Food and Drug Administration (FDA) for use against
influenza: amantadine (Symmetrel), rimantadine (Flumadine), zanamivir (Relenza), and
oseltamivir (Tamiflu).
which flu drugs are only for influenza A and what are the new reccs for them - correct
answeramantadine (Symmetrel), rimantadine (Flumadine)
high levels of resistance of influenza A viruses to amantadine and similar medications.
Because of this significant level of resistance, amantadine and rimantadine are no
longer recommended by the CDC for the treatment of influenza.
adverse affects of the 2 main flu antiviral drugs - correct answerZanamivir is inhaled and
can cause bronchospasm, especially in patients with asthma or other chronic lung
disease.
The adverse effects of oseltamivir are largely gastrointestinal; the risk of nausea and
vomiting is significantly reduced if the medication is taken with food.
When considering an adult's risk for measles, mumps, and rubella (MMR), the NP
considers the following: A. Patients born before 1957 have a high likelihood of
immunity against these diseases because of a history
of natural infection.
B. Considerable mortality and morbidity occur with all
three diseases.
C. Most cases in the United States occur in infants.
D. The use of the MMR vaccine is often associated with protracted arthralgia. - correct
answerA
The MMR vaccine contains live but weakened (attenuated) virus.
, Two immunizations 1 month apart are recommended for adults born after 1957 because
adults born before then are considered immune as a result of having had these
diseases(native or wild infection); vaccine against these three formerly common
illnesses was unavailable until the 1960s
Which of the following is true about the MMR vaccine?
A. It contains inactivated virus.
B. Its use is contraindicated in patients with a history of egg allergy.
C. Revaccination of an immune person is associated with risk of significant systemic
allergic reaction.
D. Two doses at least 1 month apart are recommended for young adults who have not
been previously immunized. - correct answerD
A 22-year-old man is starting a job in a college health center and needs proof of
German measles, measles, and mumps immunity. He received childhood
immunizations and supplies documentation of MMR vaccination at age 1.5 years. Your
best response is to:
A. obtain rubella, measles (rubeola), and mumps titers.
B. give MMR immunization now.
C. advise him to obtain IG if he has been exposed to
measles or rubella.
D. advise him to avoid individuals with skin rashes. - correct answerb
As with all vaccines, giving additional doses to patients with an unclear immunization
history is safe.
quadrivalent MMR, what is it? - correct answerA quadrivalent vaccine, protecting
against measles, mumps, rubella, and varicella (chickenpox), is also available and
usually used to immunize younger children.
Rubella - correct answerRubella typically causes a relatively mild, 3- to 5-day illness
with little risk of complication to the person infected. When rubella is contracted during
pregnancy, however, the effects on the fetus can be devastating.
measles and mumps sx - correct answerMeasles can cause severe illness with serious
sequelae, including encephalitis and pneumonia; sequelae of mumps include orchitis
and possible decreased male fertility.
MMR and pregnant women - correct answerThe MMR vaccine is safe to use during
lactation, but its use during pregnancy is discouraged because of the theoretical but
unproven risk of congenital rubella syndrome from the live virus contained in the
vaccine.
Adult immunization schedule - correct answer