Chapter 47, Vaccines TEST BANK INTRODUCTORY CLINICAL PHARMACOLOGY 12TH EDITION By Susan M Ford

1. A nurse is prepared to administer a varicella vaccine to a female client planning to start a family. How long after the vaccination should the nurse instruct the client to wait before getting pregnant? A) 2 weeks B) 4 weeks C) 8 weeks D) 12 weeks Answer: D Rationale: The nurse should instruct the client to wait at least 12 weeks (3 months) before getting pregnant after receiving measles, mumps, rubella, and varicella vaccines. Measles, mumps, rubella, and varicella vaccines are contraindicated in pregnancy, especially in the first trimester, because of the danger of birth defects in the infant. Following vaccination with these agents, the client is advised to wait for 12 weeks before getting pregnant. Question format: Multiple Choice Chapter: 47 Learning Objective: 6 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Teaching/Learning Reference: p. 637, Vaccines and Toxoids 2. A child is brought to the health care center for MMR vaccination. On assessment, the nurse discovers that the child had received an antivenin injection for a snake bite 2 days before. When should the nurse instruct the caregivers to return for this vaccine for this child? A) After 1–2 weeks B) After 3–4 weeks C) After 4–5 weeks D) After 6–8 weeks Answer: D Rationale: Live attenuated vaccines should be administered to clients after 6–12 weeks of administration of immune globulin preparation. MMR vaccine, being a live attenuated vaccine, should be administered to the child after 6–12 weeks, as the child has received immune globulin for a snake bite. Vaccinations containing live organisms are not administered within 6–12 weeks of immune globulin administration because antibodies in the globulin preparation may interfere with the immune response to the vaccination. To obtain an effective immune response to vaccination, the live vaccine has to be administered 14–30 days before or 6– 12 weeks after immune globulin administration.