CURRENT Medical Diagnosis and
Treatment 2026
65th Edition
Author(s)Maxine A. Papadakis; Michael
W. Rabow; Kenneth R. McQuaid; Paul L.
Nadler; Erika Leemann Price
TEST BANK
1
Reference
Ch. Disease Prevention & Health Promotion — Adult
Immunizations: Recombinant Zoster Vaccine (RZV)
Stem
A 68-year-old man with well-controlled type 2 diabetes
presents for routine care. He reports no prior history of shingles
and refuses live vaccines because of concern about safety.
,Which is the most appropriate vaccination recommendation
today?
A. Administer live attenuated zoster vaccine (single dose).
B. Administer two doses of recombinant zoster vaccine (RZV).
C. Defer zoster vaccination because of his diabetes.
D. Administer a single dose of high-dose influenza vaccine
instead.
Correct answer
B
Rationale — Correct (B)
RZV (two-dose series) is indicated for adults ≥50, including
those with diabetes; it is non-live and preferred for
immunocompetent older adults. CMDT recommends RZV for
prevention of herpes zoster and postherpetic neuralgia, with
higher efficacy than the older live vaccine.
Rationale — Incorrect
A. Live zoster vaccine is not preferred for adults ≥50 given lower
efficacy and RZV superiority.
C. Diabetes is not a contraindication; patients with stable
chronic disease should receive RZV.
D. Influenza vaccine is appropriate annually, but it does not
substitute for zoster protection.
Teaching point
Recombinant zoster vaccine (two doses) is recommended for
adults ≥50, including those with chronic disease.
,Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. Disease
Prevention & Health Promotion.
2
Reference
Ch. Disease Prevention & Health Promotion — Vaccination in
Pregnancy
Stem
A 28-year-old woman at 22 weeks’ gestation presents for
prenatal care. She has not received Tdap since adolescence.
Which immunization is recommended during this pregnancy?
A. Tdap now, during each pregnancy.
B. Tdap only if she is a healthcare worker.
C. Give Tdap postpartum only to protect the newborn.
D. Tdap is contraindicated in pregnancy; give in the second year
postpartum.
Correct answer
A
Rationale — Correct (A)
Tdap is recommended during each pregnancy (preferably
between 27–36 weeks) to maximize transplacental antibody
transfer and protect the neonate from pertussis. CMDT
, supports administration during every pregnancy regardless of
prior Tdap history.
Rationale — Incorrect
B. Occupational risk does not restrict indication;
recommendation is universal for each pregnancy.
C. Postpartum vaccination protects the mother but not the
infant at birth; antepartum vaccination confers passive
immunity to the newborn.
D. Tdap is not contraindicated in pregnancy.
Teaching point
Give Tdap during each pregnancy (optimal 27–36 weeks) to
protect the newborn from pertussis.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. Disease
Prevention & Health Promotion.
3
Reference
Ch. Disease Prevention & Health Promotion — Live Vaccines &
Pregnancy
Stem
A 32-year-old woman in the first trimester of pregnancy lacks
documentation of prior MMR immunity and has a nonreactive
rubella IgG. She is otherwise well. What is the best next step?
Treatment 2026
65th Edition
Author(s)Maxine A. Papadakis; Michael
W. Rabow; Kenneth R. McQuaid; Paul L.
Nadler; Erika Leemann Price
TEST BANK
1
Reference
Ch. Disease Prevention & Health Promotion — Adult
Immunizations: Recombinant Zoster Vaccine (RZV)
Stem
A 68-year-old man with well-controlled type 2 diabetes
presents for routine care. He reports no prior history of shingles
and refuses live vaccines because of concern about safety.
,Which is the most appropriate vaccination recommendation
today?
A. Administer live attenuated zoster vaccine (single dose).
B. Administer two doses of recombinant zoster vaccine (RZV).
C. Defer zoster vaccination because of his diabetes.
D. Administer a single dose of high-dose influenza vaccine
instead.
Correct answer
B
Rationale — Correct (B)
RZV (two-dose series) is indicated for adults ≥50, including
those with diabetes; it is non-live and preferred for
immunocompetent older adults. CMDT recommends RZV for
prevention of herpes zoster and postherpetic neuralgia, with
higher efficacy than the older live vaccine.
Rationale — Incorrect
A. Live zoster vaccine is not preferred for adults ≥50 given lower
efficacy and RZV superiority.
C. Diabetes is not a contraindication; patients with stable
chronic disease should receive RZV.
D. Influenza vaccine is appropriate annually, but it does not
substitute for zoster protection.
Teaching point
Recombinant zoster vaccine (two doses) is recommended for
adults ≥50, including those with chronic disease.
,Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. Disease
Prevention & Health Promotion.
2
Reference
Ch. Disease Prevention & Health Promotion — Vaccination in
Pregnancy
Stem
A 28-year-old woman at 22 weeks’ gestation presents for
prenatal care. She has not received Tdap since adolescence.
Which immunization is recommended during this pregnancy?
A. Tdap now, during each pregnancy.
B. Tdap only if she is a healthcare worker.
C. Give Tdap postpartum only to protect the newborn.
D. Tdap is contraindicated in pregnancy; give in the second year
postpartum.
Correct answer
A
Rationale — Correct (A)
Tdap is recommended during each pregnancy (preferably
between 27–36 weeks) to maximize transplacental antibody
transfer and protect the neonate from pertussis. CMDT
, supports administration during every pregnancy regardless of
prior Tdap history.
Rationale — Incorrect
B. Occupational risk does not restrict indication;
recommendation is universal for each pregnancy.
C. Postpartum vaccination protects the mother but not the
infant at birth; antepartum vaccination confers passive
immunity to the newborn.
D. Tdap is not contraindicated in pregnancy.
Teaching point
Give Tdap during each pregnancy (optimal 27–36 weeks) to
protect the newborn from pertussis.
Citation
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2026). Current
Medical Diagnosis & Treatment (65th ed.). Ch. Disease
Prevention & Health Promotion.
3
Reference
Ch. Disease Prevention & Health Promotion — Live Vaccines &
Pregnancy
Stem
A 32-year-old woman in the first trimester of pregnancy lacks
documentation of prior MMR immunity and has a nonreactive
rubella IgG. She is otherwise well. What is the best next step?
