Exam 70: The Immune System and Immunizations

The primary care NP performs a physical examination on an 89-year-old patient who is about to enter a skilled nursing facility.The patient reports having had chickenpox as a child.The NP should:

The parents of a 2-month-old infant ask the primary care nurse practitioner (NP)if they can immunize their child by giving one or two immunizations per month instead of following the recommended immunization schedule for vaccines at 2,4,6,12,and 15 months of age.The NP should:

The primary care NP sees a 65-year-old patient in October.The patient has a history of COPD and has not had any vaccines for more than 20 years.The NP should administer:

The primary care NP sees a 6-month-old infant for a routine physical examination and notes that the infant has a runny nose and a cough.The parents report a 2-day history of a temperature of 99° F to 100° F and two to three loose stools per day.Other family members have similar symptoms.The infant has had two sets of immunizations at 2 and 4 months of age.The NP should:

A parent whose child received a fourth DTaP at a recent 15-month visit calls the primary care NP to report that the child is fussy,has a temperature of 38.3° C,and has redness and swelling at the injection site.The NP should:

The primary care NP sees an 11-month-old infant for the first time and notes that the infant has not received the Hib vaccine.The NP should:

A patient receives a hepatitis A vaccine and 4 weeks later develops symptoms of hepatitis.The patient has no history of exposure to blood or body fluids.The primary care NP should tell the patient that:

A 23-year-old woman who is sexually active has an abnormal Pap smear.She asks the primary care NP about the human papillomavirus vaccine (HPV).The NP should recommend:

The parent of a 2-month-old infant who will soon begin daycare refuses the rotavirus vaccine (RV)because of fears of intussusception.The parent tells the primary care NP that the daycare is strict about preventing infants who have fever or gastrointestinal symptoms from attending.The NP should tell the parent that:

The primary care NP is performing a physical examination on a 6-month-old infant with cerebral palsy who has not had previous immunizations.The NP plans to begin vaccinations and should include:

The primary care NP sees a 4-year-old child who has persistent asthma episodes for a well-child visit in October.The child recently completed a 7-day course of oral steroids.The NP plans to give the child flu vaccine and should:

The primary care NP sees a 2-month-old infant for a well-baby examination in late November.The infant was born at 34 weeks' gestation,does not have underlying cardiac or pulmonary conditions,and does not attend daycare.The NP should recommend:

A woman who is pregnant and is planning to breastfeed tells the primary care NP that she has never had chickenpox.The NP should:

The primary care NP sees a 5-year-old child for a prekindergarten physical examination.The child's parents do not have immunization records,and a local record search does not provide proof of vaccinations,although the parent thinks the child may have had some vaccines several years ago.The NP's initial action will be to:

The primary care NP sees a 4-year-old child who has received four doses of PCV 7 in the first 15 months of life.The NP should administer:

The primary care NP sees a 12-month-old infant who needs the MMR,Varivax,influenza,and hepatitis A vaccines.The child's mother tells the NP that she is pregnant.The NP should: