2023-2024 NRNP6540 Pharmacology Midterm Exam With Answers (30 Solved Questions)

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1CorrectAnswer:A previous severe allergic reaction to influenza vaccine, regardless of thecomponent suspected of being responsible for the reaction, is acontraindication to future receipt of the vaccine.CorrectAnswer:Discuss the risks of herpes zoster and SE of vaccination with the patient anddecide on whether to immunize.Herpes ZosterRecombinant zoster vaccine (RZV) was approved by the U.S. Food and DrugAdministration in 2017 and recommended by the ACIP in 2017 for use in adultsaged 50 years and older. RZV has a significantly higher efficacy than Zostervaccine live ZVL, with rates of 90% to 97% for the prevention of herpes zosterand rates of 89% for prevention of PHN.Zoster vaccine live (ZVL) became available in 2006 and was recommended bythe ACIP in 2008 for use in adults aged 60 years and older. It is a one-dose liveattenuated strain of varicella zoster virus. ZVL has an overall vaccine efficacy of49.1%.RZV is recommended by the ACIP to be given to adults aged 50 years or older. Itis a two-dose vaccine series with the second dose given 2 to 6 months after thefirst. The ACIP recommends using RZV in preference to ZVL.Neither the Centers for Disease Control and Prevention (CDC) nor the World1.When would the influenza vaccine be absolutely contraindicated?2.You see a 69-year-old patient who recently moved to town and does not remember his lasttetanus shot. What would you do?3.E. D. is a 78-year-old woman who does not remember if she has ever had the immunization forherpes zoster. She does remember having chicken pox as a child. What would you recommend forher?CorrectAnswer:You could do one of two strategies: perform serologic testing for tetanus anddiphtheria antitoxin to see if they are immune, or give one dose of Tdap, followedby Td at least 4 weeks later, followed by another dose of Td 6–12 months later.Tetanus/Tdap:In older adults, if the recommended childhood series was not done at all, therecommendation is one dose of Tdap, followed by Td at least 4 weeks later,followed by another dose of Td 6–12 months later. If vaccination documentationis incomplete, the provider can either consider serologic testing for tetanus anddiphtheria antitoxin or assume that no vaccinations have been received andadminister vaccine as directed above for patients who have not been vaccinated.NRNP 6540 MIDTERM EXAM LATEST 2023-2024WITH QUESTIONS AND ANSWERS (VERIFIEDANSWERS).

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2CorrectAnswer:All influenza vaccines have the potential to cause an egg-related allergicreaction. Persons with a history of egg allergy who have experienced onlyurticaria after exposure to egg should receive influenza vaccine.CorrectAnswer:Before travel, older adults should be up to date on routine vaccines. Olderadults should also receive other vaccines recommended for the countries theyare visiting. These are listed by country on the CDC's Destinations Pages.CorrectAnswer:Older individuals are more likely to experience a severe infection, developpneumonia, require hospitalization, or die. Mortality rates in patients 75 yearsand older are four to eight times higher than those seen for patients aged 65 to74 years, and over 50 times higher than those seen before the age of 65 years. Atotal of 90% of deaths attributable to influenza occur in individuals aged 60 yearsand older. Following an acute care hospitalization, many older adults fail to returnto their previous level of function.Nearly 40% of relatively healthy community-dwelling older adults who reportedthe presence of influenza or influenza-like illness required more than 2 weeks torecover, 20% required new assistance with daily functional tasks, and 13.9%were hospitalized. Aging impairs the ability of the immune system to adequatelyrespond to influenza vaccination and infection, both in terms of humoral(antibody) and cell-mediated responses. The magnitude of these aging-relateddeclines is increased in the presence of both frailty and chronic cytomegalovirusinfection.4.Name the most common allergic response to the flu vaccine,5.Many older adults travel worldwide when they retire. For patients who are planning to traveloverseas, what would you recommend?6.Give three reasons why older adults are especially vulnerable to complications of influenzainfections.7.You have an 89-year-old patient on hospice care in a long-term care facility. The protocol is for fluvaccine to be given to all patients each fall. Would you vaccinate? Why, or why not?CorrectHealth Organization (WHO) have updated their recommendations since RZV wasintroduced, regarding zoster vaccination for older adults who are not sure of theirzoster vaccination status.

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