Question

1. The measles, mumps, rubella, and varicella (MMRV) combined vaccine is ordered to be given as the second dose vaccine. The RN understands the following side effect with this vaccination. A. Increased risk of fever and febrile seizures with this vaccine combination over the MMR plus varicella two-shot regimen. B. Patients must also receive MMRV as the second dose of MMR and varicella in order to build adequate immunity. C. Patients should be premedicated with acetaminophen 15 minutes before the vaccine is given. D. Patients should not be around pregnant women for the first 72 hours after the vaccine is given. 2. The Nurse understands the general principle when administering live vaccines to include the following? Select ALL that APPLY A. Do not administer to immunocompromised patients B. Do not administer to patient with a febrile illness C. Do not administer during or one month after pregnancy D. Do not administer two live vaccines the same day E. Ask the patient about egg allergies 3. True/False: The Zoster vaccine is considered Live? 4. The RN is preparing to administer the Influenza vaccine. The RN will ask the patients about the following contraindications prior to administering: A. Egg allergy B. Neomycin allergy C. Interactions with prednisone D. History of site reaction 5. The patient is on Methotrexate daily. The RN understands the following are complications to be alert for while taking Methotrexate. b A. Decreased clotting time B. Kidney damage C. Increased risk of infection D. Hepatitis 6. The 68-year-old male patient is prescribed Allopurinol for his Gout. The RN will monitor for the effectiveness of this medication by monitoring the following? A. Increased pain B. Decrease in uric acid levels C. Decrease in white blood cell count D. Increased C-reactive protein

Answer 1

1.A(Increased risk of fever and febrile seizures with this vaccine combined over the MMR plus varicella two shots regimen:The measles, mumps,rubella and varicella (MMRV) combined vaccine is orders to be given as the second dose vaccine .The registered nurse understand the following side effects with this vaccination

• Children gave fever of 102 degree102 degree fahrenheit with in 42 days of being vaccinated.
• Febrile seizures may caused during 5-12 days after vaccination.

2.General principles to administer live vaccine:

• Do not administer live vaccine to Immunocompromised patients.
• Do not administer to patient with febrile seizures
• Do not administer two live vaccines on same day.
• Do not administer live vaccine to pregnant women.
• Live vaccine does not contain any egg protein.

3.True

• The zoster vaccine considered as live attenuated vaccine indicated for prevention of herpes zoster in individual with 50yrs of age and older.
• It should not be used for prevention of primary varicella infection or postherpetic neuralgia.

4.C(Interaction with Prednisone):

• Prednisone is a immunosuppressant to suppress immune system.
• Influenza is live vaccine that is contraindicated in two conditions i.e.,Immuno suppression and in pregnant women.

5.D(Hepatitis)

• Long term usage of methotrexate cause Hepatotoxicity.
• Methotrexate elevate serum aminitransferase level and long term therapy cause development of fatty liver,fibrosis and cirrhosis.
• Hepatitis can be resolved with in 4 months after stopping of drug.

6.B(Decreased uric acid level)

• Gout is caused by accumulation of urate cyrstals in joint that cause inflammation and intense pain.
• Urate crystals can elevate uric acid level in blood that can be produced when it breaks down purines which is found naturally in the body.