Chapter 16, Drugs for Immunization and Immunomodulation: Overview of Immunity and Vaccinations—Sherpath

Question 1 of 8

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Which example reflects naturally acquired passive immunity?

• • An infant who has contracted respiratory syncytial virus (RSV)This is an example of naturally acquired active immunity as the microorganism has invaded the body naturally, making the infant sick.
• • A 25-year-old patient receiving an MMR booster vaccinationThis is an example of artificially acquired active immunity. In this case, immunity develops against a specific microorganism when a form of that organism is deliberately injected or ingested.
• Correct
  • A fetus receiving IgG from the motherNaturally acquired passive immunity transfers antibodies to the fetus indirectly from the mother.
• • A patient receiving antivenom for a poisonous snakebite.Artificially acquired passive immunity transfers as premade antibodies from one person or persons and even from animals to the affected person. An example of this is receiving antivenom for a snakebite.

Question 2 of 8

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Which type of immunity is considered “true immunity”?

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  • Naturally acquired active immunityNaturally acquired active immunity occurs when a person is exposed to a live pathogen, develops the disease, and becomes immune as a result of the body’s immune response. With naturally acquired active immunity, lymphocytes produce memory cells that are long lived. It is considered “true immunity.”
• • Artificially acquired active immunityArtificial acquired active immunity develops via exposure to a specific antigen by purposeful injection. A person’s body must learn and produce an antibody response. Typically, immunity is abundant but may require periodic booster shots.
• • Naturally acquired passive immunityNaturally acquired passive immunity is short term and develops from indirect antibody transfer from mother to fetus to provide critical protection from newly encountered organisms.
• • Artificially acquired passive immunityArtificially acquired passive immunity transfers as premade antibodies from one person or persons and even from animals to the affected person.

Question 3 of 8

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Which type of immunity would be acquired from an immunization of hepatitis B?

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  • An immunization of hepatitis BArtificially acquired immunity develops against a specific microorganism when a form of that organism is deliberately injected or ingested.
• • A child exposed to pertussis at schoolNaturally acquired active immunity is obtained directly via exposure to an antigen, with the body generating its own antibody response.
• • A patient receiving rabies antibodies after exposure to rabiesArtificially acquired passive immunity transfers as premade antibodies from one person or persons and even from animals to the affected person.
• • A person who contracts the flu at workNaturally acquired active immunity is obtained directly via exposure to an antigen, with the body generating its own antibody response.

Question 4 of 8

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Which type of white blood cell (WBC) is responsible for antibody production in response to exposure to a specific antigen?

• • NeutrophilsNeutrophils are WBCs that ingest bacteria. They are the first line of defense in the body’s response to pathogenic invaders.
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  • B lymphocytesB lymphocytes work in conjunction with T cells to build and aid in the body’s response when exposed to a specific antigen.
• • T lymphocytesT lymphocytes work in conjunction with B cells to build and aid in the body’s cell-mediated response when exposed to a specific antigen.
• • BasophilsBasophils release histamines in response to encounters with allergens. A histamine release increases blood flow to damaged tissues, resulting in swelling and inflammation.

Question 5 of 8

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Which type of vaccine is an MMR (measles, mumps, rubella) vaccination?

• • ToxoidThe MMR vaccine is attenuated, not a toxoid. Toxoid refers to a pathogenic microorganism that is modified chemically so it is no longer toxic and can be used as a vaccine.
• • InactivatedAn inactivated vaccine is a product that contains immobilized organisms, which inhibits their reproduction capable of causing disease in an activated vaccination. The MMR vaccine is attenuated and does not contain inactivated viral forms.
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  • AttenuatedMMR vaccines are attenuated, meaning that they contain live pathogenic organisms that have been weakened and modified to illicit an immune response without the capacity to induce the disease.
• • BiosyntheticBiosynthetic refers to a product made via genetic modification, which contains natural or replicated viral or bacterial extracts and is suitable for vaccine use. The MMR vaccine is attenuated, not biosynthetic.

Question 6 of 8

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Which action would the nurse take prior to giving a seasonal flu vaccine to a patient? Select all that apply. One, some, or all responses may be correct.

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  • Obtain the drug history.Obtain the drug history, including immunoglobulins and blood products to screen for potential interactions, contraindications of therapy, or other medical issues.
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  • Review the allergy history.Review the allergy history, including foods, drugs, and vaccines. A complete history allows the clinician to identify potential contraindications or interactions that could lead to poor patient outcomes.
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  • Review the medical history for immunocompromised conditions.Immunocompromised people are at increased risk for adverse reactions to live attenuated vaccines due to a decreased ability to build up an effective immune response. As such, it is important for the nurse to review the patient’s history for any immunocompromised conditions.
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  • Assess the patient for symptoms of illness.Assess the patient for current signs and symptoms of illness. Patients with active illness should delay receiving a vaccine until illness is resolved to avoid potential complications.
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  • Obtain the immunization history.Obtain the immunization history to determine current vaccination needs and identify any immunocompromised or unvaccinated persons living in the household.
• • Have patient review protocol via return demonstration.Return demonstration is appropriate when teaching a technique or procedure that the patient will have to do on their own. This does not apply to vaccination procedures.

Question 7 of 8

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Which action would the nurse take when providing education to a patient regarding the seasonal flu vaccine? Select all that apply. One, some, or all responses may be correct.

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  • Provide the current Vaccine Information Sheet (VIS).Give the patient or parent a copy of the VIS for the specific vaccine given. This document discusses side effects, adverse events, vaccine information, and safety.
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  • Review minor, expected side effects.Localized reactions, such as a sore arm and minor swelling, should be discussed along with appropriate remedies that can be used for relief.
• • Discuss the nurse’s thoughts regarding vaccines.A nurse would never impose personal beliefs that may impact a patient’s choice for treatment. It is the nurse’s responsibility to maintain professionalism and present all information available so that patients can make informed choices.
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  • Educate the patient on the importance of receiving a seasonal flu vaccine each year.The nurse would educate the patient that seasonal flu vaccines are based on current projections of which strains will be most prevalent in that given year. The current year’s vaccine may not provide immunity for subsequent years.
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  • Encourage the patient to seek emergency care if adverse reactions occur.Patients should be encouraged to seek care and report any adverse effects, such as shortness of breath, fever >101°F (38°C), or unusual rashes. This helps avoid further complications and allows providers to report issues to the health department.

Question 8 of 8

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Which process is used to determine the effectiveness of an immunization?

• • Patient assessment reportAssessing the patient is a necessary part of the nursing process that must be done. However, this assessment step does not go toward evaluating the effectiveness of current or previous immunizations.
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  • Antibody titerA vaccination does not always result in successful immunization. Antibody titers are necessary to ensure that the patient has adequate immunity and protection against potentially harmful antigens.
• • Completed vaccinations at varying intervalsFull immunization is not considered effective until the patient has achieved and sustained titer levels per laboratory referenced values.
• • Patient report of previous vaccinationDocumentation of previous vaccination is important; however, antibody titers would be performed to validate the patient’s level of antibody protection and determine whether booster vaccinations are required.