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FNP ANCC boards Questions and Correct Answers the Latest Update and Recommended Version

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Dose of Tetanus Immune Globulin (TIG) 250 units IM How many doses of Tdap or Td IM needed for protection after clean minor wounds. Three doses needed. If <3, unknown, or >10 years since last dose give dose of Tdap or Td for clean minor wounds. No need to give TIG. Non-"clean" minor wo...

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  • October 23, 2024
  • 23
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • FNP ANCC
  • FNP ANCC
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FNP ANCC boards Questions and
Correct Answers the Latest Update and
Recommended Version
Dose of Tetanus Immune Globulin (TIG)

✓ 250 units IM


How many doses of Tdap or Td IM needed for protection after clean minor wounds.

✓ Three doses needed. If <3, unknown, or >10 years since last dose give dose of Tdap or
Td for clean minor wounds. No need to give TIG.


Non-"clean" minor wounds given both of these if unknown tetanus hx or <3 doses of Tdap/Td.

✓ Tdap or Td IM & TIG


Dirty wounds (puncture, crush injury, soil, saliva, feces, dirt, avulsions, missiles, burns, frostbite)

✓ If <3 doses Tdap or Td give both Tdap and TIG 250 units. If 3 doses in past, but none in
the last 5 years then given Tdap or Td. No need to give TIG If 3 or > doses in the past


When to switch from DTap to Tdap in children

✓ Age 7 or > given Tdap


A woman becomes pregnant and received Tdap during her last pregnancy 1 year ago. When

should she receive her next dose.

✓ Tdap is recommended for each pregnancy.
✓ "Getting Tdap between 27 through 36 weeks of pregnancy is 78% more effective at
preventing whooping cough in babies younger than 2 months old (CDC)".



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A person with a hx of anaphylaxis to neomycin should avoid which immunizations (IZ)?

✓ IPV, MMR, varicella


A person with a hx of anaphylaxis to neomycin should avoid which immunizations (IZ)?

✓ IPV, vaccinia (smallpox)


A person with a hx of anaphylaxis to bakers yeast should avoid which immunizations (IZ)?

✓ Hepatitis B


A person with a hx of anaphylaxis to gelatin should avoid which immunizations (IZ)?

✓ varicella zoster (zostavax) and MMR


Epinephrine needs to be on hand for potential anaphylaxis r/t immunization rxn. What other

interventions/meds should be considered during anaphylaxis?

✓ Supine, 911, give epinephrine:

✓ 7.5-15kg: give 0.1 mg IM x1

✓ 15 to <30 kg: give 0.15mg IM; may repeat in 5-15 min x1

✓ >30 kg or Adult: Epipen 0.3mg/0.3mL IM; may repeat in 5-15 min

✓ H1/H2 blocker po (diphenhydramine, ranitidine)

✓ IV access for fluids, Oxygen.

✓ Anticipate ED might give glucagon (if on beta blocker), systemic corticosteroids,
bronchodilators


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s/s anaphylaxis

✓ Skin: pruritus, urticaria, angioedema

✓ Resp: dyspnea, wheezing (bronchospasm), stridor

✓ End-organ dysfunction: hypotension, collapse, syncope, incontinence


PCV-13

✓ Prevnar. Greater protection, Narrower coverage. Pneumococcal conjugate.


PCV23

✓ lesser protection, broader coverage


Which type of vaccine boosts immune response better? conjugate vs. polysaccharide

✓ conjugate (example: prevnar)


Live attenuated (weaned) vaccines

✓ MMR, Varicella and intranasal Flu-mist. Zostavax is also live. Shingrix is NOT live.


When is rotavirus vaccine contraindicated?

✓ SCID (severe combined immunodeficiency) or hx intussusception


Precautions after rotavirus

✓ hand washing!; viral shed in stool in first week post-vaccination




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