Fundamentals of Nursing NCLEX-PN Practice Quiz

Immune globulin (TIG, HBIG, HRIG) provides passive immunity: ready-made antibodies are handed to the person, so protection is immediate but temporary because no memory cells are formed. A vaccine, by contrast, produces active immunity that is slow to develop but long-lasting, so the option about the body making its own antibodies and the one about permanent immunity describe active immunity, not immune globulin. Immune globulin does not replace the vaccine; post-exposure it is often given alongside the vaccine series. Key takeaway: immune globulin = passive = immediate but short-lived.

For an infant under 12 months, IM vaccines are given in the vastus lateralis (anterolateral thigh) because it has the largest muscle mass at that age. The deltoid is not preferred until age 3, and the gluteal sites are avoided for vaccines (subcutaneous fat can reduce reliable IM delivery, and the dorsogluteal area carries sciatic-nerve risk). Key takeaway: infants younger than 12 months use the anterolateral thigh; for ages 1–2 the thigh remains preferred (deltoid acceptable if muscle mass is adequate); for ages 3 and older the deltoid is preferred.

For a vaccine covered by the VIS requirement, the VIS must be provided before every dose, and the nurse documents both the VIS edition date and the date the VIS was given (along with lot number, site, route, and date). Providing it only with the first dose or only on request violates the VIS requirement, and reading it aloud does not replace the required documentation. Key takeaway: VIS before every dose, and document its edition date plus the date given.

Right direction/communication requires clear, specific instructions and expected outcomes before handing off a task; a vague order with no detail or reporting parameters fails it. Right task is met (ambulation suits an AP), right person is the trained AP, and right circumstance concerns the client's stability, not how the order was worded.

Among these choices, MMR and varicella are live attenuated vaccines, which is why they carry the pregnancy and severe-immunocompromise cautions. The injectable influenza vaccine is inactivated, the zoster vaccine RZV/Shingrix is recombinant (not live), and hepatitis B and IPV are also non-live. (Rotavirus and the intranasal/nasal-spray flu vaccine are the other live vaccines a PN should recognize, though they aren't listed here.) Key takeaway: MMR and varicella are live; the flu *shot*, Shingrix, HepB, and IPV are not.