The client immunization record must include all of the following elements except:

Correct Answer: C

Rationale: Immunization records typically include the vaccine type, administration date (Choice D), body location (Choice A, e.g., left deltoid), and client identifiers like name, address, and date of birth (Choice B), per CDC and WHO standards. The provider’s date of birth (Choice C) is not required; the provider’s name or identifier is sufficient for accountability, making it the exception.

Correct Answer: C

Rationale: Anaphylaxis to a prior vaccine dose is an absolute contraindication, as it indicates a severe hypersensitivity that could recur, risking death. Choice A (local reaction) and D (mild illness) are not contraindications; vaccination can proceed unless fever is moderate/severe. Choice B (febrile seizure) is a precaution for certain vaccines (e.g., MMR), not an absolute bar.

Correct Answer: B

Rationale: Gardasil (HPV vaccine) is most effective before sexual activity begins (Choice B), as it prevents HPV infection, which is sexually transmitted. Vaccination at 9-12 years (per CDC) targets this pre-exposure window. Choice A is false—efficacy doesn’t decrease with age if unexposed. Choices C and D lack evidence linking efficacy to puberty or menses.

Correct Answer: A

Rationale: Swelling and tenderness at the injection site are common, expected side effects of DTaP, occurring in about 20-40% of recipients due to local inflammation from the vaccine antigens and adjuvants, per CDC data. Fever (Choice B) occurs but is less common (<10%) and rarely reaches 103°F. Continual crying (Choice C) and limpness (Choice D) are rare, severe reactions, not typical.

Correct Answer: D

Rationale: Monitoring and supportive care (e.g., hydration) is primary to assess fever cause (AAP). Antibiotics (Choice A) are for infections, antipyretics (Choice B) are secondary, and cold baths (Choice C) are outdated.