Which of the following is an early sign of anaphylaxis?

Correct Answer: C

Rationale: An itchy, raised rash (urticaria or hives) is an early cutaneous sign of anaphylaxis, often appearing within minutes of exposure to an allergen (e.g., vaccine component). It reflects histamine release from mast cells. Choice A (throat swelling) and B (wheezing) are also signs of anaphylaxis but typically develop later as the reaction progresses to airway involvement. Choice D (redness at injection site) is a common, benign local reaction, not indicative of anaphylaxis.

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: A

Rationale: The varicella vaccine is a live attenuated vaccine containing a weakened varicella-zoster virus to prevent chickenpox. Choice B (influenza) includes both live (LAIV) and inactivated (IIV) forms, but the question implies a specific example, and IIV is more common. Choice C (Hepatitis B) is a recombinant subunit vaccine, and Choice D (Diphtheria) is a toxoid vaccine, both inactivated. Varicella is a clear, widely recognized live vaccine example.

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.