Free PTCB Immunization Administration Exam Flashcards

No. The certificate documents knowledge only. Legal authority to administer comes from the state pharmacy practice act plus the pharmacy's protocol or standing order and pharmacist supervision. Check your state board of pharmacy before vaccinating any patient.

An active PTCB CPhT certification, and completion of a PTCB-Recognized Immunization Administration Education/Training Program. PTCB verifies both at application. Once approved, you receive an authorization email and must complete the exam within 90 days of it.

The pharmacist or other authorized prescriber. Clinical screening and the contraindication decision are not delegated. The technician supports the process: preparing the dose, providing the VIS, administering under protocol, and documenting the encounter.

A standing order is a prescriber-authored protocol that lets qualified staff vaccinate eligible patients without an individual prescription. A collaborative practice agreement is a signed agreement delegating specified patient-care functions to a pharmacist. Both define who may act and under what conditions.

A certificate documents completing a training program and passing an exam in one skill area, and PTCB states this one does not require renewal. CPhT certification is a broad credential that must be kept active through PTCB's renewal requirements.

Active immunity is produced by the person's own immune system after infection or vaccination and lasts years. Passive immunity is borrowed antibody, such as maternal antibody or immune globulin. It protects immediately but fades within weeks to months.

A live attenuated vaccine contains weakened organism that still replicates, so it is contraindicated in pregnancy and severe immunodeficiency. An inactivated vaccine cannot replicate, is acceptable in those groups, and usually needs multiple doses to build protection.

MMR, MMRV, varicella, intranasal influenza (LAIV), and oral rotavirus; travel vaccines such as yellow fever and oral typhoid are also live. Recombinant zoster vaccine (Shingrix) is NOT live. Confusing Shingrix with live Zostavax, unavailable in the U.S. since November 18, 2020, is a common error.

An adjuvant is a non-antigen component that boosts the immune response. CDC directs that non-live adjuvanted vaccines go into muscle. Giving an adjuvanted vaccine subcutaneously or intradermally can cause local irritation, induration, inflammation, and granuloma formation.

A contraindication means do not give the vaccine, for example a severe allergic reaction to a previous dose or a component. A precaution means defer unless the benefit outweighs the risk. Moderate or severe acute illness is a precaution for all vaccines.

One dose annually for all adults 19 and older. Adults 65 and older preferentially receive high-dose, adjuvanted, or recombinant influenza vaccine. LAIV, the intranasal live product, is limited to healthy non-pregnant people aged 2 through 49.

One Tdap dose for adults who have not had one, then a Td or Tdap booster every 10 years. Separately, one Tdap dose is recommended during every pregnancy, ideally at 27 through 36 weeks of gestation, to pass antibody to the newborn.

Two doses separated by 2 to 6 months for immunocompetent adults 50 and older, and for adults 19 and older who are immunodeficient or immunosuppressed. CDC does not recommend serologic testing for prior varicella before vaccinating adults 50 and older.

CDC recommends PCV15, PCV20, or PCV21 for all adults 50 and older. If PCV15 is used, a dose of PPSV23 follows about one year later. If PCV20 or PCV21 is used, no PPSV23 dose is indicated and the series is complete.

The current CDC/ACIP child-adolescent and adult immunization schedules, which are revised at least yearly. Product-specific dose volume, storage, and reconstitution come from the package insert. Never rely on a memorized or printed older schedule.

Intramuscular injections use 22 to 25 gauge. Subcutaneous injections use a 23- to 25-gauge, 5/8-inch needle. Gauge alone does not control depth. Needle length plus injection angle decides whether the dose lands in muscle or in fat.

One inch. CDC's table also lists 1 inch for adults under 130 lb, with a footnote that some experts allow a 5/8-inch needle at that weight only if the skin is stretched tightly and subcutaneous tissue is not bunched.

1.5 inches. Men 152 to 260 lb and women 152 to 200 lb get 1 to 1.5 inches. A needle that is too short leaves vaccine in fat, which increases local reactions and can blunt the immune response.

1.5 inches at any weight, though some experts accept 1 inch if the skin is stretched tightly and subcutaneous tissue is not bunched. The thigh is the alternate adult IM site when the deltoid cannot be used.

MMR must be kept refrigerated at 2°C to 8°C, protected from light, and discarded within 8 hours. Varicella vaccine is different: discard it if not used within 30 minutes of reconstitution. Using the wrong deadline wastes doses or gives an inactive dose.

Use only the diluent supplied by that manufacturer for that product, in the stated volume. Diluents are not interchangeable between vaccines, and sterile water is not a substitute. Using the wrong diluent is a reportable vaccine administration error.

ACIP discourages prefilling. If only one vaccine type is used, 10 or fewer syringes may be filled, given as soon as possible, by the same person who filled them. Manufacturer-prefilled syringes that were activated but unused are discarded at day's end.

Never. Pooling vials violates expiration dating and risks product contamination. If a full dose cannot be withdrawn from one vial, discard the remainder and start a new vial rather than topping the syringe off.

No, unless the needle was damaged or contaminated. A separate sterile needle and syringe are required for every injection and every patient. Draw doses in a designated clean medication area away from potentially contaminated items.

Intramuscular is 90 degrees to the skin. Subcutaneous is 45 degrees into pinched-up fatty tissue. Angle and needle length together decide which tissue receives the dose: if you bunch the tissue for an IM injection, CDC requires a needle at least 1 inch long.

The deltoid muscle of the upper arm, with the anterolateral thigh as the alternate. Aspiration is not necessary, because no large blood vessels lie at the recommended sites and aspirating adds pain, particularly for infants.

The anterolateral thigh, because it has more muscle mass than the deltoid. Use a 1-inch needle for infants 1 to 12 months and a 5/8-inch needle for neonates in their first 28 days of life.

The fatty tissue over the upper-outer triceps, at 45 degrees with a 5/8-inch, 23- to 25-gauge needle. Infants under 12 months get the thigh instead. MMR, MMRV, and varicella are the classic subcutaneous vaccines, though CDC now lists M-M-R II and varicella as acceptable by either route.

A 0.2 mL dose split by a dose-divider clip: 0.1 mL sprayed into each nostril with the tip inserted slightly into the naris. If the patient sneezes, coughs, or expels the dose immediately afterward, do not repeat it.

Separate the sites by at least 1 inch so local reactions can be told apart, and record which vaccine went into which site. If a vaccine and an immune globulin are given together, use separate limbs.

No. Response is unlikely to be affected, so the dose counts. The reverse is not forgiving: hepatitis B given by a non-IM route, or hepatitis B or rabies given in the gluteal site, is invalid and must be repeated.

The thick gluteal fat layer means vaccine often lands in fat rather than muscle, and adult hepatitis B immunogenicity is substantially lower there. CDC allows the site only for infants with no other usable site, and only with careful anatomic landmarking.

Most injectable vaccines are 0.5 mL, though adult hepatitis A and hepatitis B doses are 1.0 mL. If syringe, applicator, or needle leakage delivers less than a full dose, repeat the dose. Splitting a dose across visits never counts.

Clean hands with alcohol-based rub or soap and water before preparing vaccine and between every patient contact. OSHA does not require gloves unless you have open hand lesions or expect body-fluid contact. If gloves are worn, change them between patients.

Never recap it. Deploy the safety mechanism and drop the needle and syringe immediately into a labeled, puncture-proof sharps container in the same room where the vaccine was given. Recapping is a leading cause of needlestick injury.

The Bloodborne Pathogens standard, strengthened after the Needlestick Safety and Prevention Act of 2000 with revised rules effective 2001. It requires engineering controls such as safety-engineered sharps, records of sharps injuries, and frontline employee input on device selection.

Only in the designated clean medication preparation area, never in the immediate patient treatment area. A shared vial kept at the patient chair can be contaminated by direct or indirect contact, which then puts every later patient dosed from it at risk.

Yes for routine injectable vaccines. A vaccinator's own contraindication is not a reason to withdraw from administering. The exception is LAIV: severely immunosuppressed people who require a protected environment should not administer intranasal live influenza vaccine.

Epinephrine and airway-management equipment, plus a written office emergency plan every staff member knows. ACIP recommends all vaccination providers be CPR certified and that sites plan for at least three epinephrine doses in strengths matching every age group served.

Wash the site with soap and water, report the exposure immediately under the pharmacy's exposure control plan, and get prompt medical evaluation for post-exposure prophylaxis. OSHA requires the employer to keep a record of the sharps injury.

Before every dose of a covered vaccine, including each dose of a multi-dose series, regardless of the recipient's age. The National Childhood Vaccine Injury Act requires it. Handing the VIS out after the injection does not satisfy the law.

The VIS edition date, the date the VIS was provided, the date the vaccine was administered, the vaccine manufacturer and lot number, and the name, title, and office address of the person who administered it. Record it in the chart or a permanent office log.

A jurisdiction-run registry that consolidates doses from many providers into one immunization record. It supplies official records for school, day care, and camp entry and supports clinical decisions. Every IIS must operate under a written privacy policy.

Refrigerated vaccines: 2°C to 8°C (36°F to 46°F). Frozen vaccines such as varicella and MMRV: -50°C to -15°C (-58°F to 5°F). Liquid aluminum-adjuvanted vaccines permanently lose potency once frozen, even if they later thaw and look normal.

A continuously recording digital data logger with a buffered probe; the July 2026 CDC toolkit no longer specifies a logging interval. Staff still check and record the minimum and maximum temperatures at the start of each workday; if the device shows no min/max, record the current temperature at the start and end of the day.

Do not administer or discard it. Label it DO NOT USE, keep it stored at the correct temperature (a backup unit if the primary unit has failed), document the excursion, and contact your immunization program or the manufacturer for a viability decision.

Local reactions such as redness are most common and least severe, systemic reactions such as fever are less common, and anaphylaxis is rarest at roughly one per million doses. Anaphylaxis usually begins within minutes, and hives are not always present.

Intramuscular epinephrine from the 1 mg/mL preparation into the mid-outer thigh: 0.3 to 0.5 mg for adults, or 0.01 mg/kg for children up to 0.5 mg. Repeat every 5 to 15 minutes as needed. There is no absolute contraindication to epinephrine here.

Vaccinate adolescents and adults seated or lying down, and consider observing them for 15 minutes. About 80% of reported syncope episodes occur within 15 minutes of the injection, and falls have caused skull fractures and cerebral hemorrhage.

VAERS, co-managed by CDC and FDA, receives adverse events after vaccination, including every event on the Reportable Events Table. ISMP's VERP is a voluntary program for administration errors such as wrong vaccine, wrong dose, or expired product. VAERS cannot establish causality.