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1. Which of the following changes in the influenza virus is the best example of an antigenic shift?

A. An influenza A strain that mutated from H2N2 to H3N2 B. An influenza B strain isolated from a new location C. A new influenza B strain not included in the influenza vaccine D. An influenza A H1N1 strain not included in the influenza vaccine

2. Which influenza pandemic had the most severe impact on public health?

A. Swine influenza (2009, H1N1 virus) B. Hong Kong influenza (1968, H3N2 virus) C. Asian influenza (1957, H2N2 virus) D. Spanish influenza (1918, H1N1 virus)

3. Which vaccine is only recommended for adults aged 65 years and older?

A. Afluria Quadrivalent (quadrivalent inactivated influenza vaccine) B. Fluvirin (trivalent inactivated influenza vaccine [IIV3]) C. Fluad (adjuvanted IIV3) D. FluMist Quadrivalent (quadrivalent live-attenuated influenza vaccine)

4. Which vaccine is the safest option for patients with a documented egg allergy?

A. Flublok Quadrivalent (quadrivalent recombinant influenza vaccine) B. FluMist Quadrivalent (quadrivalent live-attenuated influenza vaccine) C. Afluria Quadrivalent (inactivated influenza vaccine) D. Flucelvax Quadrivalent (cell culture-based inactivated influenza vaccine)

5. Which vaccine could be administered to a 28-year-old pregnant woman?

A. Fluzone High-Dose (High-dose trivalent inactivated influenza vaccine) B. Afluria Quadrivalent (quadrivalent inactivated influenza vaccine) C. Fluad (trivalent adjuvanted inactivated influenza vaccine) D. FluMist Quadrivalent (quadrivalent live-attenuated influenza vaccine)

6. VF is 3 years old and has received 1 influenza vaccine every fall since she was 6 months old (2 total doses to date); she has not yet received a vaccine for the 2017-2018 flu season. Which of the following vaccines and dosing schedules would be the best recommendation for VF?

A. Flucelvax Quadrivalent (quadrivalent cell culture-based inactivated influenza vaccine) today B. FluMist Quadrivalent (quadrivalent live-attenuated influenza vaccine) today C. Fluarix Quadrivalent (quadrivalent inactivated influenza vaccine [IIV4]) today D. Fluarix Quadrivalent (IIV4) today plus Fluarix Quadrivalent (IIV4) in 4 weeks

7. You work at a community pharmacy that received its supply of annual influenza vaccine for the 2017-2018 flu season on July 28th, 2017. What is the best course of action?

A. Hold the vaccine until October/November to ensure patients are protected through the whole season B. Only immunize patients at high risk for complications until September C. Do not advertise you have the vaccine in stock until patients start thinking about the flu D. Begin administering the vaccine as soon as possible

8. A patient enters your pharmacy and expresses concerns about the association between autism and vaccines. What is an appropriate response to the patient?

A. More data is needed to definitively disprove the risk of autism spectrum disorder (ASD) that is associated with vaccines B. ASD is caused by some vaccines, specifically the multi-dose formulations that include thimerosal C. The risk for ASD and vaccination increases with age D. There is no link between ASD and vaccination

9. Which of the following is a competency of motivational interviewing?

A. Explain everything B. Develop discrepancy C. Counsel effectively D. Argumentation

10. Pharmacy technicians can now participate in immunization programs in each of the following roles, except:

A. Advocate for immunization by receiving the influenza vaccine themselves B. Provide patients with vaccine information statements prior to vaccination C. Select appropriate vaccinations D. Administer the influenza vaccine (where allowed by state laws and regulations)