Free Immunisation and EPI MCQs with Answers
50 Immunisation and EPI MCQs from Paediatric Nursing, each with the correct answer and a written explanation of why it is correct. Free and unlimited, with no account needed.
Immunisation covers active and passive immunity, vaccine types, routine childhood schedules under Pakistan’s Expanded Programme on Immunization, administration routes and age-based timing. It also includes cold-chain maintenance, contraindications, adverse events following immunisation, missed doses and the distinction between vaccine protection and treatment of an established infection.
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50 questions · page 2 of 3
- A. Natural active immunity
- B. Natural passive immunity
- C. Artificial active immunity
- D. Artificial passive immunity
Explanation: Maternal IgG antibodies cross the placenta and give the newborn natural passive immunity.
Correct answer: Natural passive immunity- A. Oral polio vaccine
- B. Measles and rubella vaccine
- C. Inactivated polio vaccine
- D. Bacillus Calmette-Guérin vaccine
Explanation: Inactivated polio vaccine contains killed poliovirus and cannot multiply in the child.
Correct answer: Inactivated polio vaccine- A. Keep it for use during the next session
- B. Return it to the refrigerator for later use
- C. Discard it after six hours or at session end
- D. Freeze it immediately for use within one week
Explanation: Reconstituted measles-containing vaccines are discarded after six hours or at the end of the session, whichever comes first.
Correct answer: Discard it after six hours or at session end- A. A child with mild eczema
- B. A child taking oral iron therapy
- C. A child with severe immune suppression
- D. A child with a mild non-febrile cough
Explanation: Severe immune suppression is a contraindication to most live vaccines because the weakened organism may cause serious disease.
Correct answer: A child with severe immune suppression- A. Place them directly against frozen ice packs
- B. Keep them away from direct contact with frozen ice packs
- C. Store them beside the carrier’s warmest outer wall
- D. Open each vial and leave it outside the carrier
Explanation: Pentavalent vaccine can be damaged by freezing, so it should not touch frozen ice packs directly.
Correct answer: Keep them away from direct contact with frozen ice packs- A. At birth
- B. At 6 weeks
- C. At 10 weeks
- D. At 14 weeks
Explanation: The first routine IPV dose is generally given at 14 weeks in Pakistan’s EPI schedule.
Correct answer: At 14 weeks- A. Place the child supine and assess airway and breathing
- B. Give intramuscular adrenaline immediately
- C. Give an oral antipyretic and send the child home
- D. Repeat the vaccine after the child regains consciousness
Explanation: The priority is to prevent injury, position the child safely, and assess airway, breathing and circulation.
Correct answer: Place the child supine and assess airway and breathing- A. Ignore the error if the child has no symptoms
- B. Repeat the same dose immediately by the correct route
- C. Document and report the error for clinical review
- D. Tell the parent that the dose is definitely effective
Explanation: An incorrect route is a vaccination error and should be documented and reported as part of safe AEFI and immunisation monitoring.
Correct answer: Document and report the error for clinical review29. Which statement about the pneumococcal conjugate vaccine in the childhood EPI programme is correct?
- A. It prevents all causes of childhood pneumonia
- B. It protects against disease caused by selected pneumococcal types
- C. It treats pneumonia after breathing difficulty begins
- D. It replaces every antibiotic used for bacterial infection
Explanation: Pneumococcal conjugate vaccine protects against disease caused by the pneumococcal serotypes included in the vaccine.
Correct answer: It protects against disease caused by selected pneumococcal types- A. It proves that no future vaccines will be needed
- B. It records doses and helps plan the child’s next vaccines
- C. It replaces the need to assess the child before vaccination
- D. It shows that vaccines cannot cause adverse events
Explanation: The card provides a reliable record of vaccines and helps health workers identify doses already given and those still due.
Correct answer: It records doses and helps plan the child’s next vaccines- A. At birth
- B. At 6 weeks
- C. At 15 months
- D. At 24 months
Explanation: The second measles and rubella dose is generally scheduled at 15 months in Pakistan’s routine childhood EPI schedule.
Correct answer: At 15 months- A. Record the dose and wait for the next visit
- B. Repeat the oral polio vaccine dose immediately
- C. Give an intramuscular polio vaccine instead
- D. Give an antibiotic and observe the infant
Explanation: If an infant spits out or vomits the oral polio vaccine immediately, the dose should be repeated according to immunisation practice.
Correct answer: Repeat the oral polio vaccine dose immediately- A. Sterile water from any available container
- B. The diluent supplied by the manufacturer
- C. Normal saline from an opened ward bottle
- D. Boiled water cooled to room temperature
Explanation: The specific diluent supplied with the vaccine must be used because its volume and composition are matched to that vaccine.
Correct answer: The diluent supplied by the manufacturer- A. Reuse a syringe for several children with a new needle
- B. Use a new sterile syringe and needle for every child
- C. Clean one needle with alcohol between children
- D. Place used needles on the table until the session ends
Explanation: Each child requires a new sterile syringe and needle to prevent transmission of blood-borne infections.
Correct answer: Use a new sterile syringe and needle for every child- A. Vaccinate immediately because fever never affects vaccination
- B. Postpone vaccination and refer the child for clinical assessment
- C. Give only the oral vaccine and postpone injections
- D. Double the vaccine dose after the fever settles
Explanation: A severe acute illness with high fever and lethargy requires assessment before routine immunisation, so vaccination is postponed until the…
Correct answer: Postpone vaccination and refer the child for clinical assessment- A. They are produced by the infant’s own memory cells
- B. They usually provide temporary protection without lasting memory
- C. They always provide lifelong protection against infection
- D. They are formed only after the infant receives a live vaccine
Explanation: Passive antibodies are transferred from another person or given as immunoglobulin, so they provide immediate but usually temporary…
Correct answer: They usually provide temporary protection without lasting memory- A. Only a reaction proven to be caused by a vaccine
- B. Any untoward medical event after immunisation, whether causally related or not
- C. A vaccine failure caused by incorrect injection technique only
- D. A mild local reaction that never needs documentation
Explanation: An AEFI is any untoward medical event occurring after immunisation, and it may or may not be caused by the vaccine.
Correct answer: Any untoward medical event after immunisation, whether causally related or not- A. Open the refrigerator repeatedly to check the vaccines
- B. Keep the refrigerator closed and monitor the temperature
- C. Move all vaccines into direct sunlight for warmth
- D. Discard every vaccine immediately without assessment
Explanation: Keeping the refrigerator closed limits warming and helps maintain the cold chain while the temperature is monitored.
Correct answer: Keep the refrigerator closed and monitor the temperature- A. Restart the entire series from the first dose
- B. Continue the series without restarting previous valid doses
- C. Give all missed doses together in one syringe
- D. Withhold further doses because the schedule was interrupted
Explanation: An interrupted vaccination schedule is generally continued, not restarted, because valid previous doses remain effective.
Correct answer: Continue the series without restarting previous valid doses- A. Use it if the vial monitor looks acceptable
- B. Use it only for children older than one year
- C. Do not use it and remove it according to local procedure
- D. Mix it with a fresh vial to restore its potency
Explanation: A vaccine must not be used after its expiry date, even when its cold-chain temperature and vial monitor appear satisfactory.
Correct answer: Do not use it and remove it according to local procedure