# Drag each adult-vaccination scenario to the most appropriate planning category. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=395453&lang=en > language: en > subject: Lifestyle Choices > category: HPM ## Question Drag each adult-vaccination scenario to the most appropriate planning category. **1.** A 52-year-old has no pneumococcal vaccination record Select a category Recommend vaccination at this visit Defer or evaluate before vaccination Use shared or individualized clinical decision-making **2.** A 52-year-old had shingles last year but has never received recombinant zoster vaccine Select a category Recommend vaccination at this visit Defer or evaluate before vaccination Use shared or individualized clinical decision-making **3.** A 33-year-old has not received influenza vaccine during the current season Select a category Recommend vaccination at this visit Defer or evaluate before vaccination Use shared or individualized clinical decision-making **4.** A 41-year-old asks whether to complete an HPV vaccine series Select a category Recommend vaccination at this visit Defer or evaluate before vaccination Use shared or individualized clinical decision-making **5.** A 62-year-old with diabetes asks about starting hepatitis B vaccination Select a category Recommend vaccination at this visit Defer or evaluate before vaccination Use shared or individualized clinical decision-making **6.** A 68-year-old with chronic heart failure asks about a first RSV vaccine Select a category Recommend vaccination at this visit Defer or evaluate before vaccination Use shared or individualized clinical decision-making **7.** A pregnant 29-year-old is due for the next HPV vaccine dose Select a category Recommend vaccination at this visit Defer or evaluate before vaccination Use shared or individualized clinical decision-making **8.** An adult due for routine vaccination has a moderate acute illness with fever Select a category Recommend vaccination at this visit Defer or evaluate before vaccination Use shared or individualized clinical decision-making ## Explanation Adults need annual influenza vaccination, recombinant zoster vaccination beginning at age 50, and pneumococcal vaccination beginning at age 50 when previous pneumococcal vaccination is absent or unknown. An unvaccinated adult age 50 through 74 with chronic heart failure is at increased risk of severe RSV disease and should receive one RSV vaccine dose. HPV vaccination for ages 27 through 45 and hepatitis B vaccination for some adults age 60 or older use shared clinical decision-making. HPV vaccination is delayed during pregnancy, and moderate or severe acute illness is a precaution that warrants evaluation or deferral. ## In-depth explanation Quick answer Use age and history for routine recommendations, risk and patient preference for shared decisions, and pregnancy or significant acute illness for deferral or evaluation. Why this is correct The adult schedule combines universal age-based recommendations with condition-based indications, shared clinical decision-making, contraindications, and precautions. A missed interval does not usually require restarting a vaccine series. NCLEX decision rule Assess vaccination status at every opportunity, recommend clearly, screen for contraindications and precautions, and use the current schedule rather than memory alone.References 1CDC Adult Immunization Schedule by Age 2CDC Adult Immunization Schedule Notes 3CDC Contraindications and Precautions ## Clinical scenario Preventive-care visit The clinic uses the current CDC adult immunization schedule and verifies records, medical conditions, pregnancy status, contraindications, and product availability before administration. Assume no allergy or prior dose unless stated. ## Key concepts - **Shared Clinical Decision-Making** — An individualized vaccine decision based on risk, potential benefit, preferences, and clinician discussion rather than a universal recommendation. - **Contraindication** — A condition that substantially increases the risk of serious harm and generally means a vaccine should not be administered. - **Precaution** — A condition that may increase risk or reduce response and calls for weighing benefit, risk, timing, or deferral. ## Related questions - [A client who smokes says, “I know smoking worsens my breathing, and part of me wants to qu…](https://mymerci.kr/pages/nclex_q.php?qn_id=393389&lang=en) - [A pregnant client at 34 weeks gestation reports a severe headache and blurred vision. The …](https://mymerci.kr/pages/nclex_q.php?qn_id=394059&lang=en) - [The nurse teaches parents of a 3-day-old newborn about jaundice. 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