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Med/Surg: Infectious Diseases Exam
Question with Verified Answer| Graded
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Which of the following terms refers to a state of microorganisms being present within a host without causing host interference or interaction? a) Infection b) Susceptible c) Colonization d) Immune - Answer -c) Colonization Explanation: Understanding the principle of colonization facilitates interpretation of microbiologic reports. A susceptible host is a host that does not possess immunity to a particular pathogen. An immune host is a host that is not susceptible to a particular pathogen. Infection refers to host interaction with an organism. pg. You are caring for a client with an impaired immune system. You are concerned about the client acquiring a nosocomial infection. What intervention would help nurses control nosocomial infections? a) Use proper antibiotics. b) Apply principles of medical and surgical asepsis. c) Ensure childhood immunizations. d) Maintain a proper diet and exercise regimen. - Answer - b) Apply principles of medical and surgical asepsis.
Explanation: Nosocomial infections are acquired when receiving care in a healthcare facility. To help prevent and control nosocomial infections, nurses should apply principles of medical and surgical asepsis whenever they care for clients. Childhood immunizations control community- acquired infections. Maintaining a proper diet and exercise regimen and use of antibiotics do not help control nosocomial infections. pg. Which statement reflects what is known about the Ebola and Marburg viruses? a) The diagnosis should be considered in a patient who has a febrile, hemorrhagic illness after traveling to Asia or Africa. b) Treatment during the acute phase includes administration of penicillin and ventilator and dialysis support. c) The viruses are usually transmitted by airborne exposure. d) Symptoms include severe lower abdominal pain, nausea, vomiting, and dehydration. - Answer -a) The diagnosis should be considered in a patient who has a febrile, hemorrhagic illness after traveling to Asia or Africa. Explanation: The diagnosis should be considered in a patient who has a febrile, hemorrhagic illness after traveling to Asia or Africa, or who has handled animals or animal carcasses from those parts of the world. Antibiotic therapy, such as penicillin, would not be effective for the treatment of
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? a) A painless genital ulcer that appeared about 3 weeks after unprotected sex b) Copper-colored macules on the palms and soles that appeared after a brief fever c) Patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas d) One or more flat, wartlike papules in the genital area that are sensitive to touch - Answer -a) A painless genital ulcer that appeared about 3 weeks after unprotected sex Explanation: A painless genital ulcer is a symptom of primary syphilis. Macules on the palms and soles after fever are indicative of secondary syphilis, as is patchy hair loss. Wartlike papules are indicative of genital warts. Which of the following is the medication of choice for early syphilis? a) Doxycycline b) Rocephin c) Tetracycline d) Penicillin G benzathine - Answer -d) Penicillin G benzathine Explanation: A single dose of penicillin G benzathine intramuscular injection is the medication of choice for early syphilis or early latent syphilis of less than 1 year's duration. Patients
who are allergic to penicillin are usually treated with doxycycline or tetracycline. Rocephin is not the medication of choice for syphilis. A client is admitted with bacterial meningitis. Which hospital room is the best choice for this client? a) An isolation room three doors from the nurses' station b) A private room down the hall from the nurses' station c) A two-bed room with a client who previously had bacterial meningitis d) A semiprivate room with a client who has viral meningitis - Answer -a) An isolation room three doors from the nurses' station Explanation: A client with bacterial meningitis should be kept in isolation for at least 24 hours after admission and, during the initial acute phase, should be as close to the nurses' station as possible to allow maximal observation. Placing the client in a room with a client who has viral meningitis may cause harm to both clients because the organisms causing viral and bacterial meningitis differ; either client may contract the other's disease. Immunity to bacterial meningitis can't be acquired; therefore, a client who previously had bacterial meningitis shouldn't be put at risk by rooming with a client who has just been diagnosed with this disease. pg. Patients who have had pelvic inflammatory disease (PID) are prone to which of the following complications?
A client admitted with bacterial meningitis must be transported to the radiology department for a repeat computed tomography scan of the head. His level of consciousness is decreased, and he requires nasopharyngeal suctioning before transport. Which infection control measures are best when caring for this client? a) Put on gloves, a mask, and eye protection during suctioning, and then apply a mask to the client's face for transport. b) Take no special precautions for this client. c) Use standard precautions, which require gloves for suctioning. d) Put on gloves, a mask, and eye protection. - Answer -a) Put on gloves, a mask, and eye protection during suctioning, and then apply a mask to the client's face for transport. Explanation: Bacterial meningitis is spread through contact with infected droplets. The nurse should wear gloves, a mask, and eye protection when suctioning the client. Additionally, the client should wear a mask when out of the isolation room for diagnostic testing. Standard precautions don't adequately protect staff and other clients from bacterial meningitis. pg. A nurse is caring for a male client with gonorrhea who's receiving ceftriaxone (Rocephin) and doxycycline (Vibramycin). The client asks the nurse why he's receiving two antibiotics. How should the nurse respond?
a) "Many people infected with gonorrhea are infected with chlamydia as well." b) "The combination of these two antibiotics reduces the risk of reinfection." c) "Because there are many resistant strains of gonorrhea, more than one antibiotic may be required for successful treatment." d) "This combination of medications will eradicate the infection faster than a single antibiotic." - Answer -a) "Many people infected with gonorrhea are infected with chlamydia as well." Explanation: Treatment for gonorrhea includes the antibiotic ceftriaxone. Because many people with gonorrhea have a coexisting chlamydial infection, doxycycline or azithromycin (Zithromax) is also ordered. There has been an increase in the number of resistant strains of gonorrhea, but that isn't the reason for this dual therapy. This combination of antibiotics doesn't reduce the risk of reinfection or provide a faster cure. pg. Nursing students are reviewing information about infectious diseases and events associated with infection. Students demonstrate understanding of the information when they identify the incubation period as which of the following? a) Time between exposure and onset of symptoms b) Presence of microorganisms without the host interacting with them
a) Limit the patient's food intake b) Limit the patient's fluid intake c) Monitor the patient's vital signs d) Encourage the patient to perform mild activity - Answer -c) Monitor the patient's vital signs Explanation: When caring for a patient susceptible to developing sepsis, the nurse should monitor vital signs every 4 hours or as ordered medically, because changes may be the earliest indication of sepsis. The nurse should also encourage fluid and food intake in the patient, as sufficient intake helps restore biologic defense mechanisms. The patient may be weak and, therefore, need not be encouraged to perform mild activity. pg. The nurse observes a physician leave the room of a patient in isolation for Clostridium difficile (C. difficile). The physician uses the alcohol-based hand sanitizer hanging on the wall to wash her hands and leaves the door open. Which of the following actions should the nurse take? a) Close the door to the room. b) No action is needed. The physician was following isolation protocol. c) Ask the physician to wash her hands with soap and water. d) Report the observation to the infection control department. - Answer -c) Ask the physician to wash her hands with soap and water. Explanation:
C. difficile is resistant to alcohol-based and other hand sanitizers; therefore physicians should be instructed to wash their hands with soap and water. The nurse could report the observation to the infection control department, but that does not address the immediate concern of the physician contaminating other patients. There is no need for the room door to be closed. The nurse must take action to ensure the safety of other patients. pg. The following outcome appears on the plan of care for a client with genital herpes: "Client demonstrates knowledge about measures to reduce the risk of transmission and recurrences." Which of the following, if reported by the client, would support achievement of this outcome? a) Cleans lesions with strong anti-bacaterial soap b) Applies occlusive dressings to lesions c) Consistently uses condoms with sexual activity d) Avoids sexual activity when lesions are present - Answer -c) Consistently uses condoms with sexual activity Explanation: Consistent use of condoms for sexual activity indicates that the client has knowledge of the disorder and its transmission, thereby taking steps to reduce the risk of transmission. This action supports achievement of the outcome. Sexual activity even when lesions are not present can still lead to transmission of the infection. Lesions should be cleaned with mild soap and water and patted dry; occlusive ointments, powders, or dressings should be avoided because they do not allow the lesions to dry. pg.
Common age-groups are an interesting fact. Repercussions of the disease are also important to highlight; however, prevention is most important. pg. A nurse is having a yearly employee tuberculin skin test. Which skin test results would indicate a positive result? a) An induration of 12mm b) An induration of 4 mm c) An induration of less than 1 mm d) An uneven erythemic area - Answer -An induration of 12mm Explanation: The size of the induration, not including the surrounding area of erythema, is measured in millimeters. The measurement determines whether the reaction is significant. For example, a tuberculin skin test is test is considered positive if the induration is 10 mm or greater in persons with no known risk factors for TB; smaller measurements are significant in certain risk groups, such as immunocompromised clients. The other Answer s are not indicative of positive results. pg. The nurse is instructing the family on home care of a patient with shingles. The family member asks if their teenage children should stay in a different room. What is the best response by the nurse? a) "Have they had chickenpox or the varicella vaccine?" b) "Yes, shingles is highly contagious."
c) "Because the patient is in quite a bit of pain, it would probably be best." d) "No, shingles is not contagious." - Answer -a) "Have they had chickenpox or the varicella vaccine?" Explanation: To Answer the question correctly, the nurse needs to know if the children had chickenpox or the varicella vaccine. If the children had the vaccine or the disease, then they are considered immune and no precautions are needed. If the children have not been vaccinated for chickenpox nor had the disease, it would be best to maintain distance. Shingles is contagious. Even though the patient may be in pain, this should not guide the nurse's response. pg. The nurse is observing a nursing assistant leave the room of patient diagnosed with Clostridium difficile (C. difficile) without washing hands. Which of the following is the highest priority action the nurse should follow? a) Provide written documentation about the incident. b) Report the nursing assistant to the nurse manager. c) Have the nursing assistant wash hands with soap and water. d) Teach the nursing assistant about the chain of infection.
- Answer -c) Have the nursing assistant wash hands with soap and water. Explanation: Although all actions listed are appropriate, the priority nursing action is to ensure that nursing assistants wash their hands with soap and water. Allowing nursing
Which statement made by a client with a chlamydial infection indicates understanding of the potential complications? a) "I'm glad I'm not pregnant; I'd hate to have a malformed baby from this disease." b) "I hope this medicine works before this disease gets into my urine and destroys my kidneys." c) "If I had known a diaphragm would put me at risk for this, I would have taken birth control pills." d) "I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day." - Answer -d) "I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day." Explanation: Chlamydia is a common cause of pelvic inflammatory disease and infertility. It doesn't affect the kidneys or cause birth defects. It can cause conjunctivitis and respiratory infection in neonates exposed to infected cervicovaginal secretions during delivery. Use of a diaphragm isn't a risk factor. Which organism is responsible for impetigo? a) Clostridium difficile b) Bacillus anthracis c) Staphylococcus aureus d) Histoplasma capsulatum - Answer -c) Staphylococcus aureus Explanation:
Staphylococcus aureus is the responsible organisms for impetigo. Histoplasma capsulatum is responsible for histoplasmosis. Bacillus anthracis is responsible for anthrax. Clostridium difficile is responsible for some diarrheal diseases. pg. The parent of a child diagnosed with chickenpox asks when the child can go to play group again. What is the best response by the nurse? a) "When the vesicles and pustules have crusted." b) "When the fever disappears." c) "Two days after the rash appears." d) "When the rash is changing into vesicles, and pustules appear." - Answer -a) "When the vesicles and pustules have crusted." Explanation: When the lesions have crusted, the patient is no longer contagious to others. The child remains contagious when the rash is present, and if the fever occurs as the rash is progressing. The child is still contagious when the rash is changing into vesicles and pustules. pg. Which of the following is the gold standard for herpes simplex virus (HSV) diagnosis? a) Shave biopsy b) Punch biopsy c) Culture d) Excisional biopsy - Answer -Culture Explanation:
a) Urticaria b) Syphilis c) Kaposi's sarcoma d) Psoriasis - Answer -Syphilis Explanation: Syphilis is manifested by a painless chancre lesion. Psoriasis is exhibited by plaques with scales. Kaposi's sarcomas are cutaneous lesions blue-red or dark brown in color. Urticaria is wheals or hives due to infection or allergic reactions. pg. A nurse is caring for a male client with gonorrhea. The client asks how he can reduce his risk of contracting another sexually transmitted disease (STD). The nurse should instruct the client to: a) wear a condom every time he has intercourse. b) consider intercourse safe if his partner has no visible discharge, lesions, or rashes. c) ask all potential sexual partners if they have an STD. d) expect to limit the number of sexual partners to less than five over his lifetime. - Answer -a) wear a condom every time he has intercourse. Explanation: Wearing a condom during intercourse considerably reduces the risk of contracting STDs. Asking all potential sexual partners if they have an STD; considering intercourse safe if his partner has no visible discharge, lesions, or rashes; and expecting to limit the number of sexual partners won't reduce the risk of contracting an STD to the extent wearing a condom will. A monogamous
relationship also reduces the risk of contracting STDs. pg. Which of the following is the most effective treatment for trichomoniasis? a) Doxycycline (Adoxa) b) Azithromycin (Zithromax) c) Metronidazole (Flagyl) d) Penicillin G benzathine - Answer -c) Metronidazole (Flagyl) Explanation: The most effective treatment for trichomoniasis is metronidazole and tinidazole. Penicillin G benzathine is used for syphilis. Doxycycline and azithromycin are used in the treatment of Chlamydia. A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? a) Diffuse skin rash b) Painless chancre c) Dry, hacking cough d) Burning on urination - Answer -d) Burning on urination Explanation: Burning on urination may be a symptom of gonorrhea or urinary tract infection. A dry, hacking cough is a sign of a respiratory infection, not gonorrhea. A diffuse rash may indicate secondary stage syphilis. A painless chancre is the hallmark of primary syphilis. It appears wherever the
