1.1 Infection EAQ

Which sexually transmitted disease is caused by a virus? Syphilis Gonorrhea Genital warts Chlamydial infection

Genital warts Rationale Genital warts are caused by a sexually transmitted virus. Bacteria cause syphilis, gonorrhea, and chlamydial infections.

Which condition is characterized by infection of a client's bone or bone marrow? Osteomalacia Osteomyelitis Herniated disc Spinal stenosis

Osteomyelitis Rationale Osteomyelitis is infection of bone or bone marrow. Osteomalacia is a condition characterized by softening of bones due to calcium or vitamin D deficiency. Herniated disc is caused by structural damage of the intervertebral discs in which the nucleus pulposus seeps through a torn or stretched annulus. Spinal stenosis is narrowing of the spinal canal.

Which sexually transmitted infection (STI) is caused by Treponema pallidum? Syphilis Gonorrhea Genital warts Vulvovaginitis

Syphilis Rationale Syphilis is an STI caused by Treponema pallidum. Neisseria gonorrhoeae causes gonorrhea. Haemophilus ducreyi and Klebsiella granulomatis cause genital warts. Herpes simplex virus, Trichomonas vaginalis, and Candida albicans may cause vulvovaginitis.

Which is the most common opportunistic infection in a client infected with human immunodeficiency virus (HIV)? Oropharyngeal candidiasis Cryptosporidiosis Toxoplasmosis encephalitis Pneumocystis jiroveci pneumonia

Rationale Oropharyngeal candidiasis is the most common infection associated with HIV because the immune system can no longer control Candida fungal growth. Pneumocystis jiroveci pneumonia (PCP) is the more common in a client infected with AIDs. It causes tachypnea and persistent dry cough. Cryptosporidiosis, an intestinal infection caused by Cryptosporidium organisms, presents in clients with AIDS as does toxoplasmosis encephalitis, which is caused by Toxoplasma gondii and is acquired through contact with contaminated cat feces or by ingesting infected undercooked meat.

Which condition is an example of a bacterial infection? Impetigo Candidiasis Plantar warts Verucca vulgaris

Impetigo Rationale Impetigo is the bacterial infection of skin caused by group A β-hemolytic streptococci or Staphylococcus aureus. Candidiasis is the fungal infection caused by Candida albicans. Plantar warts and verucca vulgaris are viral infections caused by the human papilloma virus.

Which influenza vaccine is administered by way of the intranasal route? Fluarix Fluvirin FluMist Fluzone

FluMist Rationale FluMist is given intranasally. Fluarix, Fluvirin, and Fluzone are also influenza vaccines administered via the intramuscular route.

Which clinical manifestation is associated with cellulitis? Lymphadenopathy Occasional papules Vesicles that evolve into pustules Isolated erythematous pustules

Lymphadenopathy Rationale Cellulitis is accompanied by lymphadenopathy. Occasional papules are present in folliculitis. Herpes simplex viral infections evolve the vesicles into pustules. Isolated erythematous pustules occur in folliculitis bacterial infections.

The clinic nurse is planning care for a client found to have chlamydia. Which treatment should the nurse plan to implement? Administration of 250 mg of acyclovir orally in a single dose Administration of 1 g of azithromycin orally in a single dose Administration of 250 mg of ceftriaxone intramuscularly in a single dose Administration of 2.4 million units of benzathine penicillin G intramuscularly in a single dose

Administration of 1 g of azithromycin orally in a single dose Rationale The treatment of choice for chlamydial infection is 1 g of azithromycin orally in a single dose. The one-dose course is preferred because of its ease of completion. Acyclovir may be prescribed in a 7-day course for a genital herpes outbreak. Administering 250 mg of ceftriaxone intramuscularly in a single dose is the drug therapy recommended for gonorrhea. Benzathine penicillin G given intramuscularly as a single 2.4 million unit dose is the treatment for primary, secondary, and early latent syphilis.

A client is receiving antibiotics and antifungal medications for the treatment of a recurring vaginal infection. What should the nurse encourage the client to do to compensate for the effect of these medications? Eat yogurt with active cultures daily. Avoid spicy foods. Drink more fruit juices. Take a multivitamin every day.

Eat yogurt with active cultures daily. Rationale Yogurt contains Lactobacillus acidophilus, which replaces the intestinal flora destroyed by antibiotics. Spicy foods, fruit juices, and multivitamins are not relevant to antibiotics or intestinal flora.

Which vaccine is used to prevent a human papilloma virus infection? Varivax RotaTeq Gardasil Hepatitis A vaccine

Gardasil Rationale Gardasil is a quadrivalent vaccine used to prevent genital cancers and warts caused by human papilloma virus. Varivax is associated with protection from the varicella virus; this vaccine is sometimes given in combination with the MMR vaccine. The RotaTeq vaccine is used to vaccinate against a rotavirus infection. The hepatitis A vaccine is used to protect against the hepatitis A virus.

A nurse is caring for a client with scabies. Which information about scabies should the nurse consider when planning care for this client? Highly contagious Caused by a fungus Chronic with exacerbations Associated with other allergies

Highly contagious Rationale Scabies is caused by the itch mite (Sarcoptes scabiei), the female of which burrows under the skin to deposit eggs. It is intensely pruritic and is transmitted by direct contact or in a limited way by soiled sheets or undergarments. It is not caused by a fungus. Scabies is an acute infestation; there are no remissions and exacerbations. It is a disease unrelated to allergies.

A young child with acute nonlymphoid leukemia is admitted to the pediatric unit with a fever and neutropenia. What are the most appropriate nursing interventions to minimize the complications associated with neutropenia? Placing the child in a private room, restricting ill visitors, and using strict hand washing techniques Encouraging a well-balanced diet, including iron-rich foods, and helping the child avoid overexertion Avoiding rectal temperatures, limiting injections, and applying direct pressure for 5 minutes after venipuncture Offering a moist, bland, soft diet; using toothettes rather than a toothbrush; and providing frequent saline mouthwashes

Placing the child in a private room, restricting ill visitors, and using strict hand washing techniques Rationale Children with leukemia most often die of infection; a low neutrophil count is associated with myelosuppressant therapy. Placing the child in a private room, restricting ill visitors, and using strict hand washing techniques are the best ways to minimize complications. Encouraging a well-balanced diet, including iron-rich foods, and helping the child avoid overexertion are not appropriate measures to prevent infection resulting from neutropenia; they are appropriate for treating the anemia. Avoiding rectal temperatures, limiting injections, and applying direct pressure for 5 minutes after venipuncture are not appropriate measures to prevent infection resulting from neutropenia; they are more appropriate for preventing bleeding. Offering a moist, bland, soft diet; using toothettes rather than a toothbrush; and providing frequent saline mouthwashes are not appropriate measures to prevent infection resulting from neutropenia; they are used to ease and treat stomatitis.

Which urinalysis finding indicates a urinary tract infection? Presence of crystals Presence of bilirubin Presence of ketones Presence of leukoesterase

Presence of leukoesterase Rationale Leukoesterases are released by white blood cells as a response to an infection or inflammation. Therefore, the presence of this chemical in urine indicates a urinary tract infection. The presence of crystals in the urine indicates that the specimen had been allowed to stand. Presence of bilirubin in the urine indicates anorexia nervosa, diabetic ketoacidosis, and prolonged fasting. The presence of ketones indicates diabetic ketoacidosis.

The nurse is caring for a client who has been bitten by a raccoon. The client states, "Where I live, there seems to be raccoons and wild animals everywhere." Which information should the nurse consider about rabies when planning care for this client? Rabies is a bacterial infection characterized by encephalopathy and opisthotonos. Rabies is an acute bacterial septicemia that results in convulsions and a morbid fear of water. Rabies is a nonspecific immune response to organisms deposited under the skin by an animal bite. Rabies is an acute viral infection, characterized by convulsions and difficulty swallowing, that affects the nervous system.

Rabies is an acute viral infection, characterized by convulsions and difficulty swallowing, that affects the nervous system. Rationale Rabies is a viral infection that enters the body through a break in the skin and is characterized by convulsions and choking. Rabies is not caused by a bacteria; its outstanding symptoms are convulsions and choking. Rabies is not associated with a bacterial septicemia; it is caused by a virus. The virus specifically attacks nervous tissue and is carried in the saliva of infected animals.

Which intervention would be most beneficial in preventing a catheter-associated urinary tract infection in a postoperative client? Pouring warm water over the perineum Ensuring the patency of the catheter Removing the catheter within 24 hours Cleaning the catheter insertion site

Removing the catheter within 24 hours Rationale Clients who undergo surgery are at a greater risk of acquiring catheter-associated urinary tract infections. Infections can be prevented by removing the catheter within 24 hours, if the client does not need it. Therefore removing the catheter within 24 hours would be the best intervention. While pouring warm water over the perineum helps voiding in the postoperative client and also reduces the chances of infection, this action would not be as beneficial as the former intervention. The catheter should be maintained in its place to avoid leakage and infection. Cleaning the catheter insertion site will definitely reduce the risk of infection, but this action cannot prevent infections if the catheter is inserted for a long time.

What is the mechanism of action for wet-to-damp saline-moistened gauze for wound debridement? Promoting the dilution of viscous exudate Removing the necrotic tissue mechanically Causing a breakdown of the denatured protein of eschar Promoting the spontaneous separation of necrotic tissue

Removing the necrotic tissue mechanically Rationale Wet-to-damp saline-moistened gauze mechanically removes the necrotic tissue. The dilution of viscous exudates is promoted through the continuous wet-gauze technique. Topical enzyme preparations cause a breakdown of the denatured protein of eschar. Moisture-retentive dressings promote the spontaneous separation of necrotic tissue through autolysis.

After surgery for insertion of a coronary artery bypass graft (CABG), a client develops a temperature of 102° F (38.9° C). Which priority concern related to elevated temperatures does a nurse consider when notifying the healthcare provider about the client's temperature? A fever may lead to diaphoresis. A fever increases the cardiac output. An increased temperature indicates cerebral edema. An increased temperature may be a sign of hemorrhage.

A fever increases the cardiac output. Rationale Temperatures of 102° F (38.9° C) or greater lead to an increased metabolism and cardiac workload. Although diaphoresis is related to an elevated temperature, it is not the reason for notifying the healthcare provider. An elevated temperature is not an early sign of cerebral edema. Open heart surgery is not associated with cerebral edema. Fever is unrelated to hemorrhage; in hemorrhage with shock, the temperature decreases.

How would the nurse describe the exudate characteristic of a serosanguineous wound? Greenish-blue pus Creamy yellow pus Blood-tinged amber fluid Beige pus with a fishy odor

Blood-tinged amber fluid Rationale Blood-tinged amber fluid is characteristic of serosanguineous wound exudate. Greenish-blue pus, creamy yellow pus, and beige pus with a fishy odor are characteristics of purulent wound exudate.

A nurse is teaching a client about human immunodeficiency virus (HIV). What are the various ways HIV is transmitted? Select all that apply. Mosquito bites Sharing syringe needles Breastfeeding a newborn Dry kissing the infected partner Anal intercourse

Sharing syringe needles, Breastfeeding a newborn, Anal intercourse Rationale Fluids such as blood and semen are highly concentrated with HIV. HIV may be transmitted parenterally by sharing needles and postnatally through breast milk. HIV may also be transmitted through anal intercourse. HIV is not transmitted by mosquito bites or dry kissing.

Trimethoprim/sulfamethoxazole is prescribed for a child with a urinary tract infection. Which statement by the parent about the drug indicates that the nurse's instructions about administration have been understood? "Mealtime is a good time to give the medication." "I'll make sure to give each pill with 6 to 8 oz (180 to 240 mL) of fluid." "It must be taken with orange juice to ensure acidity of urine." "The drug has to be taken every 4 hours to maintain a blood level."

"I'll make sure to give each pill with 6 to 8 oz (180 to 240 mL) of fluid." Rationale This is a sulfa drug; water must be encouraged to prevent urine crystallization in the kidneys. This drug does not have to be given with meals; it is administered every 12 hours. Orange juice causes an alkaline urine; water is the best fluid to be administered with this drug. This drug maintains the blood level for 8 to 12 hours; it is an intermediate-acting drug.

What is the most common cause of ophthalmia neonatorum in infants born to adolescent mothers? Chlamydia Gonorrhea Human papilloma virus Herpes simplex virus

Chlamydia Rationale Ophthalmia neonatorum is a neonatal infection caused when the infant is born to a mother who has a chlamydia infection.

A nurse teaches a client with a diagnosis of emphysema about the importance of preventing infections. What information is most significant to include? Purpose of bronchodilators Importance of meticulous oral hygiene Technique used in pursed-lip breathing Methods used to maintain a dust-free environment

Importance of meticulous oral hygiene Rationale Microorganisms in the mouth are transferred easily to the tracheobronchial tree and are a source of potential infection; meticulous oral hygiene is essential to reduce the risk of respiratory infection. Bronchodilators will not prevent infection; they dilate the bronchi. Pursed-lip breathing will not prevent infection; it promotes gas exchange in the alveoli and facilitates more effective exhalation. It is impossible to maintain a dust-free environment.

A nurse is caring for an infant born with a myelomeningocele who is scheduled for surgery. What is the priority preoperative goal for this infant? Keeping the infant sedated Keeping the infant infection free Ensuring maintenance of leg movement Ensuring development of a strong sucking reflex

Keeping the infant infection free Rationale Prevention of infection is the priority both before and after the repair of the sac. Sedatives are not indicated; analgesics are administered as needed. Leg movement may be a postoperative goal, although it may be unrealistic because these infants' lower bodies are usually paralyzed. The sucking reflex is not associated with myelomeningocele.

A nurse is caring for a 13-year-old child who has an external fixation device on the leg. What is the nurse's priority goal when providing pin care? Easing pain Minimizing scarring Preventing infection Preventing skin breakdown

Preventing infection Rationale Pin sites provide a direct avenue for organisms into the bone. Pin care will not ease pain. Some scarring will occur at the pin insertion site regardless of pin site care. Skin has a tendency to grow around the pin, rather than break down, as long as infection is prevented.

Which causative organism colonization signifies purulent exudates of greenish-blue pus with a fruity odor? Proteus Bacteroides Pseudomonas Staphylococcus

Pseudomonas Rationale The purulent exudates of greenish-blue pus with a fruity odor signifies the colonization of Pseudomonas. Proteus colonization causes pus with a fishy odor. The colonization of Bacteroides causes brownish pus with a fecal odor. Staphylococcus colonization results in purulent exudate of creamy yellow pus.

A 6-year-old child comes to the school nurse reporting a sore throat, and the nurse verifies that the child has a fever and a red, inflamed throat. When a parent of the child arrives at school to take the child home, the nurse urges the parent to seek treatment. If the sore throat is not treated, what illness is of most concern to the nurse? Tetanus Influenza Scarlet fever Rheumatic fever

Rheumatic fever Rationale The child's symptoms are suggestive of hemolytic Streptococcus infection. Rheumatic fever is an inflammatory disease involving the joints, heart, central nervous system, and subcutaneous tissue that can occur if the infection is not treated. It is thought to be an autoimmune process that causes connective tissue damage. Tetanus is not caused by a streptococcal infection. The disorder described is not influenza or scarlet fever.

While obtaining the health history of a 15-month-old toddler, the child of a migrant worker, a nurse learns that the infant recently had a fever, runny nose, cough, and white spots in the mouth lasting 3 days. A rash started on the face and spread to the whole body. What communicable disease does the nurse suspect the infant suffered from? Rubella Rubeola Pertussis Varicella

Rubeola Rationale White spots in the mouth (Koplik spots) and the rash, combined with increased mucus secretions (coryza), are indicative of measles (rubeola). Rubella (German measles) does not cause Koplik spots. Pertussis (whooping cough) has a distinctive cough, but there are no Koplik spots or rash. Varicella (chickenpox) features skin lesions rather than a rash and lesions in the mouth.

The nurse is caring for a client with a diagnosis of necrotizing fasciitis. Which is the priority concern of the nurse when caring for this client? Fluid volume Skin integrity Physical mobility Urinary elimination

Skin integrity Rationale Necrotizing fasciitis destroys subcutaneous tissue and fascia and predisposes the client to infection and sepsis. Although fluid volume and physical mobility are important, they are not the primary concern at this time. Necrotizing fasciitis is a problem of the integumentary, not the urinary, system.

A client's laboratory report reveals a CD4+ T-cell count of 520 cells/mm 3. According to the Centers for Disease Control and Prevention (CDC), which stage of human immunodeficiency virus (HIV) disease is present in the client? Stage 1 Stage 2 Stage 3 Stage 4

Stage 1 Rationale According to the CDC, HIV disease is divided into four stages. A client with a CD4+ T-cell count of greater than 500 cells/mm 3 is in the first stage of HIV disease. A client with a CD4+ T-cell count between 200 and 499 cells/mm 3 is in the second stage of HIV disease. A client with a CD4+ T-cell count of less than 200 cells/mm 3 is in the third stage of HIV disease. The fourth stage of HIV disease indicates a confirmed HIV infection with no information regarding the CD4+ T-cell counts.

Which fungal infection does the client refer to as jock itch? Tinea pedis Tinea cruris Tinea corporis Tinea unguium

Tinea cruris Rationale Tinea cruris is a fungal infection commonly referred to as jock itch. It clinically manifests with well-defined scaly plaque in the groin area. Tinea pedis is a fungal infection commonly referred to as athlete's foot. It is clinically manifested as interdigital scaling and maceration, scaly plantar surfaces, erythema, and blistering. Tinea corporis is a fungal infection commonly referred to as ringworm. It is clinically manifested as an erythematous annular, ringlike, scaly lesion with well-defined margins. Tinea unguium or onychomycosis is manifested with scaliness under the distal nail plate.