Chapter 24 Infectious Diseases and Sepsis Homework

1. Which is an example of a route of infection? A. Bloodstream B. Heart C. Intestines D. Lymph nodes

A. Bloodstream

17. A patient complains of a cough and fever, and she reports recent night sweats and weight loss. You suspect she has TB, and accordingly you and your partner begin using N-95 respirators in addition to the Standard Precautions you had already been taking. She says that the respirators are making her feel judged and insists that you remove them. What do you do? A. Explain that because you suspect an airborne disease, the respirators are to prevent the infection from spreading. B. Ask her if she would prefer you and your partner wear surgical masks. C. Tell her that if she had received the TB vaccine, she would not currently be infected. D. Tell her that it is standard procedure to wear N-95 respirators in response to any suspected infections.

A. Explain that because you suspect an airborne disease, the respirators are to prevent the infection from spreading.

18. Your partner has been exposed to the blood of a trauma patient you suspect of hepatitis B infection. The exposure was from the patient's coughing blood that splashed your partner's face around the area of the mouth. Your partner was not wearing a mask, and begins washing the exposed area. The patient complains that your partner should ignore the blood and tend to the patient. What do you do? A. Explain that washing the exposed area in such cases is necessary to do right away. B. Inform your partner later that you thought immediately washing the exposed area was unprofessional. C. Tell the patient that hepatitis B infection is no small concern, and not to worry about your partner's actions. D. Ask your partner to finish washing the exposed area later.

A. Explain that washing the exposed area in such cases is necessary to do right away.

12. Which temperatures are signs of systemic inflammatory response syndrome? A. Less than 36°C or greater than 38.3°C B. Greater than 36.3°C or less than 38°C C. Less than 36.3°C or greater than 38°C D. Greater than 36°C or less than 38.3°C

A. Less than 36°C or greater than 38.3°C

24. What makes another major outbreak almost certain? A. People can travel easily around the world. B. Health agencies have been ineffective in their responses. C. Stores of antibiotics are at an all-time low. D. The worst illnesses have defied any attempts at treatment.

A. People can travel easily around the world.

13. In a patient with a systolic BP below 90, what other sign, using SIRS criteria, would urge you to give the ED a sepsis alert? A. T 95.9°F B. R 19 C.T 100.2°F D. P 86

A. T 95.9°F

16. Treatment of croup: A. is symptomatic. B. requires vaccination. C. is unnecessary for previously infected patients. D. involves antibiotics.

A. is symptomatic.

9. A cause of sepsis involving the central nervous system is: A. meningitis. B. tracheostomy. C. pancreatitis. D. a long-term intravenous catheter.

A. meningitis.

6. Standard Precautions are intended to: A. prevent the spread of disease. B. identify and categorize infected individuals. C. make sepsis and septic shock easier to discern. D. decrease the incubation time for diseases.

A. prevent the spread of disease.

15. If you are exposed to influenza, your healthcare provider may decide it is prudent for you to: A. take an antiviral medication. B. take a round of antibiotics. C. avoid contact with others for at least 5 days. D. receive a vaccination against influenza.

A. take an antiviral medication.

2. The hepatitis B virus is very strong, and can survive outside a human body for at least a week, which demonstrates its: A. virulence. B. dose. C. resistance. D. mode of transmission.

A. virulence.

10. Which patient is most vulnerable to sepsis? A. A 44-year-old patient has an acute inflammation of gout in his right foot. B. A 76-year-old patient with a gastrostomy tube is confined to bed. C. A 17-year-old patient has a rash on his right forearm. D. A 34-year-old patient controls a cat allergy with over-the-counter medication.

B. A 76-year-old patient with a gastrostomy tube is confined to bed.

22. A resident of a nursing home asks you for the best way to avoid infection with pneumococcal pneumonia, of which there have been several recent cases at that facility. What would you not list as a prevention technique for this person? A. Observe proper hand hygiene at all times. B. Wear an N-95 respirator or at least a surgical mask. C. When coughing or sneezing, turn away from others, and use a disposable tissue or your sleeve. D. Get a vaccination against this type of pneumonia.

B. Wear an N-95 respirator or at least a surgical mask.

23. Regarding the next major outbreak, which statement is true? A. Another outbreak is unlikely, because antibiotics exist for the most dangerous microbes. B. You need to remain calm and counsel others to remain calm. C. Outbreaks are slow in the beginning, and usually localized. D. Early news reports tend to be most accurate.

B. You need to remain calm and counsel others to remain calm.

11. A respiratory rate of __________ is a sign of systemic inflammatory response syndrome. A. less than 20 B. greater than 20 C. less than 22 D. greater than 22

B. greater than 20

4. The term "severe sepsis" is no longer used because: A. the term "virulent sepsis" is used instead. B. it does not differentiate patients or predict who is at higher risk of death. C. sepsis is very rarely severe, and typically involves only local responses to infection. D. the word "severe" is considered stigmatizing and insensitive.

B. it does not differentiate patients or predict who is at higher risk of death.

14. Which patient, based on SIRS criteria, merits a sepsis alert? A. No AMS, T 96.8°F, P 90, R 22, and BP 90/60 B. No AMS, T 99.6°F, P 86, R16, and BP 92/70 C. AMS, T 94.3°F, P 110, R 30, and BP 86/56 D. AMS, T 97°F, P 87, R 17, and BP 94/64

C. AMS, T 94.3°F, P 110, R 30, and BP 86/56

20. A patient with HIV tells you that his siblings have kept their children away from him because of his infection, and this has gone on so long that he's begun to think they are right to do so. What do you say? A. If he agrees with his siblings for the good of their children, then that's his decision, and you completely respect and support it. B. You can talk to his siblings to inform them of the facts, if that is what he would like you to do. C. It's easy to avoid HIV infection with simple precautions, and with proper treatment he may not even be contagious. D. The best thing to do with the kind of ignorance his siblings have displayed is to ignore it and nurture other relationships.

C. It's easy to avoid HIV infection with simple precautions, and with proper treatment he may not even be contagious.

3. What is septic shock? A. A period during which microbes begin to multiply B. The body mounting an immune response C. The final stage of sepsis D. The body producing lactic acid

C. The final stage of sepsis

7. Vasodilation during septic shock is caused by: A. "leaky" capillaries. B. intravenous fluids. C. chemicals produced by the body. D. blood returning to the heart.

C. chemicals produced by the body.

21. You see many people at a facility where several tuberculosis cases have been reported wearing surgical masks to guard against the disease. This solution is: A. effective, because wearing a surgical mask is the minimum acceptable precaution against TB. B. effective as long as these people have been properly vaccinated against TB as well. C. ineffective, because these masks do not filter out the particles that cause this disease. D. ineffective, because TB is a bloodborne, not an airborne, illness.

C. ineffective, because these masks do not filter out the particles that cause this disease.

5. A vaccine for a particular disease: A. increases the severity of the disease when it occurs. B. always prevents that disease from occurring. C. may not exist or have been approved. D. produces greater complications when that disease occurs.

C. may not exist or have been approved.

19. You are responding to a call at the home of a patient who is experiencing a diabetic emergency. A neighbor approaches you to tell you to be careful because the patient has AIDS. What do you do? A. Inform this person that it's illegal to interfere with an EMT on duty responding to a call. B. Signal to your partner to continue to the patient while you engage the neighbor's misconceptions. C. Say that given the infection risk, the neighbor should stay well away from the scene. D. Briefly explain that the Standard Precautions you would use with any patient are sufficient here as well.

D. Briefly explain that the Standard Precautions you would use with any patient are sufficient here as well.

8. Increased capillary permeability is one of the causes of: A. sepsis. B. lactic acid production. C. a normal immune response. D. hypotension.

D. hypotension.