Chapter 66- Management of patients with Infectious diseases

The nurse is caring for a client diagnoses with severe acute respiratory syndrome (SARS). A family member asks what causes SARS. Which response by the nurse is accurate? Shigella Salmonella Coronavirus Escherichia coli

Coronavirus

A nurse would perform handwashing instead of using an alcohol-based product for which situation? During client care when moving from a contaminated body site to a clean one Before putting on sterile gloves for inserting a urinary catheter When hands are visibly soiled from client care After taking a client's vital signs

When hands are visibly soiled from client care

You are a school nurse teaching a health class about the chain of infection in the transmission of sexually transmitted diseases (STDs). A student asks you which part of the chain of infection can be missing when transmission occurs. What would be your best answer? "Not everyone is susceptible to STDs, but they still get them." "STDs can be gotten from bed linens and toilet seats, so you don't really need a reservoir." "You can be missing any part of the chain of infection except the infectious agent." "All parts of the chain of infection have to be present for the disease to be passed to another human."

"All parts of the chain of infection have to be present for the disease to be passed to another human."

The nurse educator, who is teaching a class on sexually transmitted infections, recognizes that teaching has been effective when students indicate which statement is true about the difference between colonization and infection? "Both colonization and infection require treatment with different antibiotics." "Colonization becomes infection when the host and organism interact." "Colonization results in symptoms such as redness and swelling, infection results in fever." "Colonization and infection are interchangeable terms used to describe a bacterial invasion."

"Colonization becomes infection when the host and organism interact."

A pregnant patient asks the nurse if it is all right for her take the varicella immunization for entrance into nursing school. What is the best response by the nurse? "It is not a live virus, so it should be fine." "You will have to delay entrance into the nursing program if they force you to take it." "If you will be working in the health care field, you must take the immunization." "It is not recommended that pregnant women take the live virus. You should wait until after your child is born."

"It is not recommended that pregnant women take the live virus. You should wait until after your child is born."

The nurse is talking to a client who has come to the doctor's office to ensure that the client's sexually transmitted infection (STI) has been successfully treated. Which statement by the client requires further instruction? "I will plan to use a dental dam from now on whenever I engage in oral sex." "I'm glad that the health care practitioner checked me for STIs when I came for my regular checkup because I didn't have any symptoms." "It's great that I don't have to worry about having this infection again because I'm now immune to it." "I realize that using a condom with a spermicide will eliminate most chances of getting any type of a sexually transmitted infection."

"It's great that I don't have to worry about having this infection again because I'm now immune to it."

The nurse is giving an educational talk to a local parent-teacher association. A parent asks how he can help his family avoid community-acquired infections. What would be the nurse's best response to help prevent and control community-acquired infections? "Make sure your family has all their childhood immunizations." "Encourage your family to adopt a healthy diet and exercise regimen." "Make sure your family has regular checkups." "Encourage your family to stop smoking."

"Make sure your family has all their childhood immunizations."

The nurse is caring for a client who has just been diagnosed with chlamydia and is very upset. The client says, "I don't understand this. The person I had sex with did not have any symptoms at all. How could I have known?" What is the best response by the nurse to this client? "It is very hard to see signs of infection in the heat of passion." "It is really important that you know the sexual history of every potential lover. It may be uncomfortable but it will prevent the situation you are dealing with right now." "Many people with chlamydia won't have symptoms for up to 3 weeks after being infected." "I think you realize that if you had used some form of a barrier protection such as a condom, it would have helped prevent this situation."

"Many people with chlamydia won't have symptoms for up to 3 weeks after being infected."

The nurse is caring for a client who has just been diagnosed with chlamydia and is very upset. The client says, "I don't understand this. The person I had sex with did not have any symptoms at all. How could I have known?" What is the best response by the nurse to this client? "It is very hard to see signs of infection in the heat of passion." "Many people with chlamydia won't have symptoms for up to 3 weeks after being infected." "I think you realize that if you had used some form of a barrier protection such as a condom, it would have helped prevent this situation." "It is really important that you know the sexual history of every potential lover. It may be uncomfortable but it will prevent the situation you are dealing with right now."

"Many people with chlamydia won't have symptoms for up to 3 weeks after being infected."

A client the nurse is caring for has developed a bladder infection while in the hospital. The client has had a Foley catheter for two weeks. The client's family asks you how the client got this infection. What would be the nurse's best response? "People in hospitals are often more susceptible to infections because they are already ill and they are exposed to germs while they are in the hospital." "People in hospitals sometimes exhibit signs of infections they had before being admitted." "Sometimes people in hospitals get exposed to microorganisms that their visitors bring in." "People in hospitals are surrounded by infectious agents, so they can get infections they didn't have before being admitted."

"People in hospitals are often more susceptible to infections because they are already ill and they are exposed to germs while they are in the hospital."

A client is diagnosed with a viral illness and requests an antibiotic to "cure" the illness. When the request is refused by the physician, the client states to the nurse, "I will never get better." What is the best response by the nurse? "I will speak with the physician again. You will only get better while taking an antibiotic." "Prescribing antibiotics for a viral infection may result in drug-resistant bacteria." "You need to think positively, and you will get better soon." "Taking antibiotics when you don't need them will make you sick."

"Prescribing antibiotics for a viral infection may result in drug-resistant bacteria."

The nurse is meeting with the mother of an 11-year-old girl to provide decision making support and education regarding human papillomavirus (HPV) vaccination. The mother states, "I am confused about why my 11 year old needs to be protected from a sexually transmitted infection. She is so young and not sexually active. Why does she need the vaccination now?" What is the nurse's best response? "The vaccination helps to prevent cervical cancer in adult women. It works better if she has it before she becomes sexually active. Let's talk about some of the concerns you have about the vaccination" "Although HPV infections are not very common, it is important to take precaution with vaccination. If you prefer, you can wait until your daughter is older than 15 years, because she would require fewer doses of the vaccine." "You're daughter is at risk for ectopic pregnancy and even infertility without this vaccination. If you chose not to vaccinate, you are choosing to put your daughter at risk." "HPV vaccination is very common and most parents are choosing to protect their children. Although your child is not sexually active now, she will be soon and this will protect her from sexually transmitted infections."

"The vaccination helps to prevent cervical cancer in adult women. It works better if she has it before she becomes sexually active. Let's talk about some of the concerns you have about the vaccination"

The nurse is seeing a client who was recently diagnosed with primary syphilis after reporting a painless penis lesion to his health care provider. The client states, "I don't want anyone to find out that I have this disease." How should the nurse respond? "It is part of my role to contact anyone you have had sexual contact with. Please provide the contact information to me." "Your health is personal and confidential. No one outside this room needs to know about your infection." "You're test results are reported to a public health department. You will need to share the information about your sexual contacts, and they will notify and screen those people." "It is important that you inform your sexual partners you have this infection. I can sit with you while you make the necessary phone calls."

"You're test results are reported to a public health department. You will need to share the information about your sexual contacts, and they will notify and screen those people."

A client weighing 187 lbs (85 kg) has mild dehydration and is prescribed to receive 50 mL/kg/4 hours of an oral rehydration solution. Which amount of solution will the nurse provide the client over 1 hour? Round to the nearest whole number.

1063

A child is brought to the emergency department by his parents. The child has been experiencing significant diarrhea over the past 36 hours. Further evaluation reveals infectious diarrhea with moderate dehydration. The physician orders oral rehydration solution, 100 mL/kg over the next 4 hours. The child weighs 77 lbs. How much would the nurse expect to administer?

3500

A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? One or more flat, wart-like papules in the genital area that are sensitive to touch A painless genital ulcer that appeared about 3 weeks after unprotected sex Copper-colored macules on the palms and soles that appeared after a brief fever Patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas

A painless genital ulcer that appeared about 3 weeks after unprotected sex

Which of the following medications are used to suppress viral load of the HSV-2 infection? Acyclovir (Zovirax) Penicillin Metronidazole (Flagyl) Clindamycin (Cleocin)

Acyclovir (Zovirax)

A client is admitted with bacterial meningitis. Which hospital room is the best choice for this client? A two-bed room with a client who previously had bacterial meningitis A private room down the hall from the nurses' station An isolation room three doors from the nurses' station A semiprivate room with a client who has viral meningitis

An isolation room three doors from the nurses' station

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? Use proper antibiotics. Apply principles of medical and surgical asepsis. Maintain a proper diet and exercise regimen. Ensure childhood immunizations.

Apply principles of medical and surgical asepsis

The nurse observes a physician leave the room of a client in isolation for infection with Clostridium difficile. The physician uses the alcohol-based hand sanitizer hanging on the wall to wash her hands and leaves the door open. Which action should the nurse take? Ask the physician to wash her hands with soap and water. Report the observation to the infection control department. No action is needed. The physician was following isolation protocol. Close the door to the room.

Ask the physician to wash her hands with soap and water

A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? Dry, hacking cough Painless chancre Burning on urination Diffuse skin rash

Burning on urination

The nurse is discussing childhood immunization recommendations with a pediatric patient's parent. Where would the nurse find the most current information on this topic? The Occupational Safety Health Administration The Joint Commission CDC The World Health Organization

CDC

Which term refers to a state of microorganisms being present within a host without causing host interference or interaction? Immune Susceptible Infection Colonization

Colonization

A client is diagnosed with scabies in a long-term care facility. Which type of client care precautions would the nurse institute? Respiratory Contact Enteric Strict

Contact

A nurse is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention? Cauliflower-like warts on the penis Foul-smelling discharge from the penis Rashes on the palms of the hands and soles of the feet Painful red papules on the shaft of the penis

Foul-smelling discharge from the penis

The nurse is presenting a community lecture about STIs, and emphasizes that some STIs are easily cured with early and adequate treatment. Which is not among these easily treated diseases? syphilis chlamydia genital herpes gonorrhea

Genital herpes

The nurse is assessing a client in the emergency department who grimaces and reports swelling of the testicles, burning on urination and a green discharge from the penis. The nurse suspects the client will be diagnosed with which infection? Primary syphilis Trichomoniasis Gonorrhea Herpes genitalis

Gonorrhea

When preparing a teaching presentation regarding reproductive health in women, which points should the nurse include when discussing the prevention of bacterial vaginosis? Select all that apply. Choose clothing options that are loose around the genital area Keep the frequency of your sexual activity balanced Prevent unprotected sexual encounters Use douche after your monthly menses is complete If you smoke, try to quit

If you smoke, try to quit Keep the frequency of your sexual activity balanced Prevent unprotected sexual encounters Choose clothing options that are loose around the genital area

The nurse is caring for a client with genital herpes experiencing a reoccurrence. Which nursing diagnosis would be the priority? Anxiety Powerlessness Knowledge Deficit Impaired Skin Integrity

Impaired Skin Integrity

A patient presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole (Flagyl). What is the paramount nursing intervention in discharge planning? Counsel the patient to refrain from sex for 1 week. Reassure the patient further sexually transmitted infection (STI) testing is not indicated. Instruct the patient not to drink alcohol with this treatment. Advise the patient to take medication with a glass of milk.

Instruct the patient not to drink alcohol with this treatment

Which of the following is the most effective treatment for trichomoniasis? Metronidazole (Flagyl) Azithromycin (Zithromax) Doxycycline (Adoxa) Penicillin G benzathine

Metronidazole (Flagyl)

The nurse places a client in isolation. Isolation techniques have the potential to break the chain of infection by interfering with what component of the chain of infection? Susceptible host Portal of entry Agent Mode of transmission

Mode of transmission

A nurse practitioner was preparing a health education program for freshmen college students. During orientation week, the nurse mentioned that C. trachomatis and N. gonorrhoeae are the two most common infections in sexually active young women under the age of 25. The nurse told the students that the most common finding for these infections is: Pelvic inflammatory disease. Urinary tract infections. Vaginitis. Mucopurulent cervicitis.

Mucopurulent cervicitis

The nurse is caring for a client who has acquired immunodeficiency disease (AIDS) and has developed oral thrush. What type of infection is the nurse aware that has developed due to the immunocompromised state of the client? Opportunistic Acute Chronic Secondary

Opportunistic

Which of the following is the medication of choice for early syphilis? Rocephin Doxycycline Tetracycline Penicillin G benzathine

Penicillin G benzathine

The infection control nurse collects data that indicates an increase in the number of clients in the hospital with multidrug-resistant infections. What priority education should healthcare providers receive? Performing hand hygiene Emptying trash cans immediately in client's rooms Using contact precautions on all clients in the hospital Administering antibiotics to all clients prophylactically

Performing hand hygiene

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? Put on gloves, a mask, and eye protection. Put on gloves, a mask, and eye protection during suctioning, and then apply a mask to the client's face for transport. Take no special precautions for this client. Use standard precautions, which require gloves for suctioning.

Put on gloves, a mask, and eye protection during suctioning, and then apply a mask to the client's face for transport.

A client reports nausea, vomiting, and diarrhea for 5 days. The nurse assesses the mucous membranes as pale and dry. The client has sunken eyes with the following vital signs: pulse 122 and thready, respirations 23, blood pressure 78/55, temperature 101.8°F oral. Which is the priority nursing intervention? Initiate oral rehydration therapy at 100 mL/kg of oral rehydration solution over 4 hours. Obtain stool specimen for analysis. Request an order from the physician for IV rehydration therapy. Assess vital signs every 15 minutes.

Request an order from the physician for IV rehydration therapy

A 2-year-old is brought to the clinic by her mother who tells the nurse her daughter has diarrhea and the child is complaining of pain in her stomach. The mother says that the little girl had not eaten anything unusual, consuming homemade chicken strips and carrot sticks the evening prior. Which bacterial infection would the nurse suspect this little girl of contracting? Escherichia coli Shigella Salmonella Giardia lamblia

Salmonella

Which organism is responsible for impetigo? Clostridium difficile Staphylococcus aureus Histoplasma capsulatum Bacillus anthracis

Staphylococcus aureus

Painless chancres are associated with which systemic disease? Urticaria Kaposi sarcoma Syphilis Psoriasis

Syphilis

When a hospitalized client is in contact precautions, which action is necessary? Masks should be worn when caring for the client. The client should be in a room with negative air pressure. The client's door should be closed. The client should be placed in a private room when possible.

The client should be placed in a private room when possible

A client is admitted to the acute care facility for vomiting and diarrhea. An intravenous (IV) catheter is inserted for the delivery of IV fluids. A family member is with the client and observes the nurse enter the room and begin touching the IV site without washing hands or wearing gloves. Why should the client and family member be concerned with the nurse's actions? The client will develop a healthcare-associated infection. The nurse could develop the same symptoms. The client will have an allergic reaction to the IV. Dislodging of the IV catheter.

The client will develop a healthcare-associated infection

Which statement reflects what is known about the Ebola virus? The viruses are usually transmitted by airborne exposure. Symptoms include severe lower abdominal pain, nausea, vomiting, and dehydration. Treatment during the acute phase includes administration of penicillin and ventilator and dialysis support. The diagnosis should be considered in a client who has a febrile, hemorrhagic illness after traveling to Asia or Africa.

The diagnosis should be considered in a client who has a febrile, hemorrhagic illness after traveling to Asia or Africa

A family member of a client in a long-term care facility asks why the nurse cannot insert a catheter so the client will not develop skin breakdown from being wet. What should the explanation include when the nurse responds to the family member? The invasive nature of the catheter provides a portal for infection. Catheters are no longer used for treatment of incontinence. Older adult residents are able to have catheters inserted if the family requests them. If a catheter is inserted, it must be flushed with normal saline daily.

The invasive nature of the catheter provides a portal for infection

The nurse teaches the parent of a child with chickenpox that the child is no longer contagious to others when the fever disappears. the rash is changing into vesicles, and pustules appear. the first rash appears. the vesicles and pustules have crusted.

The vesicles and pustules have crusted

The nurse is caring for a group of five clients at the hospital. To control infections when caring for the group of clients, what intervention can the nurse perform? Only use standard precautions with clients who have an infection. Use standard precautions with all clients. Wear a mask while taking care of all clients and changing the mask between clients. Place the clients on isolation precautions.

Use standard precautions with all clients

A client is placed in isolation for suspected tuberculosis. Which action should the nurse take when entering the client's room? Wear an N95 respirator. Minimize verbal interactions. Apply a face mask with an eye shield. Leave the door open when in the room.

Wear an N95 respirator

The nurse is caring for a client with secondary syphilis. What intervention should the nurse institute when caring for this client? Administer combination therapy with antiretrovirals as prescribed. Wear gloves if contact with lesions is possible. Ensure that the client is housed in a private room. Administer hydrocortisone ointment to the lesions as prescribed.

Wear gloves if contact with lesions is possible

A 47-year-old male client presented to the medical unit and the health care team suspects tuberculosis (TB). The nurse is admitting the client to a reverse isolation room. QuantiFERON testing and chest x-ray are pending. Urinalysis results are negative. No other testing was performed prior to admission to isolation. The client denies any chest pain, shortness of breath (SOB), or respiratory difficulty. The client presents with productive yellow sputum. Complete the following sentence by choosing from the lists of options. Based on the provided assessment status, the nurse should utilize Select...contact precaution sterile technique droplet precautions airborne precautions ______________ to prevent exposure and _____________ sputum urinalysis blood specimen for rapid plasma reagin (RPR)Select...to collect specimens for additional testing.

airborne precautions; sputum