P3: Chapter 26 : Infectious Disease

2. Which of the following examples provides the BEST description of indirect contact with a microorganism?

B) Touching a bloody stretcher railing with an open wound on your hand Page: 1290

23. A common sign of the measles is:

B) a blotchy red rash. Page: 1314

22. When obtaining the SAMPLE history of a person suspected of having an infectious disease, you should specifically inquire about:

B) a history of recent travel. Page: 1295

42. If you do not receive a flu vaccine and are exposed to a person with the flu:

B) antiviral drugs may be given within 48 hours after the exposure to reduce the severity of the flu if you contract it. Page: 1301

77. You receive a call for an "unresponsive person." Law enforcement arrives at the scene before you and advises that the scene is secure. When you arrive, you find the patient, a young man, lying supine on the floor of his poorly kept apartment. He is unresponsive and is breathing with a marked reduction in tidal volume. One of the police officers recognizes the patient as a known intravenous drug abuser. During your care of this patient, you should:

B) avoid removing his wallet or any other possessions from his pockets. Page: 1305

11. After an employee who believes he or she has been exposed to an infectious disease notifies the designated infection control officer (DICO), the DICO should:

B) determine whether an actual exposure occurred. Page: 1293

4. Unlike bacteria, viruses:

B) die when exposed to the environment. Page: 1296

66. In addition to children, the hepatitis A vaccine is recommended for:

B) emergency response team members traveling outside the United States. Page: 1308

18. Postexposure prophylaxis is available for all of the following diseases, EXCEPT:

B) hepatitis C. Page: 1292

71. You receive a call for a 33-year-old man with difficulty breathing. Upon arrival, you begin to assess the patient, who tells you that he is HIV-positive. During the primary assessment, you should:

B) identify and correct immediately life-threatening conditions. Page: 1295

56. If you are exposed to the hepatitis B virus and have a positive titer on file:

B) no follow-up treatment is required. Page: 1305

37. A paramedic would MOST likely be infected with TB if he or she:

B) performed mouth-to-mouth on a patient with active untreated TB. Page: 1298

51. If a paramedic is exposed to lice:

B) permethrin cream treatment may be prescribed and restrictions from patient care may be indicated until the paramedic is free of lice. Page: 1303

36. Common signs and symptoms of TB include all of the following, EXCEPT:

B) photophobia. Page: 1298

48. In males, infection with Chlamydia trachomatis would MOST likely lead to:

B) prostatitis. Page: 1302

72. A 49-year-old woman presents with a severe headache, a temperature of 103.2°F, and photosensitivity. Her blood pressure is 140/76 mm Hg, pulse rate is 120 beats/min and strong, and respiratory rate is 22 breaths/min and regular. While caring for this patient, it is MOST important to:

B) protect yourself from any nasopharyngeal secretions. Page: 1297

43. Transmission of gonorrhea occurs when contact is made with:

B) pus-containing fluid from the mucous membranes of the infected person. Page: 1301

9. In the context of a communicable disease, a ___________ is a place where organisms may live and multiply.

B) reservoir Page: 1296

29. Transmission of mumps occurs by direct contact with the ________ of an infected person.

B) saliva Page: 1315

64. If the source patient's blood tests positive for HIV:

B) the blood will be assessed for viral load and the exposed individual may be offered a 4-week trial of antiretroviral therapy. Page: 1306

58. Most patients infected with the hepatitis C virus are unaware that they acquired the infection because:

B) they do not develop phase 2 signs and symptoms. Page: 1305

16. When washing your hands after a call, you should:

B) use an antimicrobial, alcohol-based foam or gel. Page: 1290

30. In older adults, shingles arises when the _________ virus resides in the ganglion of a nerve.

B) varicella Page: 1315-1316

59. Which of the following statements regarding the hepatitis D virus (HDV) is MOST correct?

C) Infection with HDV requires the host to be infected with the hepatitis B virus. Page: 1304-1305

28. Which of the following statements regarding the mumps is correct?

C) Mumps presents with fever and swelling of the parotid glands. Page: 1315

3. Which of the following is NOT a factor in determining a person's risk of contracting an infectious disease following exposure?

C) The age and sex of the patient Page: 1295

79. After delivering a patient with a high fever and dry cough to the emergency department, you are later informed that the patient was diagnosed with severe acute respiratory syndrome. Reflecting back on the care you provided to the patient, you recall being in close proximity to her because she was hearing impaired, but you do not recall wearing a protective mask. What will MOST likely happen?

C) You may be quarantined for up to 10 days and will be asked to check your temperature daily. Page: 1317

6. Virulence is defined as the:

C) ability of an organism to invade and create disease in a host. Page: 1295

45. The primary infection with syphilis produces:

C) an ulcerative chancre at the site of infection. Page: 1301

12. In contrast to body substance isolation precautions, standard precautions:

C) emphasize protection from moist body substances that may transmit bacterial or viral infections. Page: 1294

74. You are dispatched to an apartment complex for a 20-year-old woman who is sick. When you arrive at the scene and begin assessing the patient, she tells you that she has been experiencing a purulent vaginal discharge, but denies vaginal bleeding or a fever. Her blood pressure is 104/64 mm Hg, pulse rate is 88 beats/min and strong, and respirations are 14 breaths/min and regular. This patient MOST likely has:

C) gonorrhea. Page: 1301

7. An individual's ability to fight off infection is called:

C) host resistance. Page: 1295

54. Early signs and symptoms of hepatitis B infection include all of the following, EXCEPT:

C) jaundice. Page: 1304

65. Hepatitis A is often described as a benign disease because:

C) lifelong immunity occurs once the disease is acquired. Page: 1308

33. Common signs and symptoms of meningitis include:

C) mental status changes, fever, stiff neck, and headache. Page: 1297

70. The MOST effective ways to protect your patients from nosocomial infections include:

C) not reporting to work when you are sick and keeping the interior of the ambulance clean and disinfected. Page: 1289

44. Gonorrhea in females:

C) often goes unnoticed until signs of acute abdomen appear. Page: 1301

50. Nocturnal itching and the presence of a rash involving the hands are indicative of:

C) scabies. Page: 1303

17. Most infectious disease exposures in health care providers occur due to:

C) sharps injuries. Page: 1292

38. A person who is taking antibiotic therapy following a positive TB skin test and chest radiograph should not consume alcohol because:

C) the antibiotics are toxic to the liver. Page: 1298

21. Work restriction guidelines enforced by OSHA require an employee to use sick time for an illness, unless:

C) the illness is the result of an occupational exposure. Page: 1294

27. When disinfecting the ambulance after transporting a patient with rubella, you should:

C) use standard disinfection procedures. Page: 1315

1. According to Part G of the Ryan White Comprehensive AIDS Resources Emergency Act, medical facilities are required to notify emergency responders of potentially infectious diseases involving patients they transported no longer than ___ hours from the time they have a suspect case.

D) 48 Page: 1288

24. The onset of fever commonly occurs as early as ___ days following exposure to the measles.

D) 7 Page: 1314

47. Which of the following statements regarding genital herpes is MOST correct?

D) Acyclovir is used to reduce a herpetic outbreak, but there is no cure. Page: 1302

15. Which of the following medical procedures would pose the LEAST risk of exposure to an infectious disease?

D) Assessing a patient's temperature by the oral route Page: 1290

19. Following a significant exposure, the source patient is routinely tested for all of the following, EXCEPT:

D) HBV antibody. Page: 1292-1293

31. Which of the following diseases is bacterial in nature, has an insidious onset, and is characterized by an irritating cough that may become paroxysmal in about 1 to 2 weeks?

D) Pertussis Page: 1316

68. Which of the following statements regarding West Nile virus (WNV) is correct?

D) There is no period of communicability because WNV is not transmitted from person to person. Page: 1308-1309

10. A health care worker's fear of contracting a communicable disease is MOST often the result of:

D) a lack of proper education and training. Page: 1289

35. A person with TB infection:

D) has tested positive for exposure to TB. Page: 1297-1298

63. Acquired immunodeficiency syndrome:

D) is characterized by the presence of opportunistic infections. Page: 1306

57. Occupationally acquired hepatitis C virus infection:

D) is related to a contaminated needlestick with visible blood on the sharp. Page: 1305

78. You and your partner are transferring a 76-year-old woman from a local nursing facility to the emergency department for evaluation of an acute onset of fever. While reviewing the transfer record, you note that the patient was recently treated with daptomycin. This patient MOST likely has:

D) methicillin-resistant staphylococcus aureus. Page: 1311

5. When a disease infects large numbers of people and spreads all over the world, it is considered a(n):

D) pandemic. Page: 1289

39. The leading cause of lower respiratory tract infections in infants, older people, and immunocompromised individuals is the:

D) respiratory syncytial virus. Page: 1299

62. Signs and symptoms of HIV infection may include all of the following, EXCEPT:

D) right upper quadrant pain. Page: 1306

52. Hepatitis B is also referred to as:

D) serum hepatitis. Page: 1304

73. While assessing a 59-year-old man with an acute onset of crushing chest pain and diaphoresis, the patient tells you that he recently tested positive to a tuberculin skin test. His vital signs reveal hypertension and tachycardia. You should be MOST concerned with:

D) the fact that he may be experiencing an acute myocardial infarction. Page: 1297-1298

53. Following exposure to the hepatitis B virus, a person may remain asymptomatic for up to:

A) 200 days. Page: 1304

55. The third dose of the three-series hepatitis B vaccine is given:

A) 6 months after the first dose. Page: 1304

13. Which of the following is NOT included in the Centers for Disease Control and Prevention's list of recommended immunizations and tests for health care providers?

A) Annual HIV testing Page: 1294

40. Mononucleosis is caused by the ___________________ and grows in the ________________.

A) Epstein-Barr virus, epithelium of the oropharynx Page: 1300

76. A known intravenous drug abuser presents with anorexia, body aches, a low-grade fever, and scleral icterus. She is very quiet and is not willing to share her medical history information with you. Which of the following additional clinical signs would reinforce your suspicion regarding the cause of this patient's condition?

A) Jaundiced skin Page: 1304

32. Which of the following statements regarding meningitis is correct?

A) Most epidemic outbreaks involve meningococcal meningitis. Page: 1297

25. Rubella is characterized by:

A) a low-grade fever. Page: 1314-1315

49. Chlamydia trachomatis is caused by a _________ and is treated with an _________.

A) bacterium, antibiotic Page: 1302-1303

41. The clinical presentation of mononucleosis includes:

A) fever, swollen lymph glands, and an enlarged spleen. Page: 1300

60. The primary target of infection with the human immunodeficiency virus is the:

A) immune system. Page: 1305-1306

67. In developing countries, there is a strong association between the hepatitis E virus and:

A) inadequate hygiene. Page: 1308

8. A person is exposed to the mumps virus, is asymptomatic for 16 days, and then becomes ill. The 16-day period is called the:

A) incubation period. Page: 1295

69. The avian flu:

A) is caused by a virus that occurs naturally in the bird population. Page: 1317

61. The communicable period for HIV:

A) is largely unknown. Page: 1306

80. You transported a patient with flu-like symptoms to the hospital 4 days ago. Your designated infection control officer advises you that the patient was diagnosed with the avian flu. If you documented an exposure to this patient, you will MOST likely be:

A) offered an antiviral medication. Page: 1317

46. Secondary syphilitic infection is characterized by all of the following, EXCEPT:

A) petechiae. Page: 1301

20. According to the Ryan White Comprehensive AIDS Resources Emergency Act, the medical facility must:

A) release the source patient's status to the designated infection control officer. Page: 1293

14. Personal protective equipment:

A) serves as a secondary protective barrier beyond what your body provides. Page: 1290

26. According to the Centers for Disease Control and Prevention, all children should be immunized against all of the following diseases, EXCEPT:

A) smallpox. Page: 1315

34. Antibiotic therapy following exposure to meningitis is NOT appropriate for individuals who are:

A) taking birth control pills. Page: 1297

75. A 70-year-old homeless man presents with a rash to his hands, wrists, and ankles. He denies any known allergies and states that the rash itches severely at night. His vital signs are stable, and he is breathing without difficulty. You should:

A) transport him to the hospital and thoroughly wash your hands after patient care has been completed. Page: 1303