Ch. 24- 24.3 List the common patient presentation, treatment, standard precautions and postexposure actions for each diseases.
A patient displays swelling of his parotid glands, which makes you suspect mumps. You ask this patient when the onset of swelling occurred, because if this patient is sick with mumps, he should avoid contact with other people for __________ after the appearance of the swelling. A. 5 days B. 24 hours C. 2 weeks D. 3 months
A. 5 days Sick patients should avoid contact with other people for 5 days after the swelling appears.c
A patient tells you that he has heard that receiving flu vaccinations can often be harmful and rarely works anyway, so they should be avoided. What do you tell him? A. An influenza vaccination won't always protect against every type of flu, but it rarely has adverse effects, and is often effective. B. Adverse effects from influenza vaccinations aren't that severe, so it's really not that much of a risk to get one. C. An influenza vaccination will protect against every type of flu in nearly all cases, and never has adverse effects. D. If you've had the flu before, then a vaccination isn't necessary, but otherwise everyone should be vaccinated once.
A. An influenza vaccination won't always protect against every type of flu, but it rarely has adverse effects, and is often effective. Each year, an influenza vaccine is released that works against several of the viruses that scientists believe will be the most common that season. Some years their educated guesses are better than others, but there are very few serious adverse effects, and EMTs, like other healthcare providers, should get vaccinated to prevent spreading influenza to their patients. The comment about the severity of adverse effects from influenza vaccinations might not be true, and fails to address the claim that these vaccines are ineffective. The other claims are false.
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. Briefly explain that the Standard Precautions you would use with any patient are sufficient here as well. B. Say that given the infection risk, the neighbor should stay well away from the scene. C. Signal to your partner to continue to the patient while you engage the neighbor's misconceptions. D. Inform this person that it's illegal to interfere with an EMT on duty responding to a call.
A. Briefly explain that the Standard Precautions you would use with any patient are sufficient here as well. By saying that the Standard Precautions you would use for any patient are sufficient here as well, you tell the truth while also not getting bogged down with the neighbor when you need to respond to the patient's emergency. It's not appropriate to delay care to engage in a debate with the neighbor, and the other answers involve spreading or reinforcing misinformation.
For how long is a patient with croup contagious? A. During the incubation period and until 10 days after symptoms start B. Only during the incubation period, and not when the patient becomes symptomatic C. From the beginning of the incubation period until the end of treatment D. Only after the patient becomes symptomatic and for 10 days after that
A. During the incubation period and until 10 days after symptoms start
For which disease would prevention efforts focus on proper hand hygiene and food-preparation techniques? A. Hepatitis A B. AIDS C. Hepatitis B D. Hepatitis C
A. Hepatitis A Prevention efforts for hepatitis A focus on proper hand hygiene and food-preparation techniques because this disease is transmitted through the fecal-oral route, which is not the route of transmission for these other diseases. Next Question
Your partner is reluctant to treat a patient he learns is infected with HIV. What do you do? A. Remind him that healthcare providers can avoid infection with Standard Precautions. B. Agree to treat the patient while your partner prepares the ambulance for transport. C. Advise the patient that safe prehospital care for HIV-infected patients is impossible. D. It's impossible for HIV to be transmitted from person to person, so he should relax.
A. Remind him that healthcare providers can avoid infection with Standard Precautions. You should remind your partner that healthcare providers can avoid infection with Standard Precautions.
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. Wear an N-95 respirator or at least a surgical mask. B. When coughing or sneezing, turn away from others, and use a disposable tissue or your sleeve. C. Get a vaccination against this type of pneumonia. D. Observe proper hand hygiene at all times.
A. Wear an N-95 respirator or at least a surgical mask. Prevention of pneumococcal pneumonia consists of vaccination, hand hygiene, and cough etiquette (when coughing or sneezing, turning away from others and using a disposable tissue or one's sleeve). It does not include wearing an N-95 respirator or surgical mask.
A patient with HIV who is a teacher tells you he has faced protests from parents who are against his continuing to teach. He has been receiving treatment with antiviral medication for a long time. What do you tell him? A. It's likely that his medication has mostly suppressed the virus. B. He is still highly contagious, so better safe than sorry. C. Perhaps he should consider a different kind of educational role. D. Those parents are right to be concerned for their children
A. It's likely that his medication has mostly suppressed the virus. Treatment has led to many patients' having undetectable viral loads, making it virtually impossible for them to transmit the virus. Given that this patient has been receiving antiviral treatment for a long time, it's likely that he's no longer an infection risk. The other answers validate the panic-driven view that he is highly contagious. Next Question
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. Inform your partner later that you thought immediately washing the exposed area was unprofessional. B. Explain that washing the exposed area in such cases is necessary to do right away. C. Ask your partner to finish washing the exposed area later. D. Tell the patient that hepatitis B infection is no small concern, and not to worry about your partner's actions.
B. Explain that washing the exposed area in such cases is necessary to do right away. If you sustain a significant exposure to blood or other body fluids, wash the site with soap and water (just water for an eye exposure) and see a healthcare provider right away. Telling the patient not to worry about your partner's actions doesn't explain them. It isn't appropriate to ask your partner to wash the exposed area later or to inform her that her actions were unprofessional. Next Question
Pertussis outbreaks have become more common in your state in recent years. If people express their concerns about this to you, what do you tell them? A. Antibiotics are the best means of prevention. B. The disease can be prevented by vaccination. C. People should wear N-95 respirators daily as a precautionary measure. D. People should avoid places like homeless shelters, nursing homes, and jails.
B. The disease can be prevented by vaccination. The disease can be prevented by vaccination. Antibiotics can reduce the period of communicability but are not a means of prevention. Homeless shelters, nursing homes, and jails are high-risk locations for tuberculosis. N-95 respirators are a necessary precaution for tuberculosis. Next Question
If you are exposed to influenza, your healthcare provider may decide it is prudent for you to: A. take a round of antibiotics. B. take an antiviral medication. C. receive a vaccination against influenza. D. avoid contact with others for at least 5 days.
B. take an antiviral medication If you are exposed to someone with influenza, your healthcare provider may decide it is prudent for you to take an antiviral medication. The other actions are not postexposure actions for influenza.
At a nursing home, there have been several recent cases of pneumococcal pneumonia. You learn from a resident of the home that visits there have sharply declined because of this. What do you say about this issue? A. Visitors are right to stay away until the exact cause has been determined. B. Currently healthy people are at greatest risk for infection from this disease. C. Close contact for long periods is usually required for the infection to spread to a healthy person. D. Most cases of infection from this disease occur from contact with visitors to places like nursing homes.
C. Close contact for long periods is usually required for the infection to spread to a healthy person. Close contact for long periods is usually required for the infection to spread to a healthy person. The visitors are being overly cautious, and the populations at the greatest risk from this disease are those at the extremes of age or with compromised immune systems. Visitors to places like nursing homes are not the cause of most cases of this infection.
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. Tell her that it is standard procedure to wear N-95 respirators in response to any suspected infections. B. Ask her if she would prefer you and your partner wear surgical masks. C. Explain that because you suspect an airborne disease, the respirators are to prevent the infection from spreading. D. Tell her that if she had received the TB vaccine, she would not currently be infected.
C. Explain that because you suspect an airborne disease, the respirators are to prevent the infection from spreading. You should honestly explain the reason you and your partner are wearing the respirators. Surgical masks would not be effective against TB. N-95 respirators are not necessary in response to infections that are not airborne. The TB vaccine is not very effective, and you don't know for sure that the patient has TB.
Treatment of croup: A. requires vaccination. B. involves antibiotics. C. is symptomatic. D. is unnecessary for previously infected patients.
C. is symptomatic. Treatment of croup is symptomatic. There is no vaccine against the virus that causes croup, and it is possible to be reinfected. Because croup is caused by a virus, antibiotics do not help.
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. You can talk to his siblings to inform them of the facts, if that is what he would like you to do. B. If he agrees with his siblings for the good of their children, then that's his decision, and you completely respect and support it. C. The best thing to do with the kind of ignorance his siblings have displayed is to ignore it and nurture other relationships. D. It's easy to avoid HIV infection with simple precautions, and with proper treatment he may not even be contagious.
D. It's easy to avoid HIV infection with simple precautions, and with proper treatment he may not even be contagious. You should address your patient's understanding of how HIV is transmitted and of his own contagion risk. The other answers avoid doing this.
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 as long as these people have been properly vaccinated against TB as well. B. ineffective, because TB is a bloodborne, not an airborne, illness. C. effective, because wearing a surgical mask is the minimum acceptable precaution against TB. D. ineffective, because these masks do not filter out the particles that cause this disease.
D. ineffective, because these masks do not filter out the particles that cause this disease. Prevention for TB, an airborne illness, consists primarily of having a high index of suspicion in a patient with respiratory symptoms and taking airborne disease precautions—i.e., using an N-95 respirator. A surgical mask does not filter out the small particles that spread the disease. Although there is a vaccine for TB (the BCG vaccine), it is not that effective, so its use is usually restricted to areas where TB is very common.