Chapter 71: Infection PrepU
The nurse is educating a group of people on hepatitis B. One participant asks what is the usual incubation period for hepatitis B. Which of the following responses by the nurse is appropriate?
"45 to 160 days"
The nurse is caring for a patient diagnose with severe acute respiratory syndrome (SARS). A family member asks what causes SARS. Which of the following responses by the nurse is accurate?
"<italic>Coronavirus"
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."
A nurse is caring for the following clients who have a history of genital herpes infection. Which client is most at risk for an outbreak of genital herpes?
A client who complains of genital pruritus and paresthesia
Which of the following medications are used to suppress viral load of the HSV-2 infection?
Acyclovir (Zovirax)
A client comes to the emergency department complaining of sudden onset of diarrhea, anorexia, malaise, cough, headache, and recurrent chills. Based on the client's history and physical findings, the physician suspects legionnaires' disease. While awaiting diagnostic test results, the client is admitted to the facility and started on antibiotic therapy. What's the drug of choice for treating legionnaires' disease?
Azithromycin (Zithromax)
A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea?
Burning on urination
Which of the following is a term used to describe microorganisms present without host interference or interaction?
Colonization
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?
Divide the childs weight by 2.2 to convert to kg = 35 Multiple that out by 100 to get: Answer: 3500
The nurse is caring for a patient with a meningococcus infection. What type of precautions should be used for this patient?
Droplet
Symptoms of pelvic infection usually begin with which of the following?
Dyspareunia
After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment?
Genital herpes
The nurse is presenting a community lecture about STIs. She emphasizes that some STIs are easily cured with early and adequate treatment. Which of the following is not among these easily treated diseases?
Genital herpes
A physician tells a client to return 1 week after treatment to have a repeat culture done to verify the cure. This order would be appropriate for a woman with which condition?
Gonorrhea
Which of the following sexually transmitted infections (STIs) could be transmitted perinatally?
Herpes simplex
The nurse is admitting a patient with severe diarrhea. What is the most important element of assessment for this patient?
Hydration status
The nurse is caring for a client with genital herpes experiencing a reoccurrence. Which nursing diagnosis would be the priority?
Impaired Skin Integrity
In addition to standard precaution, contact precautions should be implemented for which of the following?
Impetigo
Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis?
Latency
Flu and cold season offers excellent examples of physiologic reflexes to ward off illness. One problem is that an effective mechanical defense for one person can complete a link in the chain of infection for someone else. To which link is the above referring?
Means of transmission
Which of the following can be used for rehydration therapy for diarrheal disorders?
Oral rehydration solution (ORS)
A client is suspected of sepsis from a postsurgical incision infection. What characteristic of sepsis would the nurse recognize? Select all that apply.
Temperature of 102°F Heart rate of 120 beats/minute Respiratory rate of 24 breaths/minute
Which statement reflects what is known about the Ebola and Marburg viruses?
The diagnosis should be considered in a patient who has a febrile, hemorrhagic illness after traveling to Asia or Africa.
You are teaching a health class in the local public health center. What instructions should you provide as the single most important measure to prevent the spread of infection?
Thorough handwashing
Nursing students are reviewing information about infectious diseases and events associated with infection. Students demonstrate understanding of the information when they identify the incubation period as which of the following?
Time between exposure and onset of symptoms
Nursing students are reviewing the various infectious diseases that require transmission-based precautions. The students demonstrate understanding of the information when they identify which infectious disease as requiring airborne precautions?
Tuberculosis
A patient is placed in isolation for suspected tuberculosis. Which of the following actions should the nurse take when entering the patient's room?
Wear an N-95 respirator.
A nurse is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention?
Foul-smelling discharge from the penis
The nurse is working in the labor and delivery suite when a client with active herpes simplex virus type 2 (HSV-2) appears in active labor. Which adjustment in the plan of care will the nurse prepare for?
Prepare for a cesarean section.
When developing a teaching plan for a client with syphillis, which of the following would be most important to include?
With proper treatment, the disease can eventually be cured.
The nurse is counseling a client who has been diagnosed with two sexually transmitted infections. The client is shocked and states not knowing how this has happened. Which of the following statements is most appropriate by the nurse?
"Your partner could have been asymptomatic at that time."
An adolescent informs the school nurse that she is afraid of contracting an STI but her boyfriend does not want to use condoms. What is the best response by the nurse?
A) I can understand your concern and you should bring him here so that I can talk with him B) If he won't use a condom, then he dosen't care about you C) you are too young to be having sex at all D) The use of condoms is one of the best ways to reduce the risk of acquiring an STI Answer: D
Which of the following is the gold standard for herpes simplex virus (HSV) diagnosis?
A) Punch Biopsy B) Shave Biopsy C) Culture D) Excisional Biopsy Answer: C- culture
A client is admitted with bacterial meningitis. Which hospital room is the best choice for this client?
An isolation room three doors from the nurses' station
A patient diagnosed with influenza is admitted to the hospital. Which of the following transmission-based precautions should the nurse initiate?
Droplet
A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), the physician orders diagnostic testing of the vaginal discharge. Which STD must be reported to the public health department?
Gonorrhea
Which of the following describes host interaction with an organism?
Infection
During flu season, you are teaching clients at your clinic about the chain of infection. Which of the following are considered "links" in this chain? Select all that apply.
Infectious agent Portal of entry Susceptible host
When assessing a client with suspected pertussis, which of the following would the nurse most likely find?
Paroxysmal cough
A 28-year-old sexually active male presented to a clinic because he was concerned about a round, painless sore on the shaft of his penis that had appeared 2 days prior to his visit. The nurse practitioner recognized the lesion as a "chancre," an indicator of primary syphilis. The nurse should tell the patient:
"An antibiotic injection is the best treatment since the lesion has just occurred."
The nurse is discussing information regarding the human papilloma viral (HPV) infection. Which statement, made by the client, requires clarification?
"HPV is spread during sexual intercourse."
The nurse is instructing the family on home care of a patient with shingles. The family member asks if their teenage children should stay in a different room. What is the best response by the nurse?
"Have they had chickenpox or the varicella vaccine?"
A nurse is assessing a woman with vaginal discharge. The nurse suspects bacterial vaginosis when the client states which of the following?
"I noticed a strange fishy odor during my period."
A nurse is teaching personal hygiene care techniques to a client with genital herpes. Which statement by the client indicates the teaching has been effective?
"I will wear loose cotton underwear.
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 recommended that pregnant women take the live virus. You should wait until after your child is born."
A client you are 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 your 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."
A 36-year-old patient is in the clinic for an annual physical. The patient asks the nurse "should I get a flu shot." Which of the following is the best response by the nurse?
"The flu shot is recommended for people over 6 months of age."
A nurse is developing a plan of care for a female client experiencing her first outbreak of genital herpes. Which nursing diagnosis would the nurse most likely identify as the priority?
Acute pain related to the development of the genital lesions
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?
CDC
Which of the following is the most frequent cause of diarrheal disease worldwide?
Campylobacter infection
The nurse is providing care to a client who has been diagnosed with gonorrhea. The nurse also prepares the client for treatment of which of the following?
Chlamydia
In which group is it most important for the client to understand the importance of an annual Papanicolaou test?
Clients infected with the human papillomavirus (HPV)
Which statement made by a client with a chlamydial infection indicates understanding of the potential complications?
I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day."
When preparing a presentation for a group of senior citizens, which vaccine would the nurse recommend that this age group receive annually?
Influenza
Which of the following is the most effective treatment for trichomoniasis?
Metronidazole (Flagyl)
The nurse is trying to determine if a patient admitted to the hospital the previous day has a bacterial wound infection. What laboratory study should the nurse review to obtain this information?
Microbiology report
The six elements necessary for infection include a causative organism, a reservoir of available organisms, a portal or mode of exit from the reservoir, a mode of transmission from reservoir to host, a susceptible host, in addition to which of the following?
Mode of entry to host
The nurse is required to manage and minimize sepsis in a patient with severe infection. Which of the following would be an appropriate nursing intervention?
Monitor the patient's vital signs
A patient comes to the clinic with complaints of a painless sore on her lip 2 weeks after she had oral sex with her boyfriend. The nurse observes a chancre on the lips and the physician orders testing for syphilis. If results are positive, what is the likely stage the patient is in?
Primary
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 during suctioning, and then apply a mask to the client's face for transport.
Pelvic infection is most commonly caused by which of the following?
Sexual transmission
An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported?
Syphilis
When a hospitalized patient is in contact precautions, which of the following responses is necessary?
The patient should be placed in a private room when possible.
How often should women diagnosed with human papillomavirus (HPV) have Pap smears?
Yearly
An 82-year-old client is admitted to the hospital with a diagnosis of pneumonia. The nurse learns that the client lives alone and hasn't been eating or drinking properly. When assessing the client for dehydration, the nurse would expect to find:
tachycardia
A nurse is teaching a client with genital herpes. Education for this client should include an explanation of:
the importance of informing his partners of the disease.
The nurse teaches the parent of the child with chickenpox that the child is no longer contagious to others when
the vesicles and pustules have crusted.
A client is in the acute care facility for the administration of intravenous (IV) antibiotics to treat bacterial pneumonia. The client begins to have severe diarrhea 3 days after the IV antibiotics with abdominal cramping and pain. What does the nurse suspect the client has developed due to the antibiotic use?
Pseudomembranous colitis
The nurse is caring for a client with an abscess on his back. The nurse observes purulent drainage coming from the abscess. What type of specimen does the nurse anticipate the physician will order to determine the type of bacteria present in the exudate?
A culture
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?
Hand hygiene
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis?
A painless genital ulcer that appeared about 3 weeks after unprotected sex
A nurse is having a yearly employee tuberculin skin test. Which skin test results would indicate a positive result?
A) An induration of 4mm B) An uneven erythemic area C) An induration of less than 1 mm D) An induration of 12mm Answer: D an induration of 12mm
A client is diagnosed with a methicillin-resistant staphylococcus aureus (MRSA) infection. When developing the client's plan of care, the nurse would include which of the following?
Administration of prescribed vancomycin
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?
All parts of the chain of infection have to be present for the disease to be passed to another human
A client comes to the clinic and informs the nurse that he has a "painful area under his armpit."The nurse observes a 2-cm raised area that is erythremic and has a white substance inside of it. What does the nurse suspect the patient may be experiencing?
An abscess
The nurse is providing discharge instructions to a female client following inpatient therapy for a gonorrhea infection. The client is being discharged on doxycycline (Vibramycin) for 7 days. Which nursing instruction is essential for a therapeutic outcome?
Complete all prescribed medication.
A nurse has heard that there have been three cases of pertussis in the community and wants to make sure his or her inoculations are up to date. What action should the nurse take?
Have a single-dose Tdap administered.
The nurse is observing a nursing assistant leave the room of patient diagnosed with <italic>Clostridium difficile (<italic>C. difficile) without washing hands. Which of the following is the highest priority action the nurse should follow?
Have the nursing assistant wash hands with soap and water.
The nurse is completing the admission assessment on a patient with renal failure. The patient states, "I was diagnosed with impetigo yesterday." Which of the following is the appropriate nursing intervention?
Initiate contact isolation protocol.
A client has been admitted with diarrhea. He has mild dehydration (less than 5%). The nurse is reviewing the laboratory report of the stool specimen, as indicated in the following: WBC: Mildly elevated RBC: Few Bacteria: Positive for Escherichia coli Ova and parasites: Negative Based on the laboratory report, what should the nurse do first?
Institute enteric precautions.
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?
Instruct the patient not to drink alcohol with this treatment.
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:
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
