Connect 18

Which of the following is a gram-positive bacterium?

Staphylococcus aureus

In anthrax, Bacillus anthracis gains access to the bloodstream where it multiplies in large numbers resulting in death from an overwhelming ________.

septicemia

5. Which of the following conditions occurs if the bloodborne bacteria colonize the heart valves, causing impaired cardiac function? - Acute endocarditis - Myocarditis - Subacute endocarditis and myocarditis - Subacute endocarditis ***A 54-year-old female is admitted to the postsurgical unit following an emergency appendectomy. The surgical course was uncomplicated. 24 hours following surgery, the patient is noted to have a fever of 103°F, high heart rate, low blood pressure, and altered level of consciousness. She is transferred to the intensive care unit for close monitoring and resuscitation.

- Acute endocarditis

4. Once a diagnosis of HIV is confirmed, which of the following types of drug therapy would the nurse expect to be prescribed? - Prophylaxis for ADIs - Reverse transcriptase inhibitor - Protease inhibitor - All of these choices are correct. ***A 46-year-old male presents to a clinic reporting exposure to HIV two weeks prior. He reports a five day history of lethargy and persistent fever. The RN performs an assessment of the patient and sends clinical diagnostic tests as ordered. The patient appears anxious and the RN provides education regarding HIV infection and the treatment plan.

- All of these choices are correct.

2. The RN provides education for the patient regarding confirmation of the suspected diagnosis. Which of the following tests is most likely to be ordered? - Serum culture - Western blot test - Antibody titer - PCR ***A patient calls to speak with a telephone advice RN with concern regarding a localized rash. She reports a tick bite on her right flank with a pale center and red diffuse ring. She also reports a persistent fever and headache.

- Antibody titer

4. Which of the following drug therapies is ordered initially? - Antibiotic identified from susceptibilities - Multiple narrow-spectrum antibiotics - Broad-spectrum antibiotic - Antifungals ***A 54-year-old female is admitted to the postsurgical unit following an emergency appendectomy. The surgical course was uncomplicated. 24 hours following surgery, the patient is noted to have a fever of 103°F, high heart rate, low blood pressure, and altered level of consciousness. She is transferred to the intensive care unit for close monitoring and resuscitation.

- Broad-spectrum antibiotic

Select the phrases that apply to all of the following nonhemorrhagic fever diseases: brucellosis, Q fever, cat-scratch disease, and Rocky Mountain spotted fever. - Caused by a gram-negative bacterium - Most can be treated with doxycycline - Bacterium causing the disease is transmitted by a vector - Vaccines are available - Cause capillary fragility

- Caused by a gram-negative bacterium - Most can be treated with doxycycline

Select all of the descriptions that apply to the hemorrhagic disease yellow fever. - Caused by an arbovirus - Virus causes capillary fragility and disrupts the blood clotting system - Vector is the hard tick - No vaccine is available - Vector is the mosquito

- Caused by an arbovirus - Virus causes capillary fragility and disrupts the blood clotting system - Vector is the mosquito

4. Which of the following drug therapies is most effective in early treatment of this disease? - Ceftriaxone and amoxicillin - Doxycycline and penicillin - Ceftriaxone and penicillin - Doxycycline and amoxicillin ***A patient calls to speak with a telephone advice RN with concern regarding a localized rash. She reports a tick bite on her right flank with a pale center and red diffuse ring. She also reports a persistent fever and headache.

- Doxycycline and amoxicillin

2. Which of the following is/are the most likely causative organism(s) for this patient's condition? - Gram-negative bacteria - Fungi - Gram-positive bacteria - Gram-negative bacteria or gram-positive bacteria ***A 54-year-old female is admitted to the postsurgical unit following an emergency appendectomy. The surgical course was uncomplicated. 24 hours following surgery, the patient is noted to have a fever of 103°F, high heart rate, low blood pressure, and altered level of consciousness. She is transferred to the intensive care unit for close monitoring and resuscitation.

- Gram-negative bacteria or gram-positive bacteria

Select all of the statements that apply to HIV and AIDS. - An effective vaccine is available to prevent HIV infection. - HIV can infect and/or destroy many of the very cells needed to combat it, including the helper (T4 or CD4) class of lymphocytes, monocytes, macrophages, and even B lymphocytes. - Neonates who have escaped HIV infection prior to and during birth can still become infected through nursing. - In the United States, people are diagnosed with AIDS once they are positive for HIV. - ART, the use of multiple simultaneous antiretrovirals, has shown to be an effective treatment and has reduced the rate of HIV drug resistance.

- HIV can infect and/or destroy many of the very cells needed to combat it, including the helper (T4 or CD4) class of lymphocytes, monocytes, macrophages, and even B lymphocytes. - Neonates who have escaped HIV infection prior to and during birth can still become infected through nursing. - ART, the use of multiple simultaneous antiretrovirals, has shown to be an effective treatment and has reduced the rate of HIV drug resistance.

Select all of the statements that apply to the pathogenesis of malaria to test your understanding of this disease. - Fever is constant without the presence of chills. - Hypoglycemia is a symptom due to parasite metabolism of glucose. - Damage to white blood cells results in anemia. - The liver and spleen become enlarged. - RBCs adhere to blood vessels in the brain.

- Hypoglycemia is a symptom due to parasite metabolism of glucose. - The liver and spleen become enlarged. - RBCs adhere to blood vessels in the brain.

Select all of the statements that apply to malaria to test your understanding of this disease. - An effective vaccine is routinely used throughout the world. - It is caused by five species of the protozoan Plasmodium. - The vector is the mosquito. - The parasite goes through a sexual and asexual phase during development. - Bed nets soaked in insecticide help reduce risk of infection.

- It is caused by five species of the protozoan Plasmodium. - The vector is the mosquito. - The parasite goes through a sexual and asexual phase during development. - Bed nets soaked in insecticide help reduce risk of infection.

***A patient calls to speak with a telephone advice RN with concern regarding a localized rash. She reports a tick bite on her right flank with a pale center and red diffuse ring. She also reports a persistent fever and headache. 1. Which of the following is the most likely cause of the patient's rash, based upon her reported history and symptoms? - Lyme disease - Tularemia - Rocky Mountain spotted fever - Plague

- Lyme disease

3. The physician orders blood cultures, antibiotic therapy, oxygen administration, and a fluid bolus for blood pressure support. The RN most appropriately prioritizes these tasks in which order? - Oxygen administration, fluid bolus, blood culture, antibiotic initiation - Blood culture, antibiotic initiation, oxygen administration, fluid bolus - Fluid bolus, oxygen administration, antibiotic initiation, blood culture - Antibiotic initiation, oxygen administration, fluid bolus, blood culture ***A 54-year-old female is admitted to the postsurgical unit following an emergency appendectomy. The surgical course was uncomplicated. 24 hours following surgery, the patient is noted to have a fever of 103°F, high heart rate, low blood pressure, and altered level of consciousness. She is transferred to the intensive care unit for close monitoring and resuscitation.

- Oxygen administration, fluid bolus, blood culture, antibiotic initiation

Evaluate the statements below, and select those that correctly apply to the progression of plague. - Plague is caused by Yersinia pestis, a gram-negative rod that displays a "safety-pin" staining pattern. - Bubonic plague can spread via human-to-human transmission through respiratory droplets. - Veterinarians, the most at-risk group for developing plague, are protected by a routine vaccine. - Transmission of Yersinia occurs when fleas, the vector, carry the organism from one mammal reservoir to another. - Bubonic plague can progress to septicemic plague, whereby the organism proliferates in the blood. - Yersinia has a low infectious dose; only 3-50 organisms needed to cause disease due to effective virulence factors. - Fleas are the endemic reservoirs for Yersinia, they carry it in their gut easily transmitting it when they bite. - Bubonic and pneumonic plague are both caused by Yersinia pestis but the modes of transmission differ.

- Plague is caused by Yersinia pestis, a gram-negative rod that displays a "safety-pin" staining pattern. - Transmission of Yersinia occurs when fleas, the vector, carry the organism from one mammal reservoir to another. - Bubonic plague can progress to septicemic plague, whereby the organism proliferates in the blood. - Yersinia has a low infectious dose; only 3-50 organisms needed to cause disease due to effective virulence factors. - Bubonic and pneumonic plague are both caused by Yersinia pestis but the modes of transmission differ.

***A 54-year-old female is admitted to the postsurgical unit following an emergency appendectomy. The surgical course was uncomplicated. 24 hours following surgery, the patient is noted to have a fever of 103°F, high heart rate, low blood pressure, and altered level of consciousness. She is transferred to the intensive care unit for close monitoring and resuscitation. 1. The RN is suspicious of an infection in the patient's blood. Which of the following terms is descriptive of an infection of the bloodstream? - Serocemia - Endocarditis - Septicemia - Hemecemia

- Septicemia

3. Which of the following statements by the patient demonstrates a proper understanding of the nurse's teaching about AIDS? - I may transmit HIV through saliva - Receiving an HIV vaccine would have prevented my infection - There is no cure for HIV - My HIV infection will progress to AIDS ***A 46-year-old male presents to a clinic reporting exposure to HIV two weeks prior. He reports a five day history of lethargy and persistent fever. The RN performs an assessment of the patient and sends clinical diagnostic tests as ordered. The patient appears anxious and the RN provides education regarding HIV infection and the treatment plan.

- There is no cure for HIV

5. The patient asks the RN how she may have acquired this disease. Which of the following is the most common vector? - Deer - Humans - Ticks - Mice ***A patient calls to speak with a telephone advice RN with concern regarding a localized rash. She reports a tick bite on her right flank with a pale center and red diffuse ring. She also reports a persistent fever and headache.

- Ticks

5. All of the following are essential education points by the RN, except ________. - use of barrier protection during sex - restriction on blood donation until viral levels are undetectable - symptoms of AIDS-defining illnesses - side effects of antiretroviral therapy ***A 46-year-old male presents to a clinic reporting exposure to HIV two weeks prior. He reports a five day history of lethargy and persistent fever. The RN performs an assessment of the patient and sends clinical diagnostic tests as ordered. The patient appears anxious and the RN provides education regarding HIV infection and the treatment plan.

- restriction on blood donation until viral levels are undetectable

Select all of the phrases that apply to subacute endocarditis. - Most often caused by Staphylococcus aureus -Most often caused by low pathogenicity oral streptococci - Almost always preceded by some form of damage to heart valves - Involves colonization of normal heart valves - Prevention involves prophylactic antibiotic therapy before invasive procedures

-Most often caused by low pathogenicity oral streptococci - Almost always preceded by some form of damage to heart valves - Prevention involves prophylactic antibiotic therapy before invasive procedures

3. What further symptoms can emerge if this disease is left untreated? - Arthritis - Neurological symptoms - Cardiac symptoms - All of these choices are correct. ***A patient calls to speak with a telephone advice RN with concern regarding a localized rash. She reports a tick bite on her right flank with a pale center and red diffuse ring. She also reports a persistent fever and headache.

All of these choices are correct. - Arthritis - Neurological symptoms - Cardiac symptoms

***A 46-year-old male presents to a clinic reporting exposure to HIV two weeks prior. He reports a five day history of lethargy and persistent fever. The RN performs an assessment of the patient and sends clinical diagnostic tests as ordered. The patient appears anxious and the RN provides education regarding HIV infection and the treatment plan. 1. HIV is a retrovirus in the genus Lentivirus. Which of the following is true of retroviruses? - Contain reverse transcriptase - Display structural features of enveloped RNA viruses - Catalyze DNA replication from RNA - All of these choices are correct.

All of these choices are correct. - Contain reverse transcriptase - Display structural features of enveloped RNA viruses - Catalyze DNA replication from RNA

The bite of a tick can cause ______.

All of these: - ehrlichiosis - Lyme disease - anaplasmosis

Choose the phrase that best describes the virulence factor shared by the yellow fever, Dengue fever, Ebola, Marburg, and Lassa fever viruses to test your understanding of hemorrhagic fever diseases.

Associated with disruption of clotting factors

Which of the following diseases is characterized by the formation of a biofilm?

Endocarditis

Which of the following diseases is caused by a retrovirus?

HIV

Choose the phrase that correctly describes acute endocarditis.

Most often caused by Staphylococcus aureus

Choose the phrase that best describes septicemia.

Occurs when microorganisms are actively multiplying in the blood

Anthrax is a good potential bioterrorism weapon because Bacillus anthracis is a spore-forming bacterium that initiates disease symptoms that mimic many other infections.

TRUE

Hemorrhagic fever diseases such as yellow fever, Dengue fever, and Ebola are caused by ________, whereas nonhemorrhagic fever diseases such as brucellosis, Q fever, and cat-scratch fever have ________ as the causative agents of disease.

viruses; bacteria