Evolve: Infectious Disease

A client is admitted with the diagnosis of tetanus. For which clinical indicators should the nurse assess the client? (Select all that apply.) 1 Restlessness 2 Muscular rigidity 3 Atony of facial muscles 4 Respiratory tract spasms 5 Spastic voluntary muscle contractions

1 Restlessness 2 Muscular rigidity 4 Respiratory tract spasms 5 Spastic voluntary muscle contractions

A client has a Mantoux test as part of a yearly physical examination. The area of induration is 10 mm within 48 hours after having the test. The nurse concludes that this response indicates that the client has: 1 Contracted clinical tuberculosis 2 Passive immunity to tuberculosis 3 Been exposed to the tubercle bacillus 4 Developed a resistance to the tubercle bacillus

Correct3 Been exposed to the tubercle bacillus

A client with acquired immunodeficiency syndrome (AIDS) comments to the nurse, "There are so many rotten people around. Why couldn't one of them get AIDS instead of me?" The nurse's best response is:

"It seems unfair that you should be so ill."

A nurse is planning to provide discharge teaching to the family of a client with acquired immunodeficiency syndrome (AIDS). Which statement should the nurse include in the teaching plan?

"Wash used dishes in hot, soapy water."

A client presents to the emergency department with a fever, headache, loss of appetite, and malaise. The nurse identifies raised red bumps on the client's arms and legs. A diagnosis of chickenpox is made. The client should be placed in a private room with what kind of precautions? 1 Contact precautions 2 Droplet precautions 3 Airborne precautions 4 No additional precautions other than standard precautions

3 Airborne precautions Chickenpox is transmitted from person to person by directly touching the blisters, saliva, or mucus of an infected person. The virus can also be transmitted through the air. Chickenpox can be spread indirectly by touching contaminated items freshly soiled, such as clothing, from an infected person.

A nurse observes that an unlicensed assistive personnel (UAP) did not use a bag impervious to liquid for contaminated linen from a client who is on contact precautions. The nurse's best way to handle this situation is to: 1 Place the linen in an appropriate bag 2 Write an incident report about the situation 3 Review transmission-based precautions with the UAP 4 Place an anecdotal summary of the behavior in the UAP's personnel record

3 Review transmission-based precautions with the UAP

After surgery a client is to receive an antibiotic by intravenous (IV) piggyback in 50 mL of a diluent. The piggyback is to infuse in 20 minutes. The drop factor of the IV set is 15 gtts/mL. The nurse should set the piggyback to flow at how many gtts/min? Record your answer using a whole number. __________ gtts/min

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A nurse is teaching a client about drug therapy for gonorrhea. Which fact about drug therapy should the nurse emphasize?

Cures the infection

A client developed acute herpes zoster and was treated with antiviral medication within 72 hours of the appearance of the rash. The client is reporting persistent pain one week later. What does the nurse identify as the cause of the post therapeutic neuralgia?

Damage to the nerves

A client with scleroderma reports having difficulty chewing and swallowing. What should the nurse recommend to safely facilitate eating?

Eat a mechanical soft diet

Before the nurse can be an advocate for a client who is homosexual who has acquired immunodeficiency syndrome (AIDS), the nurse needs to do what?

Identify personal attitudes and feelings about homosexuality

A mother with the diagnosis of acquired immunodeficiency disease (AIDS) states that she has been caring for her baby even though she has not been feeling well. What important information should the nurse determine?

If the baby is breastfeeding

A nurse is counseling a client who has gonorrhea. What additional fact about gonorrhea, besides the fact that it is highly infectious, should the nurse teach this client?

It can produce sterility.

A nurse is developing a teaching plan for a client with scleroderma. What should the nurse include about skin care?

Keep skin lubricated with lotion

The nursing staff has a team conference on acquired immunodeficiency syndrome (AIDS) and discusses the routes of transmission of the human immunodeficiency virus (HIV). The discussion reveals that there is no risk of exposure to HIV when an individual:

Makes a donation of a pint of whole blood

Which disease is caused by protozoa?

Malaria

The nurse explains to a client that a positive diagnosis for human immunodeficiency virus (HIV) infection is made based on:

Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests

The nurse cares for a client who develops pyrexia three days after surgery. The nurse should monitor the client for which signs and symptoms commonly associated with pyrexia? (Select all that apply.)

Tachypnea Increased pulse rate

A nurse is preparing a teaching plan for a client with syphilis. The nurse includes that syphilis is not considered contagious in the:

Tertiary stage

A client arrives at the clinic after being bitten by a raccoon in an area in the woods where rabies is endemic. When considering the client's needs, the nurse recalls that rabies is a:

Viral infection characterized by convulsions and difficulty swallowing

A nurse is caring for a client who has been taking several antibiotic medications for a prolonged time. Because long-term use of antibiotics interferes with the absorption of fat, the nurse anticipates a prescription for:

Water-soluble forms of vitamins A and E

A client is admitted with the diagnosis of tetanus. For which clinical indicators should the nurse assess the client? (Select all that apply.)

1 Restlessness 2 Muscular rigidity 4 Respiratory tract spasms 5 Spastic voluntary muscle contractions

The nurse is reviewing blood screening tests of the immune system of a client with acquired immunodeficiency syndrome (AIDS). The nurse expects to find:

A decrease in CD4 T cells

A client is diagnosed with herpes genitalis. What should the nurse do to prevent cross-contamination?

Wear a gown and gloves when giving direct care.

A chronically ill, older client tells the home care nurse that the daughter with whom the client lives seems run-down and disinterested in her own health, as well as the health of her children, who are 5, 7, and 12 years old. The client tells the nurse that the daughter coughs a good deal and sleeps a lot. Why is it important that the nurse pursue the daughter's condition for potential case finding?

Older adults with chronic illness are more susceptible to tuberculosis.

After several years of unprotected sex, a client is diagnosed as having acquired immunodeficiency syndrome (AIDS). The client states, "I'm not worried because they have a cure for AIDS." The best response by the nurse is:

"There is no cure for AIDS but there are drugs that can slow down the virus."

A female client is upset with her diagnosis of gonorrhea and asks the nurse, "What can I do to prevent getting another infection in the future?" The nurse evaluates that the teaching is understood when the client states, "My best protection is to: 1 Douche after every intercourse." 2 Avoid engaging in sexual behavior." 3 Insist that my partner use a condom." 4 Use a spermicidal cream with intercourse."

3 Insist that my partner use a condom."

An older client with a history of congestive heart failure expresses concern about potential exposure to tuberculosis. The client states that a roommate at the extended care facility where the client resides sleeps a lot, coughs a great deal, and sometimes spits up blood. The primary reason that the nurse pursues more information about the roommate is because:

Older adults with chronic illness are affected adversely by tuberculosis

A nurse is caring for a client with acquired immunodeficiency syndrome (AIDS). What precautions should the nurse take when caring for this client? 1 Use standard precautions. 2 Employ airborne precautions. 3 Plan interventions to limit direct contact. 4 Discourage long visits from family members.

1 Use standard precautions.

A client receiving chemotherapy takes a steroid daily. The client has a white blood cell count of 12,000/mm3 and a red blood cell count of 4.5 million/mm3. What is the priority instruction that the nurse should teach the client?

Avoid large crowds and persons with infections

The health care provider prescribes peak and trough levels of an antibiotic for a client who is receiving the medication intravenous piggyback (IVPB). For peak levels the nurse should have the laboratory obtain a blood sample from the client:

Between 30 and 60 minutes after the IVPB

A client scheduled for surgery has a history of methicillin-resistant Staphylococcus aureus (MRSA) since developing an infection in a surgical site nine months ago. The site is healed and the client reports having received antibiotics for the infection. What should the nurse do to determine if the infecting organism is still present?

Obtain a prescription to culture the client's blood

Ampicillin 250 mg by mouth every six hours is prescribed for a client who is to be discharged. Which statement indicates to the nurse that the client understands the teaching about ampicillin? 1 "I should drink a glass of milk with each pill." 2 "I should drink at least six glasses of water every day." 3 "The medicine should be taken with meals and at bedtime." 4 "The medicine should be taken one hour before or two hours after meals."

4 "The medicine should be taken one hour before or two hours after meals."

A nurse is caring for a client with a diagnosis of acute salpingitis. Which condition most commonly causing inflammation of the fallopian tubes should the nurse include when planning a teaching program for this client?

Gonorrhea

After several years of unprotected sex, a client is diagnosed as having acquired immunodeficiency syndrome (AIDS). The client states, "I'm not worried because they have a cure for AIDS." The best response by the nurse is: 1 "Repeated phlebotomies may be able to rid you of the virus." 2 "You may be cured of AIDS after prolonged pharmacological therapy." 3 "Perhaps you should have worn condoms to prevent contracting the virus." 4 "There is no cure for AIDS but there are drugs that can slow down the virus."

4 "There is no cure for AIDS but there are drugs that can slow down the virus."

A nurse observes that an unlicensed assistive personnel (UAP) did not use a bag impervious to liquid for contaminated linen from a client who is on contact precautions. The nurse's best way to handle this situation is to:

Review transmission-based precautions with the UAP

What is the primary focus of nursing care for a client admitted with tetanus caused by a puncture wound? 1 Monitoring urinary output 2 Decreasing external stimuli 3 Maintaining body alignment 4 Encouraging high intake of fluid

2 Decreasing external stimuli The slightest stimulation can set off a wave of severe, painful muscle spasms involving the whole body. Nerve impulses cross the myoneural junction and stimulate muscle contraction caused by exotoxins produced by Clostridium tetani. Monitoring urinary output is not a major nursing concern for clients with tetanus. Body alignment is not an important consideration for clients with tetanus. Oral intake of fluids may not be possible because of excessive secretions and laryngospasms.

When assessing the oral cavity of a newly admitted client with acquired immunodeficiency syndrome (AIDS), the nurse identifies areas of white plaque on the client's tongue and palate. What is the nurse's initial response? 1 Scrape an area of one of the lesions and send the specimen for a biopsy. 2 Instruct the client to perform meticulous oral hygiene at least once daily. 3 Document the presence of the lesions, describing their size, location, and color. 4 Consider that these lesions are universally found in clients with AIDS and require no treatment.

3 Document the presence of the lesions, describing their size, location, and color.

A client who has been diagnosed with Lyme disease is started on doxycycline (Vibramycin) as part of the therapy. What should the nurse do when administering this drug? 1 Administer the medication with meals or a snack. 2 Provide orange or other citrus fruit juice with the medication. 3 Give the medication an hour before milk products are ingested. 4 Offer antacids 30 minutes after administration if gastrointestinal side effects occur.

3 Give the medication an hour before milk products are ingested. Any product containing aluminum, magnesium, or calcium ions should not be taken in the hour before or after an oral dose, because it decreases absorption by as much as 25% to 50%. Food interferes with absorption; it should be given one hour before or two hours after meals. Citrus juice has no influence on this drug. Antacids will interfere with absorption.

A nurse working in the health services center of a college is reviewing the vaccination records of a young adult who plans to enroll. Which immunizations are required to meet admission criteria according to the American Academy of Pediatrics? 1 One dose of diphtheria toxoid, oral poliomyelitis, live measles, live rubella, and mumps vaccines. 2 Two doses of diphtheria toxoid, oral poliomyelitis vaccine, and one dose of live measles, live rubella, and mumps vaccine. 3 Three doses of diphtheria toxoid and oral poliomyelitis vaccine, and one dose of live measles, live rubella, and mumps vaccine. 4 Three doses of diphtheria toxoid vaccine, two doses of oral poliomyelitis vaccine, and one dose of live measles, live rubella, and mumps vaccine.

3 Three doses of diphtheria toxoid and oral poliomyelitis vaccine, and one dose of live measles, live rubella, and mumps vaccine.

Isoniazid (INH) is prescribed as a prophylactic measure for a client whose spouse has active tuberculosis (TB). What statements by the client indicate that there is a need for further teaching? (Select all that apply.) 1 "I plan to start taking vitamin B6 (NesTrex) with breakfast." 2 "I'll still be taking this drug six months from now." 3 "I sometimes allow our children to sleep in our bed at night." 4 "I know I also have tuberculosis because the skin test was positive." 5 "I'll be skipping the wine but enjoying the cheese at my neighbor's party."

3 "I sometimes allow our children to sleep in our bed at night." 4 "I know I also have tuberculosis because the skin test was positive." 5 "I'll be skipping the wine but enjoying the cheese at my neighbor's party."

A nurse is caring for a client with a diagnosis of acquired immunodeficiency syndrome (AIDS). The IV infiltrates and needs to be restarted. What is necessary to protect the nurse when restarting the IV? (Select all that apply.) 1 Mask 2 Gown 3 Gloves 4 Face shield 5 Hand hygiene

3 Gloves 5 Hand hygiene Wearing gloves protects the nurse from potential contamination. Gloves are appropriate when there is a risk of the hands coming into contact with a client's blood or body fluids. Hand hygiene is the most effective way to prevent the spread of microorganisms. Wearing a mask is necessary for procedures where splashing of body fluids is anticipated or a risk. Wearing a gown is necessary for procedures where splashing of body fluids is anticipated or a risk. Wearing a face shield is necessary for procedures where splashing of body fluids is anticipated.

A client who abused intravenous drugs was diagnosed with the human immunodeficiency virus (HIV) several years ago. The nurse explains that the diagnostic criterion for acquired immunodeficiency syndrome (AIDS) has been met when the client: 1 Contracts HIV-specific antibodies. 2 Develops an acute retroviral syndrome. 3 Is capable of transmitting the virus to others. 4 Has a CD4+ T lymphocyte level of less than 200 cells/µL

4 Has a CD4+ T lymphocyte level of less than 200 cells/µL AIDS is diagnosed when an individual with HIV develops one of the following: a CD4+ T lymphocyte level of less than 200 cells/µL, wasting syndrome, dementia, one of the listed opportunistic cancers (e.g., Kaposi sarcoma [KS], Burkitt lymphoma), or one of the listed opportunistic infections (e.g., Pneumocystis jiroveci pneumonia, Mycobacterium tuberculosis). The development of HIV-specific antibodies (seroconversion), accompanied by acute retroviral syndrome (flu-like syndrome with fever, swollen lymph glands, headache, malaise, nausea, diarrhea, diffuse rash, joint and muscle pain), one to three weeks after exposure to HIV reflects acquisition of the virus, not the development of AIDS. A client who is HIV positive is capable of transmitting the virus with or without the diagnosis of AIDS.

A client arrives for a vaccination at an influenza prevention clinic. A nursing assessment identifies a current febrile illness with a cough. The nurse should: 1 Give the vaccine 2 Administer aspirin with the vaccine 3 Hold the vaccine and notify the health care provider 4 Reschedule administration of the vaccine for the next month

4 Reschedule administration of the vaccine for the next month

The nurse teaches a group of clients that nutritional support of natural defense mechanisms indicates the need for a diet high in: 1 Essential fatty acids 2 Dietary cellulose and fiber 3 Tryptophan, an amino acid 4 Vitamins A, C, E, and selenium

4 Vitamins A, C, E, and selenium

A client who abused intravenous drugs was diagnosed with the human immunodeficiency virus (HIV) several years ago. The nurse explains that the diagnostic criterion for acquired immunodeficiency syndrome (AIDS) has been met when the client:

Has a CD4+ T lymphocyte level of less than 200 cells/µL.