Exit HESI Practice: Infection

Which treatment strategies would benefit a client diagnosed with chlamydia? Select all that apply. 1 Penicillin G 2 Ceftriaxone 3 Clotrimazole 4 Doxycycline 5 Azithromycin

4 Doxycycline 5 Azithromycin Doxycycline and azithromycin are used to treat chlamydia. Penicillin G is used to treat syphilis. Ceftriaxone is used to treat gonorrhea. Clotrimazole is used to treat candidiasis.

An older adult, who alternately lives in a homeless shelter and on the street, is brought to the emergency department by friends. The client has a fever, night sweats, and a blood-tinged productive cough. The health care provider suspects that the client has tuberculosis and prescribes a purified protein derivate (PPD) test, chest x-ray, and sputum culture. Place these interventions in the order that they should be performed. 1. Institute airborne precautions. 2. Have a chest x-ray performed. 3. Perform a PPD intradermal skin test. 2. Obtain a sputum specimen. 5. Notify the Department of Health.

Tuberculosis is transmitted via microorganisms that travel with air currents. The client should be placed in a room that has at least six exchanges of air per hour and is ventilated to the outside. Caregivers should wear a high-efficiency particulate air respirator. A chest x-ray study is the quickest way to determine the presence of suspicious lesions in the lung. A PPD test can be read in 48 to 72 hours. A positive culture may not develop for 3 to 6 weeks. The Department of Health (Canada: Public Health Agency) should be notified when the diagnosis of tuberculosis is confirmed.

A student nurse is teaching a client about preventive measures for Lyme disease. Which instruction given by the student nurse indicates a need for correction? 1 "Wear dark colored dresses." 2 "Wear closed shoes or boots." 3 "Tuck your shirt into your pants." 4 "Bathe immediately after being in an infested area."

1 "Wear dark colored dresses." Lyme disease is a vector-borne disease caused by the spirochete Borrelia burgdorferi and results from the bite of an infected deer tick, also known as the blacklegged tick. Light-colored, rather than dark-colored clothing is preferred to spot the ticks easily, thereby preventing an insect bite and infection. Wearing closed shoes and boots and tucking the shirt in the pants prevent the entry and the bite of the blacklegged tick. Bathing should be done immediately after being in an infested area to prevent any possible infection.

A nurse is providing colostomy care to a client with a nosocomial infection caused by methicillin-resistant Staphylococcus aureus (MRSA). Which personal protective equipment (PPE) should the nurse use? Select all that apply. 1 Gloves 2 Gown 3 Mask 4 Goggles 5 Shoe covers 6 Hair bonnet

1 Gloves 2 Gown 4 Goggles Standard PPE, which should be used for performing colostomy care in a client positive for MRSA, includes gloves, gown, and goggles. A combination mask/eye shield may be used when caring for this client; however, a mask is not necessary. A mask would be necessary if the client had MRSA of the nares. Shoe covers and hair bonnet are not required for the client care situation described.

The nurse is caring for a client with tuberculosis. Which suggestions from the nurse will be beneficial for the client? Select all that apply. 1 "Take the daily dose during daytime." 2 "Avoid exposure to any inhalation irritants." 3 "Eat foods that are rich in protein, vitamins C and B." 4 "Cover the mouth and nose with a tissue when coughing or sneezing." 5 "Avoid sputum specimens for 2 to 4 weeks once drug therapy is initiated."

2 "Avoid exposure to any inhalation irritants." 3 "Eat foods that are rich in protein, vitamins C and B." 4 "Cover the mouth and nose with a tissue when coughing or sneezing." A client with tuberculosis should avoid exposure to any inhalation irritants because these can cause further lung damage. To increase physical stamina, the client should eat a well-balanced diet that includes foods that are rich in iron, protein, and vitamins C and B. While coughing or sneezing, the client should cover the mouth and nose with a tissue to prevent spread of infection. A client with tuberculosis should take the daily dose at nighttime to prevent nausea. Sputum specimens are usually needed every 2 to 4 weeks once the drug therapy is initiated. When the results of three consecutive sputum cultures are negative it indicates that the client is no longer infectious.

A registered nurse teaches a client regarding the therapeutic management of herpes simplex virus. Which statements made by the client indicates the need for further teaching? Select all that apply. 1 "I should wear loose clothing." 2 "I should use a sitz bath only with warm water." 3 "I should clean the lesion once a day with saline." 4 "I should apply compresses with an infusion of clove oil." 5 "I should keep the lesion dry by using cool air from a hair dryer."

2 "I should use a sitz bath only with warm water." 3 "I should clean the lesion once a day with saline." A client should clean the herpes simplex virus lesions twice a day with saline to prevent secondary infection. The client should administer sitz baths with baking soda and warm water. The client should wear loose clothing, apply compresses with an infusion of clove oil, and keep lesions dry by using cool air from a hair dryer.

A primary healthcare provider is treating the red-color wound of a client caused by pressure ulcers. Which dressings are beneficial for wound recovery? Select all that apply. 1 Absorptive dressings 2 Hydrocolloid dressings 3 Transparent film dressings 4 Moist gauze dressings with antibiotics 5 Telfa dressings with antibiotic ointment

2 Hydrocolloid dressings 3 Transparent film dressings 5 Telfa dressings with antibiotic ointment Hydrocolloid dressings, transparent film dressings, and telfa dressings with antibiotic ointment are beneficial for the healing of a red wound caused by pressure ulcers. Absorptive dressings and moist gauze dressings with antibiotics are used to treat yellow wounds, such as wounds with nonviable necrotic tissue.

A client with acquired immunodeficiency syndrome (AIDS) and Cryptococcal pneumonia frequently is incontinent of feces and urine and produces copious sputum. When giving this client a bath, which protective equipment should the nursemake it a priority to use? Select all that apply. 1 Goggles 2 Surgical mask 3 Shoe covers 4 Gown 5 Gloves 6 N95 hepa mask

2 Surgical mask 4 Gown 5 Gloves A gown, mask, and gloves when bathing the client prevent contact with feces, sputum, or other body fluids during intimate body care. Goggles would only be important if the client was on mechanical ventilation to avoid contact with sputum. An N95 hepa mask would be necessary if the client had tuberculosis, but not for Cryptococcal pneumonia alone. Shoe covers are designed for protecting a sterile environment such as a surgery suite and are not necessary for giving client care at the bedside.

An abandoned infant has been brought to the hospital. Ophthalmia neonatorum is diagnosed. What is the nurse's estimate of the infant's age? 1 2 days 2 24 hours 3 About 3 to 4 days 4 Less than 24 hours

3 About 3 to 4 days Untreated ophthalmia neonatorum becomes apparent on the third or fourth postnatal day and provides evidence that the mother may have had gonorrhea or a chlamydial infection. The most common presentation of ophthalmia neonatorum occurs by day 3 after birth.

A client who is on monoclonal antibody medication reports rigors, headache, myalgia, and gastrointestinal disturbances. The medical history shows that the client is on muromonab-CD3. Which medications could be beneficial for the reported symptoms? Select all that apply. 1 Sirolimus 2 Cyclosporine 3 Acetaminophen 4 Diphenhydramine 5 Methylprednisolone

3 Acetaminophen 4 Diphenhydramine 5 Methylprednisolone Acetaminophen, diphenhydramine, and methylprednisolone are administered to reduce the adverse effects associated with muromonab-CD3 use. When monoclonal antibodies are administered, a flulike syndrome occurs during the first few days of treatment because of cytokine release. Rigors, headache, myalgia, and gastrointestinal disturbances are the adverse effects of monoclonal antibodies. Sirolimus and cyclosporine are used in combination to reduce the graft loss that occurs in transplant recipients.

Which subjective statement made by the client helps in distinguishing bacterial vaginosis from other vaginal infections? 1 "I have painful urination." 2 "I have vaginal irritation." 3 "I have lower abdominal pain." 4 "I have a thin vaginal discharge with a fishy odor."

4 "I have a thin vaginal discharge with a fishy odor." Bacterial vaginosis (BV) is manifested by a vaginal discharge characteristic fishy odor, which occurs due to the replacement of hydrogen peroxide producing lactobacillus with anaerobic bacteria. These anaerobes cause an increase in vaginal amines that lead to an alteration of the vaginal pH and cause the odor. Painful urination, vaginal irritations, and lower abdominal pain are common manifestations in other vaginal infections.

A client is suspected of having rabies after being bitten by a raccoon. Which clinical indicators should the nurse assess in the client? Select all that apply. 1 Diarrhea 2 Forgetfulness 3 Urinary stasis 4 Nuchal rigidity 5 Pharyngeal spasm

4 Nuchal rigidity 5 Pharyngeal spasm Rabies, an acute infectious disease affecting the central nervous system (CNS), causes stiffness of the back of the neck (nuchal rigidity). Painful pharyngeal spasms when swallowing or even looking at water are responsible for the use of the term hydrophobia to refer to rabies. The CNS is affected; diarrhea is not a concern. Memory is not affected by this disease. Urinary stasis is not an expected problem; catheterization can be employed if necessary.

A nurse in a summer day camp that has access to a local beach has cared for several children with impetigo. What is the best nursing intervention to prevent complications? 1 Use of an oil-based soap for bathing 2 Administration of a systemic oral antibiotic and a topical antibiotic may be used as well 3 Removal of crusts with an antimicrobial liquid 4 Application of an antibiotic ointment to the lesions

2 Administration of a systemic oral antibiotic and a topical antibiotic may be used as well Glomerulonephritis may occur as a result of impetigo, a streptococcal infection. Systemic antibiotics are necessary to eradicate the streptococcal organism that caused the primary infection. Ointments such as mupirocin (Bactroban) may be prescribed for topical application as well. Bathing the child with a special soap will not prevent glomerulonephritis. Although removing the crusts is part of the local therapy for impetigo, using an antimicrobial liquid will not prevent glomerulonephritis; nor will applying an antibiotic ointment. impetigo is a common and highly contagious skin infection that mainly affects infants and children

A client at the women's health clinic complains of swelling of the labia and throbbing pain in the labial area after sexual intercourse. For what condition does the nurse anticipate the client will be treated? 1 Urethritis 2 Bartholinitis 3 Vaginal hematoma 4 Inflamed Skene glands

2 Bartholinitis The Bartholin glands are located beneath the vaginal vestibule; if cysts form and they become infected they cause labial, vaginal, or pelvic pain, particularly during or after intercourse (dyspareunia). Urethritis causes painful urination. A vaginal hematoma causes swelling in the vaginal wall, not the labia. The Skene glands are located in the urethra, not the labia.

A sexually active client presents with a sore throat and a generalized rash. The client states that a chancre that had been present healed approximately 3 months ago. The physical assessment and the serologic test findings indicate a diagnosis of syphilis. Which stage should the nurse determine the client is in at this time? 1 Primary 2 Secondary 3 Latent 4 Tertiary

2 Secondary The client has secondary syphilis, which occurs 1 to 3 months after healing of the primary lesion and lasts for several weeks to as long as a year; it is the stage at which the individual is most infectious. Primary syphilis is the stage of initial infection and is characterized by the presence of a chancre, a painless lesion at the site of infection. Latent syphilis occurs after the secondary stage and before the late stage of syphilis; in latent syphilis the immune system is able to suppress the infection and there are no clinical signs and symptoms. Tertiary syphilis, also known as late syphilis, is the final stage of syphilis. At this stage it is a slowly progressive inflammatory disease that can involve many organs; the skin, brain, and heart can be affected.

A client reports a cold and severe cough lasting for several minutes accompanied by frequent exhaustion. The nurse observes a "whooping" sound at the end of the cough. Which organism may responsible for this condition in the client? 1 Coronaviruses 2 Bacillus anthracis 3 Bordetella pertussis 4 Group A beta-hemolytic Streptococcus

3 Bordetella pertussis Pertussis is a respiratory infection caused by the Bordetella pertussis bacterium. In the paroxysmal stage of pertussis, the client may have a cold and a severe cough that lasts for several minutes accompanied by frequent exhaustion. A distinct "whooping" sound is heard at the end of the cough. Coronaviruses cause severe acute respiratory syndrome. Bacillus anthracis causes inhalation anthrax. Group A beta-hemolytic Streptococcus causes peritonsillar abscess.

A client visited the primary healthcare provider complaining of inflammatory lesions on the face. The primary healthcare provider examined and confirmed it as an inflammatory disorder of the sebaceous glands. Which medications does the nurse anticipate being prescribed by the primary healthcare provider? Select all that apply. 1 Bacitracin 2 Mupirocin 3 Clindamycin 4 Erythromycin 5 Metronidazole

3 Clindamycin 4 Erythromycin Clindamycin and erythromycin are topical antibiotics used in the treatment of acne vulgaris, which occurs due to inflammation of the sebaceous glands. Bacitracin is an over-the-counter topical antibiotic used in the treatment of dermatologic problems. Mupirocin is used in the treatment of superficial Staphylococcus infections such as impetigo. Topical metronidazole is used in the treatment of rosacea and bacterial vaginosis.

What is the most important nursing intervention for a 3-year-old child with a diagnosis of nephrotic syndrome? 1 Regulating diet 2 Encouraging fluids 3 Preventing infection 4 Maintaining bed rest

3 Preventing infection Infection is a constant threat because of a poor general state of nutrition, a tendency toward skin breakdown in edematous areas, corticosteroid therapy, and lowered immunoglobulin levels. Although intake of foods with high nutritional value should be encouraged, this is not the priority. Fluid monitoring is important in determining whether a fluid restriction is indicated. Bed rest may be needed for severe edema, but ambulation is preferred. Nephrotic syndrome is a kidney disorder that causes your body to pass too much protein in your urine

Five days after a client has abdominal surgery a nurse assesses the client's incision site for signs of dehiscence. Which clinical finding supports the nurse's conclusion that the client is experiencing wound dehiscence? 1 Increased bowel sounds 2 Loosening of the sutures 3 Serosanguineous drainage 4 Purplish color of the incision

3 Serosanguineous drainage Serosanguineous drainage from the wound or on the dressing forewarns about separation of the wound edges (dehiscence); dehiscence may progress to movement of abdominal organs outside of the abdominal cavity (evisceration). Bowel sounds have no relationship to wound status; bowel sounds are expected around the third or fourth postoperative day as intestinal peristalsis returns. Loosening of sutures may occur after the initial wound edema subsides but is not a sign of failure of the suture line. A purplish incision is the expected coloration of a healing wound.

Which microorganism causes maternal mastitis? 1 Escherichia coli 2 Group B streptococcus 3 Staphylococcus aureus 4 Chlamydia trachomatis

3 Staphylococcus aureus Staphylococcus aureus is a resident organism of the skin; it is the causative agent of 95% of the infections that result in maternal mastitis. Escherichia coli is found in the lower intestinal tract; it is not associated with mastitis. Group B streptococcus rarely causes mastitis. Chlamydia trachomatis can cause neonatal pneumonia and conjunctivitis, not mastitis. Frequent hand washing by staff and clients may reduce the risk of infection.

The mother of a toddler complains that the toddler has not been acting quite right lately. The child has had a fever for a couple of days and now presents with decreasing oral intake and a rash over the hands and feet. Which condition does the nurse suspect? 1 Teething 2 Food aversion 3 Streptococcus infection 4 Coxsackievirus infection

4 Coxsackievirus infection Coxsackievirus is one of the most common enteroviruses. Also known as hand-foot-mouth disease, it is most often caused by coxsackievirus A16 and is most common in children younger than 10 years. The signs and symptoms of hand-foot-mouth disease include a fever and small but painful sores on the throat, gums, and tongue and inside the cheeks. It may also cause a rash, often with blisters, on the hands, soles, and diaper area, as well as headache and a poor appetite. Teething could bring with it a slight fever, as well as decreased oral intake, but the rash on the hands and feet is specific to coxsackievirus infection. Food aversion with simple decreased intake is usually a chronic issue without any associated fever or rash. Although a streptococcal infection could produce a fever and rash, the rash on the feet and hands and the decreased oral intake resulting from sores in the mouth are specific to coxsackievirus infection.

A client with human immunodeficiency virus reports dyspnea on exertion, increased heart rate, a persistent dry cough, and a persistent low-grade fever. The nurse observes crackles during an auscultation of the breath sounds. Which organism is responsible for this condition in the client? 1 Cryptosporidium 2 Candida albicans 3 Toxoplasma gondii 4 Pneumocystis jiroveci

4 Pneumocystis jiroveci Pneumocystis jiroveci causes pneumonia, which is the most common opportunistic infection in clients infected with the human immunodeficiency virus. Symptoms of Pneumocystis jiroveci pneumonia include dyspnea on exertion, tachypnea, a persistent dry cough, and a persistent low-grade fever. An auscultation of the breath sounds indicates crackles. Cryptosporidium causes diarrhea and weight loss. Candida albicans causes mouth pain and difficulty swallowing. Toxoplasma gondii causes speech and vision difficulty.