Infection Prep U Stokes test
During flu season, a nurse is teaching clients about the chain of infection. What components are considered "links" in this chain? Select all that apply. portal of entry fomites infectious agent susceptible host virulence
infectious agent susceptible host portal of entry
Which individual is at the highest risk of developing a urinary tract infection (UTI)? A 30-year-old woman with poorly controlled diabetes mellitus A 60-year-old man with a history of cardiovascular disease who is recovering in hospital from a coronary artery bypass graft A 66-year-old man undergoing dialysis for the treatment of chronic renal failure secondary to hypertension A 38-year-old man with high urine output due to antidiuretic hormone insufficiency
A 30-year-old woman with poorly controlled diabetes mellitus
The nurse educator, who is teaching a class on sexually transmitted infections, recognizes that teaching has been effective when students indicate which statement is true about the difference between colonization and infection? "Colonization becomes infection when the host and organism interact." "Colonization and infection are interchangeable terms used to describe a bacterial invasion." "Colonization results in symptoms such as redness and swelling, infection results in fever." "Both colonization and infection require treatment with different antibiotics."
"Colonization becomes infection when the host and organism interact."
A client was unaware that intestinal flora are beneficial, stating, "I thought all bacteria were bad." Which is the nurse's most accurate response? "An interaction such as this is called commensalism: The colonizing bacteria acquire nutritional needs and shelter, and the host is able to keep their numbers under control." "The term 'mutualism' is applied to an interaction in which the microorganism and the host both derive benefits from the interaction." "There's a parasitic relationship by which the bacteria benefits but there's a minimal effect on the host's health." "Any organism capable of supporting the nutritional and physical growth requirements of another is called a host."
"The term 'mutualism' is applied to an interaction in which the microorganism and the host both derive benefits from the interaction."
The nurse is discharging a 4-year-old boy from the emergency department. The boy was seen for an insect bite that became swollen and reddened and warm and painful to touch. The client's vital signs are all within normal range for age. While giving discharge instructions to the client's father, he asks why the child is not going to get antibiotics for the infected insect bite. What would be your best response? "I'll make sure the doctor is made aware that you'd like your son to have a course of antibiotics." "Infection is not the same as inflammation. What your son has is inflammation." "In children who are previously healthy, inflammation and infections usually resolve without the need for drugs." "This is a local inflammatory response to the insect bite; it is not an infection so antibiotics will not help."
"This is a local inflammatory response to the insect bite; it is not an infection so antibiotics will not help."
The nurse is caring for several older clients. For which client would the nurse be especially alert for signs and symptoms of pyelonephritis? A client with acute renal failure A client with urinary obstruction A client with a urinary tumor A female client with preexisting chronic glomerulonephritis
A client with urinary obstruction
A 34-year-old woman presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in her lower back. She is also experiencing dysuria, urinary frequency, and a feeling of urgency. Her partner states that she has been very tired the last few days and that she looked like she may have the flu. What is the most likely diagnosis? Renal calculi Acute pyelonephritis Acute renal failure Renal cell carcinoma
Acute pyelonephritis
A client who developed acute pyelonephritis asks the nurse what may have caused the infection. Which information will be included in the nurse's response? Select all that apply. Severe hypertension often is a contributing factor in the progress of the disease. Escherichia coli is the causative agent in about 80% of cases. Acute pyelonephritis is caused by bacterial infection. Urinary reflux is the most common cause. Outflow obstruction, catheterization, and urinary instrumentation cause the complicated, acute form.
Acute pyelonephritis is caused by bacterial infection. Escherichia coli is the causative agent in about 80% of cases. Outflow obstruction, catheterization, and urinary instrumentation cause the complicated, acute form.
A nurse is counseling a client about risk factors for yeast infections. Which should the nurse list as a risk factor for an overgrowth of Candida albicans? Select all that apply. Antibiotic therapy Recent exposure to a person with athlete's foot Impaired immune system Decrease in amount of bacterial flora Core body temperature of 37°C (98.6°F)
Antibiotic therapy Impaired immune system Decrease in amount of bacterial flora
A client is taking a vacation in a foreign country. The nurse teaches the client about giardiasis, a common traveler's infection. Which statement should be included in the teaching plan? Avoid eating food and drinking beverages that might be contaminated. Avoid swimming in the coastal waters of the foreign country. Complete the necessary inoculations before traveling out of the country. Avoid close contact with other passengers while flying on an airplane.
Avoid eating food and drinking beverages that might be contaminated.
A nurse is preparing to administer a client's scheduled dose of subcutaneous heparin. To reduce the risk of needlestick injury, the nurse should perform what action? Recap the needle immediately before leaving the room. Recap the needle before leaving the bedside. Wear gloves when administering the injection. Avoid recapping the needle before disposing of it.
Avoid recapping the needle before disposing of it.
The nurse is reviewing the medical records of several patients who have been diagnosed with the following infections: A: Mumps Patient B: Respiratory syncytial virus Patient C: Tuberculosis Patient D: Impetigo Patient E: Scabies Patient The nurse would implement contact precautions for which patients? Select all that apply. Patient A Patient D Patient E Patient C Patient B
B D E
Acute pyelonephritis is a result of: Viral infection Bacterial infection Chronic reflux Renal failure
Bacterial infection
A nurse is conducting a health history on a patient who is seeing her health care provider for symptoms consistent with a UTI. The nurse understands that the most common route of infection is which of the following? The result of urethra abrasion (sexual intercourse) By ascending infection (transurethral) Through the bloodstream (hematogenous spread) Due to a fistula (direct extension)
By ascending infection (transurethral)
Which objective symptom of a UTI is most common in older adults, especially those with dementia? Hematuria Incontinence Change in cognitive functioning Back pain
Change in cognitive functioning
A nurse is preparing to insert a peripheral intravenous access device into the arm of a client. When preparing the skin for insertion, which of the following should the nurse use to prevent possible health-care associated bloodstream infections? Povidone-iodine Alcohol Normal saline Chlorhexidine
Chlorhexidine
A client has a concentration of S. aureus located on his skin. The client is not showing signs of increased temperature, redness, or pain at the site. The nurse is aware that this is a sign of a microorganism at which of the following stages? Colonization Bacteremia Disease Infection
Colonization
Which term is used to describe microorganisms present in a host without host interference or interaction? Colonization Infection Reservoir Normal flora
Colonization
A woman reports to the nurse that she has developed a yeast infection. The woman does not understand how she could get a yeast infection since she has been on antibiotics for a urinary tract infection. What is the rationale for this client's complaint? Yeast prefers a warm, moist, and dark environment, such as that present in the female perineum. Yeast grows well when exposed to sugar, which is found as a carrier substance in most antibiotics. Antibiotics allow yeast to access sterile environments in the body. Destroying one type of resident flora (bacteria) can allow overproliferation of another competing type (yeast).
Destroying one type of resident flora (bacteria) can allow overproliferation of another competing type (yeast).
An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale? If risk for chronic pyelonephritis is likely Detects calculi, cysts, or tumors Reveals causative microorganisms Shows damage to the kidneys
Detects calculi, cysts, or tumors
A client's diagnostic testing revealed that he is colonized with vancomycin-resistant enterococcus (VRE). What change in the client's health status could precipitate an infection? Development of a skin break Use of a narrow-spectrum antibiotic Persistent contact of the bacteria with skin surfaces Treatment of a concurrent infection using vancomycin
Development of a skin break
A client diagnosed with influenza is admitted to the hospital. Which transmission-based precautions should the nurse initiate? Droplet Contact Airborne Neutropenic
Droplet
Infectious agents produce products or substances called virulence factors that make it easier for them to cause disease. Which of these are virulence factors? Select all that apply. Evasive factors Toxins Adhesion factors Invasive factors Prodromal factors
Evasive factors Adhesion factors Invasive factors Toxins
A gerontologic nurse is assessing a client who has numerous comorbid health problems. What assessment findings should prompt the nurse to suspect a UTI? Select all that apply. Upper abdominal pain Insatiable thirst Food cravings Fever New onset of confusion
Fever New onset of confusion
A middle-aged woman is admitted with acute pyelonephritis. Which assessment finding correlates with this diagnosis? systemic infection poorly controlled hypertension Flank pain, dysuria, and nausea/vomiting scarring and deformation of the renal calyces and pelvis
Flank pain, dysuria, and nausea/vomiting
The nurse is providing care for an older adult client who has developed signs and symptoms of Calicivirus (Norovirus). What assessment should the nurse prioritize when planning this client's care? Respiratory status Fluid intake and output Deep tendon reflexes and neurological status Pain
Fluid intake and output
A nurse is assessing a client with diarrheal disease and determines that the condition has most likely resulted from a parasitic infection. Which of the following would be a potential cause? Select all that apply. Giardia Shigella Salmonella Cryptosporidium E. coli
Giardia Cryptosporidium
Acute postinfectious glomerulonephritis, as its name implies, follows an acute infection somewhere else in the body. What is the most common cause of acute postinfectious glomerulonephritis? S. aureus Group A β-hemolytic streptococci E. coli P. aeruginosa
Group A β-hemolytic streptococci
A nurse is interviewing a client with fever, myalgia, headache, and lethargy. Which question is most important for the nurse to ask related to identifying the cause of these symptoms and the possible need for quarantining the client? Did you receive an influenza vaccine this season? Have you or any family members traveled outside the country recently? Have you been exposed to anyone who has not been vaccinated recently? Are these symptoms similar to an illness you have had in the past?
Have you or any family members traveled outside the country recently?
Everyone in the family except the mother currently has influenza. What should the nurse tell the mother are appropriate measures to avoid this infection? Select all that apply. Immunization Frequent hand washing Avoid close contact with family members Sterilization
Immunization Frequent hand washing Avoid close contact with family members
A nurse advises a client with recurring UTIs to drink large amounts of water. What normal protective action is the nurse telling the client to utilize? Thin mucus to prevent bacterial adherence Increase immune availability Decrease acidity of urine Increase washout of urine
Increase washout of urine
Which of the following describes host interaction with an organism? Infectious disease Colonization Infection Reservoir
Infection
What is the term for parasitic relationships between microorganisms and the human body in which the human body is harmed? Commensal disease Mutual disease Infectious disease Communicable disease
Infectious disease
A nurse is giving discharge instructions for a client who was diagnosed with acute pyelonephritis 3 days previously. Which instruction is important for the nurse to discuss when teaching the client? Because the client received antibiotics in the hospital, there are no further medications required. It is important that the client take the prescribed antibiotic for the duration of the prescription. The client will require bed rest at home for 7 days. Restrict fluid intake to 1 L/day.
It is important that the client take the prescribed antibiotic for the duration of the prescription.
A nurse who provides care in a long-term care facility is aware of the high incidence and prevalence of urinary tract infections among older adults. What action has the greatest potential to prevent UTIs in this population? Limit the use of indwelling urinary catheters. Toilet residents who are immobile on a scheduled basis. Administer prophylactic antibiotics as prescribed. Encourage frequent mobility and repositioning.
Limit the use of indwelling urinary catheters.
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? MRI report Microbiology report Chemistry studies The complete blood count (CBC)
Microbiology report
The nurse places a client in isolation. Isolation techniques have the potential to break the chain of infection by interfering with what component of the chain of infection? Susceptible host Mode of transmission Agent Portal of entry
Mode of transmission
Clients with which medical history will have an increased risk for developing urinary tract infections? Select all that apply. Neurogenic disorders A premenopausal woman Prostate disease Not sexually active Urinary obstruction Elderly
Neurogenic disorders Prostate disease Urinary obstruction Elderly
The nurse educator identifies the student understands the function of normal flora in the human body when the student makes which statement? Normal flora fight infection by working to engulf invading pathogens. Normal flora becomes the cause of illness when the body perceives threat of foreign bacteria. Normal flora includes the bacteria that cause sexually transmitted infections in humans. Normal flora compete with potential pathogens and work symbiotically with the host.
Normal flora compete with potential pathogens and work symbiotically with the host.
Following a knee replacement, a client develops an infection at the site. After months of unsuccessful anti-infective therapy, the surgeon removed the implant. What explanation can the nurse provide when the client asks why the anti-infective therapy did not work? Toxins in the organism have damaged the new joint implant. The knee replacement may have been contaminated at the factory. Microbes are becoming more resistant to antibiotic therapy. Organisms on a colonized implant produce a self-protecting biofilm.
Organisms on a colonized implant produce a self-protecting biofilm.
When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions? Glaucoma and renal failure Liver necrosis, or hepatic failure Ototoxicity and nephrotoxicity Hypoglycemia and hyperglycemia
Ototoxicity and nephrotoxicity
A nurse would implement droplet precautions for a client with which condition? Select all that apply. Parvovirus B 19 Scabies Ebola virus Pertussis Mumps
Parvovirus B19 Pertussis Mumps
If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection? Use sterile technique to disconnect the catheter from the tubing to obtain urine specimens Place the catheter bag on the client's abdomen when moving the client Use clean technique during insertion Perform meticulous perineal care daily with soap and water
Perform meticulous perineal care daily with soap and water
A nurse implements aseptic technique as a means to break the chain of infection at which element? Portal of entry Reservoir Means of transmission Portal of exit
Portal of entry
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? An allergic reaction to the antibiotic Pseudomembranous colitis A helminth infection Food poisoning
Pseudomembranous colitis
When assessing a client with infectious diarrhea, which of the following would lead the nurse to suspect that the client is experiencing severe dehydration? Increased thirst Rapid, thready pulse Sunken eyes Dry oral mucous membranes
Rapid, thready pulse
A cytotechnologist is examining a blood sample. Which must be identified for a diagnosis of infectious disease? Recovery of probable pathogen Detection of pathogenic metabolites Genomic sequences Positive serology
Recovery of probable pathogen
There are two criteria that have to be met in order for a diagnosis of an infectious disease to occur. What are these two criteria? Identification by microscopic appearance and Gram stain reaction Serology and an antibody titer specific to the serology Propagation of a microorganism outside the body and testing to see what destroys it. Recovery of probable pathogen and documentation of signs and symptoms compatible with an infectious process.
Recovery of probable pathogens and documentation of signs and symptoms compatible with an infection process
The nurse is providing an education program to reduce the incidence of infection currently on the rise in the community. What areas should the nurse focus on when presenting this program? (Select all that apply.) Regulated health practices Immunization programs Swimming in the community pool Sanitation techniques The use of antibiotics to prevent infections
Regulated health practices Immunization programs Sanitation techniques
A 72-year-old female clinic patient is started on trimethoprim-sulfamethoxazole for treatment of a urinary tract infection. Prior to administering this drug, the nurse should assess the patient for which of the following conditions? Diabetes mellitus Hypertension Asthma Renal impairment
Renal impairment
A client reports nausea, vomiting, and diarrhea for 5 days. The nurse assesses the mucous membranes as pale and dry. The client has sunken eyes with the following vital signs: pulse 122 and thready, respirations 23, blood pressure 78/55, temperature 101.8°F oral. Which is the priority nursing intervention? Request an order from the physician for IV rehydration therapy. Assess vital signs every 15 minutes. Obtain stool specimen for analysis. Initiate oral rehydration therapy at 100 mL/kg of oral rehydration solution over 4 hours.
Request an order from the physician for IV rehydration therapy.
A client with a sacral pressure ulcer has had a urinary catheter inserted. As a result of this new intervention, the nurse should prioritize what nursing diagnosis in the client's plan of care? Impaired physical mobility related to presence of an indwelling urinary catheter Disturbed body image related to urinary catheterization Toileting self-care deficit related to urinary catheterization Risk for infection related to presence of an indwelling urinary catheter
Risk for infection related to presence of an indwelling urinary catheter
A client is ordered to receive a fluoroquinolone, ciprofloxacin, to treat a bacterial infection. The nurse instructs the client to monitor for which potentially dangerous side effect associated with fluoroquinolone therapy? High fevers Tendon rupture Photophobia and phototoxicity Renal failure
Tendon rupture
A parent asks the nurse what signs and symptoms a child would display if the child had a urinary tract infection. Which is the best response by the nurse? The same symptoms as an adult. The child does not present with typical symptoms. The child will not have a fever. The child's immune system is weak so he or she will not have foul-smelling urine.
The child does not present with typical symptoms.
An adult client in the ICU has a central venous catheter in place. Over the past 24 hours, the client has developed signs and symptoms that are suggestive of a central line associated bloodstream infection (CLABSI). What aspect of the client's care may have increased susceptibility to CLABSI? The client has received antibiotics and IV fluids through the same line. The client was treated for vancomycin-resistant enterococcus (VRE) during a previous admission. The client had blood cultures drawn from the central line. The client's central line was placed in the femoral vein.
The client's central line was placed in the femoral vein.
You work on a long-term care unit. In the last two weeks more than half the clients on your unit have been diagnosed with gastroenteritis. What is the most likely reason? The clients don't wash their hands after going to the bathroom. The clients are in too small an area, so they pass around diseases. The infection is being transmitted by healthcare personnel. The visitors brought the disease into the unit.
The infection is being transmitted by healthcare personnel.
The nurse is teaching a health class about UTIs to a group of older adults. What characteristic of UTIs should the nurse cite? Men of all ages are less prone to UTIs, but typically experience more severe symptoms. The prevalence of UTIs in men older than 50 years of age approaches that of women in the same age group. Men over age 65 are equally prone to UTIs as women, but are more often asymptomatic. The prevalence of UTIs in men cannot be reliably measured, as men generally do not report UTIs.
The prevalence of UTIs in men older than 50 years of age approaches that of women in the same age group.
A female client has been prescribed a course of antibiotics for the treatment of a UTI. When providing health education for the client, the nurse should address what topic? The need to undergo a series of three urine cultures after the antibiotics have been completed The need to expect a heavy menstrual period following the course of antibiotics The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy The risk of developing antibiotic resistance after the course of antibiotics
The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy
Which are characteristics of resident flora? Select all that apply. They provide a type of natural immunity. They do not compete with disease-producing microorganisms. They do not cause harm to the body They live on nonsterile areas of the body.
They provide a type of natural immunity. They do not cause harm to the body They live on nonsterile areas of the body.
What is the best rationale for health care providers receiving the influenza vaccination on a yearly basis? To prevent the emergence of drug-resistant strains of the influenza virus To decrease risk of transmission to vulnerable clients To eventually eradicate the influenza virus in the United States To decrease nurses' susceptibility to healthcare-associated infections
To decrease risk of transmission to vulnerable clients
Which of the following is the most common site of a nosocomial infection? Respiratory tract Skin Urinary tract Gastrointestinal tract
Urinary tract
A female client's most recent urinalysis results are suggestive of bacteriuria. When assessing this client, the nurse's data analysis should be informed by what principle? A diagnosis of bacteriuria requires three consecutive positive results. Most UTIs in female clients are caused by viruses and do not cause obvious symptoms. Urine contains varying levels of healthy bacterial flora. Urine samples are frequently contaminated by bacteria normally present in the urethral area.
Urine samples are frequently contaminated by bacteria normally present in the urethral area.
The nurse educator is discussing emerging diseases with a group of nurses. The educator should cite what causes of emerging diseases? Select all that apply. Use of extended-spectrum antibiotics Globalization of food supplies Population movements Increased global travel Progressive weakening of human immune systems
Use of extended-spectrum antibiotics Population movements Globalization of food supplies Increased global travel
An 8-year-old female is diagnosed with a third urinary tract infection (UTI) this calendar year. For what condition is it most important for the nurse to advocate assessment? Autosomal dominant polycystic kidney disease Vesicoureteral reflux Goodpasture syndrome Nephrotic syndrome
Vesicoureteral reflux
The nurse who teaches a client about preventing recurrent urinary tract infections would include which statement? Increase intake of coffee, tea, and colas. Void every 5 hours during the day. Take tub baths instead of showers. Void immediately after sexual intercourse
Void immediately after sexual intercourse
A nurse is caring for a child who was admitted to the pediatric unit with infectious diarrhea. The nurse should be alert to what assessment finding as an indicator of dehydration? Diaphoresis Weak pulse Labile BP Fever
Weak pulse
The nurse is scheduled to administer tetanus, diphtheria, and pertussis (Tdap) vaccine to a client at the clinic. The client states, "I had a reaction the last time I got an immunization." What action should the nurse take first? Withhold the immunization. Administer the Tdap as ordered. Obtain further history regarding the reaction and immunization. Document the reaction to the previous immunization.
Withhold the immunization.
A fomite is a/an: natural antibiotic. infection transfer agent. tick-like ectoparasite. natural disinfectant.
infection transfer agent.
A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed: acute postinfectious glomerulonephritis. kidney stones. nephrotic syndrome. acute renal failure.
acute postinfectious glomerulonephritis.
A client with gastroenteritis is admitted to an acute care facility and presents with severe dehydration and electrolyte imbalances. Diagnostic tests reveal the Norwalk virus as the cause of gastroenteritis. Based on this information, the nurse knows that: enteric precautions must be continued. the client's infection may be caused by droplet transmission. the client requires an antiviral agent. enteric precautions can be discontinued.
enteric precautions must be continued.
The bacteria that line the gut of a human help maintain normal gut health and provide essential nutrients. This type of relationship is: parasitic. saprophytic. commensal. mutualistic.
mutualistic.
A nurse is assessing a client who may be in the early stages of dehydration. Early manifestations of dehydration include: sunken eyeballs and poor skin turgor. increased heart rate with hypotension. coma or seizures. thirst or irritability.
thirst or irritability.