ML8 CH 24

The nurse reminds the visitor of a client with an antibiotic-resistant infection that gloves are necessary. The visitor states, "I need to directly hold my loved one's hand without a barrier." What essential information does the nurse need to explain to the visitor to prevent transmission of the organism? A. "Your loved-one has an antibiotic-resistant infection which means that there are a limited number or no antibiotics available to treat it." B. "If you do not wear gloves you will also get the infection." C. "Your loved-one understands why you have to wear gloves because he or she has been educated about the infection and barrier precautions." D. "The glove is an important barrier in preventing the transmission of your loved-one's antibiotic-resistant infection to you or other people you come in contact with."

D. "The glove is an important barrier in preventing the transmission of your loved-one's antibiotic-resistant infection to you or other people you come in contact with."

A client has tested positive for methicillin-resistant Staphylococcus aureus after being swabbed on admission to the hospital. Bacterial resistance to antibiotics is an example of: A. Means of transmission B. Spore production C. Aerobic activity D. Survival adaptation

D. Survival adaptation

A nurse is caring for a client who is diagnosed with tuberculosis. Which nursing intervention promotes infection control based on nursing practice standards for safety? A. The nurse places the client in a private room with the door open. B. The nurse uses droplet precautions when providing care for the client. C. The nurse keeps visitors 3 feet away from the infected person. D. The nurse places the client in a private room with monitored negative air pressure.

D. The nurse places the client in a private room with monitored negative air pressure.

What is the most common client site for development of healthcare-associated infections (HAI)? A. Surgical wound B. Respiratory tract C. Bloodstream D. Urinary tract

D. Urinary tract

The nurse is preparing to perform handwashing. Place the following steps in the correct order. Use all options.

Turn on the faucet and adjust force and temperature of the water. Wet the hand and wrists. Apply soap. Wash the palms and backs of the hands for at least 20 seconds. Pat the hands dry with a paper towel. Turn the faucet off with a paper towel.

A nurse has finished giving care to a client who has a communicable respiratory infection. In which order should the personal protective equipment (PPE) be removed? 1. Gloves 2. Respirator 3. Gown 4. Goggles

1, 4, 3, 2

Unbeknownst to him, a nursing student has inhaled droplets containing common cold viruses and is soon to develop a cold himself. Place the following stages of infection in the sequence in which they will occur.

1. Incubation period 2. Prodromal stage 3. Full stage of illness 4. Convalescent period

The nurse is caring for a client who has active tuberculosis and is under airborne precautions. The health care provider prescribes a computed tomography (CT) examination of the chest. Which action by the nurse is appropriate? A. Place a surgical mask on the client and transport to the CT department at the specified time. B. Notify the CT department in advance so other clients and staff can be removed from the area. C. Question the need for the examination, because the client must remain under airborne precautions. D. Request that the examination be done at the bedside.

A. Place a surgical mask on the client and transport to the CT department at the specified time.

Which action is the best example of a nurse donning/removing protective equipment properly? A. Removing respirator after leaving client's room B. Removing gown after leaving client's room C. Donning gown after entering client's room D. Donning respirator inside of client's room

A. Removing respirator after leaving client's room

A nurse is caring for four clients. Which client has the highest risk of infection? A. older male with an enlarged prostate B. toddler with a benign heart murmur C. woman in second trimester of pregnancy D. young woman with a history of scoliosis

A. older male with an enlarged prostate

The nurse is adding a sterile solution onto a prepared sterile field. What is the best technique performed by the nurse? A. pouring the sterile solution from a height of 5 in. (13 cm) B. touching the tip of the bottle to the sterile container to avoid splashing C. placing the cap on the table with edges down D. discarding any unused sterile solution

A. pouring the sterile solution from a height of 5 in. (13 cm)

The nurse observes an unlicensed assistive personnel (UAP) collecting a urine specimen from a client with Staphylococcus aureus infection. Which action by the UAP would require the nurse to intervene? A. removes gloves and walks out of the room B. asks the client to state name and date of birth C. applies a mask with face shield D. performs hand hygiene before donning gloves

A. removes gloves and walks out of the room

A nurse is caring for a 55-year-old postoperative client. The client returns to the ICU after surgery intubated and mechanically ventilated with a Salem sump nasogastric tube, a Foley catheter, and a PICC line in place. Based on the nurse's knowledge of the most common hospital-acquired infections, which apparatus is most important to remove first? A. urinary catheter B. PICC line C. Salem sump nasogastric tube D. endotracheal tube

A. urinary catheter

The nurse is caring for a client admitted with tuberculosis (TB). What would be the best action by the nurse? A. Wear a protective gown and gloves with any direct contact. B. Apply a nonparticulate (N-95) respirator when entering the room. C. Have the client wear a mask during care. D. Wear a mask with face shield during invasive procedures.

B. Apply a nonparticulate (N-95) respirator when entering the room.

Nurses wear personal protective equipment (PPE) to protect themselves and clients from infectious materials. Which examples accurately represent the proper use of personal protective equipment in a health care agency? Select all that apply. A. Nurses need only apply clean gloves when performing or assisting with invasive client procedures. B. During some care activities for an individual client, nurses may need to change gloves more than once. C. Nurses may use a waterproof gown more than one time. D. Nurses should remove PPE at the doorway or in an anteroom, except for the respirator. E. To remove a gown, nurses should unfasten ties, if at the neck and back, and allow the gown to fall away from shoulders. F. Nurses may lower a mask around the neck when not being worn and bring it back over the mouth and nose for reuse.

B. During some care activities for an individual client, nurses may need to change gloves more than once. D. Nurses should remove PPE at the doorway or in an anteroom, except for the respirator. E. To remove a gown, nurses should unfasten ties, if at the neck and back, and allow the gown to fall away from shoulders.

A nurse is applying the principles of Standard and Contact Precautions in the care of a hospital client. Which action violates these principles? A. The nurse performs hand hygiene after touching the client's surroundings. B. The nurse removes her gown and then removes her gloves. C. The nurse performs hand hygiene before putting on gloves. D. The nurse applies nonmedicated hand cream after performing hand hygiene.

B. The nurse removes her gown and then removes her gloves.

The nurse is caring for a client with tuberculosis. The prior shift's nurse has placed the client in droplet precautions. Which is the appropriate nursing action? A. change to contact precautions B. change to airborne precautions C. change to standard precautions D. continue with droplet precautions

B. change to airborne precautions

The nurse is caring for an older adult with influenza. Which precautions will the nurse begin? A. airborne B. droplet C. contact D. none

B. droplet

A nurse is providing care to a client diagnosed with impetigo. The nurse would institute which type of infection control? A. Airborne precautions B. Droplet precautions C. Contact precautions D. Protective isolation

C. Contact precautions

The nurse is caring for a client who has been placed in strict isolation. Which nursing action is appropriate? A. Allow many family members to visit at once. B. Deliver flowers and balloons to the room. C. Remove fresh fruit from the room. D. No special precautions are required.

C. Remove fresh fruit from the room.

The nurse is educating a client with human immunodeficiency virus (HIV) about ways the virus can be transmitted. Which statements made by the client demonstrates the education provided was effective? Select all that apply. A. "If someone is exposed to my blood, I may transmit the virus to him or her." B. "I may transmit the virus to my child during pregnancy and childbirth." C. "I may transmit the virus if I share needles with another person." D. "If I sweat at the gym and someone touches me, he or she can contract the virus." E. "If someone uses the bathroom after I have been on the toilet, he or she can catch the virus."

A. "If someone is exposed to my blood, I may transmit the virus to him or her." B. "I may transmit the virus to my child during pregnancy and childbirth." C. "I may transmit the virus if I share needles with another person."

The client presents to the Emergency Department reporting fever, chills, and a productive cough. The chest x-ray shows an area of infiltrate, and the primary care provider prescribes a broad spectrum antibiotic. Which client teaching statement from the nurse is most appropriate regarding the prescribed drug? A. "This antibiotic is the best choice since the causative organism is not known." B. "This antibiotic causes fewer side effects than a narrow spectrum antibiotic." C. "Drug resistance can develop when the wrong antibiotic is used for pneumonia." D. "Pneumonia is usually caused by multiple organisms."

A. "This antibiotic is the best choice since the causative organism is not known."

A nurse is caring for a client, age 4 years, who is being treated for osteomyelitis in his left femur. He is on a 28-day course of IV vancomycin to be administered daily at 1300. Today is day 3 of treatment, and the pharmacist asks the nurse to draw a peak vancomycin level. What would be the most appropriate time to draw this blood? A. 1500 B. 1200 C. 2000 D. Wait until day 5 of treatment.

A. 1500

The nurse is preparing to don a gown to care for a client requiring contact precautions. When should the nurse don the gown? A. Before entering the client's room B. After entering the client's room C. Before taking the client's pulse D. After taking the client's pulse

A. Before entering the client's room

A client who has had abdominal surgery develops an infection in the wound while still hospitalized. Which precautions are implemented by the nurse to prevent the spread of infection? A. Contact precautions B. Droplet precautions C. Airborne precautions D. Protective isolation precautions

A. Contact precautions

The nurse is inserting an indwelling catheter. What steps will the nurse distinguish as priority in preventing an infection? A. Create an area for sterile field and opening packages B. Place water-soluble lubricant on catheter tip prior to insertion C. Wash the perineal area with soap and water D. Ensure opening port of the catheter is closed

A. Create an area for sterile field and opening packages

A veteran nurse is working with a new graduate nurse. The graduate nurse states that she was exposed to a client's blood and that she was not wearing any PPE. Which would be considered significant blood exposures by occupational health? Select all that apply. A. Hepatitis B B. Hepatitis C C. Tuberculosis D. HIV

A. Hepatitis B B. Hepatitis C D. HIV

A nurse follows surgical asepsis techniques for inserting an indwelling urinary catheter in a client. What is an accurate guideline for using this technique? A. Hold sterile objects above waist level to prevent inadvertent contamination. B. Consider the outside of the sterile package to be sterile. C. Consider the outer 3-in. (8-cm) edge of a sterile field to be contaminated. D. Open sterile packages so that the first edge of the wrapper is D. directed toward the nurse.

A. Hold sterile objects above waist level to prevent inadvertent contamination.

A client has sought care because of a knee wound that appears to have become infected. Which process is a component of the cellular stage of inflammation that occurred earlier in his body's response to infection? A. Migration of leukocytes to the area of the wound B. Constriction of the small blood vessels near the wound C. Release of histamine D. Production of antibodies

A. Migration of leukocytes to the area of the wound

Following a demonstration to a family member on how to insert a straight catheter, the nurse instructs the family member to remove the gloves by inverting one glove into the other. Which step would the nurse instruct the family member to do next? A. Perform hand hygiene B. Don a new pair of gloves to dispose of materials C. Wrap all used materials together and discard in biohazard container D. Use an appropriate lotion that does not interfere with antimicrobial effect of gloves or soaps

A. Perform hand hygiene

The nurse planning to insert an indwelling urinary catheter into a client should utilize which technique? A. Surgical asepsis B. Medical asepsis C. Universal precautions D. Contact precautions

A. Surgical asepsis

Which should be documented by the nurse? A. The fact that sterile technique was used for a given procedure B. The fact that the nurse donned gloves two different times during a procedure C. The fact that the nurse washed her hands before a procedure D. The specific items that the nurse transferred into a sterile field

A. The fact that sterile technique was used for a given procedure

The nurse is teaching a new nurse about preparing a sterile field. Which action made by the new nurse would indicate further teaching is required? A. The new nurse touches 1.5 in (4 cm) from the outer edges. B. The sterile field is set up at waist level. C. Direct visualization of the sterile field is maintained. D. The top flap of the package is opened away from the new nurse's body.

A. The new nurse touches 1.5 in (4 cm) from the outer edges.

A nurse is preparing a sterile field for the health care provider to perform a biopsy on a client. Which actions follow recommended guidelines for maintaining the sterile field for this procedure? Select all that apply. A. The nurse considers the outer 1-inch (2.5-cm) edge of the sterile field to be contaminated. B. The nurse places the cap of an opened solution on the table with edges down. C. The nurse discards a sterile field when a portion of it becomes contaminated. D. The nurse calls for help when realizing a supply is missing. E. The nurse drops a sterile item on a sterile field from the height of 12 inches (30 cm). F. The nurse holds an agency-wrapped item with the top flap opening toward the body.

A. The nurse considers the outer 1-inch (2.5-cm) edge of the sterile field to be contaminated. C. The nurse discards a sterile field when a portion of it becomes contaminated. D. The nurse calls for help when realizing a supply is missing.

Personal protective equipment (PPE) is used in health care facilities for primarily which reason? A. To protect both the staff and clients from becoming infected by one another B. To protect clients from becoming infected by staff members C. To protect staff members from becoming infected by clients D. To protect the hospital from legal liability

A. To protect both the staff and clients from becoming infected by one another

The nurse is caring for a client who is hospitalized and has an indwelling urethral catheter. Which finding would most likely indicate the client has developed an infection? A. Urine culture is positive for vancomycin-resistant enterococci (VRE). B. The client reports nausea and vomiting. C. The unlicensed assistive personnel (UAP) documents the client's oral temperature as 99°F (37.22°C) D. The nurse notes the client's urine is dark yellow with sediment.

A. Urine culture is positive for vancomycin-resistant enterococci (VRE).

After providing care to a client, the nurse is disposing of waste materials. Which waste would the nurse identify as injurious waste? Select all that apply. A. Used syringe with attached needle B. Used fingerstick lancet C. Blood-soiled dressings D. Cotton-tipped applicator used for wound cleaning E. Chemotherapy solution container

A. Used syringe with attached needle B. Used fingerstick lancet

Which are the names of the transmission-based precautions defined by the Centers for Disease Control and Prevention (CDC)? Select all that apply. A. airborne precautions B. droplet precautions C. contact precautions D. respiratory precautions E. microbial precautions F. body fluid precautions

A. airborne precautions B. droplet precautions C. contact precautions

The nurse is caring for a client with a surgical wound. Which action by the nurse best reduces the reservoir of infection? A. changing the soiled dressing B. wearing clean unsterile gloves when changing the dressing C. isolating the client's belongings D. applying a face mask with shield

A. changing the soiled dressing

The nurse is preparing discharge instructions for a family member who will be caring for a client with an abdominal incision. Which concept should be the priority in the teaching plan? A. hand washing B. sterile technique C. putting on gloves D. signs of healing

A. hand washing

The nurse is receiving a confused client with a draining wound onto the medical-surgical unit. Which room assignment will the nurse make? A. into a private room B. with a client with pneumonia C. with a client with a myocardial infarction D. with another client with a draining wound

A. into a private room

The nurse is using aseptic technique to insert an indwelling urinary catheter. Which technique made by the nurse is correct? A. keeping sterile field above waist level B. putting on sterile gloves before opening sterile package C. maintaining a 3-in. (7.5-cm) border around the sterile field D. opening the sterile package toward the nurse to prevent reaching over

A. keeping sterile field above waist level

A nurse is educating adolescents on how to prevent infections. The nurse determines which statement(s) by participants indicates more education is needed? A. "I need to wash my hands before and after going to the bathroom, so I will not contaminate my food." B. "It is okay to share glasses and eating utensils with my family and friends because they are all pretty healthy." C. "Everyone coughs and sneezes during allergy season so it is better to be safe and take precautions." D. "I do not need a flu shot because I am not considered a high-risk client"

B. "It is okay to share glasses and eating utensils with my family and friends because they are all pretty healthy."

When preparing a sterile field, the nurse notes that the bottle of sterile saline was opened 48 hours ago and is half full. What action does the nurse take to ensure that the saline used is sterile? A. Since the bottle has been open, previously used, and unexpired, "lip" it by pouring a small amount into a waste container or waste cup. B. Discard the bottle and get a new one because the saline has expired. C. Pour the saline into a sterile container on the sterile field by holding it 6 in (15 cm) above the container. D. Use the saline for the procedure and discard the remaining amount because it has been 48 hours since opening.

B. Discard the bottle and get a new one because the saline has expired.

The nurse is caring for an older adult with pneumonia. What action by the nurse will help the client prevent further pulmonary infections? A. Advise taking prophylactic antibiotics for the prevention of pneumonia B. Immunize the client with the pneumococcal vaccination once in a lifetime C. Discuss starting corticosteroids at low doses to prevent pulmonary infections D. Instruct client to limit fluids when coughing and congestion occurs

B. Immunize the client with the pneumococcal vaccination once in a lifetime

Nurses working in bed management are assigning clients from the emergency room to semiprivate rooms. Clients with which two diagnoses are appropriate to room together, based on safety and infection control standards? A. Clostridium difficile and diabetic ketoacidosis B. Reactive airway disease and exacerbation of chronic obstructive pulmonary disorder (COPD) C. Tuberculosis and pneumonia D. Appendectomy and a draining leg ulcer positive for methicillin-resistant Staphylococcus aureus

B. Reactive airway disease and exacerbation of chronic obstructive pulmonary disorder (COPD)

A client has a diagnosis of HIV and has been admitted to the hospital with an opportunistic infection that originated with the client's normal flora. Why did this client most likely become ill from his resident microorganisms? A. The resident microorganisms mutated and became virulent B. The client's immune system became further weakened C. The client's normal flora proliferated because of a nutritional deficit D. The client's normal flora began producing spores

B. The client's immune system became further weakened

The nurses on a busy surgical ward use hand hygiene when caring for postsurgical patients. Which action represents an appropriate use of hand hygiene? A. The nurse uses gloves in place of hand hygiene. B. The nurse keeps fingernails less than 1/4 in (0.63 cm) long. C. The nurse uses hand hygiene instead of gloves when in contact with blood. D. The nurse refrains from using hand moisturizer following hand hygiene.

B. The nurse keeps fingernails less than 1/4 in (0.63 cm) long.

Which clients are at a heightened risk for infection? Select all that apply. A. client with hypothermia B. client with gastric tube feeding C. client with an indwelling catheter D. client with an IV catheter E. client with hypertension

B. client with gastric tube feeding C. client with an indwelling catheter D. client with an IV catheter

When a nurse picks up a client's contaminated tissue without gloves and fails to wash the hands sufficiently, the nurse provides for the client's organisms to be spread by which type of transmission? A. airborne B. contact C. vector D. vehicle

B. contact

The nurse is preparing a sterile field for a procedure in the client's presence. Which is the most appropriate instruction to give the client in this situation? A. "Do not touch this, or I will have to start over. " B. "Everything is ready, I will leave the tray here for the provider." C. "I have set up this sterile field for your procedure, so please do not touch anything around the tray." D. "It is alright if you want to look at the supplies. Just be careful not to touch them."

C. "I have set up this sterile field for your procedure, so please do not touch anything around the tray."

The nurse is caring for a client who is to have a sterile dressing change to a wound. A student nurse enters the client's room and notices the nurse preparing the sterile field. After reviewing the image, which response by the student nurse to the nurse is the most accurate understanding of this procedure? A. "It is okay to turn the drape on the other side." B. "I use my whole hand to touch the non-waterproof surface before placing the sterile equipment on it." C. "The way you are doing it helps to minimize contamination of the non-waterproof side." D. "Using either side of the drape is okay, as long as you do not contaminate the sterile supplies on the field."

C. "The way you are doing it helps to minimize contamination of the non-waterproof side."

A pregnant woman with a history of genital herpes infection who is near term asks the nurse why she must have a cesarean section when she has not had an outbreak in a "long time". The nurse responds: A. "You will likely have an outbreak due to the stress of labor and delivery." B. "Have you discussed this with your physician?" C. "You may have infection in your birth canal that you are unaware of." D. "A cesarean section will prevent a herpes outbreak."

C. "You may have infection in your birth canal that you are unaware of."

A nurse is preparing an operating room theatre for a surgical procedure. Which point regarding the principles of surgical asepsis should the nurse keep in mind when preparing sterilized surgical instruments? A. When a sterile item touches something that is not sterile, it may not be contaminated. B. Any partially uncovered sterile package need not be considered contaminated. C. A commercially packaged surgical item is not considered sterile if past expiration date. D. Sterility may not be preserved even when one sterile item touches another sterile item.

C. A commercially packaged surgical item is not considered sterile if past expiration date.

What is an accurate guideline for removing soiled gloves after client care? A. Use the nondominant hand to grasp the opposite glove, near the cuffed end on the outside exposed area. B. Remove the glove on the nondominant hand by pulling it straight off, keeping the contaminated area on the outside. C. After removing the glove on the nondominant hand, hold the removed glove in the remaining gloved hand. D. After removing the first glove, slide the fingers of the ungloved hand between the remaining glove and the wrist and pull the glove straight off, with the contaminated area on the outside.

C. After removing the glove on the nondominant hand, hold the removed glove in the remaining gloved hand.

The nurse has finished caring for a client on contact precautions. Which nursing action regarding the stethoscope used to auscultate this client's lungs and bowel sounds is appropriate? A. Discard it in the waste can. B. Do nothing; it can be used again immediately. C. Disinfect it with alcohol swabs. D. Sterilize it by placing it in the autoclave.

C. Disinfect it with alcohol swabs.

An experienced nurse is teaching a student nurse about the proper use of hand hygiene. Which guideline should the nurse provide to the student? A. The use of gloves eliminates the need for hand hygiene. B. The use of hand hygiene eliminates the need for gloves. C. Hand hygiene is needed after contact with objects near the client. D. Hand lotions should not be used after hand hygiene.

C. Hand hygiene is needed after contact with objects near the client.

The student nurse asks the nursing instructor to explain why stress can increase the risk of infection. The instructor explains: A. Stress causes the body to increase insulin production and the resulting hypoglycemia predisposes the patient to infection. B. Stress is not considered a risk for infection. C. Stress causes the body to release cortisol, which can increase the risk of infection. D. Cortisol decreases the level of serum glucose, leading to infection.

C. Stress causes the body to release cortisol, which can increase the risk of infection.

The nurse is caring for a client with acute viral conjunctivitis. Which precautions will the nurse begin? A. airborne B. droplet C. contact D. none

C. contact

The nurse is assisting a client with a history of vancomycin resistant enterococcus (VRE). What precaution should the nurse implement? A. standard precautions B. droplet precautions C. contact precautions D. airborne precautions

C. contact precautions

The nurse is recovering from a mild upper respiratory infection with no fever. The nurse is assigned to care for four clients. What is the appropriate nursing action to prevent clients from getting the infection? A. perform meticulous hand hygiene B. only accept clients who are not immune compromised and perform meticulous hand hygiene C. perform meticulous hand hygiene and don a new mask with each client encounter C. wear a mask and don gloves with each client encounter until symptoms are completely gone.

C. perform meticulous hand hygiene and don a new mask with each client encounter

The nurse has worn a gown and gloves while caring for a client in contact isolation. How will the nurse appropriately remove this personal protective equipment (PPE)? A. remove gloves, wash hands, remove gown B. remove gown, wash hands, remove gloves C. remove gloves, remove gown, wash hands D. remove gown, remove gloves, wash hands

C. remove gloves, remove gown, wash hands

An infection or the products of infection carried throughout the body by the blood is called: A. contamination. B. infectious disease. C. septicemia. D. viral illness.

C. septicemia.

The nurse performs hand hygiene with soap and water before caring for a client. What is the primary rationale for this action? A. to protect the integrity of the nurse's immune system B. to prevent the nurse from developing disease C. to eliminate disease-producing organisms from the nurse's skin D. to sterilize the nurse's hands to prevent infection

C. to eliminate disease-producing organisms from the nurse's skin

A nursing student is performing a urinary catheterization for the first time on a female client and inadvertently contaminates the catheter by touching the bed linens. What should the nurse do next to maintain surgical asepsis for this procedure? A. Clean the client's genital area with disinfectant-soaked cotton swabs from inside to outside B. Connect the catheter to the drainage bag using sterile medical tubing C. Clean the catheter with antiseptic wipes and allow to dry D. Gather new sterile supplies and start over

D. Gather new sterile supplies and start over

The nurse must assign a room for a client admitted with endocarditis and methicillin-resistant Staphylococcus aureus (MRSA) in the blood. A client with which diagnosis can share a room with this client? A. Vancomycin-resistant enterococci and urinary tract infection B. Clostridium difficile and colitis C. Coronary artery bypass grafting D. MRSA in the wound

D. MRSA in the wound

A lead nurse is removing personal protective equipment after dressing the infected wounds of a client. Which is the prioritynursing action? A. remove the garments that are most contaminated B. make contact between two contaminated surfaces C. make contact between two clean surfaces D. handwashing before leaving the client's room

D. handwashing before leaving the client's room

The nurse is educating a client and caregivers about recurrent infections the client has experienced. What priority intervention can the nurse include that is a first line of defense? A. the cell-mediated immune response B. early intervention with antibiotics C. staying home when sick D. intact skin and mucous membranes E. low levels of flora

D. intact skin and mucous membranes

A client comes to the emergency department reporting becoming very ill after consuming shrimp and lobster. How will the nurse document this condition? A. contagious disease B. infectious disease C. communicable disease D. noncommunicable disease

D. noncommunicable disease