Subtopic Immunologic System and Infectious Diseases

What are the clinical manifestations during the fulminant stage in a client with inhalation anthrax? Select all that apply. 1 Septic shock 2 Harsh cough 3 Mild chest pain 4 Pleural effusion 5 Body temperature of 104 °F

1 Septic shock 4 Pleural effusion 5 Body temperature of 104 F Inhalation anthrax is a bacterial infection caused by Bacillus anthracis. Manifestations such as septic shock, pleural effusion, and body temperature above 103°F indicate the fulminant stage of inhalation anthrax. The prodromal stage is the early stage of inhalation anthrax; clinical manifestations include a harsh cough and mild chest pain.

What should be used to clean needles and syringes between intravenous drug users (IDUs)? 1 Bleach 2 Hot water 3 Ammonia 4 Rubbing alcohol

1 Bleach Intravenous drug users (IDUs) should be instructed to fill syringes with household bleach and shake the syringe for 30 to 60 seconds. Hot water, ammonia, or rubbing alcohol are not used to disinfect used syringes.

Which drug can be administered via the intramuscular route to treat anaphylaxis? 1 Epinephrine 2 Methdilazine 3 Phenylephrine 4 Mycophenolate mofetil

1 Epinephrine Epinephrine is administered through the intramuscular route to treat anaphylaxis. Methdilazine is administered to treat allergic reactions and pruritus. Phenylephrine is administered orally, not intramuscularly, to treat anaphylaxis. Mycophenolate mofetil is administered intravenously as an immunosuppressant agent.

Which bacteria colonies are commonly found in a client's large intestine? 1 Escherichia coli 2 Neisseria gonorrhoeae 3 Staphylococcus aureus 4 Haemophilus influenzae

1 Escherichia coli Escherichia coli are bacteria that are part of the normal flora in the large intestine. Neisseria gonorrhoeae causes gonorrhea and pelvic inflammatory disease. Staphylococcus aureus secretes toxins that damage cells and causes skin infections, pneumonia, urinary tract infections, acute osteomyelitis, and toxic shock syndrome. Haemophilus influenzae causes nasopharyngitis, meningitis, and pneumonia.

Which organism is responsible for causing dermatitis related to a sexually transmitted infection? 1 Phthirus pubis 2 Candida albicans 3 Campylobacter jejuni 4 Ureaplasma urealyticum

1 Phthirus pubis Phthirus pubis is responsible for dermatitis related to sexually transmitted infections. Candida albicans may lead to vulvovaginitis. Campylobacter jejuni may cause proctitis. Ureaplasma urealyticum may cause salpingitis, infertility, reproductive loss, and ectopic pregnancies.

Which dietary modifications can help improve the nutritional status of a client with acquired immunodeficiency syndrome (AIDS)? 1 Refraining from consuming fatty foods 2 Refraining from consuming frequent meals 3 Refraining from consuming high-calorie foods 4 Refraining from consuming high-protein foods

1 Refraining from consuming fatty foods Many clients with AIDS become intolerant to fat due to the disease and the antiretroviral medications. Therefore the client should be instructed to refrain from consuming fatty foods. The client should be encouraged to eat small and frequent meals to improve nutritional status. High-calorie and high-protein foods are beneficial to clients with AIDS because they provide energy and build immunity.

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. The Centers for Disease Control and Prevention (Canada: Public Health Agency of Canada) states that standard precautions should be used for all clients; these precautions include wearing of gloves, gown, mask, and goggles when there is risk for exposure to blood or body secretions. There is no indication that airborne precautions are necessary. Planning interventions to limit direct contact and discouraging long visits from family members will unnecessarily isolate the client.

The nurse is counseling a client infected with human immunodeficiency virus (HIV) regarding prevention of HIV transmission. Which statement by the client indicates the nurse needs to follow up? 1 "I should abstain from sexual activity." 2 "I can safely have anal sex without any barriers." 3 "I should get HIV counseling if planning for pregnancy." 4 "I will use condoms while having sexual intercourse."

2 "I can safely have anal sex without any barriers." The client with HIV should use barrier protection when engaging in insertive sexual activity such as anal, oral, and vaginal. Therefore the nurse should follow up to provide the client with the correct information. All the other statements are correct and need no follow up. Abstaining from all sexual activity is a safe way to eliminate the risk of exposure to HIV in semen and vaginal secretions. The client should undergo HIV counseling and routinely offer access to voluntary HIV-antibody testing when planning for pregnancy. The most commonly used barrier is a condom, which allows for protected intercourse.

The nurse is caring for a client with a respiratory tract infection that started with a common cold but has progressed to whooping cough. The client also has coughing fits that last for several minutes. Which organism is responsible for the client's condition? 1 Bacillus anthracis 2 Bordetella pertussis 3 Streptococcus pneumoniae 4 Mycobacterium tuberculosis

2 Bordetella pertussis This disease is caused by Bordetella pertusis. Pertussis is a respiratory tract infection that begins with the common cold and progresses to whooping cough. The client also develops coughing fits that last for several minutes. Inhalation anthrax is caused by Bacillus anthracis. Streptococcus pneumoniae may cause pneumonia. Mycobacterium tuberculosis infection leads to tuberculosis.

What determines if a client will develop AIDS from an HIV infection? 1 Level of IgM in the blood 2 The number of CD4+ T-cells available 3 Presence of antigen-antibody complexes 4 Speed with which the virus invades the RNA

2 The number of CD4+ T-cells available Whether HIV becomes AIDS depends upon the number of CD4+ T-cells. IgM and the presence of antigen-antibody complexes have no effect on HIV. The speed with which HIV invades the RNA has no impact on the future development of AIDS.

Which disorder does the image illustrate? (image of woman's face with flat reddened areas/circles on cheeks and nose) 1 Angioedema 2 Oral candidiasis 3 Systemic sclerosis 4 Systemic lupus erythematosus

4 Systemic lupus erythematosus Systemic lupus erythematosus is a chronic, progressive, inflammatory connective tissue disorder that causes major body organs and systems to fail. The image illustrates a "butterfly" rash, which is a major skin manifestation of systemic lupus erythematosus. Angioedema is the diffuse swelling of the eyes and lips. In oral candidiasis, white plaque-like lesions appear on the tongue, palate, pharynx, and buccal mucosa. In systemic sclerosis, skin thickening on the trunk, face, and extremities is observed.

A school nurse is asked to develop a program for teachers about infection control, especially focusing on hand washing technique. What is the most effective way for the nurse to evaluate what the teachers have learned? 1 Observe the teachers lecture the children about hand hygiene. 2 Give an objective written final examination to the teachers. 3 Schedule a seminar for the teachers to share their knowledge. 4 Watch the teachers demonstrate infection control techniques.

4 Watch the teachers demonstrate infection control techniques. The best way to evaluate learning is by feedback demonstration of precautions related to infection control, such as hand washing techniques. This method is observable and must meet objective criteria. Although observing a lecture, giving a written exam, or sharing what has been learned in a seminar are all evaluation techniques that may be used, none of these methods are as objective and definitive as observing an actual psychomotor demonstration of techniques.