Fundamentals Exam 1 set 5 infection control, prevention, and management

A client who comes to the clinic asks the nurse, "Somebody told me that stress increases my risk for infection. How does this happen?" Which response by the nurse would be most appropriate?

"Stress leads to increased secretion of cortisol, which suppreses your immune response."

The mother of a newborn asks the nurse about her newborn's risk for infection. Which statement by the nurse would be most appropriate?

"Your baby's resistance comes from the antibodies you passed on to him before birth and now with breast feeding."

A nurse in an oncology care unit is reviewing the laboratory test results of several clients. The nurse identifies that the client with which leukocyte count most likely has an infection?

18,000 cells/mm

A nurse in an oncology care unit is reviewing the laboratory test results of several clients scheduled to receive chemotherapy. The nurse determines that the client with which leukocyte count will most likely have the chemotherapy withheld?

2,500 cells/mm3

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 1 p.m. 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?

3 pm

The postoperative client refuses to do deep breathing, and he refuses to turn while in bed. He informs the nurse that it hurts for him to do both of these things. Which intervention should the nurse perform first?

Assess client's pain level and manage pain accordingly.

A nursing instructor is describing the phases of a febrile episode. What would the instructor describe as happening first?

Chill

A client has a concentration of Staphylococcus aureus located on his skin. He 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 stage?

Colonization

The nurse works on a long-term care unit. In the last 2 weeks more than half the clients on the unit have been diagnosed with gastroenteritis. What is the most likely reason?

The infection is being transmitted by health care personnel.

A nurse suspects that a client has a respiratory infection. Which symptom would the nurse be least likely to assess?

clear mucus

The nurse has admitted a new client to the unit. This client has an open draining sore on the leg. Which diagnostic test would the nurse anticipate being ordered?

culture and sensititivty

After educating students about changes in the immune system and risk for infection as people age, the instructor determines that the education was successful when the students identify:

decreased cellular immunity.

A nursing student is reviewing the progression of an infection. Place the following in the order in which each would occur during the communicable period.

exposure to the pathogen nonspecific symptoms positive laboratory tests return of appetite

A client who thinks he has an infection has come to the clinic. During the assessment, which question would the nurse most likely ask first?

how long have you had the infection"?

The physician orders a serum trough drug level for a client who is receiving antibiotic therapy. The client is receiving the drug every 6 hours: at midnight, 6 a.m., noon and 6 p.m. The nurse anticipates that the specimen would be obtained:

just before the 6 a.m. dose

A nurse is assessing a client for signs and symptoms of infection. What would the nurse expect to asses? Select all that apply.

lymph node enlargement, increased respiratory rate, fever

A client with an infection is experiencing prolonged, severe, shaking chills with a high fever. What may the nurse expect to administer to alleviate the shaking chills?

meperdine

During an interaction with a client who is HIV-positive, the nurse learns that the client has nonspecific symptoms such as nausea, fever, general weakness, and aches and pains. The nurse interprets these findings as reflecting which stage of the communicable period?

prodromal

A client is receiving prescribed antibiotic therapy to treat an infection. On the fourth day of therapy, the client comes to the clinic and tells the nurse that she has developed a really sore mouth. After inspection, the nurse suspects that the client has developed a fungal oral infection. The nurse identifies this as:

superinfection

On a preoperative surgical unit, as a standard of care, all clients are swabbed for methicillin-resistant Staphylococcus aureus (MRSA). Prior to his surgery, a nurse notes that a specific client's results have come back positive. The client asks the nurse what this means. What is the nurse's best response?

• "These results indicate that you are colonized with MRSA."

A nurse is working with a 50-year-old woman status post liver transplant. She is on multiple immunosuppressive drug therapies, is intubated, and is n.p.o. with parenteral nutrition running through a central line. What would raise the nurse's suspicions that the client is developing septicemia? Select all that apply.

• A WBC count of 15,000 with 12% bands • temperature of 103.1°F (39.5°C)

A nurse assessing a client with an injured ankle observes edema and pus formation around the injury. Which of the following are systemic responses to inflammation? Select all that apply.

• presence of fever and fatigue • loss of appetite • presence of aches in muscles

A nurse is preparing an education plan for a client being discharged home after successful treatment for a wound infection. What would the nurse be least likely to include in the education plan?

intravenous antibiotic adminstration

A nursing instructor is preparing a class about the different types of white blood cells. Which of the following would the instructor include as agranulocytes? Select all that apply.

monocytes and t-lymphocytes