115 PrepU Ch.66 Management of Patients with Infectious Diseases

The nurse is providing education to a client who has been diagnosed with chlamydia. The client will begin treatment with azithromycin today. Which teaching point should the nurse reinforce with this client?

"Abstain from any sexual activity for 1 week after the antibiotic is complete."

A client weighing 187 lbs (85 kg) has mild dehydration and is prescribed to receive 50 mL/kg/4 hours of an oral rehydration solution. Which amount of solution will the nurse provide the client over 1 hour? Round to the nearest whole number.

1063

You are a school nurse teaching a health class about the chain of infection in the transmission of sexually transmitted diseases (STDs). A student asks you which part of the chain of infection can be missing when transmission occurs. What would be your best answer?

"All parts of the chain of infection have to be present for the disease to be passed to another human."

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."

The nurse is instructing the family on home care of a client with shingles. The family member asks whether their teenage children should stay in a different room. What is the best response by the nurse?

"Have they had chickenpox or the varicella vaccine?"

The nurse is seeing a female client in a community health clinic who reports having dyspareunia and pelvic tenderness after her menstrual period. The client also reports she experiences pain when she has a bowel movement. What question should the nurse include when obtaining the client's health history?

"Have you ever been assessed for gonorrhea and chlamydia in the past?"

The nurse has been teaching a client with genital herpes how to care for the lesions. Which of the following statements by the client indicates that she needs additional instruction?

"I'll wear occlusive underwear to prevent transmission of the virus."

A pregnant patient asks the nurse if it is all right for her take the varicella immunization for entrance into nursing school. What is the best response by the nurse?

"It is not recommended that pregnant women take the live virus. You should wait until after your child is born."

A child is brought to the emergency department by his parents. The child has been experiencing significant diarrhea over the past 36 hours. Further evaluation reveals infectious diarrhea with moderate dehydration. The physician orders oral rehydration solution, 100 mL/kg over the next 4 hours. The child weighs 77 lbs. How much would the nurse expect to administer?

3500

A client the nurse is caring for has developed a bladder infection while in the hospital. The client has had a Foley catheter for two weeks. The client's family asks you how the client got this infection. What would be the nurse's best response?

"People in hospitals are often more susceptible to infections because they are already ill and they are exposed to germs while they are in the hospital."

The nurse is meeting with the mother of an 11-year-old girl to provide decision making support and education regarding human papillomavirus (HPV) vaccination. The mother states, "I am confused about why my 11 year old needs to be protected from a sexually transmitted infection. She is so young and not sexually active. Why does she need the vaccination now?" What is the nurse's best response?

"The vaccination helps to prevent cervical cancer in adult women. It works better if she has it before she becomes sexually active. Let's talk about some of the concerns you have about the vaccination"

The parent of a child diagnosed with chickenpox asks when the child can go to play group again. What is the best response by the nurse?

"When the vesicles and pustules have crusted."

The nurse is providing education to a client who has been diagnosed with trichomoniasis. When providing information about metronidazole, what should the nurse be certain to include?

"You will need to avoid alcohol during treatment and for 3 days after the medication is complete."

A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis?

A painless genital ulcer that appeared about 3 weeks after unprotected sex

A nurse is having a yearly employee tuberculin skin test. Which skin test results would indicate a positive result?

An induration of 12mm

A client is admitted with bacterial meningitis. Which hospital room is the best choice for this client?

An isolation room three doors from the nurses' station

You are caring for a client with an impaired immune system. You are concerned about the client acquiring a nosocomial infection. What intervention would help nurses control nosocomial infections?

Apply principles of medical and surgical asepsis.

Which of the following is the medication of choice for early syphilis?

Penicillin G benzathine

Which is the most frequent cause of diarrheal disease in the United States?

Campylobacter infection

The nurse is caring for a group of clients at a public health clinic. Which sexually transmitted disease would the nurse focus the client education on curative goals?

Chlamydia

The nurse is providing care to a client who has been diagnosed with gonorrhea. The nurse also prepares the client for treatment of which of the following?

Chlamydia

A long-term care facility is the site of an outbreak of infectious diarrhea. The nurse educator has emphasized the importance of hand hygiene to staff members. The use of alcohol-based cleansers may be ineffective if the causative microorganism is identified as what?

Clostridium difficile

Which of the following describes microorganisms present without host interference or interaction?

Colonization

Which term is used to describe microorganisms present in a host without host interference or interaction?

Colonization

A client is diagnosed with scabies in a long-term care facility. Which type of client care precautions would the nurse institute?

Contact

Patients who have had pelvic inflammatory disease (PID) are prone to which of the following complications?

Ectopic pregnancy

A nurse is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention?

Foul-smelling discharge from the penis

The nurse is assessing a client in the emergency department who grimaces and reports swelling of the testicles, burning on urination and a green discharge from the penis. The nurse suspects the client will be diagnosed with which infection?

Gonorrhea

The nurse is visiting the home of a client with shingles. Which information will the nurse emphasize with the client and family members? Select all that apply.

Hand hygiene techniques NOT- Cleaning products for home use Actions to protect skin integrity Adherence to antibiotic therapy Reasons to contact the health care provider

The nurse is caring for a client with genital herpes experiencing a reoccurrence. Which nursing diagnosis would be the priority?

Impaired Skin Integrity

The infection control nurse collects data that indicates an increase in the number of clients in the hospital with multidrug-resistant infections. What priority education should healthcare providers receive?

Performing hand hygiene

The nurse is completing the admission assessment on a client with renal failure. The client states, "I was diagnosed with impetigo yesterday." Which is the appropriate nursing intervention?

Initiate contact isolation protocol.

A client contracts Calicivirus while on a cruise and has been experiencing nausea and diarrhea for several days. Which guidance will the nurse provide to the client?

Limit exposure to others for 2 weeks.

Which of the following is the most effective treatment for trichomoniasis?

Metronidazole (Flagyl)

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?

Mode of transmission

The nurse is seeing a client in the community health clinic who reports finding "sores" in the mouth. On assessment, the nurse notes the lesions appear flat, flesh colored and papillary. What should the nurse do next?

Obtain a health history that includes inquiring about sexual health practices

A nurse implements aseptic technique as a means to break the chain of infection at which element?

Portal of entry

The nurse has received several laboratory studies back at the clinic. Which of these results should be reported to the local health department?

Positive gonorrhea

A client admitted with bacterial meningitis must be transported to the radiology department for a repeat computed tomography scan of the head. His level of consciousness is decreased, and he requires nasopharyngeal suctioning before transport. Which infection control measures are best when caring for this client?

Put on gloves, a mask, and eye protection during suctioning, and then apply a mask to the client's face for transport.

Which organism is responsible for impetigo?

Staphylococcus aureus

Painless chancres are associated with which systemic disease?

Syphilis

Painless chancres or ulcerated lesions are associated with which systemic disease?

Syphilis

When a hospitalized client requires contact precautions, which responses is necessary?

The client should be placed in a private room when possible.

Which statement reflects what is known about the Ebola virus?

The diagnosis should be considered in a client who has a febrile, hemorrhagic illness after traveling to Asia or Africa.

The school health nurse is conducting a teaching session for parents to provide information about the human papillomavirus (HPV) vaccination. What prevention information should the nurse include in the session?

The effect of the vaccination is optimized if it is administered before the child becomes sexually active.

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 infection is being transmitted by healthcare personnel.

Nursing students are reviewing information about infectious diseases and events associated with infection. Students demonstrate understanding of the information when they identify the incubation period as which of the following?

Time between exposure and onset of symptoms

After demonstrating to a group of nursing students the proper technique for handwashing using soap and water, the nursing instructor determines that the teaching has been successful when the students demonstrate which of the following?

Vigorously scrubbing between the fingers

The nurse is caring for a client with secondary syphilis. What intervention should the nurse institute when caring for this client?

Wear gloves if contact with lesions is possible.

Which of the following nursing instructions is most important for the nurse to emphasize to the client with a new HSV-2 diagnosis?

You must inform all sexual partners.

The nurse is presenting a community lecture about STIs, and emphasizes that some STIs are easily cured with early and adequate treatment. Which is not among these easily treated diseases?

genital herpes

The six elements necessary for infection include a causative organism, a reservoir of available organisms, a portal or mode of exit from the reservoir, a mode of transmission from reservoir to host, a susceptible host, and

mode of entry into the host.

The nurse teaches the parent of a child with chickenpox that the child is no longer contagious to others when

the vesicles and pustules have crusted.

A nurse is assessing a client who may be in the early stages of dehydration. Early manifestations of dehydration include:

thirst or irritability.