PU 66 PART 11
D
A nurse is assessing a client who may be in the early stages of dehydration. Early manifestations of dehydration include: a. coma or seizures. b. sunken eyeballs and poor skin turgor. c. increased heart rate with hypotension. d. thirst or irritability.
B
A 2-year-old is brought to the clinic by her mother who tells the nurse her daughter has diarrhea and the child is complaining of pain in her stomach. The mother says that the little girl had not eaten anything unusual, consuming homemade chicken strips and carrot sticks the evening prior. Which bacterial infection would the nurse suspect this little girl of contracting? a. Escherichia coli b. Salmonella c. Shigella d. Giardia lamblia
C
A 28-year-old sexually active male presented to a clinic because he was concerned about a round, painless sore on the shaft of his penis that had appeared 2 days prior to his visit. The nurse practitioner recognized the lesion as a "chancre," an indicator of primary syphilis. The nurse should tell the patient: a. "Abstain from sexual activity for 2 weeks, after which the lesion will resolve." b. "No treatment is necessary unless you notice a rash on your chest." c. "An antibiotic injection is the best treatment since the lesion has just occurred." d. "Without treatment, the lesion will increase in size and become painful."
A E
A 47-year-old male client presented to the medical unit and the health care team suspects tuberculosis (TB). The nurse is admitting the client to a reverse isolation room. QuantiFERON testing and chest x-ray are pending. Urinalysis results are negative. No other testing was performed prior to admission to isolation. The client denies any chest pain, shortness of breath (SOB), or respiratory difficulty. The client presents with productive yellow sputum. Based on the provided assessment status, the nurse should utilize __1__ to prevent exposure and __2__ to collect specimens for additional testing. 1: a. airborne precautions b. droplet precautions c. contact precautions d. sterile technique 2. e. sputum f. urinalysis g. blood specimen for rapid plasma reagin (RPR)
C
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? a. Use standard precautions, which require gloves for suctioning. b. Put on gloves, a mask, and eye protection. c. Put on gloves, a mask, and eye protection during suctioning, and then apply a mask to the client's face for transport. d. Take no special precautions for this client.
A
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? a. Limit exposure to others for 2 weeks. b. Continue with normal activities of daily living. c. Use an over-the-counter disinfectant in the home. d. Rectal bleeding is the most common complication.
C
A client in the emergency department is diagnosed with a communicable disease. When complications of the disease are discovered, the client is admitted to the hospital and placed in respiratory isolation. Which infection warrants airborne isolation? a. Mumps b. Impetigo c. Measles d. Cholera
A
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? a. "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." b. "People in hospitals sometimes exhibit signs of infections they had before being admitted." c. "Sometimes people in hospitals get exposed to microorganisms that their visitors bring in." d. "People in hospitals are surrounded by infectious agents, so they can get infections they didn't have before being admitted."
A
A client who is blind is admitted for treatment of gastroenteritis. What does the nurse recognize as the highest priority for this client? a. Fluid volume deficit b. Risk for injury c. Activity intolerance d. Limited mobility
B
A client with genital warts is receiving treatment with a local application of trichloroacetic acid. Which client statement indicates adequate understanding of the procedure? a. "One or two treatments should get rid of the warts." b. "I'm temporarily not contagious once the warts are destroyed." c. "Once the warts are gone, then I know I'm cured." d. "My partner doesn't need to be treated."
A
A client with suspected primary syphilis is to undergo diagnostic testing. Which of the following would the nurse expect to be done to confirm this diagnosis? a. Direct identification in a specimen from the chancre lesion b. Venereal Disease Research Laboratory (VDRL) test c. Rapid plasma reagin circle card test (RPR-CT) d. Fluorescent treponemal antibody absorption tests (FTA-ABS)
B
A group of students are reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which of the following as the cause of condylomata? a. Herpes virus b. Human papilloma virus c. Treponema pallidum d. Hemophilus ducreyi bacillus
A
A nurse has heard that there have been three cases of pertussis in the community and wants to make sure his or her inoculations are up to date. What action should the nurse take? a. Have a single-dose Tdap administered. b. It is not necessary to be inoculated since there is a slim chance of acquiring the disease. c. Take a series of 3 Tdap 3 months apart. d. Have a Tdap administered and 6 months later have another.
D
A nurse implements aseptic technique as a means to break the chain of infection at which element? a. Reservoir b. Portal of exit c. Means of transmission d. Portal of entry
A
A nurse is assessing a client with vaginal discharge. The nurse suspects bacterial vaginosis when the client states which of the following? a. "I noticed a strange fishy odor during my period." b. "I've been experiencing some really intense itching." c. "The discharge looks almost like cottage cheese." d. "The discharge is yellowish but thin."
D
A nurse is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention? a. Rashes on the palms of the hands and soles of the feet b. Cauliflower-like warts on the penis c. Painful red papules on the shaft of the penis d. Foul-smelling discharge from the penis
A
A nurse is developing a plan of care for a female client experiencing her first outbreak of genital herpes. Which nursing diagnosis would the nurse most likely identify as the priority? a. Acute pain related to the development of the genital lesions b. Deficient knowledge related to the disease and its transmission c. Ineffective coping related to the increased stress associated with the infection d. Hyperthermia related to body's response to an infectious process
D
A nurse is preparing a presentation for a local community group in a small rural area about hantavirus pulmonary syndrome. Which of the following would the nurse suggest as a major prevention strategy? a. Vaccinating infants and children b. Avoiding whirlpool spas c. Wearing insect repellent d. Eliminating rodent food sources in areas near humans
A
A nurse who provides care in a busy ED is in contact with hundreds of clients each year. The nurse has a responsibility to receive what vaccine? a. Hepatitis B vaccine b. Human papillomavirus (HPV) vaccine c. Clostridium difficile vaccine d. Staphylococcus aureus vaccine
A
A nurse would anticipate instituting contact precautions for a client with which of the following? a. Clostridium difficile infection b. Measles c. Varicella d. Mumps
A
A patient presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole (Flagyl). What is the paramount nursing intervention in discharge planning? a. Instruct the patient not to drink alcohol with this treatment. b. Counsel the patient to refrain from sex for 1 week. c. Advise the patient to take medication with a glass of milk. d. Reassure the patient further sexually transmitted infection (STI) testing is not indicated.
B
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? a. Washing the hands for 5 to 10 seconds b. Vigorously scrubbing between the fingers c. Removing the soap with a paper towel before rinsing d. Washing underneath artificial fingernails
C
An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported? a. Genital herpes b. Hepatitis B c. Syphilis d. Condyloma acuminata
B C D
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. a. virulence b. infectious agent c. portal of entry d. susceptible host e. fomites
A
Flu and cold season offers excellent examples of physiologic reflexes to ward off illness. One problem is that an effective mechanical defense for one person can complete a link in the chain of infection for someone else. To which link is the above referring? a. means of transmission b. reservoir c. portal of entry d. infectious agent
B
Painless chancres or ulcerated lesions are associated with which systemic disease? a. Kaposi sarcoma b. Syphilis c. Psoriasis d. Urticaria
A
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? a. The effect of the vaccination is optimized if it is administered before the child becomes sexually active. b. The vaccination is available only to girls but, in the long term, protects both genders from sexually transmitted infections. c. The HPV vaccination prevents the future need for cervical cancer screening in women. d. A Pap smear test is required prior to administration of the HPV vaccination.
A
Symptoms of pelvic infection usually begin with which of the following? a. Pain b. Fever c. Anorexia d. Headache
A
The nurse is assessing a client who reports stiff joints and alopecia. While taking the client's health history, the client reports having multiple sexual partners in the past 6 months and finding a lesion on her labia about 1 month before today's appointment. What should the nurse anticipate based on the signs and symptoms presented? a. The client will require treatment for the secondary stage of syphilis. b. Treatment planning for a chlamydial infection is needed. c. Pelvic inflammatory disease is the likely cause of the hair loss. d. The client will require a colposcopy to confirm any diagnosis.
C
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 a. mode of exit from the host. b. virulent host. c. mode of entry into the host. d. latent time period.
A
The nurse is caring for a client who asks, "I heard the nurse tell my doctor I have adnexal tenderness. What does that mean?" The client has also been experiencing fever and loss of appetite. How should the nurse respond? a. "This means the internal body parts surrounding your uterus are also sore. Knowing this helps confirm that you have pelvic inflammatory disease and now you can be given the correct treatment." b. "It means your adrenal glands are also sore and painful. This means the infection that caused the pelvic inflammatory disease has spread to other parts of your body." c. "This kind of pelvic pain means you probably have an ectopic pregnancy. This problem usually leads to infertility. Further investigation is needed." d. "This is a symptoms of bacterial vaginosis. This is a mild infection and you do not need to be hospitalized for treatment. You will have antibiotics as an outpatient."
B
The nurse is completing a community education via a pamphlet on sexually transmitted diseases. Which key point is most important for the nurse to emphasize? a. Common age-groups for clients with sexually transmitted diseases are in their late teens and 20s. b. Many people are asymptomatic and show no symptoms contributing to the spread of the disease. c. Some sexually transmitted diseases can cause infertility caused by scarring of reproductive organs. d. Some sexually transmitted diseases can be transmitted to newborns through the birth canal.
A
The nurse is counseling a client who has been diagnosed with two sexually transmitted infections. The client is shocked and states not knowing how this has happened. Which of the following statements is most appropriate by the nurse? a. "Your partner could have been asymptomatic at that time." b. "You should have asked your partner if they have any infections." c. "Sexually transmitted infections have obvious signs of their presence." d. "Your partner should have told you of a previous infection."
B
The nurse is discussing information regarding the human papilloma viral (HPV) infection. Which statement, made by the client, requires clarification? a. "HPV transmission may occur when the client is asymptomatic." b. "HPV is spread during sexual intercourse." c. "HPV may be spread to a newborn at the time of delivery." d. "HPV can be spread by autoinoculation."
C
The nurse is giving an educational talk to a local parent-teacher association. A parent asks how to help the family avoid community-acquired infections. What would be the nurse's best response to help prevent and control community-acquired infections? a. "Encourage your family to adopt a healthy diet and exercise regimen." b. "Encourage your family to stop smoking." c. "Make sure your family has all their childhood immunizations." d. "Make sure your family has regular checkups."
A
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? a. genital herpes b. chlamydia c. gonorrhea d. syphilis
B
The nurse is providing education to a client who has a positive nontreponemal test (NTT). The client states, "If I've already had a positive test and I know I have syphilis, why do I need to have another test?" How should the nurse respond? a. "An additional test needs to be done to determine which antibiotics you will need." b. "A second test can help confirm the diagnosis, because the NTT can give a false-positive result." c. "This test will help determine of the infection has moved to the third stage." d. "Another test can identify additional sexually transmitted infections you may have acquired."
B
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? a. "It is very important to maintain good handwashing, even while you are being treated." b. "Abstain from any sexual activity for 1 week after the antibiotic is complete." c. "Coinfection with the herpes simplex virus is common with chlamydia." d. "If you become reinfected, symptoms will immediately be present."
B
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? a. "You will need to have a follow up appointment to determine if you have been cured." b. "You will need to avoid alcohol during treatment and for 3 days after the medication is complete." c. "Sexual activity with your partner can continue as usual while you are being treated." d. "This infection is not curable and treatment is aimed at symptom management."
B
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? a. Inform the client that the lesion in the mouth is consistent with a human papillomavirus (HPV) infection b. Obtain a health history that includes inquiring about sexual health practices c. Provide the client with information about having a colposcopy d. Suggest serology testing for herpes simplex virus (HSV)
B
The nurse observes a nursing assistant leave the room of client diagnosed with Clostridium difficile infection without washing hands. Which is the priority action by the nurse? a. Report the nursing assistant to the nurse manager. b. Have the nursing assistant wash hands with soap and water. c. Provide written documentation about the incident. d. Teach the nursing assistant about the chain of infection.
A B D
The nurse recognizes what groups of people are at an increased risk for infection? Select all that apply. a. Debilitated clients b. Older adults c. Adolescents d. Clients with impaired skin e. Clients with pancreatic disease
A
The nurse teaches the parent of a child with chickenpox that the child is no longer contagious to others when a. the vesicles and pustules have crusted. b. the first rash appears. c. the fever disappears. d. the rash is changing into vesicles, and pustules appear.
A
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? a. "When the vesicles and pustules have crusted." b. "Two days after the rash appears." c. "When the fever disappears." d. "When the rash is changing into vesicles, and pustules appear."
B
When assessing a client with suspected pertussis, which of the following would the nurse most likely find? a. High fever b. Paroxysmal cough c. Chest pain d. Diarrhea
C
Which condition of generally requires the identification and treatment of sexual partners? a. Bartholinitis b. Candidiasis c. Chlamydia trachomatis infection d. Endometriosis
D
Which instruction should be given to a woman newly diagnosed with genital herpes? a. Obtain a Papanicolaou (Pap) test every 3 years. b. Have your partner use a condom when lesions are present. c. Use a water-soluble lubricant for relief of pruritus. d. Limit stress and emotional upset as much as possible
D
Which is the usual incubation period (from infection to first symptom) for AIDS? a. 3 to 6 months b. 1 year c. 5 years d. 10 years
A
Which of the following describes host interaction with an organism? a. Infection b. Colonization c. Infectious disease d. Reservoir
A
Which of the following describes microorganisms present without host interference or interaction? a. Colonization b. Infection c. Infectious disease d. Reservoir
A
Which of the following is the most common sexually transmitted infection (STI) among young, sexually active people? a. Human papillomavirus (HPV) b. Gonorrhea c. Chlamydia d. Trichomoniasis
D
Which organism is responsible for impetigo? a. Histoplasma capsulatum b. Bacillus anthracis c. Clostridium difficile d. Staphylococcus aureus
A
Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis? a. Latency b. Secondary c. Primary d. Tertiary
A
Which statement reflects what is known about the Ebola virus? a. The diagnosis should be considered in a client who has a febrile, hemorrhagic illness after traveling to Asia or Africa. b. Treatment during the acute phase includes administration of penicillin and ventilator and dialysis support. c. The viruses are usually transmitted by airborne exposure. d. Symptoms include severe lower abdominal pain, nausea, vomiting, and dehydration.
A
Which term describes the time interval after primary infection when a microorganism lives within the host without producing clinical evidence? a. Latency b. Virulence c. Incubation period d. Susceptibility
C
Which term refers to a state of microorganisms being present within a host without causing host interference or interaction? a. Susceptible b. Immune c. Colonization d. Infection
D
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? a. The clients are in too small an area, so they pass around diseases. b. The clients don't wash their hands after going to the bathroom. c. The visitors brought the disease into the unit. d. The infection is being transmitted by healthcare personnel.
