Deck 15: Infection

Question 1

A patient who is currently being treated for rheumatoid arthritis exhibits symptoms suspicious of tuberculosis (TB).The nurse anticipates that:

A)the symptoms are a result of the patient's rheumatoid arthritis.
B)the symptoms are actually side effects of corticosteroid therapy.
C)a chest radiograph will definitively confirm a diagnosis of TB.
D)a purified protein derivative (PPD)skin test will likely be negative.

Answer 1

a purified protein derivative (PPD)skin test will likely be negative.

Question 2

The nurse caring for an older adult patient currently receiving traditional drug therapy for methicillin-resistant Staphylococcus aureus (MRSA)recognizes that the patient is at risk for developing:

A)Clostridium difficile infection.
B)vancomycin-resistant Enterococcus (VRE)infection.
C)autoimmune hepatitis.
D)systemic lupus erythematosus.

Answer 2

vancomycin-resistant Enterococcus (VRE)infection.

Question 3

An older patient asks the nurse about taking Echinacea to prevent colds.What response by the nurse is best?

A)"That's fine;it's a very common herb."
B)"Older people should not use herbs."
C)"This herb may not be well produced."
D)"Echinacea has a deleterious effect on immunity."

Answer 3

"This herb may not be well produced."

Question 4

The nurse caring for a cognitively impaired older adult admitted to an acute care facility best minimizes this particular patient's risk for developing a nosocomial infection by:

A)proper hand washing after each patient contact.
B)admitting the patient to a private room.
C)assigning staff to assist the patient with eating meals.
D)screening visitors to minimize contract with pathogens.

Question 5

An older patient smoked tobacco most of the adult life.When planning health promotion education for this patient,the nurse includes information that such smoking:

A)may produce alterations in the immune response.
B)is a risk factor for community-acquired pneumonia.
C)decreases the production of an immunoglobulin called IgA.
D)increases the risk of gastric cancer.

Question 6

A student nurse is caring for a patient who has vancomycin-resistant enterococcus (VRE).What action by the student requires the nurse to intervene?

A)Washes hands for 15 seconds prior to entering the room
B)Takes own stethoscope and unit Glucometer in the room
C)Helps transfer the patient into a private room for isolation
D)Puts on gloves and a gown prior to changing the linens

Question 7

An older adult patient is experiencing problems with chewing while recovering from extensive oral surgery.The nurse best affects this patient's risk for infection by:

A)ordering a mechanical soft diet for the patient.
B)monitoring the patient regularly for any low-grade fever.
C)providing regular oral care with an antibiotic mouthwash.
D)asking which flavors of protein supplement drink the patient would prefer.

Question 8

The nurse is preparing an educational facts sheet on human immunodeficiency virus (HIV)and acquired immunodeficiency syndrome (AIDS)for older adults.What information does the nurse include? (Select all that apply. )

A)Tainted blood transfusions are the greatest risk factor in older adults.
B)Delayed recognition of HIV contributes to its poor prognosis.
C)Twenty-five percent of AIDS cases in the United States are in persons older than 60.
D)There is a short interval from HIV infection to AIDS in older adults.
E)HIV and AIDS cases in this age cohort have stabilized since the late 1990s.

Question 9

The geriatric nurse identifies the patient with the greatest risk of immunosuppression as:

A)having a roommate infected with MRSA.
B)having numerous oral mucosal ulcers.
C)receiving treatment for rheumatoid arthritis.
D)being cognitively impaired.

Question 10

A nurse has identified an older patient as being at high risk of infection.Which assessment data indicate that priority goals for this diagnosis have been met?

A)The patient remains afebrile.
B)The patient's white blood cells (WBCs)are normal.
C)The patient has no subjective complaints.
D)The patient's mental status is unchanged.

Question 11

The nurse caring for an older adult patient being treated for influenza is especially careful to monitor and document assessment data related to:

A)cognitive function.
B)respiratory function.
C)fluid intake.
D)urinary output.

Question 12

The geriatric nurse caring for the older female immunosuppressed patient is particularly concerned when the patient reports which of the following? (Select all that apply. )

A)Flulike muscle aching
B)Burning upon urination
C)Nausea
D)Night sweats
E)Constipation

Question 13

An older patient is hospitalized for an exacerbation of chronic obstructive pulmonary disease (COPD),for which the patient is on chronic steroid use.The patient also has a fresh dog bite on the arm,which is not reddened,swollen,and only slightly tender.The patient is afebrile,but the nurse finds the patient confused and agitated.What action by the nurse is most appropriate?

A)Place the patient on fall precautions.
B)Put a bed alarm on the patient's bed.
C)Call the rapid response team.
D)Perform a sepsis screening exam.

Question 14

The nurse caring for an older adult patient engages in appropriate cancer-related health screening when which of the following occur? (Select all that apply. )

A)Preparing a patient for a lung biopsy
B)Collecting a 24-hour urine specimen
C)Assisting a patient schedule a mammogram
D)Drawing blood for a prostate sensitive antigen (PSA)test
E)Keeping a patient NPO for a bladder biopsy

Question 15

To educate patients on health promotion measures to minimize the effect of normal age-related changes in immunity,the geriatric nurse:

A)describes the effects of low-dosage antibiotic therapy on opportunistic infections.
B)reinforces the usefulness of lymphocyte counts to detect new infections.
C)discusses the need for yearly flu immunization.
D)stresses the importance of maintaining intact skin and mucous membranes.

Question 16

The nurse wishes to control infection by manipulating the portal of entry.What action best demonstrates this process?

A)Using sterile technique to insert a catheter
B)Encouraging patients to eat high-protein meals
C)Ensuring housekeeping keeps rooms clean
D)Providing patients with vitamin supplements

Question 17

A patient claims that all food is bland since "I got old." What suggestions does the nurse provide to this patient?

A)Add extra salt to your food.
B)Try eating some tart foods.
C)Eat soft food with gravy.
D)Drink high-protein shakes.

Question 18

An older adult patient who is generally in good health starts experiencing numerous colds and now pneumonia.What factor from the nursing history most likely has placed the patient at increased risk for the development of these infections?

A)A beloved pet died 6 months ago.
B)The patient was diagnosed with osteoarthritis 5 years ago.
C)The patient worked as an oncology nurse before retiring.
D)The patient's spouse is immunosuppressed.

Question 19

A patient is hospitalized with a nonhealing leg ulcer.Lab work does not demonstrate anemia.What action by the nurse is best?

A)Encourage the patient to choose high-protein meal items.
B)Request a consultation with the registered dietician.
C)Consult the physician regarding a serum zinc level.
D)Consult the physician about adding an iron supplement.

Question 20

An immunosuppressed older adult patient reports symptoms of fatigue,facial rash,intermittent low-grade fever,and painfully swollen finger joints.The nurse anticipates that diagnosis will be confirmed by:

A)the presence of subcutaneous nodules on the hands.
B)a positive antinuclear antibody (ANA)blood serum test.
C)a liver biopsy that confirms cirrhosis.
D)the presence of bilateral ocular scleritis.

Question 21

The nurse studying immunity understands that which are age-related changes in immune system functioning? (Select all that apply. )

A)Decreased number of lymphocytes
B)Decreased number of T suppressor cells
C)Atrophy of the thymic cortex
D)Increased numbers of antibodies to self-antigens
E)Decreased number of B cells

Question 22

A patient is receiving chemotherapy to treat cancer.What instructions does the nurse provide the patient and family to reduce the chance of infection? (Select all that apply. )

A)Take a full bath everyday if possible.
B)If you can't bathe,perform pericare.
C)Avoid large crowds and ill people.
D)You have to give away your pets.
E)Eat high-calorie,high-protein food if able.

Question 23

The student learning about immunity understands that the chain of infection contains which parts? (Select all that apply. )

A)Portal of entry
B)Susceptible host
C)Virulence factors
D)Reservoir
E)Decreased immunity