Question 1

Which of the following public health actions has been particularly instrumental in reducing childhood infectious diseases in the United States?

Accepted Answer

Vaccines are one of the most effective methods of preventing and controlling communicable diseases. Hopefully, all nurses answer questions, remind colleagues to think about immunizations whenever a child is seen, and encourage continuing free or low-cost immunization clinics. One of the most effective programs has been the "no shots, no school" legislation, which has resulted in the immunization of most children by the time they enter school.

Question 2

Which of the following is the number one cause of death worldwide?

Accepted Answer

In countries with higher standards of living, where people live longer, chronic diseases-heart disease, cancer, and stroke-are the leading causes of death. Infectious diseases, however, are still the number-one cause of death worldwide.

Question 3

Which of the following places best describes where the incidence of Vancomycin-resistant Staphylococcus aureus (VRSA) and methicillin-resistant S. aureus (MRSA) is currently rising?

Accepted Answer

Vancomycin-resistant Staphylococcus aureus (VRSA) and methicillin-resistant S. aureus (MRSA) remain problems for people who acquire the bacteria in the hospital, but there is a growing incidence of community-acquired MRSA in places where people closely share facilities such as locker rooms, prisons, and other close bathing areas.

Question 4

Which of the following is the most probable cause of the increase in new emerging infectious diseases?

Accepted Answer

Most of the emergence factors are consequences of activities and behavior of the human hosts and of environmental changes such as deforestation, urbanization, and industrialization. For example, the rise in households with two working parents has increased the number of children in daycare, and with this shift has come an increase in diarrheal diseases such as shigellosis. Urbanization is not a problem, but increasing development into formerly unaffected areas such as rainforests is.

Question 5

Which of the following best describes the current goal in relation to communicable diseases?

Accepted Answer

The goal of prevention and control programs is to reduce the prevalence of a disease to a level at which it no longer poses a major public health problem. In some cases, diseases may even be eliminated or eradicated. The goal of elimination is to remove a disease from a large geographical area (e.g., a country or region of the world), such as has been done with polio in the Americas. Eradication is the irreversible termination of all transmission of infection by extermination of the infectious agents worldwide, as has been done with smallpox.

Question 6

Which of the following data would most likely be collected in a syndromic surveillance system?

Accepted Answer

Syndromic surveillance systems use existing health data in real time to provide immediate analysis and feedback to those charged with investigation and follow-up of potential outbreaks. These systems incorporate factors such as the previously mentioned temporal and geographic clustering and unusual age distributions with groups of disease symptoms or syndromes (e.g., flaccid paralysis, respiratory signs, skin rashes, gastrointestinal symptoms) with the goal of detecting early signs of diseases that could result from a bioterrorism-related attack. Syndromic surveillance systems may include tracking emergency department visits sorted by syndrome symptoms as well as other indicators of illness including school absenteeism and sales of selected over-the-counter medications. In recent years, the tracking of cold medicines used to make crystal methamphetamine has received considerable attention.

Question 7

A student complains to the college health nurse that her academic work has been going downhill because of lack of sleep. "My 3-year-old probably misses her babysitter since she has started going to the big daycare center. She hasn't been sleeping well and keeps scratching her bottom. Hopefully, she'll adapt to daycare soon." Which of the following information should the nurse provide to the student?

Accepted Answer

Enterobiasis (pinworm infection) is the most common helminthic infection in the United States with about 42 million cases a year. This infection is seen most often among children in institutional settings. Pinworms cause itching, especially around the anus, which can result in a lack of sleep for both child and caregiver.

Question 8

Which of the following best represents an example of infectious disease spreading via a vector?

Accepted Answer

Vertical transmission is the passing of infection from parent to offspring via placenta. Horizontal transmission is the person-to-person spread of infection through (among other ways) contact. Common vehicle refers to transportation of the infectious agent from an infected host to a susceptible host via food, water, milk, or other substance. Vectors include mosquitoes, which can transmit the infectious agent by biting the host.

Question 9

Which of the following is the most common vector-borne disease worldwide?

Accepted Answer

Globally, malaria is the most prevalent vector-borne disease, with over 2.4 billion people at risk and more than 275 million cases reported each year. More than 1 million children die of malaria each year. Dengue is the second most common vector-borne disease.

Question 10

Which of the following biological warfare agents poses the greatest bioterrorism threat to a community?

Accepted Answer

Because of factors such as the ability to become an aerosol, the resistance to environmental degradation, and a high fatality rate, inhalational anthrax is considered to have an extremely high potential for being the single greatest biological warfare threat.

Question 11

A man loudly protests his increased property tax bill right after the public health department has made a plea for more funds. "Why," he asks, "should my tax dollars be used to pay for their children to be immunized?" Which of the following would be the best response by the nurse?

Accepted Answer

Herd immunity is the resistance of a group of people to invasion and spread of an infectious agent because a high proportion of individual members of a group are resistant to the infection. Higher immunization coverage will lead to greater herd immunity, which in turn will block the further spread of the disease.

Question 12

Which of the following components of the epidemiologic triangle contributes most to a female client developing a vaginal infection caused by fungi after successful treatment of her strep throat with antibiotics?

Accepted Answer

The antibiotic therapy eliminates a specific pathological agent, but it also may alter the balance of normally occurring organisms in the woman's body, which causes a change in the vaginal environment and allows normally present fungi to proliferate, resulting in a yeast infection.

Question 13

There is great concern in the nurse's community over three local cases of West Nile virus. Which of the following actions should the nurse take to get the community involved in addressing this problem?

Accepted Answer

Periodic outbreaks of West Nile virus appear to result from a complex interaction of multiple factors, including weather-especially hot, dry summers followed by rain, which influences mosquito breeding sites and population growth. Removing standing water will remove mosquito breeding sites.

Question 14

A community is experiencing an epidemic of the measles. The nurse is trying to determine if this problem is happening in other communities as well. Which of the following resources should the nurse use to answer this question?

Accepted Answer

Requirements for disease reporting in the United States are mandated by state rather than federal law. The list of reportable diseases varies by state. State health departments, on a voluntary basis, report cases of selected diseases to the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia. The National Notifiable Diseases Surveillance System (NNDSS) data are collated and published weekly in the Morbidity and Mortality Weekly Report (MMWR).

Question 15

A student comes to the college health clinic with typical cold symptoms of fever, sneezing, and coughing, but the nurse also notes small white spots on the inside of the student's cheeks. Which of the following actions should be taken by the college health nurse?

Accepted Answer

Measles is an acute, highly contagious disease that, although considered a childhood illness, is often seen in the United States in adolescents and young adults. Symptoms include fever, sneezing, coughing, conjunctivitis, small white spots on the inside of the cheek (Koplik spots), and a red, blotchy rash beginning several days after the respiratory signs. Measles is serious. Around 10% of measles cases require hospital admission. It can lead to pneumonia and encephalitis, and it can kill. Persons who may have been exposed should be informed that anyone under 18 who has not received both immunization doses should receive measles vaccine.

Question 16

A nurse's Mantoux test is positive for exposure to tuberculosis. Which of the following conclusions should be drawn by the nurse?

Accepted Answer

An individual who tests positive has been exposed and may be infected, but if that person shows no clinical signs, the person is not diseased. Infection refers to the entry, development, and multiplication of the infectious agent in the susceptible host. Disease is one of the possible outcomes of infection. People with latent TB have no symptoms, are not infectious, and can continue on with life. They may develop active TB. A nurse who interacts with clients may receive INH for a year as a precaution.

Question 17

An instructor is reviewing Salmonella infections with her class. Which of the following comments indicates that the student needs further review on how Salmonella is spread?

Accepted Answer

Meat, poultry, and eggs are the foods most often associated with salmonellosis outbreaks. Animals are the common reservoir for the various Salmonella serotypes, although infected humans may also fill this role. Animals are more likely to be chronic carriers. Reptiles such as iguanas have been implicated as Salmonella carriers, along with pet turtles, poultry, cattle, swine, rodents, dogs, and cats. Person-to-person transmission is an important consideration in daycare and institutional settings. Anthrax (not Salmonella) forms spores when infected blood is exposed to air.

Question 18

During an outbreak of hepatitis A, nurses are giving injections of hepatitis A immunoglobulin to selected susceptible persons. Which of the following best describes the type of immunity that will follow the administration of these injections?

Accepted Answer

Passive immunity refers to immunization through the transfer of a specific antibody from an immunized individual to a nonimmunized individual, such as the transfer of antibody by administration of an antibody-containing preparation (immune globulin or antiserum). Passive immunity from immune globulin is almost immediate but short-lived. It often is induced as a stopgap measure until active immunity has had time to develop after vaccination.

Question 19

A student engages in unprotected sex under the influence of alcohol. The student decides to have an HIV test completed the next day. Which of the following results will most likely occur?

Accepted Answer

It may take up to 6 months after exposure to the HIV virus before an HIV antibody test can test positive, although most infected people will test positive within 3 months. A negative test, therefore, is not a reliable indicator of infection status if exposure is very recent. The incubation period or the time interval between invasion by an infectious agent and the first appearance of signs and symptoms of the disease may be between 10 and 15 years for AIDS.

Question 20

Which of the following is the most common vector-borne disease in the United States?

Accepted Answer

All four are diseases borne by ticks as the vectors. Lyme disease became a nationally notifiable disease in 1991 and is now the most common vector-borne disease in the United States.

Quiz 26: Infectious Disease Prevention and Control