Question 1

In which of the following cases would the school nurse be correct to advise the parents of an HIV-infected child to keep the child home from school? (Select all that apply.)

Accepted Answer

Not attending school may be advisable if cases of childhood infections, such as chickenpox or measles, occur in the school, because the immunosuppressed child is at greater risk for suffering complications. Alternative arrangements, such as homebound instruction, might be instituted if a child is unable to control body secretions or displays biting behavior. HIV-positive children are encouraged to obtain routine immunizations, because their immune systems are compromised and they are more susceptible to such infections. To date, no cases of HIV infections being transmitted in a school setting have occurred in the United States. Strong disapproval by parents of well children is an opportunity to teach these persons how HIV is transmitted.

Question 2

The public health nurse comes to the hospital to see a client just diagnosed with hepatitis A. The nurse says, "I'm sorry to bother you when you're not feeling well, but I need to ask you a few questions." Which of the following questions would be most appropriate for the nurse to ask the client? (Select all that apply.)

Accepted Answer

The nurse should ask about sexual contacts and ask who (if anyone) lives with the client because the named individuals will need to have immune globulin administered to hopefully prevent the spread of hepatitis A and a community epidemic. The nurse should also ask about the client's place of employment because certain settings warrant special considerations. For example, in restaurants, hospitals, daycare centers, or other institutions, the lack of careful hand-washing by an infected worker can result in contamination of many others.

Question 3

A mother felt very guilty that her baby was born HIV positive. When the nurse suggested the usual DPT and MMR immunizations, the mother was extremely upset. "Don't you know HIV children are immunosuppressed?" she exclaimed. Which of the following would be the nurse's best response?

Accepted Answer

Because of impaired immunity, children with HIV infection are more likely to get childhood diseases and suffer serious consequences of the diseases. Therefore, DPT, IPV, and MMR vaccines should be given at regularly scheduled times for children infected with HIV. Other immunizations may also be recommended after medical evaluation. Many states do have a "no shots, no school" law, but exceptions can be made. The APA does recommend immunizations for most children, but this is not the best answer.

Question 4

A woman and man who have come to the health clinic begin to argue loudly. "You gave me an STD!" the man yells. The woman screams back, "Not me. I don't have an STD!" Which of the following statements would be most appropriate for the nurse to say to them? (Select all that apply.)

Accepted Answer

Often cases of gonorrhea and chlamydia are asymptomatic, so treatment may not be sought and these infections are spread to others through sexual activity. Similarly, during latency, syphilis has no symptoms. It should be noted, however, that STD test results can sometimes be incorrect and the coexistence of other medical conditions may cause a false-positive test result. Having a partner retested, if the results were negative, would also suggest retesting the first person.

Question 5

A high school student is planning to volunteer at the hospital after school, so she needs to have a Mantoux test before beginning. Which of the following information should the nurse provide to the new volunteer?

Accepted Answer

The Mantoux test is a TB skin test that involves a 0.1-ml injection containing 5 tuberculin units of PPD tuberculin (not tines as in the TB tine test). The site should be examined for a reaction 48 to 72 hours (2 to 3 days) after injection. Only induration should be measured, and the results should be recorded in millimeters.

Question 6

A nurse was reading PPD tests 24 hours after another nurse had administered them. Which of the following findings would cause the nurse to interpret the test as positive?

Accepted Answer

Erythema alone does not indicate a positive finding. For a PPD test to be positive, induration (swelling with increased firmness) must be present. A diameter of 10 mm induration would be a positive finding in an immigrant from a region with high TB infection. A small pustule in a homeless client undoubtedly is an infection but may not be due to the PPD test.

Quiz 27: HIV Infection, Hepatitis, Tuberculosis, and Sexually Transmitted Diseases

In which of the following cases would the school nurse be correct to advise the parents of an HIV-infected child to keep the child home from school? (Select all that apply.)

A mother felt very guilty that her baby was born HIV positive. When the nurse suggested the usual DPT and MMR immunizations, the mother was extremely upset. "Don't you know HIV children are immunosuppressed?" she exclaimed. Which of the following would be the nurse's best response?

A woman and man who have come to the health clinic begin to argue loudly. "You gave me an STD!" the man yells. The woman screams back, "Not me. I don't have an STD!" Which of the following statements would be most appropriate for the nurse to say to them? (Select all that apply.)

A high school student is planning to volunteer at the hospital after school, so she needs to have a Mantoux test before beginning. Which of the following information should the nurse provide to the new volunteer?

A nurse was reading PPD tests 24 hours after another nurse had administered them. Which of the following findings would cause the nurse to interpret the test as positive?