Deck 15: Infectious Diseases

Question 1

Which of the following factors or conditions were responsible, in the first third of the 20th century, for the high incidence of infant and childhood mortality?

A) lack of medical doctors
B) infectious diseases
C) sudden infant death syndrome
D) high-fat diets

Answer 1

infectious diseases

Question 2

Which of the following phrases about infectious diseases is always true?

A) They are contagious from person to person.
B) They can be stopped by consistent and adequate handwashing.
C) They are caused by pathogenic organisms in the body.
D) They can be eradicated by vaccinating people around the world.

Answer 2

They are caused by pathogenic organisms in the body.

Question 3

Which of the following best describes the reservoir, one of six factors in the chain of infection?

A) living and nonliving places there pathogens can survive without multiplication
B) a pool of water there mosquitoes can breed and thus more quickly spread infection
C) the stomach, which holds a large number of pathogens for a significant amount of time
D) any area there a stable amount of water is present

Answer 3

living and nonliving places there pathogens can survive without multiplication

Question 4

Which of the following best describes a vector?

A) the point at which an infection entering the body intersects with an infection leaving the body
B) the area of initial bite or contact by the disease-bearing animal or insect
C) a person or animal who is infected with an organism but does not have the disease
D) an animal or insect that carries the infectious organism from one host to another

Question 5

The nurse working with a pediatrician in the doctor's office setting knows it is a top priority to properly clean all surfaces and toys touched by the children who come to the office, or make certain they have been properly cleaned, because of which of the following reasons?

A) Organisms tend to enter the body through the mouth.
B) Many organisms remain viable from hours up to several weeks on surfaces.
C) The nurse has a responsibility to stop the spread of HIV in the office setting.
D) Failure to ensure thorough cleansing can result in malpractice for the nurse.

Question 6

A child comes to see the pediatrician and breaks out the next day in the characteristic lesions of chickenpox. The nurse working in this pediatric clinic knows that:

A) this is not a problem, as the child was not contagious before the skin lesions erupted
B) only children physically touched by the child who developed chickenpox were exposed
C) all the children in the doctor's office that day need to be quarantined and isolated
D) the doctor needs to see and evaluate all the children who were in the office and exposed

Question 7

The school nurse is working with teenaged parents and their babies in a high school program designed to keep these parents in school and to teach them how to care for their children. The nurse teaches the mothers to change diapers on:

A) a soft towel that can be washed as needed
B) a washable surface that is disinfected after each use
C) upholstered furniture that can be wiped off
D) a changing station with a cushioned cover

Question 8

Which of the following best describes the term vertical transmission?

A) oral intake of germs that go through the body and are secreted rectally
B) when the person contracts the disease or infection while awake and standing
C) droplet infection that drops downward into the respiratory tract
D) the process of transmitting a disease from one generation to another

Question 9

Infections that can be transmitted through vertical transmission are:

A) influenza, meningitis, and varicella
B) rubella, herpes, and human immunodeficiency virus
C) staphylococci, streptococci, and Escherichia coli
D) hepatitis B and C and Rickettsia rickettsii

Question 10

Which of the following groups of children are susceptible to infections from staphylococci and Escherichia coli?

A) adolescents
B) preschoolers
C) toddlers
D) newborns

Question 11

Caregivers could best reduce the number of infections that infants have by:

A) taking the infant to the pediatrician's office whenever the infant has a fever, diarrhea, or nasal discharge
B) washing hands frequently, not kissing the infants' hands, and washing all objects that go into a baby's mouth
C) limiting the number of people who visit the home and not letting other people pick up and hold the baby
D) starting medication sooner whenever the infant has a fever or any other symptoms of infection

Question 12

You are a nurse working with toddlers and preschoolers. One of the children has a skin infection, which is diagnosed as tinea corporis. In assessing this condition, you would ask the caregivers which of the following questions?

A) "What kind of detergent have you been using?"
B) "Has your child been swimming in a public swimming pool?"
C) "Does your child have any known contact allergies?"
D) "Has your child been playing with cats or dogs?"

Question 13

You are a nurse working with children of various ages. You would teach the caregivers not to give acetylsalicylic acid (aspirin) to children:

A) of any age
B) under 6 years
C) under 13 years
D) under 18 years

Question 14

The school nurse, on discovering any outbreaks of head lice, scabies, and pinforms, will teach the children to avoid:

A) sitting next to infected children
B) wearing head scarves or any head covering
C) keeping their coats and hats on their desks and to instead hang them on the coat rack
D) sharing and swapping clothing, as well as avoiding sharing personal items

Question 15

The leading cause of pneumonia for schoolchildren is which of the following organisms?

A) Staphylococcus
B) Streptococcus pneumoniae
C) Mycoplasma pneumoniae
D) Pneumocystiscarinii

Question 16

Erythema infectiosum, or fifth disease, has which of the following characteristics?

A) intensely red "slapped cheeks" appearance
B) swelling and tenderness in the fifth digits
C) various sizes and shapes of red rash areas
D) redness of the feet as if the child was in hot water

Question 17

You are a nurse working with adolescents and assessing them to see what immunizations they need. You would advise adolescents and their caregivers to have booster doses of tetanus and diphtheria approximately how many years after the last dose?

A) 1
B) 5
C) 10
D) 15

Question 18

Adolescents most often lack which of the following types of immunity and need to be immunized because of the danger of acquiring this type of infection through sexual contact?

A) hepatitis A
B) hepatitis B
C) chlamydia
D) gonorrhea

Question 19

College-bound adolescents who will live in a dormitory or residence hall need to be advised most on the importance of vaccination against:

A) influenza
B) tetanus
C) meningococcal disease
D) Legionnaires' disease

Question 20

Adolescents who are addicted to crack cocaine are:

A) usually not sexually active
B) about as sexually active as adolescents who are not addicted to cocaine
C) less sexually active than students who smoke marijuana
D) more likely to have sex with several partners and be at risk for sexually transmitted diseases (STDs)

Question 21

You are a school nurse working with adolescents. An adolescent tells you that he thinks he has a sexually transmitted disease (STD). He wants to see a doctor to get diagnosis and treatment if necessary, but he says he definitely does not want to tell his parents. Your best initial action would be to:

A) reassure him that you will not contact his parents
B) convince him to talk with his parents
C) check the laws of your state to find the age at which adolescents can seek diagnosis and treatment of STDs without parental consent
D) Refer the adolescent to the local clinic that provides free STD testing

Question 22

Caregivers ask the pediatric nurse what things they need to especially look at when selecting day care. The nurse will stress preparing and asking a number of questions related to which of the following areas as a priority in selecting day care?

A) the type and amount of food served
B) sanitation practices and illness policies
C) provision for naps
D) activities for the children

Question 23

Children who have been in day care have which of the following experiences with respiratory infections once they enter school (as compared to children who have not been in day care)?

A) greater number of respiratory infections
B) about the same number of episodes
C) different types of respiratory infections
D) fewer episodes of respiratory infections

Question 24

You have just taken a job in a pediatric clinic. You will be teaching caregivers about immunization schedules and either giving or scheduling immunizations. Your best initial preparation for this job would be to:

A) review your pediatric text that you used in nursing school in order to memorize immunization schedules
B) obtain a current printed copy of the recommended childhood immunization schedule as approved by the American Academy of Pediatrics and others
C) study the policy and procedure manuals of the pediatric clinic there you work to ascertain the immunization schedules of the clinic
D) contact the local school district to ascertain which immunizations are required

Question 25

You are a nurse working in a pediatric clinic. Your goal is to have accurate, up-to-date immunization records on all the children who come to the clinic. Which of the following record-keeping efforts would best help you meet your goal?

A) Have the caregivers document all the immunizations and dates of immunizations for each child.
B) Have caregivers list all those who gave immunizations to their children and sign consent forms for release of information; then combine the records into one.
C) Assume that immunizations are not up-to-date and begin the process at the beginning.
D) Have the caregiver document all past immunizations with a note that this is caregiver recall and then chart new immunizations.

Question 26

Why does the nurse need to read the package insert to see if a vaccine has been properly stored before administering the vaccine?

A) Improper storage will frequently cause the vaccine to be more virulent.
B) An improperly stored vaccine can clog the needle, leading to an infiltration.
C) Improper storage or handling can result in a decrease in vaccine potency and ineffective immunization.
D) The vaccine may be too hot or too cold to inject into the muscle or subcutaneous areas.

Question 27

The National Childhood Vaccine Injury Act of 1986 provides:

A) legal services on a sliding-fee scale for any family suffering from a reaction to one or more recommended or required vaccinations
B) rehabilitative services for anyone requiring rehabilitation due to vaccine injury
C) funds for hospitalization and burial for any child under age 21 who dies as a result of a vaccination
D) an alternative to civil litigation in which anyone who was injured or lost a family member due to a vaccine may seek compensation

Question 28

You are being oriented to the pediatric unit. You notice that after giving a vaccination, the nurse records, in addition to the date of administration, the name of the vaccination, the site and route, the nurse's name and title, and which of the following information?

A) parents' or legal guardian's full names and permanent addresses
B) the manufacturer, lot number, and expiration date of the vaccine
C) any adverse reaction sustained by the recipient
D) the height, weight, vital signs, health status, and blood work of the child

Question 29

You are working in an immunization clinic providing vaccinations prior to the school year. You are required to get the parent(s) or guardian to sign a vaccination consent form. Before accepting the consent form from the parents or guardian and filing it, you would most want to make certain that the form:

A) is in a language the parent(s) or guardian understands and can read or that it is read to them in a language they understand
B) has a witness signature as well as the title and address of the person witnessing the signature of the parent(s) or guardian
C) has been duplicated and sent to the school office and to the public health department
D) is approved by the state department of public health or the county department of public health and safety

Question 30

Which of the following includes the two true permanent contraindications to vaccination?

A) consistent occurrence of otitis media and upper respiratory infections after vaccinations in the past
B) history of severe anaphylactic reaction to a vaccine or its component and encephalopathy within 7 days of administration of DTaP
C) diarrhea, stomach cramping, and nausea after vaccinations in the past
D) multiple allergies to mold, grasses, trees, and dust and taking allergy vaccines for 2 years or more in the past 5-year period

Question 31

A mother asks the nurse why her child needs a polio vaccination when polio has been eliminated in the United States and eradicated in most of the world. The nurse's best answer would be:

A) "Only one of many strains of polio has been eradicated. We believe that new strains are being formed."
B) "Some children suddenly lose their immunity, and we have no explanation for why this happens."
C) "You might have to travel to a foreign country, and when you might be exposed to the polio virus."
D) "Polio virus still exists in parts of the world, which means this virus could be introduced accidentally into this country again and we could have an epidemic of polio."

Question 32

The school nurse is talking with a group of adolescent females about the measles, mumps, and rubella (MMR) vaccine. The school nurse will caution the female students not to take the vaccine if there is any chance they may be pregnant or become pregnant in the next 3 months. The reason the nurse tells the students not to take the vaccine during the first 3 months of pregnancy is:

A) This vaccine can cause developmental abnormalities in the fetus during the first trimester.
B) The baby could be prematurely vaccinated against MMR.
C) The vaccine could cause the fetus to develop measles or mumps while in utero and this is hard to treat.
D) The vaccine during this time will cause the mother to have adverse side effects and be severely ill.

Question 33

You are working on the medical unit at the hospital. A client says he may have been exposed to diphtheria. The client has a low-grade fever and some nasal discharge. In order to diagnose or rule out diphtheria in this client, the physician will order which of the following tests?

A) sputum culture
B) blood and stool cultures
C) gastric analysis
D) nose and throat cultures

Question 34

The Epstein-Barr virus is responsible for which of the following?

A) erythema infectiosum
B) infectious mononucleosis
C) mumps
D) roseola

Question 35

The school nurse becomes aware that a student with a diagnosis of infectious mononucleosis has been reporting to sports practice. The nurse will advise the student and the coach that:

A) the student should drink 8 to 10 glasses of water a day and not get overheated in practice
B) the student should rest until any splenomegaly resolves, as the spleen could rupture
C) there are few complications from infectious mononucleosis
D) the student should not play unless she is free of any fever

Question 36

You are the school nurse advising the caregivers of a student who has mumps. The mother asks how long this student must remain at home. The school nurse will tell the caregivers that students with mumps must stay home until they meet which of the following criteria?

A) Nine days have passed after the beginning of the parotid swelling.
B) The parotid swelling has resolved.
C) The student is free of any pain in the parotid area.
D) The student is totally free of fever for at least 2 days.

Question 37

An infant of 4 months is hospitalized with a case of pertussis. The child is started on erythromycin orally for 14 days. The nursing staff will enforce observation of respiratory isolation for how long?

A) until the child is no longer coughing
B) 5 days after initiation of antibiotic treatment
C) until the child is fever free for 1 week
D) when the child has been on cough medicine 2 weeks

Question 38

Which of the following tests is used in diagnosing polio?

A) nasal culture
B) stool culture
C) arterial blood gases
D) magnetic resonance imaging (MRI)

Question 39

Group A beta-hemolytic streptococci cause which of the following diseases?

A) varicella
B) measles
C) diphtheria
D) scarlet fever

Question 40

A father calls the school nurse and asks when his daughter, who has chickenpox, can return to school. The best reply by the nurse would be:

A) whenever she is fever free for 2 days
B) when there are no new lesions
C) when the itching has stopped
D) when all lesions are crusted over

Question 41

Caregivers of a child with chickenpox tell the pediatric nurse that their child is not eating or drinking much because the child says the "sores in the mouth hurt." The best advice by the nurse would be for the caregivers to try which one of the following actions and call back if it does not improve the intake of fluids?

A) Double the amount of acetaminophen.
B) Offer gelatin and Popsicles.
C) Give a solution of seltzer water and honey.
D) Contact the pediatrician to determine if intravenous hydration is necessary.

Question 42

The transmission of tetanus to humans is when a skin wound comes in contact with:

A) rusty metals such as a rusted nail
B) soil contaminated with animal feces
C) the bite of an insect carrying the tetanus organisms
D) the saliva of an infected dog

Question 43

The school nurse is advising students who are going on a weeklong field trip into a wooded area. The nurse would tell the students to:

A) use sunscreen and wear lightweight clothing and high-top tennis shoes or high-top boots
B) apply a mosquito repellent and wear camouflage clothing or dark clothing
C) use DEET, wear light-colored long-sleeve top and pants, and inspect clothing and body daily
D) wear shorts and sleeveless shirts and drink lots of water during the day while hiking in the woods

Question 44

The school nurse gets a call from a caregiver who is planning to send her child to summer camp, but recently heard there was a case of Rocky Mountain spotted fever at the camp the previous year. The mother asks, "What causes Rocky Mountain spotted fever?" The best answer by the nurse would be:

A) the bite of an infected tick, which is carried by dogs and wild rodents
B) a bite from an infected species of Mexican free-tail bats
C) contact with bodily fluids of a child who has the disease
D) airborne droplets spread by coughing or sneezing

Question 45

An expectant mother asks the nurse about cytomegalovirus (CMV). The nurse's best answer would be:

A) "This is a highly contagious disease, and you need to be vaccinated against it."
B) "Ninety-five percent of newborns have this disease, which can be tested for and treated at birth."
C) "You need to discuss this with your doctor after your baby is born."
D) "Most adults have been infected by the time of adulthood and most infants with CMV are asymptomatic; however, about 5% of infants have significant problems."

Question 46

The expectant mother asks the nurse how CMV is diagnosed in infants. The best answer by the nurse would be:

A) "Check for the presence of IgM CMV antibodies in cord blood, which identifies congenitally infected infants; there is another test for detecting antibodies in the baby's blood."
B) "Inspect for the presence of symptoms characteristic of this disease."
C) "Conduct a test on the fluids of the eye, which are carefully collected on a swab and placed in a special tube."
D) "Inspect for the effects of the IgM CMV antibodies, which are evident in special tissue tests done in utero or shortly after birth."

Question 47

Unless contraindicated because of complications or secondary infections, home is the ideal environment for the management of children who have infectious or communicable diseases, because:

A) it is quieter and more restful in the home environment
B) the child can remain in his or her bed for comfort
C) the spread of infection is limited to those in the immediate environment
D) this qualifies the child for a home tutor so her or she will not get behind in her schoolwork

Question 48

The caregivers of a child with chickenpox telephone the nurse and ask what they can do about their child scratching the lesions. The best answer by the nurse would be:

A) "Offer the child a reward for not scratching, and keep a behavioral chart with stars for not scratching."
B) "Wrap tape around the hands and tips of the fingernails, and paint the lesions with clear nail polish."
C) "Put body lotion on the lesions during the day and night, cut the nails short, and use Epsom salts in the bathwater."
D) "Cut the fingernails short, cover the hands at night, and use a drying solution such as calamine, oatmeal, or baking soda in bathwater."

Question 49

A group of caregivers are talking with the nurse about sexually transmitted diseases (STDs) in adolescents. One caregiver asks the nurse what is the earliest age at which children can get an STD. The best answer by the nurse would be to say that children:

A) are usually not sexually active until they are 12 or older today
B) can acquire an STD in utero, in the birth canal, or at a very young age, which can suggest the possibility of sexual abuse
C) can acquire an STD about 2 years before the advent of puberty
D) can acquire an STD anytime after birth, although it is rare for a child to have an STD before the age of 11

Question 50

Caregivers ask the nurse how children or adolescents can contract syphilis. The best response by the nurse is which of the following?

A) by sexual intercourse
B) transplacentally, at delivery, by sexual intercourse, or through sexual abuse
C) anal, oral, or vaginal contact with semen
D) by contact with any body fluids of an infected person

Question 51

An expectant mother is found to have syphilis. Which of the following courses of treatment do you most expect to see ordered?

A) penicillin G benzathine IM two doses, 1 week apart
B) tetracycline four times a day for 2 weeks
C) erythromycin twice a day for 14 days
D) a single dose of procaine penicillin G IM daily for 10 days

Question 52

A baby is found to have congenital syphilis. Which of the following treatments would you expect to see ordered?

A) erythromycin IM twice a day for 14 days
B) single dose of procaine penicillin G IM daily for 10 days or a regimen of aqueous crystalline penicillin G IV
C) penicillin V potassium crushed and administered in the feeding bottle with the baby's formula or expressed mother's milk
D) tetracycline for 14 days

Question 53

A mother calls the pediatric nurse. Her child who is in day care has experienced chronic diarrhea that is watery, greasy, and foul smelling. The child complains of stomachache, has flatulence, and is losing weight. Another child in the day care has the same symptoms, and the mother also has some of these symptoms. The pediatric nurse will suspect which of the following causes of the problem?

A) poor diet
B) food poisoning
C) pinforms
D) giardiasis

Question 54

The treatment of giardiasis is which of the following medications?

A) furazolidone (Furoxone) or metronidazole (Flagyl)
B) mebendazole or piperazine
C) penicillin
D) chlorine added to the water

Question 55

A nurse is providing education to the parents of a school-aged child. The parents are asking the nurse about the potential illnesses or infections associated with allowing their child to attend a sleepover at a friend's house. Which of the following responses made by the nurse would accurately identify illnesses or infections associated with sharing bed linens? Select all that apply.

A) scleroderma
B) scabies
C) tinea corporis
D) tinea capitis

Question 56

A 6-month-old infant presents to the clinic for routine immunizations. Prior to this visit, the infant has remained up-to-date with immunizations. The nurse anticipates the infant will need which of the following immunizations recommended at 6 months? Select all that apply.

A) diphtheria, tetanus, and pertussis (DTaP)
B) Haemophilus influenzae type b (Hib)
C) measles, mumps, rubella (MMR)
D) pneumococcal

Question 57

The nurse is providing education to the parent of a child who has received the polio immunization. The parent has asked how polio is transmitted. Which of the following responses made by the nurse would be accurate? Select all that apply.

A) fecal-oral route
B) respiratory
C) through a bite from an infected tick
D) discharge from eyes and skin lesions