Question 1

Which of the following infections continues to increase in the United States?

Accepted Answer

Treatable STDs,such as gonorrhea,chlamydia,and syphilis,are still occurring at significant rates.Gonorrhea had plateaued or declined until 2009 but increased steadily since that time.Reported infections with chlamydia reached an all-time high in 2011 (CDC,2012c).

Question 2

A patient walks into a community clinic complaining of severe intestinal cramps and diarrhea.Which of the following actions can be taken to protect the staff at the clinic?

Accepted Answer

In the late 1980s,the Centers for Disease Control and Prevention (CDC)developed a set of guidelines,called universal precautions,to prevent transmission of diseases found in blood and other body fluids.These guidelines were developed because infected people may be asymptomatic and have no knowledge of their conditions; therefore,health care workers must assume that all patients are infectious and protect themselves.Refusing to treat the patient,sending the patient to an emergency department,or treating the patient with antibiotics and fluids would not be appropriate measures to protect the staff.

Question 3

Which of the following statements is true concerning tuberculosis (TB)infections in the United States?

Accepted Answer

The principle of multicausation emphasizes that an infectious agent alone is not sufficient to cause disease; the agent must be transmitted within a conducive environment to a susceptible host.Mycobacterium tuberculosis kills cells.M.tuberculosis has low infectivity,low pathogenicity,but high virulence if untreated.

Question 4

The nurse could not find a vaccine in the refrigerator.The unopened vaccine vial had been put in a storage cabinet with the other medications.The nurse drew up the appropriate dose in the syringe and then put the vial of vaccine in the refrigerator.Which of the following would be the most likely result?

Accepted Answer

Primary vaccine failure is the failure of a vaccine to stimulate any immune response.It can be caused by improper storage that may render the vaccines ineffective,improper administration route,or exposure of light-sensitive vaccines to light.Secondary vaccine failure is the waning of immunity following an initial immune response,often occurring with immunosuppressed and organ transplant patients in whom the immune memory is essentially destroyed.Although the injection will not feel so cold to the client,the problem that will result is primary vaccine failure.

Question 5

A city that depended on tourist dollars had feedback that tourists were saying they were never returning because of the constant mosquito bites.Which of the following actions should be taken by the city?

Accepted Answer

Knowing the reservoirs for infectious agents is important,because,in some cases,transmission can be controlled by eliminating the reservoir,such as eliminating the standing water where mosquitoes breed.The other interventions,not having events at dusk or dawn,providing bug repellent,and wearing bright colors are ways the tourists can cope with the mosquitos that are present,but they do not eliminate the breeding and presence of the mosquitos.

Question 6

Which of the following is the first step in preventing further spread of a particular sexually transmitted disease (STD)?

Accepted Answer

Antiinfective drugs,such as antibiotics,antivirals,antiretrovirals,and antimalarials,play important roles in controlling infectious diseases.Not only do they permit recovery of the infected person,but they also play a major role in preventing transmission of the pathogens to another.The first step in preventing transmission of tuberculosis and syphilis is to treat the infected person with antibiotics.Because the question asks about further spread,infection in a person has been diagnosed,so education is needed,but it is too late for that person.Adults not in school also are infected with STDs.A stronger,more effective sanitizing agent would not be the most effective strategy to prevent spread of STDs.

Question 7

One child in a kindergarten room had a slight fever and did not eat lunch.Otherwise,the child seemed OK.Three days later,several children were absent from kindergarten.Which of the following best describes what happened?

Accepted Answer

Frequently,the communicable period begins before symptoms are present.The communicable period,or communicability,follows latency and begins with shedding of the agent.The incubation period is the time from invasion to the time when disease symptoms first appear.Thus,even if parents kept their children away from the child with the fever,this could possibly be ineffective because their children may have already been exposed before the child exhibited symptoms.It is unlikely that the children suddenly changed schools.Although,there may be many reasons why parents keep their children home from school,in this situation there is a specific reason that can be identified.

Question 8

Which of the following best describes what is happening with infectious diseases in the United States?

Accepted Answer

Probably one of the most profound failures in infectious disease control in the United States and elsewhere is that the successes are not equally distributed in the general population.Infectious diseases continue to be differentially distributed by income and ethnic groups,and the poor and minorities continue to experience the greater burden.There continues to be an increase in vector-borne infections,but there has been a decrease in food-borne and waterborne infections.There is concern that deadly pathogens will be weaponized by terrorists.

Question 9

Which of the following statements best explains how infectious diseases are different from any other health problem?

Accepted Answer

Because of their potential to spread and cause communitywide or worldwide emergencies,infectious diseases require organized,public efforts for their prevention and control.Most human diseases (e.g.,cancer or diabetes)can be classified as personal health problems.Individuals with a personal health problem can be treated by the health care system one person at a time.By contrast,infectious diseases are categorized as public or community health problems.

Question 10

The charge nurse notes that two patients had communicable infectious diseases and were treated appropriately.Which of the following actions should be taken next by the nurse?

Accepted Answer

Because state health departments have the responsibility for monitoring and controlling communicable diseases within their respective states,they determine which diseases will be reported within their jurisdiction.Because the state health department requirements will dictate what action is taken next,it may not be necessary to report the cases to the CDC,regional health department,or to the Morbidity and Mortality Weekly Report.

Question 11

During an outbreak in the hospital,all staff members were given immunoglobulin if they were not already immune to the disease.Which of the following types of immunity will the staff who received the immunoglobulin have?

Accepted Answer

Passive immunity is the temporary resistance that has been donated to the host through transfusions of plasma proteins,immunoglobulins,or antitoxins,or transplacentally from mother to neonate.Passive immunity lasts only as long as these substances remain in the bloodstream.Active immunity is when the body produces its own antibodies against an antigen,from either infection with the pathogen or introduction of the pathogen in a vaccine.

Question 12

A school had tried very hard to uphold the requirement for all children to be vaccinated.However,state law allowed parents to exempt their child if they had a religious reason for refusal.Two children have been diagnosed with chickenpox.Which of the following will be the most likely result?

Accepted Answer

Herd immunity is a state in which those not immune to an infectious agent will be protected if a certain proportion (generally considered to be 80%)of the population has been vaccinated or is otherwise immune.Because most children in the school are immune,it will be difficult for the chickenpox to spread.

Question 13

Which of the following would be one of the first steps in attempting to control a disease?

Accepted Answer

Standardized definitions of diseases are necessary for public health monitoring and surveillance across all levels of government.Diseases are defined and classified according to confirmed cases,probable cases,laboratory-confirmed cases,clinically compatible cases,epidemiologically linked cases,genetic typing,and clinical case definition.Once defined,disease occurrence can be compared across time,populations,and geographic areas; and appropriate control efforts can be implemented.

Question 14

The daily patrons of a local town restaurant became ill with nausea,vomiting,and diarrhea.Without knowing the cause,which of the following actions should be taken immediately to help avoid future problems?

Accepted Answer

Agents leave the human host through a portal of exit and invade through a portal of entry.Portals of exit include respiratory secretions,vaginal secretions,semen,saliva,lesion exudates,blood,and feces.Portals of entry are associated with the portal of exit and include the respiratory passages,mucous membranes,skin and blood vessels,oral cavity,and the placenta.Because it was food poisoning of some sort,until the cause is known,it can be assumed to probably be a fecal-oral transmission.Thus,the interventions of cooking classes,covering your mouth when sneezing,and using bleach to clean the entire restaurant would be ineffective.Therefore,staff need to again be reminded of the importance of careful hand washing after using the facilities.

Question 15

Which of the following is a fairly recent surprise regarding infectious diseases in the United States?

Accepted Answer

Recent scientific discoveries on the infectious etiology of stomach ulcers,coronary artery disease,and cervical cancer,for example,suggest that infectious agents may be responsible for more morbidity and mortality than previously recognized.Mortality caused by infectious diseases has decreased.Endemic refers to a disease that is regularly found among people in a certain area.In our society today,there are no endemic infectious diseases.Advances in public health and health care have made it easier to control infectious diseases such as H1N1 flu.

Question 16

A day care center asked the nurse to come because they had several children out as a result of chickenpox.Which of the following statements should the nurse make to the staff?

Accepted Answer

Other considerations for understanding the action of agents include their power to invade and infect large numbers of people (infectivity),their ability to produce disease in those infected with the agent (pathogenicity),and their ability to produce serious disease in their hosts (virulence).When the above concepts are applied,the chickenpox virus has high infectivity,high pathogenicity,and very low virulence.

Question 17

Which of the following best describes why clinical areas are so careful to ensure sanitization of surfaces and equipment between each patient?

Accepted Answer

Indirect transmission is the spread of infection through a vehicle of transmission outside the host.These may be contaminated fomites or vectors.Fomites can be any inanimate object,material,or substance that acts as a transport agent for a microbe (e.g.,water,a telephone,or a contaminated tissue).

Question 18

A female client develops a fungal vaginal infection after being treated with antibiotics for strep throat.Which of the following components of the epidemiological triangle is primarily responsible?

Accepted Answer

Infectious diseases are the result of interaction among the human host,an infectious agent,and the environment,which surrounds the human host and where transmission is occurring.This interaction is pictured in the epidemiological triad of agent,host,and environment also discussed in Chapter 5.The antibiotic therapy eliminated a specific pathological agent,but it also may alter the balance of normally occurring organisms in the woman's body,which caused a change in the vaginal environment,allowing normally present fungi to proliferate,resulting in a yeast infection.

Question 19

A case of severe acute respiratory syndrome (SARS)was diagnosed immediately on signs of illness at a tourist site in China.Which of the following actions should be taken to protect the badly needed income from tourist dollars?

Accepted Answer

Quarantine is an enforced isolation or restriction of movement of those who have been exposed to an infectious agent during the incubation period; this is another method of controlling the reservoir.Quarantine was used effectively during the outbreak of SARS in 2003,when some hospitals required that their staff exposed to SARS patients remain at the hospital until proved to be symptom free at the end of the incubation period.Immunization and screening would not protect the population from exposure to this infectious disease.It is likely that others besides tourists could be exposed or infected by this disease,thus,closing airports would be ineffective in controlling the spread of the disease.

Question 20

A community health clinic put a tax levy on the ballot.An angry man asks a nurse,"How can you ask me to pay taxes to buy immunizations for parents who do not want to pay for their kids to get their shots?" Which of the following is the most appropriate response by the nurse?

Accepted Answer

Herd immunity is a state in which those not immune to an infectious agent will be protected if a certain proportion (generally considered to be 80%)of the population has been vaccinated or is otherwise immune.If most persons are immune,it will be difficult for an infectious disease to spread.

Quiz 25: Communicable Disease