Communicable Disease Questions II

 

Communicable Disease Questions II

Situation 7: Ralph, a student nurse began to feel joint pains and eye pains associated with high fever. He noticed some pinpoint rashes on his legs. He is diagnosed with Dengue fever.

31. In the prevention of dengue fever, which of the following measures is included?

a. Mass vaccination during rainy season

b. Prophylactic drug treatment with antivirals

c. Removal of small collections of water such as flower vases

d. Fogging or daily spraying of insecticides

32. The most effective control measure for dengue hemorrhagic fever is:

a. Isolation of patient

b. Mosquito control

c. Health education

d. Concurrent disinfection

33. The treatment and control of dengue hemorrhagic fever include all of the following EXCEPT:

a. Treat shock with IVF

b. Encourage vaccination

c. Eradication of vector

d. Community participation

34. The best nursing intervention in the management of dengue fever among patients admitted in the hospital would be:

a. Observation

b. Contact Isolation

c. Administration of antivirals

d. Platelet administration

35. Which is an independent nursing intervention for a patient with Dengue Hemorrhagic Fever?

a. Give aspirin for fever and muscle pains

b. Put ice bag over forehead if patient has nose bleed

c. Place patient in prone position to relieve abdominal pain

d. Give high fiber diet

Situation 8: The BHW of Barangay Jacinto reported series of adults having cases of spasmodic coughing and fever for the past two weeks. The CHN in the area alarmed by the reports decided to investigate the community.

36. Which among the following diagnostic tests does NOT indicate active tuberculosis?

a. Sputum smear positive times three

b. Chest x-ray as diagnosed by the TBDC

c. An induration of 10 post tuberculin test

d. Chest x-ray after having three negative sputum smears

37. Mang Jose, 42 years old, went to the Chest Center to avail of the free Direct Sputum Smear Microscopy. Which among the following is a contraindication for sputum collection?

a. Pleural effusion  c. Hemoptysis

b. TB meningitis d. Miliary TB

38. Mang Jose began his treatment regimen for tuberculosis. He complains of frequent tingling sensation of his feet. Which among the following diets shout be encouraged?

a. Fish c. Milk

b. Kangkong d. Beef

39. As a nurse working in the Barangay Health Center, it is essential to counsel the client on the side effects of the treatment regimen. Which among the following side effects should be reported immediately to the physician?

a. Hemoptysis c. Flu-like symptoms

b. Red-colored urine d. Yellowish palms

40. Which among the following is considered as the most important health teaching given to clients with Tuberculosis?

a. Strict compliance to treatment regimen

b. Frequent handwashing

c. Proper disposal of soiled tissues

d. Covering of mouth while coughing or sneezing

Situation 9: The nurse is aware of the misuse of antibiotics , which resulted to the emergence of new strains of microorganisms that proves to effect a catastophic effect on human health.

41. The period between the first exposure and multiplication of the SRAS causative agent would be:

a. 2-10 days c. 1-20 days

b. 5-11 days d. 1-5 days

42. SARS remains to be an enigma among health practitioners and had proven its virulence. The nurse knows that the virus could be categorized as:

a. Rhabdovirus c. Coronavirus

b. Togavirus d. Paramyxovirus

43. Which of the following best defines standards precaution?

a. These are guidelines created to prevent transmission of microorganisms in hospitals

b. It is a strategy of assuming that all patients are infectious, and using barrier protections during nurse-client interactions

c. These are precautions based on contagious or epidemiologically significant organisms are recognized.

d. It pertains to the use of handwashing.

44. In managing individuals with SARS, the nurse should be aware of the different signs and symptoms of the disease. Which among the following characterize the prodromal phase:

a. The patient is usually not infectious at this time.

b. Dry hacking cough is present

c. Fever is present, but does not rise beyond 38oC

d. The patient requires mechanical ventilation at this stage

45. Handwashing deters the spread of microorganisms. A nurse involved in the care of a patient diagnosed with SARS should:

a. Perform handwashing before client contact

b. Perform handwashing after eating

c. Perform handwashing after food preparation

d. Perform handwashing before using the toilet

Situation 10: Filariasis is endemic in some parts of the Philippines. The disease often progresses to become chronic, debilitating and often unfamiliar to health workers.

46. Effective methods that the government would likely to pursue to eliminate filariasis in the country are all of the following EXCEPT:

a. Pursue annual mass drug administration using two drugs in all endemic areas for at least five consecutive years

b. Vaccination of all susceptible in high risk areas and high risk populations

c. Intensify health information and advocacy campaigns in its prevention, control and elimination

d. Halt progression of disease through disability prevention

47. The vector for Filariasis is

a. Wuchereria bancrofti

b. Aedes poecillus

c. Anopheles

d. Aedes egypti

48. A long incubation period characterizes Filariasis that typically ranges from:

a. 2-4 weeks c. 2-3 years

b. 4-6 weeks d. 8-16 months

49. A 36-year-old man is brought by his wife to a doctor's clinic to be tested for filariasis. The most likely diagnostic test that he will undergo is:

a. Immunochromatographic test (ICT)

b. Nocturnal Blood Examination

c. Stool examination

d. Urinalysis

50. A client in the acute stage of the disease will include which of the following clinical findings?

a. Lymphangitis, lymphadenitis, epidydimitis

b. Hydrocele, lymphedema, elephantiasis

c. Orchitis, hydrocele, elephantiasis

d. Lymphadenitis, lympedema and orchitis

Situation 11: Specific defenses of the body involve the immune system. Nurses should be knowledgeable on the importance of immunity in the prevention of communicable diseases.

51. Ayisha is given the hepatitis B immune globulin serum, which will provide her with passive immunity. One advantage of passive immunity is that it:

a. Has effects that last a long time

b. Is highly effective in the treatment of disease

c. Offers immediate protection

d. Encourages the body to produce antibodies

52. Nurse Keith explains to a mother whose child just received a tetanus toxoid injection that the toxoid confers which of the following immunity?

a. Lifelong passive immunity

b. Long-lasting active immunity

c. Lifelong active natural immunity

d. Lifelong active artificial immunity

53. Simon, who is suspected of having tetanus, asks Nurse Benny about immunizations against tetanus. Nurse Benny explains that the major benefit in using tetanus antitoxin is that it:

a. Stimulates plasma cells directly 

b. Provides a high titer of antibodies

c. Provides immediate active immunity

d. Stimulates long-lasting passive immunity

54. Justin, who was exposed to hepatitis A is given gamma globulin to provide passive immunity, which:

a. Increases production of short-lived antibodies 

b. Provides antibodies that neutralize the antigen

c. Accelerates antigen-antibody union at the hepatic sites

d. Stimulates the lymphatic system to produce large numbers of antibodies

55. A mother asked Nurse Edna on the duration of the effectiveness of a natural passive immunity. Nurse Edna is correct when she tell the mother that the effect lasts for:

a. 2 to 3 weeks c. 6 months to 1 year

b. Permanent d. 2 to 5 years

Situation 12. Whenever possible, the nurse implements strategies to prevent infection. If infection cannot be prevented, the nurse's goal is to prevent the spread of the infection within and between persons, and to treat the existing infection.

56. Gino is a chronic carrier of infection. To prevent the spread of the infection to other clients or health care providers, the nurse emphasizes interventions that do which of the following?

a. Eliminate the reservoir

b. Block the portal of exit from the reservoir

c. Block the portal of entry into the host

d. Decrease the susceptibility of the host

57. The most effective nursing action for controlling the spread of infection includes which of the following?

a. Thorough hand cleansing

b. Wearing gloves and masks when providing direct client care

c. Implementing appropriate isolation precautions

d. Administering broad-spectrum prophylactic antibiotics

58. In caring for Mark who is on contact precautions for a draining infected foot ulcer, Nurse Bong should perform which of the following?

a. Wear a mask during dressing changes

b. Provide disposable meal trays and silverware

c. Follow standard precautions in all interactions with the client

d. Use surgical aseptic technique for all direct contact with the client

59. When caring for a single client during one shift, it is appropriate for the nurse to reuse which of the following personal protective equipment?

a. Goggles c. Surgical mask

b. Gown d. Clean gloves

60. After teaching a client and family strategies to prevent infection, which statement by the client would indicate effective learning has occurred?

a. “We will use antimicrobial soap and hot water to wash our hands at least three times per day.”

b. “We must wash or peel all raw fruits and vegetables before eating.”

c. “A wound or sore is not infected unless we see it draining pus.”

d. “We should not share toothbrushes but it is OK to share towels and washcloths.”

Communicable Disease Answers II

31. C.

A and B. There is no known vaccination and prophylactic antivirals for Dengue fever.

D. Eliminating the breeding sites of mosquitoes is better than killing the mosquitoes.

32. B

33. B. There is no known vaccination for Dengue fever.

34. A. Patient should be observed closely for signs of deterioration (shock) such as hypotension, tachycardia, tachypnea, cold clammy perspiration and prostration.

B. This is not necessary.

C. There is no known antivirals for Dengue fever.

D. Platelet administration is done to prevent bleeding, but this is a dependent function.

35. B. This promotes vasoconstriction.

A. Aspirin is contraindicated. It may worsen the bleeding.

C. Patient should be placed in dorsal recumbent to facilitate blood circulation.

D. Diet should be low fiber, low fat, non-irritating, and non-carbonated.

36. C. Tuberculin/Mantoux test only indicate exposure to the mycobacterium, not active infection.

A and D. After obtaining three sputum negative results, chest x-ray can be done to assess parenchymal involvement. Diagnosis of TB through x-ray can be made by the TB

Diagnostic Center (TBDC).

B. Direct Sputum Smear Microscopy (DSSM) is the primary diagnostic tool for TB.

37. C. Hemoptysis is the only contraindication for sputum collection.

A, B and D are indications for hospitalization of clients with TB.

38. B. The Isoniazid in the treatment regimen causes peripheral neuropathy. Client should be advised to increase intake of Vitamin B6, which is commonly found in green leafy vegetables, such as kangkong.

39. D. Yellowish palms may indicate liver problem. Anti-tuberculous drugs, particularly Pyrazinamide, are hepatotoxic drugs.

A. Hemoptysis is not a side effect, but must be reported immediately to the physician. Massive hemoptysis requires hospitalization.

B and C are side effects of Isoniazid. Clients should be advised to increase oral fluid intake. Paracetamol is given to manage the fever.

40. A. Strict compliance to the treatment regimen is a must while undergoing treatment for TB, to avoid relapses and prevent the development of multi-drug resistant strain of TB.

B, C and D are part of the health teaching to clients with tuberculosis, but strict compliance to treatment regimen should be given utmost emphasis.

41. A. The incubation period for SARS is 2-10 days but may be long as 13 days.

42. C.

A. Rhabdovirus causes rabies infection.

B. Togavirus causes German measles.

D. The family of paramyxovirus is responsible for measles and mumps.

43. B.

A. This pertain to isolation precaution.

C. This pertain to transmission-based precaution.

D. Handwashing is a universal precautionary measure.

44. A. During the prodromal phase, infectivity is none to low. Infectivity is highest during the respiratory phase (within 2-7 days).

B and D are seen during the respiratory stage.

C. Fever during the prodromal phase of SRAS is above 380C.

45. A. Handwashing is performed before and after client contact

B. Handwashing is performed before eating.

C. Handwashing is performed before food preparation.

D. Handwashing is performed after using the toilet.

46. B. There is no known vaccination for Filariasis. Diethycarbamezine Citrate (DEC) is given to patients with clinical manifestations and/or microfilariae.

47. B. A. This is the causative agent for filariasis. Other causative agents include Brugia malayi and Brugia timori.

C. This is the vector for Malaria.

D. This is the vector for Dengue.

48. D. Incubation period ranges from 8-16 months.

49. A. The clinic is only open from 8am to 5pm. The ICT is an antigen test that can be done in daytime. Nocturnal blood smear is also a diagnostic test for Filariasis, but the patient's blood is taken at the patient's residence or in the hospital after 8pm.

50. A. The clinic is only open from 8am to 5pm. The ICT is an antigen test that can be done in daytime. Nocturnal blood smear is also a diagnostic test for Filariasis, but the patient's blood is taken at the patient's residence or in the hospital after 8pm.

51. A. Lymphangitis, lymphadenitis, epidydimitis, funiculitis and orchotis are acute clinical manifestations of Filariasis. Hydrocele, lymphedema, and elephantiasis are clinical manifestations of Chronic Filariasis.

52. Answer: C Rationale: Passive immunity provides immediate protection, it is short-lived, is limited in effectiveness, and does not stimulate the body to produce antibodies. (NSNA NCLEX-RN Review, 4th Edition)

53. Answer: B

Rationale: Tetanus antitoxin provides antibodies, which confer immediate passive artificial immunity, the same with antiserums and immune globulins. Option A is incorrect because antitoxins doesn't stimulate production of antibodies. Option C is incorrect because it provides passive, not active, immunity. Option D is incorrect because passive immunity, by definition, is not long-lasting. (Mosby's, 18th Edition)

54. Answer: B

Rationale: Gamma globulin, an immune globulin, contains most of the antibodies circulating in the blood. When injected into an individual, it prevents a specific antigen from entering a host cell. Options A and D are incorrect because this does not stimulate antibody production. Option C is incorrect because this does not affect antigen-antibody function. (Mosby's, 18th Edition)

55. Answer: C

Rationale: The effectiveness of a natural passive immunity lasts for 6 months to 1 year. Option B is for natural active immunity. Option A is for artificial passive immunity. Option C is for artificial active immunity.

56. Answer: B

Rationale: Blocking the movement of the organism from the reservoir will succeed in preventing the infection of any other persons. In option A, since the carrier person is the reservoir and the condition is chronic, it is not possible to eliminate the reservoir. Option C and D are incorrect because blocking the entry into a host or decreasing the susceptibility of the host will be effective for only that one single individual and, thus, is not effective as blocking exit from the reservoir.

57. Answer: A Rationale: Since the hands are frequently in contact with clients and equipment, they are the most obvious source of transmission. Regular and routine hand cleansing is the most effective way to prevent movement of potentially infective materials. Option B is incorrect because personal protective equipment (PPE) such as gloves and masks is indicated for situations requiring Standard Precautions. Option C is incorrect because Isolation precautions are used for clients with known communicable diseases. Option D is incorrect because use of antibiotics is not effective and can be harmful due to the incidence of superinfection and development of resistant organisms.

58. Answer: C Rationale: Standard Precautions include all aspects of contact precautions with the exception of placing the client in a private room. In option A, a mask is indicated when working over a sterile wound rather than an infected one. Option B is incorrect because disposable food trays are not necessary for clients with infected wounds unlikely to contaminate the client's handstion D is incorrect because sterile technique (surgical asepsis) is not indicated for all contact with the client. The nurse would utilize clean technique when dressing the wound to prevent introduction of additional microbes.

59. Answer: A Rationale: Unless overly contaminated by material that has splashed in the nurse's face and cannot be effectively rinsed off, goggles may be worn repeatedly. In option B, since gowns are at high risk for contamination, they should be used only once and hen discarded or washed. Option C and D are incorrect because surgical mask and clean gloves are never washed or reused.

60.Answer: B Rationale: Raw foods touched by human hands can carry significant infectious organisms and must be washed or peeled. Option A is incorrect because antimicrobial soap is not indicated for regular use and may lead to resistant organisms. Hand cleansing should occur as needed. Hot water can dry and harm skin, increasing the risk of infection. In option C, clients should learn all the signs of inflammation and infection (e.g., redness, swelling, pain and heat) and not rely on the presence of pus to indicate this. Option D is incorrect because persons should not share washcloths or towels.