Question 1

The clinic clients respond negatively to the need for a yearly flu shot. They ask why the medical communities don't just create one shot that will last for several years. Which is the best response from the nurse?

Accepted Answer

CThe flu is caused by a virus, not bacteria, making option A incorrect. The flu virus undergoes frequent genetic changes or mutations, which can make it resistant to previous vaccines, as stated in option B. Additionally, there are multiple strains of the flu virus circulating each year, and the vaccine is updated annually to protect against the most common strains expected to be prevalent, as mentioned in option C. Option D is incorrect because flu shots are formulated to provide protection for the entire flu season, not just 3 to 6 months.

Question 2

Nursing students in an enclosed classroom begin to become ill with a gastrointestinal illness. The public health department identifies this occurrence as an emerging epidemic and isolates the population that is ill. Which factor will become apparent among those who survive this disease?

Accepted Answer

Survivors of an infectious disease often develop improved defenses against reinfection due to the adaptive response of their immune system, which learns to recognize and more effectively combat the pathogen if exposed again in the future.

Question 3

Three years after exposure to a virulent form of the flu, a population faces the same flu strain. The public health department determines that there are members of the population who have not been exposed to the flu strain. Which will the public health department predict will occur next?

Accepted Answer

The unexposed population is not likely to contract the illness because they have developed immunity to the flu strain after the initial exposure three years ago.

Question 4

The public health department is conducting research in an area where medical resources are limited. Which environmental factors should the department most consider when evaluating the likelihood of a disease outbreak? (Select all that apply.)

Accepted Answer

Temperature, precipitation, and humidity are critical environmental factors that can influence the likelihood of a disease outbreak. High temperatures and humidity can create environments conducive to the spread of certain pathogens. Precipitation can affect the breeding sites of vectors like mosquitoes, leading to outbreaks of diseases such as malaria or dengue fever.

Question 5

Tent communities are constructed in a rural community by the American Red Cross after a disaster. Because of overcrowding, surrounding states create accommodations for the displaced and homeless. The survivors are accommodated in the cities of four Southern states. Which factors will most likely increase the possibility of disease emergence in these cities? (Select all that apply.)

Accepted Answer

Poor hygiene and poor sanitation are factors that can lead to the spread of infectious diseases, especially in crowded living conditions.

Question 6

An 80-year-old client is being treated for chronic urinary tract infections with multiple antibiotics in the past 6 months. The healthcare provider orders a urine culture. The results of the urine culture reveals Staphylococcus aureus >100,000 colonies and demonstrated resistance to sulfamethoxazole and trimethoprim, penicillin, methicillin, and erythromycin. The client is diagnosed with methicillin-resistant S. aureus (MRSA) on the basis of the findings of her urine test. The nurse would predict this is the result of which microbial action?

Accepted Answer

The correct answer is adaptation. The development of resistance to multiple antibiotics by Staphylococcus aureus, resulting in methicillin-resistant S. aureus (MRSA), is a clear example of microbial adaptation. This process involves genetic changes that allow the bacteria to survive in the presence of antibiotics that would normally kill them or inhibit their growth.

Question 7

The community health nurse works in a region where severe acute respiratory syndrome (SARS) has just been reintroduced into the environment. Which measure is imperative for the nurse to take to prevent spread of the disease?

Accepted Answer

Enhanced infection control measures are crucial to prevent the spread of SARS, as it is a viral infection and not treatable with antibiotics.

Question 8

There is an outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in the community. The nurse is responsible for the dissemination of the education plan adopted by the public health department. Which key components of the plan should the nurse include? (Select all that apply.)

Accepted Answer

Respiratory hygiene, hand hygiene, and droplet precautions for visitors in contact with affected clients are key components of the education plan for an outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV).

Question 9

International health experts have determined that the avian flu is the virus most likely to cause the next pandemic. Which factor will most likely improve its transmissibility to the public?

Accepted Answer

Antigenic shift is a significant change in the influenza virus that can lead to new virus strains to which people have little to no immunity, increasing the risk of widespread transmission and potentially leading to a pandemic.

Question 10

The nurse is responsible for the construction of an isolation unit during an H5N1 outbreak. The unit is designated for only those clients with a confirmed diagnosis of H5N1. Which unit should the nurse prioritize to fulfill this need?

Accepted Answer

Negative air pressure units are crucial in preventing the spread of airborne diseases like H5N1 by keeping the air within the isolation unit from moving to other parts of the facility.

Question 11

Ten documented cases of West Nile virus (WNV) have occurred recently in the community. Which points should the nurse prioritize when educating the community about this outbreak? (Select all that apply.)

Accepted Answer

West Nile virus is primarily spread through the bites of infected mosquitoes. Eliminating standing water helps reduce mosquito breeding sites, directly addressing the vector of the disease. Avoiding contact with birds or those with a confirmed diagnosis, and avoiding exposure to the environment during daylight hours are less relevant, as mosquitoes, not birds or person-to-person contact, are the primary transmission vector, and mosquitoes that spread WNV are often more active from dusk to dawn, not necessarily during daylight hours.

Question 12

The client is diagnosed with Lyme disease. He states that he is not a hiker and does not remember being bitten by a tick. Which is the best response from the nurse?

Accepted Answer

A history of a tick bite is not required for a Lyme disease diagnosis, as many people do not recall being bitten.

Question 13

The nurse admits a client to the hospital with the diagnosis of Escherichia coli O157:H7. The client is dehydrated and febrile. During the history phase of the admission, the client states that he doesn't know how he could have gotten sick at the local county fair---the hamburger he bought was well done. Which factor would the nurse predict was most responsible for the transmission of the bacteria?

Accepted Answer

The answer of The nurse admits a client to the...

Question 14

Four employees at a local restaurant have positive purified protein derivative (PPD) tuberculin skin tests and have been diagnosed with latent tuberculosis (TB) infection. Which employee would the nurse predict to be at the greatest risk for contracting active TB disease?

Accepted Answer

Individuals taking immunosuppressants are at a higher risk for contracting active TB disease because their immune system is weakened, making it harder for their body to fight off infections like tuberculosis.

Question 15

The nurse assesses a client in the local neighborhood clinic. He exhibits signs and symptoms of tuberculosis (TB) yet has a negative tuberculin skin test result. Which factor will lead the nurse to predict the healthcare provider will order additional tests?

Accepted Answer

Being HIV positive can affect the immune response to the tuberculin skin test, leading to a false-negative result in someone with tuberculosis. This is because HIV weakens the immune system, making it less likely to react to the test even if TB bacteria are present.

Question 16

The nurse is responsible for the directly observed therapy (DOT) program in the community. Which represent the best methods to ensure compliance with clients' drug regimens? (Select all that apply.)

Accepted Answer

Social service support, housing assistance, and treatment enablers are effective methods to ensure compliance with clients' drug regimens in a directly observed therapy (DOT) program. These methods address potential barriers to compliance by providing support and resources that facilitate the completion of treatment.

Question 17

As the occupational health nurse in a factory finds that five employees out of 30 have positive tuberculin skin test results. One employee on the 3-to-11 shift has been diagnosed with active tuberculosis (TB). She asks if this means that the whole factory has been exposed. Which factor would the nurse point out would most likely increase the possibility of infecting others? (Select all that apply.)

Accepted Answer

A) Concentration of infectious droplet nuclei in the air, B) Duration of exposure to the infected person, and C) Proximity to the infected person are significant factors in the spread of tuberculosis. Higher concentrations of infectious droplets, longer durations of exposure, and closer proximity to an infected person increase the risk of transmission. Safety gloves (D) and physical exertion (E) do not directly affect the airborne transmission of TB.

Question 18

A man who lives in a homeless shelter is diagnosed with active tuberculosis (TB). The shelter keeps a list of those who are assigned beds, and the majority of those sleeping there are regulars. Which finding would indicate a positive tuberculin skin test result using a two-step process?

Accepted Answer

A positive tuberculin skin test result, especially in individuals who are at high risk for TB (such as those living in homeless shelters), is typically defined as an induration of 5 mm or greater. Therefore, a 6-mm induration would indicate a positive result.

Question 19

Each employee in a small community hospital is informed that he or she needs a tuberculin skin test and of the date that the test is due. The kitchen employees tell the nurse that they don't need the test and never had to have it before. Which is the best response by the nurse?

Accepted Answer

Tuberculosis guidelines require testing of all individuals in a healthcare setting, regardless of their specific role or direct patient contact, to ensure a safe environment for both staff and patients.

Question 20

A nurse is studying the Institute of Medicine's convergence model to learn how four types of interrelated and overlapping microbe--human interactions can lead to emerging/reemerging infectious diseases. Which four types of interactions will the nurse be to point out as essential after learning about this model? (Select all that apply.)

Accepted Answer

The Institute of Medicine's convergence model identifies genetic and biologic, physical/environmental, ecologic, and social, political, and economic interactions as essential factors that contribute to the emergence and reemergence of infectious diseases.

Quiz 15: Emerging Infectious Diseases