14 - Communicable and Infectious Disease Risks Flashcards
In comparison with HIV infection in adults, HIV infection in infants and children:
a. ) has the same signs and symptoms.
b. ) has a shorter incubation period.
c. ) has a longer survival period.
d. ) is detected by using the same tests.
b.) has a shorter incubation period.
HIV infection in infants and children has a shorter incubation period. The physical signs and symptoms in children are different and include failure to thrive, unexplained persistent diarrhea, developmental delays, and bacterial infections such as tuberculosis (TB) and severe pneumonia. Detection is made through different tests in infants of infected mothers than from those who are over 18 months. The effectiveness of antiretroviral therapy in pregnant women and newborns in preventing transmission from mother to fetus or infant has made pediatric HIV rates decline sharply; thus, these children are less likely to contract the virus.
A nurse is caring for a client who is HIV positive. Which of the following roles of the nurse would be the most important for the nurse to implement?
a. ) Advocate, lobbying for AIDS research
b. ) Counselor, discussing implications of future sexual activity
c. ) Role model, providing supportive care
d. ) Policy maker, addressing laws governing privacy rights of HIV-positive persons
c.) Role model, providing supportive care
The priority role of the nurse should be role model, as nurses must be role models because many HIV-positive patients are stigmatized. The need to be an advocate and policy maker does not address the individual needs of the client. The nurse is able to counsel the client while providing supportive care.
Which type of hepatitis would likely be found where sanitation is inadequate?
a. ) A
b. ) B
c. ) C
d. ) D
a.) A
Hepatitis A would likely be found where sanitation is inadequate. Hepatitis B and C are spread through blood and body fluids. Hepatitis D can only exist in people who are already infected with Hepatitis B.
A nurse is caring for a client who has been diagnosed with a bacterial sexually transmitted infection (STI). Which of the following infections does this client most likely have?
a. ) Trichomonas
b. ) HIV
c. ) Syphilis
d. ) Genital warts
c.) Syphilis
Trichomonas, HIV, and genital warts are caused by viruses. Syphilis is caused by bacteria.
A nurse is examining a child in the early stages of HIV infection. Which of the following would the nurse expect to find?
a. ) Failure to thrive and developmental delays
b. ) Kaposi’s sarcoma and developmental delays
c. ) Toxoplasmosis and oral candidiasis
d. ) Fatigue and shortness of breath
a.) Failure to thrive and developmental delays
Early symptoms of pediatric HIV infection include failure to thrive and developmental delays. Kaposi’s sarcoma and oral candidiasis are common opportunistic diseases later in the disease process. Fatigue is a symptom seen with hepatitis and TB.
A nurse counsels a client to have the enzyme-linked immunosorbent assay (EIA) test. Which of the following best describes the rationale for this test?
a. ) To indicate the presence of the antibody to HIV
b. ) To reveal whether or not the client has AIDS
c. ) To isolate the HIV virus
d. ) To confirm HIV after having a positive Western blot
a.) To indicate the presence of the antibody to HIV
The EIA is used to indicate the presence of the antibody to HIV. To minimize false positive results, the Western blot is used as a confirmatory test to verify the results. The EIA does not isolate the virus, nor does it reveal whether the individual has symptomatic AIDS.
Which part of the immunological system suffers the greatest damage as a result of HIV infection?
a. ) Dendrite cells
b. ) CD4+ T-lymphocytes
c. ) Macrophages
d. ) Monocytes
b.) CD4+ T-lymphocytes
When HIV enters the body, a person may experience a mononucleosis-like syndrome, referred to as a primary infection, which lasts for few weeks. This may go unrecognized. The body’s CD4 white blood cell count drops for a brief time when the virus is most plentiful in the body. The dendrite cells, macrophages, and monocytes are not as severely damaged as the CD4 cells.
A nurse screens blood products, donor organs, and tissues for the hepatitis C infection. Which of the following best describes this nursing action?
a. ) Primary prevention
b. ) Secondary prevention
c. ) Tertiary prevention
d. ) Health promotion
a.) Primary prevention
Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Screening blood products, organs, and tissues for infection protects the population from exposure to hepatitis C, which prevents them from contracting the disease. Secondary prevention includes screening for diseases to ensure their early identification, treatment, and follow-up with contact to prevent further spread. Tertiary prevention focuses on chronic care and rehabilitation. Health promotion focuses on the primary prevention activities to promote health and prevent disease.
A nurse is working in a public health center. A patient who has been newly diagnosed as HIV positive comes for counseling. By law, which of the following actions must be taken by the nurse?
a. ) Give antiviral medications to the patient
b. ) Ask the person to name all of his or her sexual contacts
c. ) Refer the patient to the social worker as someone possibly needing case management
d. ) Report the HIV-infected person to the state health department
d.) Report the HIV-infected person to the state health department
It is mandatory to report HIV cases by name in all states, although not all states require viral load and CD4 counts. There are not laws in place that mandate administration of medications, naming of sexual contacts, or referral to case management.
The nurse teaches the family of an AIDS client about managing symptomatic illness by preventing deteriorating conditions, such as diarrhea, skin breakdown, and inadequate nutrition. Which of the following best describes the action taken by the nurse?
a. ) Primary prevention
b. ) Secondary prevention
c. ) Tertiary prevention
d. ) Primary health care
c.) Tertiary prevention
Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Primary health care refers to the first line of care provided to patients typically by a physician or other health care provider.
A nurse is uncomfortable discussing such topics as sexual behavior and sexual orientation when counseling clients and avoids this topic with clients. Which of the following is the most likely outcome of this avoidance?
a. ) Potential risks and risky behaviors will not be identified.
b. ) Transmission of STDs will remain unchanged.
c. ) Clients will develop a trusting relationship with health care providers.
d. ) The nurse will be violating the laws in several states.
a.) Potential risks and risky behaviors will not be identified.
It is important that nurses be able to discuss these topics to help prevent and control STDs. Without discussion of these topics, it is possible that clients will not be aware that they have an STD and may transmit it to others. Thus, the transmission of STDs may increase. A trusting relationship with a health care provider may or may not develop and is not dependent on whether these issues are discussed. There are not laws that mandate nurses to discuss sexual behavior and sexual orientation with clients.
Which of the following groups would be most likely to receive an injection of prophylactic immune globulin for possible exposure to hepatitis A?
a. ) Persons who have had direct contact with blood
b. ) Those who ate at the same restaurant as the person with hepatitis A
c. ) All health care workers
d. ) All those who had household or sexual contact with persons with hepatitis A
d.) All those who had household or sexual contact with persons with hepatitis A
Those who have been in close contact with persons who develop hepatitis A should receive immune globulin. The other groups do not describe populations in direct contact with the person who has hepatitis A.
A nurse is examining the route of HIV transmission for a newly diagnosed HIV client. Which of the following would most likely be discovered by the nurse?
a. ) Having contact with an HIV-positive individual who is coughing
b. ) An infant receiving breast milk from an HIV-positive mother
c. ) Receiving a mosquito bite while in Africa
d. ) Being near an HIV-positive individual who is sneezing
b.) An infant receiving breast milk from an HIV-positive mother
HIV can be transmitted through breast milk. HIV is not transmitted by coughing, sneezing, or mosquito bites.
Pelvic inflammatory disease (PID) is a common complication of:
a. ) gonorrhea.
b. ) syphilis.
c. ) chlamydia.
d. ) herpes.
a.) gonorrhea.
PID is a common complication of gonorrhea. PID is not a common complication of syphilis, chlamydia, or herpes.
A nurse is educating intravenous (IV) drug users about sharing equipment. Which of the following information would be appropriate for the nurse to include in this education?
a. ) Tell the clients to throw away their equipment after one use
b. ) Educate the clients on using full-strength bleach on their drug paraphernalia for 30 seconds
c. ) Suggest limiting the number of people who share the equipment
d. ) Provide clean needles and syringes to whoever wants them
b.) Educate the clients on using full-strength bleach on their drug paraphernalia for 30 seconds
Using bleach on the needles and syringes is a way to decrease cross-contamination. This is the last-resort option. People who inject drugs are difficult to reach for health care services, so providing them education is important so that they can protect themselves and others as they most likely will not throw away their equipment, or be selective about whom they share their equipment with. Providing needles and syringes does not provide the appropriate education to prevent the spread of disease.
