Chapter 13

Question 1

When caring for a client with methicillin-resistant S. aureus (MRSA), the community health nurse should know:

a. Persons with MRSA usually have a chronic illness.
b. MRSA is a hospital-acquired infection and not often seen in the community.
c. VRE (vancomycin-resistant Staphylococcus aureus) follows MRSA.
d. MRSA is becoming more common in the community.

Answer 1

ANS: D
MRSA is being seen more and more in the community with outbreaks frequently associated with school athletic programs and prison populations.

Question 2

The time interval between invasion by an infectious agent and the first appearance of signs and symptoms of the disease is called:

a. Communicable period
b. Incubation period
c. Infectiousness
d. Pathologic reaction

Answer 2

ANS: B
The incubation period is the time interval between invasion by an infectious agent and the first appearance of signs and symptoms.

Question 3

The ability of an agent to produce a severe pathologic reaction is known as:

a. Antigenicity
b. Invasiveness
c. Toxicity
d. Virulence

Answer 3

ANS: D

The ability of an agent to produce a severe pathologic reaction is known as virulence.

Question 4

Immunity is a characteristic of the:

a. Agent factor
b. Host factor
c. Environmental factor
d. Epidemiologic triad

Answer 4

ANS: B

Immunity refers to species-determined resistance to an infectious agent.

Question 5

The nurse teaches food handlers to wash utensils after contact with raw meat. This prevention focuses on the:

a. Agent
b. Host
c. Environment
d. Food handler

Answer 5

ANS: C

Teaching food handlers to wash utensils after contact with raw meat is a prevention that focuses on the environment.

Question 6

An example of an agent is:

a. Host resistance
b. Virus
c. Infectiousness
d. Bug bite

Answer 6

ANS: B

An agent is described by its ability to cause disease and the nature and the severity of the disease.

Question 7

An example of a vertical transmission of a disease is through:

a. Breast milk
b. Sexual transmission
c. Mosquitoes
d. Contaminated food

Answer 7

ANS: A
Vertical transmission is the passing of infection from parent to offspring via sperm, placenta, milk, or contact in the vaginal canal at birth.

Question 8

An example of a vector is:

a. Contaminated water
b. A tick
c. A dirty needle
d. An infected person

Answer 8

ANS: B

Vectors transmit the infectious agent by biting or depositing the infective material near the host.

Question 9

When one case of smallpox occurs in a population in which it was considered to be previously eliminated, it is called:

a. Endemic
b. An epidemic
c. Pandemic
d. Infectivity

Answer 9

ANS: B
The occurrence of one case of smallpox in a population in which it was considered to be previously eliminated is an epidemic.

Question 10

A nurse is providing education to a mother about the importance of having her infant immunized for measles, mumps, and rubella. This immunization will provide what type of immunity?

a. Active
b. Passive
c. Natural
d. Acquired

Answer 10

ANS: A
Active immunity refers to the immunization of an individual by administration of an antigen (infectious agent or vaccine) and is usually characterized by the presence of an antibody produced by the individual host.

Question 11

The nurse provides footwear and gloves to leprosy clients to prevent trauma to their insensitive and deformed hands and feet. This is an example of ____ prevention.

a. A primary level of
b. A secondary level of
c. A tertiary level of
d. Primary health care

Answer 11

ANS: C

Tertiary prevention reduces complications through treatment and rehabilitation.

Question 12

Rabies post-exposure immunization is an example of which of the following levels of prevention with regard to infectious disease interventions?

a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Assessment

Answer 12

ANS: B

Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

Question 13

Requirements for disease reporting in the United States are mandated by:

a. The Centers for Disease Control and Prevention (CDC)
b. Federal laws
c. State laws and regulations
d. The World Health Organization (WHO)

Answer 13

ANS: C

Requirements for disease reporting in the United States are mandated by state laws and regulations.

Question 14

A nurse is providing information to a local newspaper about the presence of infectious diseases in the United States. Which statement by the nurse is accurate?

a. “It is the goal of the World Health Organization to prevent the transmission of the plague by avoiding direct contact with inflicted individuals.”
b. “Rabies is easily spread by contact with animals.”
c. “Polio has been eliminated in the United States since 1994.”
d. “The onset of tularemia is characterized by a distinct skin lesion often called a bull’s-eye lesion.”

Answer 14

ANS: C
The plague is a vector-borne disease and cannot be spread by direct contact with inflicted individuals. Rabies is a rare event because of the widespread vaccination of dogs in the 1950s. The Americas were certified as polio free in 1994. The onset of Lyme’s disease is characterized by a bull’s-eye lesion.

Question 15

Which situation describes the role of a nurse being involved in surveillance?

a. Educating clients about influenza immunizations
b. Collecting information about occurrence of measles
c. Evaluating the effectiveness of a HIV/AIDS prevention program
d. Advocating for changes in the national disease reporting requirements

Answer 15

ANS: B
Nurses are frequently involved in surveillance by collecting data, making diagnoses, investigating and reporting cases, and providing information to the general public.

Question 16

A nurse is working in a health department when a patient arrives who has been traveling to South America and has been diagnosed with malaria. The nurse knows:

a. The Morbidity and Mortality Weekly Report should be consulted to investigate the rate of malaria in the United States.
b. This is a disease that must be reported to the state health department.
c. The nurse should take precautions to wear a mask and gown to avoid exposure.
d. The patient is very ill and should be sent to the hospital immediately.

Answer 16

ANS: B

Malaria is on the list of infectious diseases notifiable at the national level.

Question 17

The most common vector-borne disease in the United States is:

a. Malaria
b. Yellow fever
c. Lyme disease
d. Rocky Mountain spotted fever

Answer 17

ANS: C

Over 15,000 cases of Lyme disease are reported per year. Malaria is most common worldwide.

Question 18

A public health nurse understands that the emergence of new infectious diseases is influenced by the:

a. Increased availability of immunizations
b. Globalization of food supplies
c. Decreased use of child care facilities
d. Creation of sanitation systems in third world countries

Answer 18

ANS: B

This is one of the many factors that can influence the emergence of infectious diseases.

Question 19

West Nile Virus is an example of which of the following types of illness?

a. Foodborne
b. Vectorborne
c. Waterborne
d. Zoonoses

Answer 19

ANS: B

West Nile virus is carried by a mosquito, which is a vector.

Question 20

A nurse is presenting information to the county health department about potential bioterrorism threats. Which of the agents would the nurse discuss in this presentation?

a. Smallpox
b. West Nile Virus
c. Severe acute respiratory syndrome (SARS)
d. Novel influenza A H1N1

Answer 20

ANS: A
Susceptibility to smallpox is 100% in the unvaccinated and fatality rate is estimated at 20% to 40% or higher. The agents of highest concern are anthrax, plague, smallpox, botulism, tularemia, and selected hemorrhagic viruses.

Question 21

Which strategy would be the most appropriate for a public health nurse to use to increase the immunization coverage of infants and toddlers?

a. Read the Mortality and Morbidity Weekly Report to learn about vaccinations.
b. Require that children have all their immunizations before going to public school.
c. Track children known to be at risk for underimmunization.
d. Lead teams of health care workers to enforce laws related to immunizations.

Answer 21

ANS: C

This is a function of public health nurses who work in health departments where immunizations are given and tracked.

Question 22

Food intoxication is caused by:

a. Toxins produced by bacterial growth and chemical contaminants
b. Bacterial, viral, or parasitic invasion of food
c. Overcooking of meat and produce
d. Adding too many spices or ingredients to food

Answer 22

ANS: B

Food intoxication is caused by bacterial, viral, or parasitic invasion of food.

Question 23

Which information is important for the nurse to know about preventing and controlling parasitic infections?

a. The medication to prescribe to treat these infections
b. The nature and symptoms of all parasitic illnesses
c. What specimens to collect and how and when to collect them
d. Public policy about parasitic infections

Answer 23

ANS: C
Nurses need to be cognizant about what specimens to collect, how and when to collect, and what laboratory techniques to use.

Question 24

A community health nurse investigates an outbreak of pinworm at a local day care center. What suggestions would the nurse give to the day care workers?

a. Close the day care until all surfaces are cleaned.
b. No action is necessary because it is easily treated with oral vermicides.
c. Using good hand washing is important to prevent the transmission.
d. Every child in the day care should be treated because they all are probably infected.

Answer 24

ANS: C

Transmission is through the fecal-oral route, so good hand washing after toileting is essential.

Question 25

What is the best method for preventing hospital-acquired infections?

a. Perform good hand washing before and after approaching every patient.
b. Prevention is almost impossible due to the high infection rates in hospitals.
c. Isolate every patient having surgery.
d. Use contact isolation for every patient at risk.

Answer 25

ANS: A

Hand washing is the best way to prevent infection.

Question 26

Adoption of universal precautions by health care workers is an example of:

a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Specific protection

Answer 26

ANS: A

Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.