chapter 16 Flashcards
- Women who develop vaginal fungal infections (commonly referred to as yeast infections)
usually have a history of having been prescribed antibiotics for bacterial infections. Which
component of the epidemiological triangle (agent–host–environment) contributes most to the
development of vaginal infections?
a. Agent
b. Environment
c. Host
d. Agent and host
b. Environment
- A communicable disease outbreak has occurred in a town. At a town meeting with public
health officials, a community health nurse (CHN) is asked to explain the phrase “virulent
organism.” What definition of virulence is correct?
a. Virulence is the ability to bypass normal immunological response mechanisms.
b. Virulence is the ability to invade major organ systems.
c. Virulence is the ability to produce toxins and poisons that weaken the body.
d. Virulence is the ability to produce severe physical reactions.
d. Virulence is the ability to produce severe physical reactions.
Virulence is the ability to produce a severe pathological reaction.
- CHNs have been advised by the medical director to give injections of hepatitis A
immunoglobulin to selected susceptible persons in the event of a hepatitis A epidemic. What
outcome will be the result?
a. Active immunization
b. Long-lasting immunity
c. Natural immunity
d. Passive immunization
d. Passive immunization
Passive immunization refers to immunization through the transfer of a specific antibody from
an immunized individual to a nonimmunized individual, such as the transfer of antibodies
from mother to infant or the administration of an antibody-containing preparation (immune
globulin or antiserum). Passive immunity from immune globulin is almost immediate but
short-lived. It is often induced as a stop-gap measure until active immunity has time to
develop after vaccination. Examples of commonly used immune globulins include those for
hepatitis A, rabies, and tetanus.
- Which statement about Salmonella made in a class about disease prevention indicates that
additional teaching is needed?
a. “Certain pets and farm animals may be Salmonella carriers.”
b. “It is possible to transmit Salmonella through person-to-person contact.”
c. “Salmonella may be spread through blood once the infected blood is exposed to
air.”
d. “Salmonella outbreaks are usually due to contaminated meat, poultry, and eggs.”
c. “Salmonella may be spread through blood once the infected blood is exposed to
air.”
Meat, poultry, and eggs are the foods most often associated with salmonellosis outbreaks.
Animals are common reservoirs for the various Salmonella serotypes. Although infected
humans may also be carriers, animals are more likely to be chronic carriers. Reptiles, such as
iguanas, have been implicated as Salmonella carriers, as well as turtles, poultry, cattle, swine,
rodents, dogs, and cats. Person-to-person transmission is an important consideration in
daycare and institutional settings. Anthrax (not Salmonella) forms spores when infected blood
is exposed to air.
- Which infectious disease intervention best represents primary prevention?
a. Giving a tetanus booster every 10 years
b. Giving a tetanus booster to a client after she steps on a nail
c. Giving tetanus immunoglobulin to a client after he steps on a nail
d. Giving antibiotics to a client who has tetanus and placing the client on seizure
precautions
a. Giving a tetanus booster every 10 years
Giving tetanus boosters before any exposure has occurred is a primary prevention measure.
Giving boosters after exposure (i.e., the client may be infected but disease has not developed)
is considered to be a secondary prevention measure (similar to the textbook examples of
immunoglobulin and rabies immunizations given after exposure). Tetanus immunoglobulin
would be given if the client who steps on a nail had not been previously immunized; however,
this is done following exposure and would therefore be a secondary prevention. Giving
antibiotics to a client who has already developed tetanus is not primary prevention.
Which infectious disease intervention is most representative of secondary prevention?
a. Clients with human immunodeficiency virus (HIV) infection are encouraged to use
condoms to protect their sexual partners.
b. Clients with HIV infection are given medications to improve immunological
response.
c. Health care workers are encouraged to receive annual vaccinations for influenza.
d. Health care workers are required to have a tuberculosis (TB) skin test or chest Xray
d. Health care workers are required to have a tuberculosis (TB) skin test or chest Xray
- A student asks the school nurse how acquired immune deficiency syndrome (AIDS) is
diagnosed. Which answer is correct?
a. AIDS is diagnosed through the negative results of a screening test called an
enzyme-linked immunosorbent assay (ELISA).
b. Antibodies to HIV, which form in about 6 weeks to 3 months following infection
with HIV, are detected in the blood.
c. Antibodies to HIV reach peak levels of 200/mL of blood.
d. AIDS is diagnosed through positive ELISA results and clinical signs of AIDS.
d. AIDS is diagnosed through positive ELISA results and clinical signs of AIDS.
- A CHN asks a class to describe the ways in which HIV can be transmitted. Which student
response indicates a need for additional teaching?
a. “HIV can be transmitted by droplet spread from sneezing or coughing.”
b. “HIV can be transmitted by having unprotected sex with someone who is
infected.”
c. “HIV can be transmitted by sharing needles when shooting up drugs.”
d. “HIV can be transmitted through transfusions of blood products that are
contaminated with HIV.”
a. “HIV can be transmitted by droplet spread from sneezing or coughing.”
b. “HIV can be transmitted by having unprotected sex with someone who is
infected.”
- For what reason should the school nurse recommend that an HIV-infected child not be
allowed to attend school?
a. The child develops allergies with sneezing.
b. The school system requires students to receive routine immunizations.
c. There is an outbreak of chicken pox at the school.
d. There is strong objection from parents of well children.
c. There is an outbreak of chicken pox at the school.
- What sexually transmitted infections (STIs) can be prevented through immunization?
a. Chlamydia
b. Gonorrhea
c. Hepatitis B
d. Herpes
c. Hepatitis B
- What presents a challenge for human papillomavirus (HPV) prevention?
a. HPV can be transmitted through all body fluids.
b. HPV warts may grow in areas that a barrier (e.g., a condom) does not cover.
c. With HPV, thin-walled pustules may rupture to form honey-coloured crusts.
d. With HPV, vesicles are hidden and ulcerate within 1 day.
b. HPV warts may grow in areas that a barrier (e.g., a condom) does not cover.
- What would be a tertiary prevention measure implemented by the CHN to prevent TB?
a. Administering a purified protein derivative (PPD) to the contacts of those infected
with TB
b. Initiating directly observed therapy (DOT) for TB-positive clients
c. Providing education about the prevention of TB to members of the community
d. Using skin tests to screen all health
d. Using skin tests to screen all health
- A client with TB wants to know why DOT is required as part of the treatment. What CHN
response would be the most appropriate one?
a. “Clients with TB are often noncompliant; DOT will ensure that you take the drugs
prescribed to you.”
b. “This therapy is recommended by TB experts as the best way to ensure that you
receive the treatment you need and that the infection doesn’t become resistant to
treatment.”
c. “This ensures that you get your medication even at the late stages of TB, when
your memory may be affected by inadequate oxygenation to the brain.”
d. “TB medications are very expensive, and this method ensures that government
health care resources are not wasted by those who will not take the drugs
regularly.”
b. “This therapy is recommended by TB experts as the best way to ensure that you
receive the treatment you need and that the infection doesn’t become resistant to
treatment.”
