Chapter 6 - Infectious Disease

Question 1

Pertussis vaccination should begin at which age?

a. Birth
b. 2 months
c. 6 months
d. 12 months

Answer 1

b. 2 months

Question 2

A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain?

a. This cannot be prevented.
b. Infants do not feel pain as adults do.
c. This is not a good reason for refusing immunizations.
d. A topical anesthetic can be applied before injections are given.

Answer 2

d. A topical anesthetic can be applied before injections are given.

Question 3

A 4-month-old infant comes to the clinic for a well-infant checkup. Immunizations she should receive are DTaP (diphtheria, tetanus, acellular pertussis) and IPV (inactivated poliovirus vaccine). She is recovering from a cold but is otherwise healthy and afebrile. Her older sister has
cancer and is receiving chemotherapy. Nursing considerations should include which?

a. DTaP and IPV can be safely given.
b. DTaP and IPV are contraindicated because she has a cold.
c. IPV is contraindicated because her sister is immunocompromised.
d. DTaP and IPV are contraindicated because her sister is immunocompromised.

Answer 3

a. DTaP and IPV can be safely given.

These immunizations can be given safely. Serious illness is a contraindication. A mild illness with or without fever is not a contraindication. These are not live vaccines, so they do not pose a risk to her sister

Question 4

Which serious reaction should the nurse be alert for when administering vaccines?

a. Fever
b. Skin irritation
c. Allergic reaction
d. Pain at injection site

Answer 4

c. Allergic reaction

Question 5

Which muscle is contraindicated for the administration of immunizations in infants and young children?

a. Deltoid
b. Dorsogluteal
c. Ventrogluteal
d. Anterolateral thigh

Answer 5

b. Dorsogluteal

The dorsogluteal site is avoided in children because of the location of nerves and veins. The deltoid is recommended for 12 months and older. The ventrogluteal and anterolateral thigh sites can safely be used for the administration of vaccines to infants.

Question 6

Which is described as an elevated, circumscribed skin lesion that is less than 1 cm in diameter and filled with serous fluid?

a. Cyst
b. Papule
c. Pustule
d. Vesicle

Answer 6

d. Vesicle

Question 7

Which vitamin supplementation has been found to reduce both morbidity and mortality in measles?

a. A
b. B1
c. C
d. Zinc

Answer 7

a. A

Question 8

What does impetigo ordinarily results in?

a. No scarring
b. Pigmented spots
c. Atrophic white scars
d. Slightly depressed scars

Answer 8

a. No scarring

Impetigo tends to heal without scarring unless a secondary infection occurs.

Question 9

What often causes cellulitis?

a. Herpes zoster
b. Candida albicans
c. Human papillomavirus
d. Streptococci or staphylococci

Answer 9

d. Streptococci or staphylococci

Question 10

Lymphangitis (streaking) is frequently seen in what?

a. Cellulitis
b. Folliculitis
c. Impetigo contagiosa
d. Staphylococcal scalded skin

Answer 10

a. Cellulitis

Lymphangitis is frequently seen in cellulitis. If it is present, hospitalization is usually required for parenteral antibiotics. Lymphangitis is not associated with folliculitis, impetigo, or
staphylococcal scalded skin.

Question 11

What is most important in the management of cellulitis?

a. Burow solution compresses
b. Oral or parenteral antibiotics
c. Topical application of an antibiotic
d. Incision and drainage of severe lesions

Answer 11

b. Oral or parenteral antibiotics

Question 12

What causes warts?

a. A virus
b. A fungus
c. A parasite
d. Bacteria

Answer 12

a. A virus

Question 13

What is the primary treatment for warts?

a. Vaccination
b. Local destruction
c. Corticosteroids
d. Specific antibiotic therapy

Answer 13

b. Local destruction

Question 14

Herpes zoster is caused by the varicella virus and has an affinity for which?

a. Sympathetic nerve fibers
b. Parasympathetic nerve fibers
c. Lateral and dorsal columns of the spinal cord
d. Posterior root ganglia and posterior horn of the spinal cord

Answer 14

d. Posterior root ganglia and posterior horn of the spinal cord

The herpes zoster virus has an affinity for posterior root ganglia, the posterior horn of the spinal cord, and the skin. The zoster virus does not involve the nerve fibers listed.

Question 15

Treatment for herpes simplex virus (type 1 or 2) includes which?

a. Corticosteroids
b. Oral griseofulvin
c. Oral antiviral agent
d. Topical or systemic antibiotic

Answer 15

c. Oral antiviral agent

Question 16

What should the nurse explain about ringworm?

a. It is not contagious.
b. It is a sign of uncleanliness.
c. It is expected to resolve spontaneously.
d. It is spread by both direct and indirect contact.

Answer 16

d. It is spread by both direct and indirect contact.

Question 17

When giving instructions to a parent whose child has scabies, what should the nurse include?

a. Treat all family members if symptoms develop.
b. Be prepared for symptoms to last 2 to 3 weeks.
c. Carefully treat only areas where there is a rash.
d. Notify practitioner so an antibiotic can be prescribed

Answer 17

b. Be prepared for symptoms to last 2 to 3 weeks.

The mite responsible for the scabies will most likely be killed with the administration of medications. It will take 2 to 3 weeks for the stratum corneum to heal. That is when the
symptoms will abate. Initiation of therapy does not wait for clinical symptom development. All individuals in close contact with the affected child need to be treated. Permethrin, a scabicide, is the preferred treatment and is applied to all skin surfaces.

Question 18

Which is usually the only symptom of pediculosis capitis (head lice)?

a. Itching
b. Vesicles
c. Scalp rash
d. Localized inflammatory response

Answer 18

a. Itching

Question 19

The school reviewed the pediculosis capitis (head lice) policy and removed the no nit requirement. The nurse explains that now, when a child is found to have nits, the parents must do which before the child can return to school?

a. No treatment is necessary with the policy change.
b. Shampoo and then trim the childs hair to prevent reinfestation.
c. The child can remain in school with treatment done at home.
d. Treat the child with a shampoo to treat lice and comb with a fine-tooth comb every day until nits
are eliminated.

Answer 19

c. The child can remain in school with treatment done at home.

Many children have missed significant amounts of school time with no nit policies. The child should be appropriately treated with a pediculicide and a fine-tooth comb. The environment needs to be treated to prevent reinfestation. The treatment with the pediculicide will kill the lice
and leave nit casings. Cutting the childs hair is not recommended; lice infest short hair as well as long. With a no nit policy, treating the child with a shampoo to treat lice and combing the hair with a fine-tooth comb every day until nits are eliminated is the correct treatment. The policy
change recognizes that most nits do not become lice.

Question 20

The nurse should know what about Lyme disease?

a. Very difficult to prevent
b. Easily treated with oral antibiotics in stages 1, 2, and 3
c. Caused by a spirochete that enters the skin through a tick bite
d. Common in geographic areas where the soil contains the mycotic spores that cause the disease

Answer 20

c. Caused by a spirochete that enters the skin through a tick bite