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CIC > Identification of Infectious Disease Process > Flashcards

Identification of Infectious Disease Process Flashcards

1
Q

A patient was just admitted to a long-term care facility from the local hospital. The patient is being treated for psoriasis. The psoriasis does not appear to be responding to treatment, and 48 hours later, the infection preventionist (IP) receives a report that a Certified Nursing Assistant has developed an itchy rash. The patient’s physician visits and determines that the patient has crusted scabies and not psoriasis. Another name for crusted scabies is:

a. American scabies
b. Norwegian scabies
c. Canadian scabies
d. English scabies

A

b. Norwegian scabies

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2
Q

Guidelines for transporting specimens include: 1) Transport within 2 hours of collecting a specimen 2) Transport in leakproof specimen containers and sealable leakproof bags 3) Transport specimen in the syringe used to collect it 4) Refrigerate all specimens prior to transport

a. 1, 4
b. 2, 3
c. 1, 2
d. 3, 4

A

c. 1, 2

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3
Q

Which is true about a tuberculin skin test (TST):

a. Positive TST indicates active tuberculosis (TB) infection
b. Negative TST rules out active TB infection
c. Positive TST indicates past exposure to TB
d. Negative TST indicates past exposure to TB

A

c. Positive TST indicates past exposure to TB

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4
Q

The optimal time to collect a sputum specimen for acid-fast bacilli (AFB) testing to rule out TB would be:

a. First thing in the morning
b. After a respiratory treatment
c. Prior to the patient going to bed
d. Prior to a respiratory treatmen

A

a. First thing in the morning

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5
Q

A hospital has hired a new manager of the Microbiology section of the Laboratory. During the initial discussion with the manager about the Infection Prevention and Control program, the IP stresses the importance of collaboration between the departments in reducing healthcare-associated infections (HAIs). Of the choices below, which activity will best meet this goal?

a. The Microbiology staff’s compliance with the annual flu vaccination program and tuberculosis skin testing
b. The Microbiology staff’s participation in the periodic infection prevention educational sessions for hospital staff
c. Microbiology’s prompt notification to the Infection Prevention and Control Department of any organism’s unusual resistance pattern
d. The Microbiology manager’s attendance at local, state, and/or national infection prevention and control educational conferences

A

c. Microbiology’s prompt notification to the Infection Prevention and Control Department of any organism’s unusual resistance pattern

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6
Q

The primary immune response after exposure to a communicable disease pathogen or vaccine is production of:

a. Immunoglobulin G (IgG)
b. Immunoglobulin M (IgM)
c. Immunoglobulin A (IgA)
d. Immunoglobulin C (IgC

A

b. Immunoglobulin M (IgM)

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7
Q

When are IgM antibodies to Hepatitis A virus (HAV) detectable in the blood?

a. Within 24 hours of exposure
b. Within 3 weeks of exposure
c. 30 days after exposure
d. 8 to 12 weeks after exposure

A

b. Within 3 weeks of exposure

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8
Q

The incubation period for pertussis in immunocompetent persons is usually:

a. 7 to 10 days
b. 3 to 5 days
c. 1 to 2 days
d. 2 to 4 days

A

a. 7 to 10 days

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9
Q

A patient who was hospitalized for 2 days calls 3 days after discharge complaining that he has developed healthcare- associated scabies due to his recent inpatient stay. The IP knows that his scabies infestation is not healthcare-associated because:

a. Scabies is only transmitted through contaminated linens, and the IP confirmed that all linens the patient came into contact with had been properly laundered
b. The incubation period for scabies is longer than 5 days
c. The incubation period for scabies is shorter than 3 days
d. Scabies is only transmitted through direct contact and none of the healthcare personnel who cared for the patient are infested

A

b. The incubation period for scabies is longer than 5 days

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10
Q

A nurse is concerned that a patient in the neurology ward has a prion disease after receiving a lab report stating that the patient had a positive nucleic acid test for John Cunningham virus (JCV) in the cerebrospinal fluid. What is the best response to give this nurse?

a. The test is positive for Creutzfeldt-Jakob disease, which is a prion disease
b. The test is positive for Campylobacter jejuni, which is not a prion disease
c. The test is positive for JCV (a polyomavirus), which is not a prion disease
d. The test is positive for JCV (a polyomavirus), which is a prion disease

A

c. The test is positive for JCV (a polyomavirus), which is not a prion disease

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11
Q

An IP is conducting an educational session to help the nursing staff understand infectious disease transmission. She explains that the initial element in virulence is the ability of an organism to survive in the external environment during transit between hosts. What is the second element of virulence?

a. Secretion of enzymes that enhance spread through tissues
b. A mechanism for transmission to a new host
c. Invasion and dissemination in the host
d. Avoidance of host resistance

A

b. A mechanism for transmission to a new host

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12
Q

The management of an infected surgical site includes the following foundational principles:

1) Open and drain the incision
2) Debride fibrous debris and necrotic soft tissue
3) Replace hardware
4) Implement antimicrobial management as needed
5) Manage the open wound

a. 1, 2, 3, 4
b. 2, 3, 4, 5
c. 1, 3, 4, 5
d. 1, 2, 4, 5

A

d. 1, 2, 4, 5

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13
Q

During annual TST, an employee’s test result was read as 10 mm induration. The employee’s last TST was negative. This initial result indicates a:

a. Positive test
b. False positive
c. Negative test
d. False negative

A

a. Positive test

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14
Q

A microbe that can grow in the absence of oxygen but is also able to utilize oxygen for growth is a/an:

a. Aerobe
b. Obligate anaerobe
c. Facultative anaerobe
d. Microaerophilic aerobe

A

c. Facultative anaerobe

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15
Q

Western blot testing for human immunodeficiency virus (HIV) is used to detect:

a. HIV DNA in a serum sample
b. HIV RNA in a serum sample
c. HIV antibodies in a serum sample
d. HIV proteins in a serum sample

A

c. HIV antibodies in a serum sample

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16
Q

An infection preventionist (IP) is reviewing the cerebrospinal fluid (CSF) results from a patient admitted the previous night. The CSF is cloudy and has an elevated white blood cell count (WBC), markedly increased neutrophils, low glucose level, and elevated protein concentration. What type of meningitis should she suspect?

a. Bacterial
b. Viral
c. Fungal
d. Aseptic

A

a. Bacterial

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17
Q

Which of the following statements about influenza is false?

a. Influenza is primarily spread between individuals via respiratory secretions (droplets)
b. Viral shedding starts 48 to 72 hours after infection and typically 48 hours before the onset of symptoms
c. Viral shedding normally persists for less than 5 days but can be longer in children and in immunocompromised persons
d. The typical influenza symptomology is not always predictive of influenza in elderly or immunocompromised persons

A

b. Viral shedding starts 48 to 72 hours after infection and typically 48 hours before the onset of symptoms

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18
Q

Which of the following statements is false regarding influenza viruses?

a. They are divided into three categories: A, B, and C b. Influenza A strains have been the predominant cause of worldwide epidemics (pandemics)
c. Influenza A and B strains have been named according to the city or state and year of their initial isolation
d. Influenza B strains have not been associated with large epidemics

A

d. Influenza B strains have not been associated with large epidemics

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19
Q

Which factor is commonly associated with Clostridium difficile infections (CDIs)?

a. Chemotherapeutic agents
b. ACE inhibitors
c. Prophylactic antibiotics or antibiotic to treat a primary bacterial infection
d. Antiviral medication to treat a primary viral infection

A

c. Prophylactic antibiotics or antibiotic to treat a primary bacterial infection

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20
Q

The IP is reviewing the history of a patient who has been in the facility on a ventilator for 1 week. All of the following are risk factors for colonization and infection with multidrug-resistant pathogens except:

a. Antimicrobial therapy in preceding 90 days
b. Current hospitalization of 5 days or more
c. Immunosuppressive state or therapy
d. Low frequency of antibiotic resistance in the facility

A

d. Low frequency of antibiotic resistance in the facility

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21
Q

The current community-acquired pneumonia (CAP) national quality measures used in the United States include all of the following except:

a. Antibiotic timing (within 6 hours of arrival)
b. Antibiotic selection
c. Blood cultures performed in the Emergency Department before antibiotics were administered
d. Ensure that all patients are screened for pneumococcal vaccination

A

d. Ensure that all patients are screened for pneumococcal vaccination

22
Q

Measures that can be practiced for prevention of aspiration include all of the following except:

a. Antibiotic prophylaxis
b. Oropharyngeal cleaning and decontamination with an aseptic agent (e.g., chlorhexidine)
c. Orotracheal intubation, unless contraindicated, rather than nasotracheal intubation
d. The head of the bed elevated at an angle of 30 to 45 degrees

A

a. Antibiotic prophylaxis

23
Q

All of the following are descriptions of patients with immunocompromised status except:

a. HIV with CD4 count <200
b. Leukemia or lymphoma
c. Neutropenia (absolute neutrophils count <500/mm3) d. 1 year post-bone marrow transplant

A

d. 1 year post-bone marrow transplant

24
Q

The paroxysmal stage of pertussis usually lasts:

a. 1 to 6 weeks
b. 11 to 15 weeks
c. 15 to 20 weeks
d. 6 to 21 weeks

A

a. 1 to 6 weeks

25
Q

Which of the following is not an effect of malnutrition on the body’s immune system?

a. Intestinal bacteria may be altered
b. Tissue integrity is impaired
c. Mucosal secretions are decreased
d. Urine may be colonized with bacteria

A

d. Urine may be colonized with bacteria

26
Q

Lyme disease is commonly found in all of the following regions of the United States except:

a. New England
b. Mid-Atlantic
c. Upper Midwest
d. Southeast

A

d. Southeast

27
Q

All of the following organisms can penetrate the intact epithelium of the conjunctiva or cornea except:

a. Staphylococcus aureus
b. Streptococcus pneumoniae
c. Neisseria meningitidis
d. Neisseria gonorrhoeae

A

a. Staphylococcus aureus

28
Q

A patient is admitted with pruritic lesions on the hands, webs of fingers, wrists, the extensor surfaces of the elbows and knees, and the outer surfaces of the feet, armpits, buttocks, and waist. The most likely diagnosis is:

a. Scarlet fever
b. Herpes zoster
c. Scabies
d. Measles

A

c. Scabies

29
Q

Which of the following is not likely to contaminate total parenteral nutrition?

a. Mycobacterium fortuitum
b. Candida albicans
c. Pseudomonas aeruginosa
d. Staphylococcus epidermidis

A

a. Mycobacterium fortuitum

30
Q

A urine specimen collected from an indwelling urinary catheter was sent to the laboratory for culture and sensitivity testing. Culture results reported a colony count of 50,000 CFU/mL of Escherichia coli. Sensitivity testing reported resistance to cephalosporin and sensitivity to ciprofloxacin. This organism is an example of:

a. Methicillin resistance
b. Aminoglycoside resistance
c. Extended-spectrum beta-lactam (ESBL) resistance
d. Quinolone resistance

A

c. Extended-spectrum beta-lactam (ESBL) resistance

31
Q

A patient has a nasal swab positive for methicillin-resistant Staphylococcus aureus (MRSA) in the absence of symptoms. This is an example of:

a. Normal flora
b. Colonization
c. Asymptomatic infection
d. Symptomatic infection

A

b. Colonization

32
Q

Which of the following is not a mechanical barrier to infection?

a. Intact skin
b. Mucous membranes
c. Secretions
d. Cilia

A

c. Secretions

33
Q

Patients with cell-mediated immunity dysfunction are susceptible to infections attributed to pathogenic intracellular bacteria. Examples of these organisms include:

1) Salmonella typhi
2) Bacteroides fragilis
3) Listeria monocytogenes
4) Staphylococcus aureus

a. 2, 3
b. 1, 3
c. 1, 2
d. 3, 4

A

b. 1, 3

34
Q

What is the name for a substance that prevents water-soluble elements such as antibiotics and disinfectants from reaching pathogens?

a. Cell wall
b. Biofilm
c. Sludge
d. Biocarbon

A

b. Biofilm

35
Q

A Gram-negative bacterium that is responsible for chronic antral gastritis and is a major factor in peptic ulcer disease is:

a. Streptococcus pyogenes
b. Salmonella typhi
c. Clostridium difficile
d. Helicobacter pylori

A

d. Helicobacter pylori

36
Q

The spirochete Borrelia burgdorferi is the agent responsible for:

a. Legionnaires’ disease
b. Lyme disease
c. Aseptic meningitis
d. Syphilis

A

b. Lyme disease

37
Q

Higher morbidity rates in chronic Hepatitis B virus (HBV) carriers are associated with a co-infection of which of the following:

a. Hepatitis A
b. Hepatitis D
c. Hepatitis C
d. Hepatitis E

A

b. Hepatitis D

38
Q

Gram stains classify an organism as Gram-positive or Gram- negative. The determinant factors for Gram stains are cell wall components of:

a. Peptidoglycans
b. Lipids
c. Polysaccharides
d. Mycolic acids

A

a. Peptidoglycans

39
Q

An example of an obligate intracellular parasitic bacterium would be an organism responsible for:

1) Hepatitis
2) Q fever
3) Malaria
4) Epidemic typhus

a. 2, 3
b. 2, 4
c. 3, 4
d. 1, 2

A

b. 2, 4

40
Q

Which one of the following statements is true regarding bacterial spores?
a. They are resistant to antibiotics
b. They allow the bacteria to multiply in adverse
condition
c. They are usually formed by Gram-negative bacteria
d. They can be identified with Gram stain

A

a. They are resistant to antibiotics

41
Q

Which organism found in food poisoning causes the most rapid onset of symptoms?

a. Salmonella enteritidis
b. Shigella sonnei
c. Staphylococcus aureus
d. Escherichia coli

A

c. Staphylococcus aureus

42
Q

The IP is teaching nurses how to assess infection risks in patients. Depletion of what cell type provides the best indication of susceptibility to most bacterial infections?

a. Monocyte
b. Eosinophil
c. Neutrophil
d. Lymphocyte

A

c. Neutrophil

43
Q

A 14-year-old boy from rural Maryland was seen in the emergency room with fever, fatigue, chills, headache, and a large annular lesion on his left thigh, which the patient described as burning and itching. What is the most probable vector of this child’s illness?

a. Tick
b. Mosquito
c. Flea
d. Louse

A

a. Tick

44
Q

Which immune marker represents past exposure to disease?

a. IgG
b. IgE
c. IgM
d. IgA

A

a. IgG

45
Q

The Emergency Department reports three cases of cramping, abdominal pain, and diarrhea within a 24-hour period. All persons are from the same community, and onset of symptoms was within 12 to 36 hours of a picnic they all attended. The IP suspects which of the following foodborne illnesses:

a. Salmonella
b. Hepatitis A
c. Staphylococcus aureus
d. Clostridium perfringens

A

a. Salmonella

46
Q

When reviewing the Gram stain of a person with a wound infection, the IP sees Gram-positive organisms in clusters. Which organism would this most likely represent?

a. Streptococcus
b. Enterococcus
c. Corynebacterium
d. Staphylococcus

A

d. Staphylococcus

47
Q

The IP receives a call from a young man who thinks he was exposed to HIV. He has just taken his first test (an enzyme-linked immunosorbent assay [ELISA]), which was negative. Which of the following is the most likely time frame after exposure in which HIV antibodies would be measureable in a blood test?

a. 6 months
b. 1 to 3 months
c. 12 months
d. 7 days

A

b. 1 to 3 months

48
Q

The causative organism of Creutzfeldt-Jakob disease is a:

a. Helminth
b. Diphtheroid
c. Spirochete
d. Prion

A

d. Prion

49
Q

Anaerobic cultures should be used for any of the following sites except:

a. Blood
b. Transtracheal aspirate
c. Spinal fluid
d. Sputum

A

d. Sputum

50
Q

Routine microbiologic sampling is indicated for which of the following?

a. Respiratory therapy equipment
b. Dialysis fluid
c. Sterile disposable equipment
d. Operating room surfaces

A

b. Dialysis fluid

CIC (9 decks)

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