Test Bank NURS 2900 Infection Questions and Answers Rationale,100% CORRECT

Test Bank NURS 2900 Infection Questions and Answers Rationale 1. You are caring for a client with a stage IV leg ulcer. You are closely monitoring the client for sepsis. What would indicate that sepsis has occurred and that you should notify the physician of immediately? A) The client feels restless and hungry. B) The client exhibits an increased urinary output. C) The client's heart rate is greater than 90 beats/minute. D) The client's respiratory rate is less than 20 breaths/minute. Ans: C Feedback: A heart rate greater than 90 beats/minute or a respiratory rate greater than 20 breaths/minute will indicate that sepsis has occurred. Sepsis does not increase the client's appetite or affect the client's urinary output. 2. The nurse is giving an educational talk to a local parent–teacher association. A parent asks how he can help his family avoid community-acquired infections. What would be the nurse's best response to help prevent and control community-acquired infections? A) “Encourage your family to adopt a healthy diet and exercise regimen.” B) “Encourage your family to stop smoking.” C) “Make sure your family has all their childhood immunizations.” D) “Make sure your family has regular checkups.” Ans: C Feedback: To help prevent and control community-acquired infections, nurses should encourage childhood immunizations. Vaccines stimulate the body to produce antibodies against a specific disease organism. The immunization protects children as well as adults who may not have developed sufficient immunity. Following a proper diet and exercise regimen and going for regular checkups are important, but these measures do not help prevent or control community-acquired infections. Smoking cessation does not reduce the risk of such infections either. 3. You are teaching a health class in the local public health center. What instructions should you provide as the single most important measure to prevent the spread of infection? A) Minimal social contact B) Regular immunizations C) Thorough handwashing D) Sufficient food intake Ans: C Feedback: Hand hygiene remains the single most important measure to prevent the spread of infection. It reduces the number of transient and resident microorganisms. Sufficient food intake helps restore biologic defense mechanisms but does not prevent spread of infections. Although minimal social contact and regular immunizations may help prevent the spread of infection, especially community-acquired infections, these are not practical measures. 4.A nurse on your unit sustains a needlestick injury while caring for a client whose infectious status is unknown. What would be the best course of action for the nurse to follow? A) Avoid notifying the supervisor of the injury until the client's infectious status is confirmed. B) Avoid revealing the identity of the client or source of blood. C) Be tested for disease antibodies at appropriate intervals. D) Document the injury in writing after the client's infectious status is confirmed. Ans: C Feedback: If a needlestick injury has occurred, the nurse should be tested for disease antibodies immediately and at appropriate intervals thereafter. The nurse should document the injury in writing immediately and should not wait until the client's infectious status is confirmed. The nurse should also notify the supervisor of the injury immediately and identify the person or source of blood, if possible. 5. The nursing instructor is teaching beginning nursing students about infection. Toward the end of class, the instructor gives the students a scenario of a client with an infection who has developed fever and diarrhea. What should the student nurse instruct the client to avoid? A) Tea and coffee B) Ice water and broth C) Fruit juices D) Milk and gelatin Ans: A Feedback: A client with fever and diarrhea should avoid tea, coffee, and carbonated beverages containing caffeine because these promote diuresis. The intake of ice water, broth, fruit juices, gelatin, and milk should be encouraged to add proteins and calories. 6. You are working on a gerontology unit. A family member calls and tells you he wants to bring the family in to see one of the clients on the unit. The family member is concerned because several of the family members have colds. What instructions should you provide to someone with a respiratory infection? A) Avoid intake of frozen foods. B) Avoid visiting older adults. C) Avoid direct sunlight. D) Avoid meats and other protein-rich foods. Ans: B Feedback: The nurse should instruct anyone with respiratory infections to avoid visiting older adults until symptoms subside; older adults are more susceptible to infections because their defense mechanisms are less efficient. It is not essential for the client to avoid frozen or protein-rich foods or direct sunlight. 7. You are an intensive care unit nurse caring for a client with a transmissible spongiform encephalopathy. You know that this type of encephalopathy is caused by what type of infectious agent? A) Prion B) Protozoa C) Helminth D) Rickettsia Ans: A Feedback: A prion is a protein that does not contain nucleic acid. Research suggests that normal prions present in brain cells protect against dementia. When a prion mutates, however, it is capable of becoming an infectious agent and altering other normal prion proteins into similar mutant copies. The mutant prions, which can be formed by genetic predisposition or acquired by transmission between the same or similar infected animal species, cause transmissible spongiform encephalopathies. Transmissible spongiform encephalopathies are not caused by protozoa, helminths, or rickettsias. 8. Which of the following would be considered a mechanical defense mechanism? A) Cast B) Coughing C) Clothing D) Sunscreen Ans: B Feedback: Mechanical defense mechanisms are physical barriers that prevent microorganisms from gaining entry or expel microorganisms before they multiply. Examples are the skin and mucous membranes, physiologic reflexes (e.g., sneezing, coughing, vomiting), and macrophages. Casts, clothing, and sunscreen do not keep microorganisms from gaining entry to the body. 9. You have admitted a new client to your unit. This client has an open draining sore on his leg. What diagnostic test would you anticipate being ordered? A) Platelet count B) Culture and sensitivity C) Sputum culture D) Urinalysis Ans: B Feedback: A culture identifies bacteria in a specimen taken from a person with symptoms of an infection. The source of the specimen may be body fluids or wastes, such as blood, sputum, urine, or feces, or the purulent exudate, collection of pus, from an open wound. A platelet count would not tell you about the infection. A sputum culture would not be indicated for a leg wound, nor would a urinalysis. 10. You are caring for a client with breast cancer who has been receiving chemotherapy. The client was admitted with an infected lesion on her left leg. The physician has ordered Neupogen. What will Neupogen do for this client? A) Increase platelet count B) Boost the immune system C) Increase white blood cell production D) Boost red blood cell production Ans: B, C Feedback: Bone marrow transplantation or administration of drugs that boost white blood cell production, such as filgrastim (Neupogen), may help immunosuppressed clients. Neupogen does not increase the platelet count or boost red blood cell production. 11.A client with a Staphylococcus aureus infection present in a sacral pressure ulcer has received treatment with three courses of antibiotics without eliminating the infection. What does the nurse understand has occurred with the client? A) The client has a multidrug-resistant strain of bacteria. B) The client has been misdiagnosed and has another type of microorganism present. C) Staphylococcus aureus cannot be treated by antibiotics. D) Staphylococcus aureus is a fungus and must be treated with an antifungal agent, not an antibiotic. Ans: A Feedback: Some bacteria, such as Staphylococcus aureus, Streptococcus pneumoniae, and Escherichia coli, are developing multidrug resistance, the ability to remain unaffected by antimicrobial drugs such as antibiotics. There are no facts to indicate the client has been misdiagnosed. Staphylococcus aureus is treated with antibiotics and is a bacterium, not a fungus. 12.A client is diagnosed with a viral illness and requests an antibiotic to “cure” his illness. When the request is refused by the physician, the client states to the nurse, “I will never get better.” What is the best response by the nurse? A) “I will speak with the physician again. You will only get better while taking an antibiotic.” B) “Prescribing antibiotics for a viral infection may result in drug-resistant bacteria.” C) “You need to think positively, and you will get better soon.” D) “Taking antibiotics when you don't need them will make you sick.” Ans: B Feedback: Causes of antibiotic resistance, a consequence of bacterial mutations that interfere with the mechanism of antibiotic action, are related to inappropriate prescription of antibiotics for viral (rather than bacterial) infection. Because viral infections are often self-limiting, with symptoms control, the client will get better. Indicating that the client is not thinking positively is a nontherapeutic comment. Option D is not an informative response. 13.The infection control nurse collects data that indicates an increase in the number of clients in the hospital with multidrug-resistant infections. What priority education should healthcare providers receive? A) Using contact precautions on all clients in the hospital B) Administering antibiotics to all clients prophylactically C) Hand hygiene D) Emptying trash cans immediately in client's rooms Ans: C Feedback: Infections with multidrug-resistant microorganisms are very difficult to destroy with current pharmacologic agents, increasing the need to be vigilant about performing hand hygiene measures. It is unnecessary to use contact precautions, administer antibiotics prophylactically, or empty trash cans immediately for the preventions of multidrug- resistant infections. 14.A client visits the clinic with the complaint of a circular rash on the upper right arm. The rash is diagnosed as tinea corporis. What type of infection does the nurse anticipate the client will be treated for? A) Rickettsiae B) Protozoans C) Mycoplasma D) Fungus Ans: D Feedback: One type of fungal infection is superficial (dermatophytoses), which affect the skin, hair, and nails; examples include tinea corporis, or ringworm, and tinea pedis, also known as athlete's foot. Rickettsiae, protozoans, and mycoplasma have different characteristics and transmission than fungus. 15.A client has received a diagnosis of Lyme disease. What does the nurse understand about the transmission of infection resulting in this disease? A) The disease is spread by a prion. B) The disease is spread by single-celled fungi-like microorganisms C) The disease is spread by helminths D) The disease is spread by arthropods. Ans: D Feedback: Example of arthropods includes fleas, ticks, lice, mosquitoes, and mites. Some rickettsial diseases that are spread by arthropods include Lyme disease. Prions may mutate and can be formed by genetic predisposition or acquired by transmission between the same or similar infected animal species and are not the same as arthropods. The disease is not spread by single-celled fungi-like microorganisms or helminths. 16.A family member wants to donate blood for a client who needs a blood transfusion. What information from the family member would make them ineligible for donation? A) The family member was serving in the military in England in 1993 for 2 years. B) The family member had a surgical procedure 4 years previously for an inguinal hernia. C) The family member received a blood transfusion 10 years previously at a hospital in Canada. D) The family member takes an antihypertensive medication for control of blood pressure. Ans: A Feedback: The American Red Cross bans blood collection from anyone who has lived in the United Kingdom for a total of 6 months or longer between 1980 and 1996, lived in various countries in Europe including while serving in the military since 1980, received a blood transfusion in the United Kingdom, or lived 5 or more years in various European countries from 1980 to the present. There is a higher risk among these potential donors for BSE or “mad cow disease.” The other answers are not exclusion criteria for donating blood. 17.A family member of a client in a long-term care facility asks the nurse why he cannot insert a catheter so the client will not develop skin breakdown from being wet. What should the explanation include when the nurse responds to the family member? A) Catheters are no longer used for treatment of incontinence. B) Older adult residents are able to have catheters inserted if the family requests them. C) The invasive nature of the catheter provides a portal for infection. D) If a catheter is inserted, it must be flushed with normal saline daily. Ans: C Feedback: Catheters provide a portal for infection because they are invasive. Although catheters are not used as frequently in older adults for the control of urinary incontinence, there are some bed-confined clients who use them. Family requests for catheters may be considered, but physicians make the decision if it will benefit the patient. Catheters are not flushed daily with anything. 18.The nurse is caring for an older adult client who develops a fever, rash over the trunk, and back and complains of feeling achy and very tired. What should the nurse suspect is occurring with this client? A) A roundworm infection B) Bacterial meningitis C) A urinary tract infection D) An autoimmune response Ans: D Feedback: Healthcare providers must carefully assess for symptoms in older adults that may indicate autoimmune responses (i.e., rash, malaise, fever, aching, etc.). 19.A client informs the nurse that she has been using a douche to cleanse the vagina on a daily basis and is now experiencing itching and burning in the vaginal area. What should the nurse explain to the client that occurs when the vaginal pH is changed? A) It causes destruction of the normal flora of the vagina and allows the development of vaginal infections. B) The bottle must be contaminated with bacteria, and when the pH is changed, it allows the bacteria to enter the vaginal area. C) It will cause an allergic reaction in the vaginal area. D) When the vaginal pH is changed, it allows cancer cells to spread from the vagina to the cervix. Ans: A Feedback: The acid environment is unfavorable for the multiplication of pathogenic bacteria and fungi. A change in vaginal pH or destruction of the normal flora, however, can promote the development of a vaginal infection. Bacteria do not cause the vaginal pH to change; the pH change allows bacteria to grow. Change in vaginal pH does not cause an allergic reaction and does not allow the development of cancer cells. 20.A client is admitted to an acute care facility with a diagnosis of appendicitis. Which laboratory results demonstrate the client's leukocytosis? A) Hemoglobin of 12 mg/dL B) Lymphocytes 1,500 C) Neutrophils of 3,150/mm3 D) White blood cell (WBC) count of 22,000 cells/mm3 Ans: D Feedback: The body manufactures more WBCs as needed, a process referred to as leukocytosis. The WBC of 22,000 cells/mm3 indicates an abundance of white blood cells. Hemoglobin does not represent the presence of infection. The lymphocytes and neutrophils are within normal range and do not demonstrate leukocytosis. 21.A client comes to the clinic and informs the nurse that he has a “painful area under his armpit.” The nurse observes a 2-cm raised area that is erythremic and has a white substance inside of it. What does the nurse suspect the patient may be experiencing? A) A lesion B) An abscess C) A fluid-filled vesicle D) A cancerous tumor Ans: B Feedback: To prevent the spread of pathogens to adjacent tissues, a fibrin barrier forms around the injured area. Inside the barrier, a thick, white exudate (pus) accumulates. This collection of pus is called an abscess, which may break through the skin and drain or continue to enlarge internally. A lesion would not be filled with pus, nor would a cancerous tumor. A fluid-filled vesicle is associated with a viral type illness. 22.A client is suspected of sepsis from a postsurgical incision infection. What characteristic of sepsis would the nurse recognize? Select all that apply. A) Temperature of 102° F B) Heart rate of 120 beats/minute C) Respiratory rate of 24 breaths/minute D) PaCO2 of 42 mm Hg E) Blood pressure of 120/80 mm Hg Ans: A, B, C Feedback: Two or more of the following characterize sepsis: temperature greater than 100.4° F (38° C), heart rate greater than 90 beats/minute, respiratory rate greater than 20 breaths/minute or PaCO2 less than 32 mm Hg, WBC count greater than 12,000 cells/mm3, or 10% immature (band) forms. Blood pressure is not an indicator of sepsis, and a PaCO2 of 42 mm Hg is not an indicator. 23.A client is admitted to the acute care facility for vomiting and diarrhea. An intravenous (IV) catheter is inserted for the delivery of IV fluids. A family member is with the client and observes the nurse enter the room and begin touching the IV site without washing his hands or wearing gloves. Why should the client and family member be concerned with the nurse's actions? A) The client will have an allergic reaction to the IV. B) The nurse could develop the same symptoms. C) The client will develop a nosocomial infection. D) Dislodging of the IV catheter. Ans: C Feedback: Nosocomial infections are infections acquired while receiving care in a healthcare agency that were not active, incubatory, or chronic at admission. They occur for many reasons. Hospitalized clients are more susceptible to infections than well people because they are exposed to pathogens in the healthcare environment; may have incisions or invasive equipment (e.g., IV lines) that compromise skin integrity; or may be immunosuppressed from poor nutrition, their disease process, or its treatment. Also, because healthcare personnel are in frequent and direct contact with many clients who harbor various microorganisms, the risk for transmitting pathogenic microorganisms between and among clients is high. Allergic reaction to the IV, the nurse developing the same symptoms, and dislodging of the IV catheter are not the priority concerns. 24.A client arrives at the clinic with the complaint that she is having a vaginal discharge after having sexual intercourse with her boyfriend 1 week ago. The patient is diagnosed with gonorrhea and given a prescription for treatment. What type of infection transmission does the nurse understand occurred? A) Direct contact B) Droplet C) Airborne D) Vehicle Ans: A Feedback: The route of transmission for a sexually transmitted disease is by direct contact. An infected person transmits the infection to a susceptible person. A droplet transmission is a spray of moist particles within a 3-foot radius of an infected person. An airborne transmission is suspension and transport on air currents beyond 3 feet. An infection transmitted by vehicle is on or in contaminated food, water, objects, or equipment. 25.A client arrives at the emergency department complaining of severe diarrhea and vomiting that began after ingesting a hot dog at the ball park 6 hours ago. How does the nurse understand that the contaminated food was transmitted to the client? A) Droplet B) Airborne C) Vehicle D) Vector Ans: C Feedback: Vehicle is the route of transmission for this client's illness. It is found on or in contaminated food, water, objects, or equipment and can occur from eating or drinking tainted products. The route of transmission, droplet is by a spray of moist particles within a 3-foot radius of infected persons. Airborne is a route of transmission that is a suspension and transport on air currents beyond 3 feet. An infection by vector is found on infected animals or insect to susceptible persons. 26.A client comes to the clinic with complaints of fever, chills, and coughing and is found to be positive for influenza. The nurse is aware that the flu is transmitted from one infected person to another. What type of infection is this considered? A) Localized B) Generalized C) Community acquired D) Nosocomial Ans: C Feedback: Community-acquired infections are transmitted from one infected species to another. Common signs and symptoms are the same as generalized plus organ-specific or disease- specific manifestations. Examples of the infections transmitted are influenza, chickenpox, and tuberculosis. Localized infection is confined to a small area such as a furuncle (boil). Generalized infection is a systemic or widespread infection in one or two organs such as urosepsis. A nosocomial infection is acquired in a healthcare agency. 27.The nurse is caring for a client who has acquired immunodeficiency disease (AIDS) and has developed oral thrush. What type of infection is the nurse aware that has developed due to the immunocompromised state of the client? A) Acute B) Chronic C) Secondary D) Opportunistic Ans: D Feedback: An opportunistic or superinfection occurs among immunocompromised hosts. Examples would be yeast infections in the mouth, bladder infections, gastroenteritis, and Pneumocystis carinii. An acute infection has a sudden onset with serious and sometimes life-threatening manifestations. A chronic infection is an extended infection that resists treatment. A secondary infection is a complication of some other disease process that occurred first. 28.A client informs the nurse that he “thinks he is getting sick.” Chief complaint of the client is low-grade fever, headache, and “has no energy.” What stage of the infection does the nurse recognize the client is experiencing? A) Incubation period B) Prodromal stage C) Acute stage D) Convalescent stage Ans: B Feedback: In the prodromal stage, the initial symptoms appear; they may be vague and nonspecific. Possible symptoms include mild fever, headache, and loss of usual energy. The incubation period does not exhibit any recognizable symptoms. The acute stage is when the symptoms become severe and specific to the affect tissue or organ. The convalescent stage is when symptoms subside as the host overcomes the infectious agent. 29. The nurse is caring for a group of five clients at the hospital. In order to control infections when caring for the group of clients, what intervention can the nurse perform? A) Use standard precautions with all clients. B) Only use standard precautions with clients who have an infection. C) Wear a mask while taking care of all clients and changing the mask between clients. D) Place the clients on isolation precautions. Ans: A Feedback: Nurses and other healthcare personnel must take precautions to control infections when caring for all clients, regardless of diagnosis or infection status. These precautions are called standard precautions, measures for reducing the risk of transmitting pathogens from both recognized and unrecognized sources of infections. It is unnecessary to use a mask when caring for clients who do not have a droplet or airborne infection. Clients should not be placed in isolation unless they have an infection that could be transmitted to others. 30. The nurse gave a client an injection and, when attempting to recap the needle, sustained a needlestick injury to the finger. What is the priority action by the nurse? A) Report the injury or exposure to the supervisor. B) Document the injury in writing. C) Receive instructions on monitoring potential symptoms and medical follow-up. D) Receive the most appropriate postexposure prophylaxis. Ans: A Feedback: Should needlestick injury or other exposure to a potential blood-borne pathogen occur, healthcare workers are advised to follow postexposure recommendations; report the injury or exposure to one's supervisor immediately; document the injury in writing; identify the person or source of blood; obtain the HIV and HBV statuses of the source of blood, if it is legal to do so. Unless the client gives permission, testing and revealing HIV status are prohibited. Obtain counseling on the potential for infection. Receive the most appropriate postexposure prophylaxis; be tested for disease antibodies at appropriate intervals. Receive instructions on monitoring potential symptoms and medical follow-up. 31. The nurse is caring for a client with an abscess on his back. The nurse observes purulent drainage coming from the abscess. What type of specimen does the nurse anticipate the physician will order to determine the type of bacteria present in the exudate? A) A sensitivity test B) Test for ova and parasites C) White blood cell (WBC) count D) A culture Ans: D Feedback: A culture identifies bacteria in a specimen taken from a person with symptoms of an infection. The source of the specimen may be body fluids or wastes, such as blood, sputum, urine, or feces, or the purulent exudate, collection of pus, from an open wound. A test for ova and parasites is a stool specimen that is examined for evidence of any forms in the infecting microorganism's life cycle. A WBC count may determine that infection is present in the body but does not isolate the bacteria. A sensitivity test is done to determine which antibiotic inhibits the growth of a nonviral microorganism and will be most effective in treating the infection. 32.A nurse is having a yearly employee tuberculin skin test. Which skin test results would indicate a positive result? A) An induration of 12 mm B) An uneven erythemic area C) An induration of less than 1 mm D) An induration of 4 mm Ans: A Feedback: The size of the induration, not including the surrounding area of erythema, is measured in millimeters. The measurement determines whether the reaction is significant. For example, a tuberculin skin test is test is considered positive if the induration is 10 mm or greater in persons with no known risk factors for TB; smaller measurements are significant in certain risk groups, such as immunocompromised clients. The other answers are not indicative of positive results. 33.A client is hospitalized for an infected decubitus ulcer of the sacral area. The physician is planning to remove the dead and damaged tissue. What type of procedure will the nurse prepare the client for? A) Application of a dry dressing B) Debridement C) Administration of filgrastim (Neupogen) D) Inject antibiotics into the wound Ans: B Feedback: Debridement is the removal of dead and damaged tissue surgically. Application of a dry dressing will not debride the wound, nor will the administration of Neupogen or injecting antibiotics into the wound. 34.A client is in the acute care facility for the administration of intravenous (IV) antibiotics to treat bacterial pneumonia. The client begins to have severe diarrhea 3 days after the IV antibiotics with abdominal cramping and pain. What does the nurse suspect the client has developed due to the antibiotic use? A) Food poisoning B) An allergic reaction to the antibiotic C) A helminth infection D) Pseudomembranous colitis Ans: D Feedback: When a client is taking an antibiotic, a superinfection can result from overgrowth of microorganisms not affected by the drug. This can lead to a serious inflammation of the colon called pseudomembranous colitis accompanied by potentially life-threatening diarrhea. Report fever, abdominal cramps, and severe diarrhea immediately. The other distractors are incorrect and not related to the use of the antibiotics.