Community/Public Health Nursing, 7th Edition ch 26: Communicable Disease

Community/Public Health Nursing, 7th Edition ch 26: Communicable Disease 26: Communicable Disease Nies: Community/Public Health Nursing, 7th Edition MULTIPLE CHOICE A city that depended on tourist dollars had feedback that tourists were saying they were never returning because of the constant mosquito bites. Which action should be taken by the city? a. Do not have any tourist events at dawn or dusk. b. Have everyone in town search for and remove any standing stagnant water. c. Give free bug repellent to each tourist. d. Tell tourists to avoid wearing bright colors. ANSWER: B Knowing the reservoirs for infectious agents is important, because, in some cases, transmission can be controlled by eliminating the reservoir, such as eliminating the standing water where mosquitoes breed. The other interventions, not having events at dusk or dawn, providing bug repellent, and wearing bright colors are ways the tourists can cope with the mosquitos that are present, but they do not eliminate the breeding and presence of the mosquitos. DIF: Cognitive Level: Apply (Application) The daily patrons of a local town restaurant became ill with nausea, vomiting, and diarrhea. Without knowing the cause, which action should be taken immediately to help avoid future problems? a. Establish a series of cooking classes for all citizens b. Have a citywide campaign to cover your mouth when sneezing c. Use bleach to clean the entire restaurant d. Strongly emphasize the importance of proper hand washing to staff ANSWER: D Agents leave the human host through a portal of exit and invade through a portal of entry. Portals of exit include respiratory secretions, vaginal secretions, semen, saliva, lesion exudates, blood, and feces. Portals of entry are associated with the portal of exit and include the respiratory passages, mucous membranes, skin and blood vessels, oral cavity, and the placenta. Because it was food poisoning of some sort, until the cause is known, it can be assumed to probably be a fecal-oral trANSWERmission. Thus, the interventions of cooking classes, covering your mouth when sneezing, and using bleach to clean the entire restaurant would be ineffective. Therefore, staff need to again be reminded of the importance of careful hand washing after using the facilities. DIF: Cognitive Level: Apply (Application) Which best describes why clinical areas are so careful to ensure sanitization of surfaces and equipment between each patient? e. To avoid direct patient-to-patient trANSWERmission of infection f. To provide a clean environment for clients and staff g. To decrease trANSWERmission by fomites h. To decrease trANSWERmission by vectors ANSWER: C Indirect trANSWERmission is the spread of infection through a vehicle of trANSWERmission outside the host. These may be contaminNatUedRfSomIitNeGs TorBCtoOrsM. Fomites can be any inanimate object, material, or substance that acts as a trANSWERport agent for a microbe (e.g., water, a telephone, or a contaminated tissue). DIF: Cognitive Level: Understand (Comprehension) Which is the first step in preventing further spread of a particular sexually trANSWERmitted disease (STD)? i. Have a citywide free screening program in all high schools and colleges j. Provide public education about safe sex from abstinence to monogamous relationships k. Require all public facilities to sanitize all restrooms with a stronger, more effective agent l. Treat each infected person with the appropriate pharmaceutical agent ANSWER: D Antiinfective drugs, such as antibiotics, antivirals, antiretrovirals, and antimalarials, play important roles in controlling infectious diseases. Not only do they permit recovery of the infected person, but they also play a major role in preventing trANSWERmission of the pathogens to another. The first step in preventing trANSWERmission of tuberculosis and syphilis is to treat the infected person with antibiotics. Because the question asks about further spread, infection in a person has been diagnosed, so education is needed, but it is too late for that person. Adults not in school also are infected with STDs. A stronger, more effective sanitizing agent would not be the most effective strategy to prevent spread of STDs. DIF: Cognitive Level: Understand (Comprehension) A case of severe acute respiratory syndrome (SARS) was diagnosed immediately on signs of illness at a tourist site in China. Which action should be taken to protect the badly needed income from tourist dollars? m. Close the airports and refuse to let the tourists in the area leave n. Begin to immunize everyone in the immediate area with protective vaccine as soon as possible o. Quarantine the ill person and use isolation techniques when providing care p. Screen everyone in the area by requiring a blood and urine sample ANSWER: C Quarantine is an enforced isolation or restriction of movement of those who have been exposed to an infectious agent during the incubation period; this is another method of controlling the reservoir. Quarantine was used effectively during the outbreak of SARS in 2003, when some hospitals required that their staff exposed to SARS patients remain at the hospital until proved to be symptom free at the end of the incubation period. Immunization and screening would not protect the population from exposure to this infectious disease. It is likely that others besides tourists could be exposed or infected by this disease, thus, closing airports would be ineffective in controlling the spread of the disease. DIF: Cognitive Level: Apply (Application) 6. A patient walks into a community clinic complaining of severe intestinal cramps and diarrhea. Which action can be taken to protect the staff at the clinic? a. Refuse to see anyone that sick as clinics have a different mission than secondary N R I G B.C M and tertiary care of the obvUiousSly iNll T O b. Send the patient immediately to the closest hospital emergency department c. Treat the patient with broad-spectrum antibiotics and lots of fluids d. Use universal precautions with all patients regardless of the situation ANSWER: D The Centers for Disease Control and Prevention (CDC) developed a set of guidelines, called universal precautions, to prevent trANSWERmission of diseases found in blood and other body fluids. These guidelines were developed because infected people may be asymptomatic and have no knowledge of their conditions; therefore, health care workers must assume that all patients are infectious and protect themselves, other health care workers, and other patients. Refusing to treat the patient, sending the patient to an emergency department, or treating the patient with antibiotics and fluids would not be appropriate measures to protect the staff. DIF: Cognitive Level: Apply (Application) 14. During an outbreak in the hospital, all staff members were given immunoglobulin if they were not already immune to the disease. Which type of immunity will the staff who received the immunoglobulin have? a. Active immunity b. Long-lasting immunity c. Natural immunity d. Passive immunity