CHAPTER 15: INFECTIOUS DISEASES My Nursing Test Banks

CHAPTER 15: INFECTIOUS DISEASES

MULTIPLE CHOICE

1.Which of the following factors or conditions were responsible, in the first third of the 20th century, for the high incidence of infant and childhood mortality?

a.

lack of medical doctors

c.

sudden infant death syndrome

b.

infectious diseases

d.

high-fat diets

ANS: B

Feedback

A

Incorrect. Lack of medical doctors was not a factor in the first third of the 20th century for the high incidence of infant and childhood mortality.

B

Correct. In the early part of the 20th century, infectious diseases were responsible for the high incidence of infant and child mortality.

C

Incorrect. Sudden infant death syndrome was not a factor in the first third of the 20th century for the high incidence of infant and childhood mortality.

D

Incorrect. High-fat diets were not a factor in the first third of the 20th century for the high incidence of infant and childhood mortality.

PTS: 1 REF: p. 470 Infectious Diseases OBJ: Cognitive Level: Knowledge

2.Which of the following phrases about infectious diseases is always true?

a.

They are contagious from person to person.

b.

They can be stopped by consistent and adequate handwashing.

c.

They are caused by pathogenic organisms in the body.

d.

They can be eradicated by vaccinating people around the world.

ANS: C

Feedback

A

Incorrect. Not all infectious diseases are communicable.

B

Incorrect. Not all infectious diseases can be stopped by consistent and adequate handwashing.

C

Correct. An infectious disease is any disease caused by invasion and multiplication of microorganisms in the body.

D

Incorrect. Not all infectious diseases can be eradicated by vaccinating people around the world.

PTS:1REF:p. 470 Infectious Diseases

OBJ: Cognitive Level: Comprehension

3.Which of the following best describes the reservoir, one of six factors in the chain of infection?

a.

living and nonliving places there pathogens can survive without multiplication

b.

a pool of water there mosquitoes can breed and thus more quickly spread infection

c.

the stomach, which holds a large number of pathogens for a significant amount of time

d.

any area there a stable amount of water is present

ANS: A

Feedback

A

Correct. The reservoir, one of six factors in the chain of infection, is best described as living and nonliving places there pathogens can survive without multiplication.

B

Incorrect. The reservoir, one of six factors in the chain of infection, is not best described as a pool of water there mosquitoes can breed and thus more quickly spread infection.

C

Incorrect. The reservoir, one of six factors in the chain of infection, is not best described as the stomach, which holds a large number of pathogens for a significant amount of time.

D

Incorrect. The reservoir, one of six factors in the chain of infection, is not best described as any area there a stable amount of water is present.

PTS:1REF:p. 470 Infectious Diseases

OBJ: Cognitive Level: Comprehension

4.Which of the following best describes a vector?

a.

the point at which an infection entering the body intersects with an infection leaving the body

b.

the area of initial bite or contact by the disease-bearing animal or insect

c.

a person or animal who is infected with an organism but does not have the disease

d.

an animal or insect that carries the infectious organism from one host to another

ANS: D

Feedback

A

Incorrect. A vector is not best described as the point at which an infection entering the body intersects with an infection leaving the body.

B

Incorrect. A vector is not best described as the area of initial bite or contact by the disease-bearing animal or insect.

C

Incorrect. A vector is not best described as a person or animal who is infected with an organism but does not have the disease.

D

Correct. A vector is best described as an animal or insect that carries the infectious organism from one host to another.

PTS:1REF:p. 470 Infectious Diseases

OBJ: Cognitive Level: Comprehension

5.The nurse working with a pediatrician in the doctors office setting knows it is a top priority to properly clean all surfaces and toys touched by the children who come to the office, or make certain they have been properly cleaned, because of which of the following reasons?

a.

Organisms tend to enter the body through the mouth.

b.

Many organisms remain viable from hours up to several weeks on surfaces.

c.

The nurse has a responsibility to stop the spread of HIV in the office setting.

d.

Failure to ensure thorough cleansing can result in malpractice for the nurse.

ANS: B

Feedback

A

Incorrect. A top priority is to properly clean all surfaces and toys touched by children, but not because organisms tend to enter the body through the mouth.

B

Correct. A top priority is to properly clean all surfaces and toys touched by children because many organisms remain viable from hours up to several weeks on surfaces.

C

Incorrect. A top priority is to properly clean all surfaces and toys touched by children, but not because the nurse has a responsibility to stop the spread of HIV in the office setting.

D

Incorrect. A top priority is to properly clean all surfaces and toys touched by children, but not because failure to ensure thorough cleansing can result in malpractice for the nurse.

PTS:1REF:p. 471 Anatomy and Physiology

OBJ: Cognitive Level: Application

6.A child comes to see the pediatrician and breaks out the next day in the characteristic lesions of chickenpox. The nurse working in this pediatric clinic knows that:

a.

this is not a problem, as the child was not contagious before the skin lesions erupted

b.

only children physically touched by the child who developed chickenpox were exposed

c.

all the children in the doctors office that day need to be quarantined and isolated

d.

the doctor needs to see and evaluate all the children who were in the office and exposed

ANS: B

Feedback

A

Incorrect. In the case of chickenpox, the child is contagious before the skin lesions erupt.

B

Correct. Many children may remain asymptomatic but are able to transmit pathogens before they become ill. For example, children exposed to the varicella virus, which causes chickenpox, are contagious the day prior to becoming ill.

C

Incorrect. Not every child coming in contact with the child with chickenpox will develop chickenpox, hence there is not need for quarantine.

D

Incorrect. Not every child coming in contact with the child with chickenpox will develop chickenpox, hence the doctor does not need to see and evaluate all the children who were in the office and exposed.

PTS:1REF:p. 471 Anatomy and Physiology

OBJ: Cognitive Level: Comprehension

7.The school nurse is working with teenaged parents and their babies in a high school program designed to keep these parents in school and to teach them how to care for their children. The nurse teaches the mothers to change diapers on:

a.

a soft towel that can be washed as needed

b.

a washable surface that is disinfected after each use

c.

upholstered furniture that can be wiped off

d.

a changing station with a cushioned cover

ANS: B

Feedback

A

Incorrect. A soft towel that can be washed as needed may be used more than once and will harbor pathogens.

B

Correct. It is important to instruct caregivers to wipe surface areas used for diaper changing with a disinfectant after each use, using only a washable surface that will not harbor pathogens.

C

Incorrect. Upholstered furniture does not represent a washable surface that will not harbor pathogens.

D

Incorrect. A cushioned cover does not represent a washable surface that will not harbor pathogens.

PTS:1REF:p. 471 Anatomy and Physiology

OBJ: Cognitive Level: Application

8.Which of the following best describes the term vertical transmission?

a.

oral intake of germs that go through the body and are secreted rectally

b.

when the person contracts the disease or infection while awake and standing

c.

droplet infection that drops downward into the respiratory tract

d.

the process of transmitting a disease from one generation to another

ANS: D

Feedback

A

Incorrect. Vertical transmission is not best described as the oral intake of germs that go through the body and are secreted rectally.

B

Incorrect. Vertical transmission is not best described as when the person contracts the disease or infection while awake and standing.

C

Incorrect. Vertical transmission is best described as a droplet infection that drops downward into the respiratory tract.

D

Correct. Vertical transmission is best described as the process of transmitting a disease from one generation to another.

PTS: 1 REF: p. 472 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Application

9.Infections that can be transmitted through vertical transmission are:

a.

influenza, meningitis, and varicella

b.

rubella, herpes, and human immunodeficiency virus

c.

staphylococci, streptococci, and Escherichia coli

d.

hepatitis B and C and Rickettsia rickettsii

ANS: B

Feedback

A

Incorrect. Influenza, meningitis, and varicella are not transmitted through vertical transmission.

B

Correct. Vertical transmission can occur through the placenta while the infant is in utero, during delivery, or through breast milk following delivery. Among the infections transmitted in this way are rubella, herpes, hepatitis B and C, and human immunodeficiency virus (HIV).

C

Incorrect. Staphylococci, streptococci, and Escherichia coli are not transmitted through vertical transmission.

D

Incorrect. Hepatitis B and C are transmissible by way of vertical transmission, but not Rickettsia rickettsii.

PTS: 1 REF: p. 472 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Comprehension

10.Which of the following groups of children are susceptible to infections from staphylococci and Escherichia coli?

a.

adolescents

c.

toddlers

b.

preschoolers

d.

newborns

ANS: D

Feedback

A

Incorrect. Adolescents are not susceptible to invasive infection by bacterial organisms such as staphylococci and Escherichia coli.

B

Incorrect. Preschoolers are not susceptible to invasive infection by bacterial organisms such as staphylococci and Escherichia coli.

C

Incorrect. Toddlers are not susceptible to invasive infection by bacterial organisms such as staphylococci and Escherichia coli.

D

Correct. Newborns are susceptible to invasive infection by bacterial organisms such as staphylococci and Escherichia coli.

PTS: 1 REF: p. 472 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Knowledge

11.Caregivers could best reduce the number of infections that infants have by:

a.

taking the infant to the pediatricians office whenever the infant has a fever, diarrhea, or nasal discharge

b.

washing hands frequently, not kissing the infants hands, and washing all objects that go into a babys mouth

c.

limiting the number of people who visit the home and not letting other people pick up and hold the baby

d.

starting medication sooner whenever the infant has a fever or any other symptoms of infection

ANS: B

Feedback

A

Incorrect. Taking the infant to the pediatricians office whenever the infant has a fever, diarrhea, or nasal discharge is in reaction to an infection, not to prevention.

B

Correct. Caregivers could best reduce the number of infections that infants have by washing hands frequently, not kissing the infants hands, and washing all objects that go into a babys mouth.

C

Incorrect. Limiting the number of people who visit the home and not letting other people pick up and hold the baby is not the best means to reduce the number of infections that infants have.

D

Incorrect. Starting medication sooner whenever the infant has a fever or any other symptoms of infection is in reaction to an infection, not to prevention.

PTS: 1 REF: p. 472 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Application

12.You are a nurse working with toddlers and preschoolers. One of the children has a skin infection, which is diagnosed as tinea corporis. In assessing this condition, you would ask the caregivers which of the following questions?

a.

What kind of detergent have you been using?

b.

Has your child been swimming in a public swimming pool?

c.

Does your child have any known contact allergies?

d.

Has your child been playing with cats or dogs?

ANS: D

Feedback

A

Incorrect. Tinea corporis requires contact with dogs and cats, not detergent.

B

Incorrect. Tinea corporis requires contact with dogs and cats, not swimming in a public pool.

C

Incorrect. Tinea corporis requires contact with dogs and cats and is not related to allergies.

D

Correct. Playing with infected animals may cause tinea corporis (ringworm of the body or cat scratch fever).

PTS: 1 REF: p. 473 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Application

13.You are a nurse working with children of various ages. You would teach the caregivers not to give acetylsalicylic acid (aspirin) to children:

a.

of any age

c.

under 13 years

b.

under 6 years

d.

under 18 years

ANS: C

Feedback

A

Incorrect. You would teach the caregivers not to give acetylsalicylic acid (aspirin) to children under 13 years, not of any age.

B

Incorrect. You would teach the caregivers not to give acetylsalicylic acid (aspirin) to children under 6 years of age, and not until they reach 13 years.

C

Correct. Caregivers should not use aspirin to treat the pain and fever of viral illnesses such as influenza and varicella (chickenpox) in children under 13 years of age. The use of aspirin has been linked to the subsequent development of Reyes syndrome, which is a disorder combining both encephalopathy and fatty degeneration of the liver.

D

Incorrect. You would teach the caregivers not to give acetylsalicylic acid (aspirin) to children under the age of 13, not 18 years.

PTS: 1 REF: p. 473 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Comprehension

14.The school nurse, on discovering any outbreaks of head lice, scabies, and pinforms, will teach the children to avoid:

a.

sitting next to infected children

b.

wearing head scarves or any head covering

c.

keeping their coats and hats on their desks and to instead hang them on the coat rack

d.

sharing and swapping clothing, as well as avoiding sharing personal items

ANS: D

Feedback

A

Incorrect. Sitting next to infected children cannot result in outbreaks of head lice, scabies, pinforms, tinea corporis, and tinea capitis.

B

Incorrect. The school nurse will teach that sharing head scarves is to be avoided, not wearing them.

C

Incorrect. The school nurse will teach that sharing their coats and hats is to be avoided, not keeping them on their desk and hanging them on the coat rack.

D

Correct. Sharing beds and linens and clothes as well as personal items such as combs can result in outbreaks of head lice, scabies, pinforms, tinea corporis, and tinea capitis.

PTS: 1 REF: p. 473 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Application

15.The leading cause of pneumonia for schoolchildren is which of the following organisms?

a.

Staphylococcus

c.

Mycoplasma pneumoniae

b.

Streptococcus pneumoniae

d.

Pneumocystiscarinii

ANS: C

Feedback

A

Incorrect. Staphylococcus is not the leading cause of pneumonia for schoolchildren.

B

Incorrect. Streptococcus pneumoniae is not the leading cause of pneumonia for schoolchildren.

C

Correct. The leading cause of pneumonia for schoolchildren is mycoplasma pneumoniae and can be found there children are grouped together.

D

Incorrect. Pneumocystiscarinii is not the leading cause of pneumonia for schoolchildren.

PTS: 1 REF: p. 473 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Knowledge

16.Erythema infectiosum, or fifth disease, has which of the following characteristics?

a.

intensely red slapped cheeks appearance

b.

swelling and tenderness in the fifth digits

c.

various sizes and shapes of red rash areas

d.

redness of the feet as if the child was in hot water

ANS: A

Feedback

A

Correct. Erythema infectiosum, or fifth disease, has a characteristically lacy rash and is highly contagious. The illness is caused by parvovirus B19. By the time the rash erupts, they are no longer contagious, but the epidemic nature of this disease and the uniqueness of the rash (intensely red with a slapped-cheek appearance) can give caregivers cause for concern.

B

Incorrect. Erythema infectiosum, or fifth disease, is not characterized by swelling and tenderness in the fifth digits.

C

Incorrect. Erythema infectiosum, or fifth disease, is not characterized by various sizes and shapes of red rash areas.

D

Incorrect. Erythema infectiosum, or fifth disease, is not characterized by redness of the feet as if the child was in hot water.

PTS: 1 REF: p. 473 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Comprehension

17.You are a nurse working with adolescents and assessing them to see what immunizations they need. You would advise adolescents and their caregivers to have booster doses of tetanus and diphtheria approximately how many years after the last dose?

a.

1

c.

10

b.

5

d.

15

ANS: C

Feedback

A

Incorrect. It is not appropriate to advise adolescents and their caregivers to have booster doses of tetanus and diphtheria every year.

B

Incorrect. It is not appropriate to advise adolescents and their caregivers to have booster doses of tetanus and diphtheria every 5 years.

C

Correct. It is appropriate to advise adolescents and their caregivers to have booster doses of tetanus and diphtheria every 10 years.

D

Incorrect. It is not appropriate to advise adolescents and their caregivers to have booster doses of tetanus and diphtheria every 15 years.

PTS: 1 REF: p. 474 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Comprehension

18.Adolescents most often lack which of the following types of immunity and need to be immunized because of the danger of acquiring this type of infection through sexual contact?

a.

hepatitis A

c.

chlamydia

b.

hepatitis B

d.

gonorrhea

ANS: B

Feedback

A

Incorrect. The hepatitis A series may be indicated only for adolescents in high-risk categories.

B

Correct. Adolescents most often lack immunity against hepatitis B, a viral infection that could be acquired during this period or early adulthood through sexual contact.

C

Incorrect. Chlamydia is a parasite, categorized as a specialized bacteria, is a sexually transmitted disease, for which no vaccine exists.

D

Incorrect. Gonorrhea is a bacteria, sexually transmitted disease, for which no vaccine exists.

PTS: 1 REF: p. 473 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Comprehension

19.College-bound adolescents who will live in a dormitory or residence hall need to be advised most on the importance of vaccination against:

a.

influenza

c.

meningococcal disease

b.

tetanus

d.

Legionnaires disease

ANS: C

Feedback

A

Incorrect. College-bound adolescents who will live in a dormitory or residence hall will not need to be advised most on the importance of vaccination against influenza.

B

Incorrect. College-bound adolescents who will live in a dormitory or residence hall will not need to be advised most on the importance of vaccination against tetanus.

C

Correct. College-bound adolescents who will live in a dormitory or residence hall need to be advised most on the importance of vaccination against meningococcal disease.

D

Incorrect. College-bound adolescents who will live in a dormitory or residence hall will not need to be advised most on the importance of vaccination against Legionnaires disease.

PTS: 1 REF: p. 474 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Comprehension

20.Adolescents who are addicted to crack cocaine are:

a.

usually not sexually active

b.

about as sexually active as adolescents who are not addicted to cocaine

c.

less sexually active than students who smoke marijuana

d.

more likely to have sex with several partners and be at risk for sexually transmitted diseases (STDs)

ANS: D

Feedback

A

Incorrect. It is untrue that adolescents who are addicted to crack cocaine are usually not sexually active.

B

Incorrect. It is untrue that adolescents who are addicted to crack cocaine are about as sexually active as adolescents who are not addicted to cocaine.

C

Incorrect. It is untrue that adolescents who are addicted to crack cocaine are less sexually active than students who smoke marijuana.

D

Correct. Adolescents who are addicted to crack cocaine are more likely to have sex with several partners and be at risk for sexually transmitted diseases (STDs).

PTS: 1 REF: p. 474 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Comprehension

21.You are a school nurse working with adolescents. An adolescent tells you that he thinks he has a sexually transmitted disease (STD). He wants to see a doctor to get diagnosis and treatment if necessary, but he says he definitely does not want to tell his parents. Your best initial action would be to:

a.

reassure him that you will not contact his parents

b.

convince him to talk with his parents

c.

check the laws of your state to find the age at which adolescents can seek diagnosis and treatment of STDs without parental consent

d.

Refer the adolescent to the local clinic that provides free STD testing

ANS: C

Feedback

A

Incorrect. In the case an adolescent tells you that he thinks he has a sexually transmitted disease (STD), your best initial action would not be to reassure him that you will not contact his parents.

B

Incorrect. In the case an adolescent tells you that he thinks he has a sexually transmitted disease (STD), your best initial action would not be to convince him to talk with his parents.

C

Correct. In the case an adolescent tells you that he thinks he has a sexually transmitted disease (STD), your best initial action would be to check the laws of your state to find the age at which adolescents can seek diagnosis and treatment of STDs without parental consent.

D

Incorrect. In the case an adolescent tells you that he thinks he has a sexually transmitted disease (STD), your best initial action would not be to refer the adolescent to the local clinic that provides free STD testing.

PTS: 1 REF: p. 474 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Application

22.Caregivers ask the pediatric nurse what things they need to especially look at when selecting day care. The nurse will stress preparing and asking a number of questions related to which of the following areas as a priority in selecting day care?

a.

the type and amount of food served

c.

provision for naps

b.

sanitation practices and illness policies

d.

activities for the children

ANS: B

Feedback

A

Incorrect. The nurse will not advise the caregiver to focus most upon the type and amount of food served.

B

Correct. When advising caregivers about things they need to especially look at when selecting day care, he nurse will stress preparing and asking a number of questions related to sanitation practices and illness policies.

C

Incorrect. The nurse will not advise the caregiver to focus most upon the provision for naps.

D

Incorrect. The nurse will not advise the caregiver to focus most upon the activities for the children.

PTS: 1 REF: p. 475 Infectious Diseases in Day Care and School Settings

OBJ: Cognitive Level: Application

23.Children who have been in day care have which of the following experiences with respiratory infections once they enter school (as compared to children who have not been in day care)?

a.

greater number of respiratory infections

c.

different types of respiratory infections

b.

about the same number of episodes

d.

fewer episodes of respiratory infections

ANS: D

Feedback

A

Incorrect. Children who have been in day care as compared to children who have not been in day care do not suffer a greater number of respiratory infections once they enter school.

B

Incorrect. Children who have been in day care as compared to children who have not been in day care do not suffer about the same number of episodes of respiratory infections once they enter school.

C

Incorrect. Children who have been in day care as compared to children who have not been in day care do not suffer a different type of respiratory infections once they enter school.

D

Correct. Children who have been in day care actually suffer fewer episodes of respiratory infections once they enter school (as compared to children who have not been in day care).

PTS: 1 REF: p. 475 Infectious Diseases in Day Care and School Settings

OBJ: Cognitive Level: Comprehension

24.You have just taken a job in a pediatric clinic. You will be teaching caregivers about immunization schedules and either giving or scheduling immunizations. Your best initial preparation for this job would be to:

a.

review your pediatric text that you used in nursing school in order to memorize immunization schedules

b.

obtain a current printed copy of the recommended childhood immunization schedule as approved by the American Academy of Pediatrics and others

c.

study the policy and procedure manuals of the pediatric clinic there you work to ascertain the immunization schedules of the clinic

d.

contact the local school district to ascertain which immunizations are required

ANS: B

Feedback

A

Incorrect. As a new nurse in a pediatric clinic, your best initial preparation for this job would not be to review your pediatric text that you used in nursing school in order to memorize immunization schedules.

B

Correct. As a new nurse in a pediatric clinic, your best initial preparation for this job would not be to obtain a current printed copy of the recommended childhood immunization schedule as approved by the American Academy of Pediatrics and others.

C

Incorrect. As a new nurse in a pediatric clinic, your best initial preparation for this job would not be to study the policy and procedure manuals of the pediatric clinic there you work to ascertain the immunization schedules of the clinic.

D

Incorrect. As a new nurse in a pediatric clinic, your best initial preparation for this job would not be to contact the local school district to ascertain which immunizations are required.

PTS: 1 REF: p. 476 Infectious Diseases in Day Care and School Settings

OBJ: Cognitive Level: Application

25.You are a nurse working in a pediatric clinic. Your goal is to have accurate, up-to-date immunization records on all the children who come to the clinic. Which of the following record-keeping efforts would best help you meet your goal?

a.

Have the caregivers document all the immunizations and dates of immunizations for each child.

b.

Have caregivers list all those who gave immunizations to their children and sign consent forms for release of information; then combine the records into one.

c.

Assume that immunizations are not up-to-date and begin the process at the beginning.

d.

Have the caregiver document all past immunizations with a note that this is caregiver recall and then chart new immunizations.

ANS: B

Feedback

A

Incorrect. The combination of caregiver immunization records with the clinic records is the gold standard.

B

Correct. To best meet your goal as a nurse working in a pediatric clinic to maintain accurate, up-to-date immunization records on all the children who come to the clinic, have caregivers list all those who gave immunizations to their children and sign consent forms for release of information; then combine the records into one.

C

Incorrect. Assume that the records are incomplete, and require a combination of the caregiver immunization records with the clinic records.

D

Incorrect. The combination of caregiver immunization records with the clinic records is the gold standard.

PTS: 1 REF: p. 476 Infectious Diseases in Day Care and School Settings

OBJ: Cognitive Level: Application

26.Why does the nurse need to read the package insert to see if a vaccine has been properly stored before administering the vaccine?

a.

Improper storage will frequently cause the vaccine to be more virulent.

b.

An improperly stored vaccine can clog the needle, leading to an infiltration.

c.

Improper storage or handling can result in a decrease in vaccine potency and ineffective immunization.

d.

The vaccine may be too hot or too cold to inject into the muscle or subcutaneous areas.

ANS: C

Feedback

A

Incorrect. The nurse needs to read the package insert to see if a vaccine has been properly stored before administering the vaccine but not because improper storage will frequently cause the vaccine to be more virulent.

B

Incorrect. The nurse needs to read the package insert to see if a vaccine has been properly stored before administering the vaccine but not because an improperly stored vaccine can clog the needle, leading to an infiltration.

C

Correct. The nurse needs to read the package insert to see if a vaccine has been properly stored before administering the vaccine because improper storage or handling can result in a decrease in vaccine potency and ineffective immunization.

D

Incorrect. The nurse needs to read the package insert to see if a vaccine has been properly stored before administering the vaccine but not because the vaccine may be too hot or too cold to inject into the muscle or subcutaneous areas.

PTS:1REF:p. 480 Immunizations

OBJ: Cognitive Level: Application

27.The National Childhood Vaccine Injury Act of 1986 provides:

a.

legal services on a sliding-fee scale for any family suffering from a reaction to one or more recommended or required vaccinations

b.

rehabilitative services for anyone requiring rehabilitation due to vaccine injury

c.

funds for hospitalization and burial for any child under age 21 who dies as a result of a vaccination

d.

an alternative to civil litigation in which anyone who was injured or lost a family member due to a vaccine may seek compensation

ANS: D

Feedback

A

Incorrect. The National Childhood Vaccine Injury Act of 1986 does not provide legal services on a sliding-fee scale for any family suffering from a reaction to one or more recommended or required vaccinations.

B

Incorrect. The National Childhood Vaccine Injury Act of 1986 does not provide rehabilitative services for anyone requiring rehabilitation due to vaccine injury.

C

Incorrect. The National Childhood Vaccine Injury Act of 1986 does not provide funds for hospitalization and burial for any child under age 21 who dies as a result of a vaccination.

D

Correct. The National Childhood Vaccine Injury Act of 1986 provides an alternative to civil litigation in which anyone who was injured or lost a family member due to a vaccine may seek compensation.

PTS:1REF:p. 480 Immunizations

OBJ: Cognitive Level: Comprehension

28.You are being oriented to the pediatric unit. You notice that after giving a vaccination, the nurse records, in addition to the date of administration, the name of the vaccination, the site and route, the nurses name and title, and which of the following information?

a.

parents or legal guardians full names and permanent addresses

b.

the manufacturer, lot number, and expiration date of the vaccine

c.

any adverse reaction sustained by the recipient

d.

the height, weight, vital signs, health status, and blood work of the child

ANS: B

Feedback

A

Incorrect. After giving a vaccination, the nurse does not record parents or legal guardians full names and permanent addresses.

B

Correct. After giving a vaccination, the nurse records, in addition to the date of administration, the name of the vaccination, the site and route, the nurses name and title, the manufacturer, lot number, and expiration date of the vaccine.

C

Incorrect. After giving a vaccination, the nurse does not record any adverse reaction sustained by the recipient.

D

Incorrect. After giving a vaccination, the nurse does not record the height, weight, vital signs, health status, and blood work of the child.

PTS:1REF:p. 480 Immunizations

OBJ: Cognitive Level: Comprehension

29.You are working in an immunization clinic providing vaccinations prior to the school year. You are required to get the parent(s) or guardian to sign a vaccination consent form. Before accepting the consent form from the parents or guardian and filing it, you would most want to make certain that the form:

a.

is in a language the parent(s) or guardian understands and can read or that it is read to them in a language they understand

b.

has a witness signature as well as the title and address of the person witnessing the signature of the parent(s) or guardian

c.

has been duplicated and sent to the school office and to the public health department

d.

is approved by the state department of public health or the county department of public health and safety

ANS: A

Feedback

A

Correct. Before accepting the consent form from the parents or guardian and filing it, you would most want to make certain that the form is in a language the parent(s) or guardian understands and can read or that it is read to them in a language they understand.

B

Incorrect. Before accepting the consent form from the parents or guardian and filing it, you would not most want to make certain that the form has a witness signature.

C

Incorrect. Before accepting the consent form from the parents or guardian and filing it, you would most want to make certain that the form has been duplicated and sent to the school office and to the public health department.

D

Incorrect. Before accepting the consent form from the parents or guardian and filing it, you would most want to make certain that the form is approved by the state department of public health or the county department of public health and safety.

PTS:1REF:p. 480 Immunizations

OBJ: Cognitive Level: Application

30.Which of the following includes the two true permanent contraindications to vaccination?

a.

consistent occurrence of otitis media and upper respiratory infections after vaccinations in the past

b.

history of severe anaphylactic reaction to a vaccine or its component and encephalopathy within 7 days of administration of DTaP

c.

diarrhea, stomach cramping, and nausea after vaccinations in the past

d.

multiple allergies to mold, grasses, trees, and dust and taking allergy vaccines for 2 years or more in the past 5-year period

ANS: B

Feedback

A

Incorrect. Otitis media and upper respiratory infections are not the two true permanent contraindications to vaccination.

B

Correct. A history of severe anaphylactic reaction to a vaccine or its component and encephalopathy within 7 days of administration of DTaP are the two true permanent contraindications to vaccination.

C

Incorrect. Diarrhea, stomach cramping, and nausea are not the three true permanent contraindications to vaccination.

D

Incorrect. Multiple allergies to mold, grasses, trees, and dust and taking allergy vaccines for 2 years or more in the past 5-year period are not the two true permanent contraindications to vaccination.

PTS:1REF:p. 481 Immunizations

OBJ: Cognitive Level: Comprehension

31.A mother asks the nurse why her child needs a polio vaccination when polio has been eliminated in the United States and eradicated in most of the world. The nurses best answer would be:

a.

Only one of many strains of polio has been eradicated. We believe that new strains are being formed.

b.

Some children suddenly lose their immunity, and we have no explanation for why this happens.

c.

You might have to travel to a foreign country, and when you might be exposed to the polio virus.

d.

Polio virus still exists in parts of the world, which means this virus could be introduced accidentally into this country again and we could have an epidemic of polio.

ANS: D

Feedback

A

Incorrect. Answering a mothers question about why her child needs a polio vaccination, the nurses best answer would not be: Only one of many strains of polio has been eradicated. We believe that new strains are being formed.

B

Incorrect. Answering a mothers question about why her child needs a polio vaccination, the nurses best answer would not be: Some children suddenly lose their immunity, and we have no explanation for why this happens.

C

Incorrect. Answering a mothers question about why her child needs a polio vaccination, the nurses best answer would not be: You might have to travel to a foreign country, and when you might be exposed to the polio virus.

D

Correct. Answering a mothers question about why her child needs a polio vaccination then polio has been eliminated in the United States and eradicated in most of the world, the nurses best answer would be: Polio virus still exists in parts of the world, which means this virus could be introduced accidentally into this country again and we could have an epidemic of polio.

PTS:1REF:p. 481 Immunizations

OBJ: Cognitive Level: Application

32.The school nurse is talking with a group of adolescent females about the measles, mumps, and rubella (MMR) vaccine. The school nurse will caution the female students not to take the vaccine if there is any chance they may be pregnant or become pregnant in the next 3 months. The reason the nurse tells the students not to take the vaccine during the first 3 months of pregnancy is:

a.

This vaccine can cause developmental abnormalities in the fetus during the first trimester.

b.

The baby could be prematurely vaccinated against MMR.

c.

The vaccine could cause the fetus to develop measles or mumps while in utero and this is hard to treat.

d.

The vaccine during this time will cause the mother to have adverse side effects and be severely ill.

ANS: A

Feedback

A

Correct. When administering MMR vaccine to adolescent females, it is important to assess for the possibility of pregnancy. The vaccine is a teratogen (any substance or process that interferes with normal prenatal development) and can cause developmental abnormalities in the fetus when given during the first trimester.

B

Incorrect. When administering MMR vaccine to adolescent females, it is important to assess for the possibility of pregnancy, but not because the baby could be prematurely vaccinated against MMR.

C

Incorrect. When administering MMR vaccine to adolescent females, it is important to assess for the possibility of pregnancy, but not because the vaccine could cause the fetus to develop measles or mumps while in utero and this is hard to treat.

D

Incorrect. When administering MMR vaccine to adolescent females, it is important to assess for the possibility of pregnancy, but not because the vaccine during this time will cause the mother to have adverse side effects and be severely ill.

PTS:1REF:p. 490 Nursing Management

OBJ: Cognitive Level: Application

33.You are working on the medical unit at the hospital. A client says he may have been exposed to diphtheria. The client has a low-grade fever and some nasal discharge. In order to diagnose or rule out diphtheria in this client, the physician will order which of the following tests?

a.

sputum culture

c.

gastric analysis

b.

blood and stool cultures

d.

nose and throat cultures

ANS: D

Feedback

A

Incorrect. In order to diagnose or rule out diphtheria in this client, the physician will not order a sputum culture.

B

Incorrect. In order to diagnose or rule out diphtheria in this client, the physician will not order blood and stool cultures.

C

Incorrect. In order to diagnose or rule out diphtheria in this client, the physician will not order a gastric analysis.

D

Correct. In the instance when a client says he may have been exposed to diphtheria, and presents with a low-grade fever and some nasal discharge, in order to diagnose or rule out diphtheria in this client, the physician will order nose and throat cultures.

PTS: 1 REF: p. 490 Nursing Management OBJ: Cognitive Level: Knowledge

34.The Epstein-Barr virus is responsible for which of the following?

a.

erythema infectiosum

c.

mumps

b.

infectious mononucleosis

d.

roseola

ANS: B

Feedback

A

Incorrect. The Epstein-Barr virus is not responsible for erythema infectiosum.

B

Correct. The Epstein-Barr virus is responsible for infectious mononucleosis.

C

Incorrect. The Epstein-Barr virus is not responsible for mumps.

D

Incorrect. The Epstein-Barr virus is not responsible for roseola.

PTS: 1 REF: p. 483 Nursing Management OBJ: Cognitive Level: Knowledge

35.The school nurse becomes aware that a student with a diagnosis of infectious mononucleosis has been reporting to sports practice. The nurse will advise the student and the coach that:

a.

the student should drink 8 to 10 glasses of water a day and not get overheated in practice

b.

the student should rest until any splenomegaly resolves, as the spleen could rupture

c.

there are few complications from infectious mononucleosis

d.

the student should not play unless she is free of any fever

ANS: B

Feedback

A

Incorrect. Becoming aware that a student with a diagnosis of infectious mononucleosis has been reporting to sports practice, the school nurse will not advise the student should drink 8 to 10 glasses of water a day and not get overheated in practice.

B

Correct. Becoming aware that a student with a diagnosis of infectious mononucleosis has been reporting to sports practice, the school nurse will advise the student and the coach that the student should rest until any splenomegaly resolves, as the spleen could rupture.

C

Incorrect. Becoming aware that a student with a diagnosis of infectious mononucleosis has been reporting to sports practice, the school nurse will not advise there are few complications from infectious mononucleosis.

D

Incorrect. Becoming aware that a student with a diagnosis of infectious mononucleosis has been reporting to sports practice, the school nurse will not advise the student should not play unless she is free of any fever.

PTS:1REF:p. 483 Nursing Management

OBJ: Cognitive Level: Application

36.You are the school nurse advising the caregivers of a student who has mumps. The mother asks how long this student must remain at home. The school nurse will tell the caregivers that students with mumps must stay home until they meet which of the following criteria?

a.

Nine days have passed after the beginning of the parotid swelling.

b.

The parotid swelling has resolved.

c.

The student is free of any pain in the parotid area.

d.

The student is totally free of fever for at least 2 days.

ANS: A

Feedback

A

Correct. The school nurse will tell the caregivers that students with mumps must stay home until nine days have passed after the beginning of the parotid swelling to reduce the potential for transmission.

B

Incorrect. The school nurse will not tell the caregivers that students with mumps must stay home until the parotid swelling has resolved.

C

Incorrect. The school nurse will not tell the caregivers that students with mumps must stay home until the student is free of any pain in the parotid area.

D

Incorrect. The school nurse will not tell the caregivers that students with mumps must stay home until the student is totally free of fever for at least 2 days.

PTS:1REF:p. 484 Nursing Management

OBJ: Cognitive Level: Comprehension

37.An infant of 4 months is hospitalized with a case of pertussis. The child is started on erythromycin orally for 14 days. The nursing staff will enforce observation of respiratory isolation for how long?

a.

until the child is no longer coughing

b.

5 days after initiation of antibiotic treatment

c.

until the child is fever free for 1 week

d.

when the child has been on cough medicine 2 weeks

ANS: B

Feedback

A

Incorrect. Following hospitalization of an infant of 4 months with a case of pertussis, once antibiotic treatment is commenced, the nursing staff will not enforce observation of respiratory isolation until the child is no longer coughing.

B

Correct. Following hospitalization of an infant of 4 months with a case of pertussis, once antibiotic treatment is commenced, the nursing staff will enforce observation of respiratory isolation for 5 days.

C

Incorrect. Following hospitalization of an infant of 4 months with a case of pertussis, once antibiotic treatment is commenced, the nursing staff will not enforce observation of respiratory isolation until the child is fever free for 1 week.

D

Incorrect. Following hospitalization of an infant of 4 months with a case of pertussis, once antibiotic treatment is commenced, the nursing staff will not enforce observation of respiratory isolation until the child has been on cough medicine 2 weeks.

PTS:1REF:p. 485 Nursing Management

OBJ: Cognitive Level: Comprehension

38.Which of the following tests is used in diagnosing polio?

a.

nasal culture

c.

arterial blood gases

b.

stool culture

d.

magnetic resonance imaging (MRI)

ANS: B

Feedback

A

Incorrect. A nasal culture is not used in diagnosing polio.

B

Correct. Diagnosing polio requires throat or stool culture.

C

Incorrect. An arterial blood gas test is not used in diagnosing polio.

D

Incorrect. Magnetic resonance imaging (MRI) is not used in diagnosing polio.

PTS: 1 REF: p. 485 Nursing Management OBJ: Cognitive Level: Knowledge

39.Group A beta-hemolytic streptococci cause which of the following diseases?

a.

varicella

c.

diphtheria

b.

measles

d.

scarlet fever

ANS: D

Feedback

A

Incorrect. Group A beta-hemolytic streptococci do not cause varicella.

B

Incorrect. Group A beta-hemolytic streptococci do not cause measles.

C

Incorrect. Group A beta-hemolytic streptococci do not cause diphtheria.

D

Correct. Group A beta-hemolytic streptococci cause scarlet fever.

PTS: 1 REF: p. 488 Nursing Management OBJ: Cognitive Level: Knowledge

40.A father calls the school nurse and asks when his daughter, who has chickenpox, can return to school. The best reply by the nurse would be:

a.

whenever she is fever free for 2 days

c.

when the itching has stopped

b.

when there are no new lesions

d.

when all lesions are crusted over

ANS: D

Feedback

A

Incorrect. Advising a parent when his daughter who has chickenpox about returning to school, the best reply by the nurse would not be whenever she is fever free for 2 days.

B

Incorrect. Advising a parent when his daughter who has chickenpox about returning to school, the best reply by the nurse would not be when there are no new lesions.

C

Incorrect. Advising a parent when his daughter who has chickenpox about returning to school, the best reply by the nurse would not be when the itching has stopped.

D

Correct. Advising a parent when his daughter who has chickenpox about returning to school, the best reply by the nurse would be when all lesions are dry and crusted over to minimize the potential for transmission.

PTS:1REF:p. 489 Nursing Management

OBJ: Cognitive Level: Application

41.Caregivers of a child with chickenpox tell the pediatric nurse that their child is not eating or drinking much because the child says the sores in the mouth hurt. The best advice by the nurse would be for the caregivers to try which one of the following actions and call back if it does not improve the intake of fluids?

a.

Double the amount of acetaminophen.

b.

Offer gelatin and Popsicles.

c.

Give a solution of seltzer water and honey.

d.

Contact the pediatrician to determine if intravenous hydration is necessary.

ANS: B

Feedback

A

Incorrect. Acetaminophen is indicated for fever reduction.

B

Correct. Being told by the caregivers of a child with chickenpox that their child is not eating or drinking much because the child says the sores in the mouth hurt, the best advice by the nurse would be to maintain fluid intake with cool, non-acidic fluids, gelatin and Popsicles.

C

Incorrect. The best advice by the nurse would not be for the caregivers to try a solution of seltzer water and honey, and call back if it does not improve the intake of fluids.

D

Incorrect. The best advice by the nurse would not be for the caregivers to contact the pediatrician to determine if intravenous hydration is necessary.

PTS:1REF:p. 489 Nursing Management

OBJ: Cognitive Level: Application

42.The transmission of tetanus to humans is when a skin wound comes in contact with:

a.

rusty metals such as a rusted nail

b.

soil contaminated with animal feces

c.

the bite of an insect carrying the tetanus organisms

d.

the saliva of an infected dog

ANS: B

Feedback

A

Incorrect. The transmission of tetanus to humans is not when a skin wound comes in contact with rusty metals such as a rusted nail.

B

Correct. The transmission of tetanus to humans is when a skin wound comes in contact with soil contaminated with animal feces.

C

Incorrect. The transmission of tetanus to humans is not when a skin wound comes in contact with the bite of an insect carrying the tetanus organisms.

D

Incorrect. The transmission of tetanus to humans is not when a skin wound comes in contact with the saliva of an infected dog.

PTS:1REF:p. 488 Nursing Management

OBJ: Cognitive Level: Comprehension

43.The school nurse is advising students who are going on a weeklong field trip into a wooded area. The nurse would tell the students to:

a.

use sunscreen and wear lightweight clothing and high-top tennis shoes or high-top boots

b.

apply a mosquito repellent and wear camouflage clothing or dark clothing

c.

use DEET, wear light-colored long-sleeve top and pants, and inspect clothing and body daily

d.

wear shorts and sleeveless shirts and drink lots of water during the day while hiking in the woods

ANS: C

Feedback

A

Incorrect. Advising students about avoiding Lyme disease, the school nurse would not tell the students to use sunscreen and wear lightweight clothing and high-top tennis shoes or high-top boots.

B

Incorrect. Advising students about avoiding Lyme disease, the school nurse would not tell the students to apply a mosquito repellent and wear camouflage clothing or dark clothing.

C

Correct. Advising students who are going on a weeklong field trip into a wooded area, the nurse would tell the students to use DEET, wear light-colored long-sleeve top and pants, and inspect clothing and body daily. This is directed at avoiding Lyme disease.

D

Incorrect. Advising students about avoiding Lyme disease, the school nurse would not tell the students to wear shorts and sleeveless shirts and drink lots of water during the day while hiking in the woods.

PTS:1REF:p. 484 Nursing Management

OBJ: Cognitive Level: Application

44.The school nurse gets a call from a caregiver who is planning to send her child to summer camp, but recently heard there was a case of Rocky Mountain spotted fever at the camp the previous year. The mother asks, What causes Rocky Mountain spotted fever? The best answer by the nurse would be:

a.

the bite of an infected tick, which is carried by dogs and wild rodents

b.

a bite from an infected species of Mexican free-tail bats

c.

contact with bodily fluids of a child who has the disease

d.

airborne droplets spread by coughing or sneezing

ANS: A

Feedback

A

Correct. Answering a mothers question, What causes Rocky Mountain spotted fever?, the best answer by the nurse would be the bite of an infected tick, which is carried by dogs and wild rodents.

B

Incorrect. Answering a mothers question, What causes Rocky Mountain spotted fever?, the best answer by the nurse would not be a bite from an infected species of Mexican free-tail bats.

C

Incorrect. Answering a mothers question, What causes Rocky Mountain spotted fever?, the best answer by the nurse would not be contact with bodily fluids of a child who has the disease.

D

Incorrect. Answering a mothers question, What causes Rocky Mountain spotted fever?, the best answer by the nurse would not be airborne droplets spread by coughing or sneezing.

PTS:1REF:p. 486 Nursing Management

OBJ: Cognitive Level: Application

45.An expectant mother asks the nurse about cytomegalovirus (CMV). The nurses best answer would be:

a.

This is a highly contagious disease, and you need to be vaccinated against it.

b.

Ninety-five percent of newborns have this disease, which can be tested for and treated at birth.

c.

You need to discuss this with your doctor after your baby is born.

d.

Most adults have been infected by the time of adulthood and most infants with CMV are asymptomatic; however, about 5% of infants have significant problems.

ANS: D

Feedback

A

Incorrect. Answering an expectant mothers question about cytomegalovirus (CMV), the nurses best answer would not be: This is a highly contagious disease, and you need to be vaccinated against it. Though highly contagious, there is no vaccine.

B

Incorrect. Answering an expectant mothers question about cytomegalovirus (CMV), the nurses best answer would not be: Ninety-five percent of newborns have this disease, which can be tested for and treated at birth. Most CMV infections are asymptomatic, and do not require treatment.

C

Incorrect. Answering an expectant mothers question about cytomegalovirus (CMV), the nurses best answer would not be: You need to discuss this with your doctor after your baby is born. The typical expectant mother would conclude that CMV infection is to be greatly feared if the nurse refers the issue to a physician.

D

Correct. Answering an expectant mothers question about cytomegalovirus (CMV), the nurses best answer would be: Most adults have been infected by the time of adulthood and most infants with CMV are asymptomatic; however, about 5% of infants have significant problems.

PTS:1REF:p. 482 Nursing Management

OBJ: Cognitive Level: Application

46.The expectant mother asks the nurse how CMV is diagnosed in infants. The best answer by the nurse would be:

a.

Check for the presence of IgM CMV antibodies in cord blood, which identifies congenitally infected infants; there is another test for detecting antibodies in the babys blood.

b.

Inspect for the presence of symptoms characteristic of this disease.

c.

Conduct a test on the fluids of the eye, which are carefully collected on a swab and placed in a special tube.

d.

Inspect for the effects of the IgM CMV antibodies, which are evident in special tissue tests done in utero or shortly after birth.

ANS: A

Feedback

A

Correct. CMV is diagnosed in infants by looking for the presence of IgM CMV antibodies in cord blood, which identifies congenitally infected infants. There is another test for detecting antibodies in the babys blood.

B

Incorrect. CMV is largely asymptomatic, and can only be diagnosed using appropriate tests on infants.

C

Incorrect. Testing the fluids of the eye will not identify the presence of CMV.

D

Incorrect. The effects of the IgM CMV antibodies are not visually available for inspection, but only appear under the microscope using a polymerase chain reaction to detect the presence of CMV DNA in tissues.

PTS:1REF:p. 482 Nursing Management

OBJ: Cognitive Level: Application

47.Unless contraindicated because of complications or secondary infections, home is the ideal environment for the management of children who have infectious or communicable diseases, because:

a.

it is quieter and more restful in the home environment

b.

the child can remain in his or her bed for comfort

c.

the spread of infection is limited to those in the immediate environment

d.

this qualifies the child for a home tutor so her or she will not get behind in her schoolwork

ANS: C

Feedback

A

Incorrect. Home is the ideal environment for the management of children who have infectious or communicable diseases, but not because it is quieter and more restful in the home environment.

B

Incorrect. Home is the ideal environment for the management of children who have infectious or communicable diseases, but not because the child can remain in his or her bed for comfort.

C

Correct. Home is the ideal environment for the management of children who have infectious or communicable diseases, because the spread of infection is limited to those in the immediate environment.

D

Incorrect. Home is the ideal environment for the management of children who have infectious or communicable diseases, but not because this qualifies the child for a home tutor so he or she will not get behind in her schoolwork.

PTS: 1 REF: p. 472 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Application

48.The caregivers of a child with chickenpox telephone the nurse and ask what they can do about their child scratching the lesions. The best answer by the nurse would be:

a.

Offer the child a reward for not scratching, and keep a behavioral chart with stars for not scratching.

b.

Wrap tape around the hands and tips of the fingernails, and paint the lesions with clear nail polish.

c.

Put body lotion on the lesions during the day and night, cut the nails short, and use Epsom salts in the bathwater.

d.

Cut the fingernails short, cover the hands at night, and use a drying solution such as calamine, oatmeal, or baking soda in bathwater.

ANS: D

Feedback

A

Incorrect. Answering the caregiver of a child with chickenpox about their child scratching the lesions, the best answer by the nurse would not be offering the child a reward for not scratching. The itch is quite intense, and cannot be addressed with a star reward chart.

B

Incorrect. Answering the caregiver of a child with chickenpox about their child scratching the lesions, the best answer by the nurse would not be to tape the hands and paint the lesions with clear nail polish.

C

Incorrect. Answering the caregiver of a child with chickenpox about their child scratching the lesions, the best answer by the nurse would not be use body lotion or a bath in Epsom salts.

D

Correct. Answering the caregiver of a child with chickenpox about their child scratching the lesions, the best answer by the nurse would be: Cut the fingernails short, cover the hands at night, and use a drying solution such as calamine, oatmeal, or baking soda in bathwater.

PTS:1REF:p. 489 Nursing Management

OBJ: Cognitive Level: Application

49.A group of caregivers are talking with the nurse about sexually transmitted diseases (STDs) in adolescents. One caregiver asks the nurse what is the earliest age at which children can get an STD. The best answer by the nurse would be to say that children:

a.

are usually not sexually active until they are 12 or older today

b.

can acquire an STD in utero, in the birth canal, or at a very young age, which can suggest the possibility of sexual abuse

c.

can acquire an STD about 2 years before the advent of puberty

d.

can acquire an STD anytime after birth, although it is rare for a child to have an STD before the age of 11

ANS: B

Feedback

A

Incorrect. Answering a question from a caregiver about the earliest age at which children can get an STD, the best answer by the nurse would not be to say that children are usually not sexually active until they are 12 or older today.

B

Correct. Answering a question from a caregiver about the earliest age at which children can get an STD, the best answer by the nurse would be to say that children can acquire an STD in utero, in the birth canal, or at a very young age, which can suggest the possibility of sexual abuse.

C

Incorrect. Answering a question from a caregiver about the earliest age at which children can get an STD, the best answer by the nurse would not be to say that children can acquire an STD about 2 years before the advent of puberty.

D

Incorrect. Answering a question from a caregiver about the earliest age at which children can get an STD, the best answer by the nurse would not be to say that children can acquire an STD anytime after birth, although it is rare for a child to have an STD before the age of 11.

PTS: 1 REF: p. 472 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Application

50.Caregivers ask the nurse how children or adolescents can contract syphilis. The best response by the nurse is which of the following?

a.

by sexual intercourse

b.

transplacentally, at delivery, by sexual intercourse, or through sexual abuse

c.

anal, oral, or vaginal contact with semen

d.

by contact with any body fluids of an infected person

ANS: B

Feedback

A

Incorrect. Answering a question by a caregiver about how children or adolescents can contract syphilis, the best response by the nurse is not limited to sexual intercourse.

B

Correct. Answering a question by a caregiver about how children or adolescents can contract syphilis, the best response by the nurse is transplacentally, at delivery, by sexual intercourse, or through sexual abuse.

C

Incorrect. Answering a question by a caregiver about how children or adolescents can contract syphilis, the best response by the nurse is anal, oral, or vaginal contact with semen.

D

Incorrect. Answering a question by a caregiver about how children or adolescents can contract syphilis, the best response by the nurse is not by contact with any body fluids of an infected person.

PTS:1REF:p. 491 Nursing Management

OBJ: Cognitive Level: Application

51.An expectant mother is found to have syphilis. Which of the following courses of treatment do you most expect to see ordered?

a.

penicillin G benzathine IM two doses, 1 week apart

b.

tetracycline four times a day for 2 weeks

c.

erythromycin twice a day for 14 days

d.

a single dose of procaine penicillin G IM daily for 10 days

ANS: A

Feedback

A

Correct. Diagnosing an expectant mother to have syphilis, the nurse will expect immediate treatment to include benzathine penicillin G IM two doses one week apart.

B

Incorrect. Diagnosing an expectant mother to have syphilis, the nurse will not expect orders for tetracycline four times a day for 2 weeks.

C

Incorrect. Diagnosing an expectant mother to have syphilis, the nurse will not expect orders for erythromycin twice a day for 14 days.

D

Incorrect. Diagnosing an expectant mother to have syphilis, the nurse will not expect orders for a single dose of procaine penicillin G IM daily for 10 days.

PTS:1REF:p. 493 Future Directions

OBJ: Cognitive Level: Application

52.A baby is found to have congenital syphilis. Which of the following treatments would you expect to see ordered?

a.

erythromycin IM twice a day for 14 days

b.

single dose of procaine penicillin G IM daily for 10 days or a regimen of aqueous crystalline penicillin G IV

c.

penicillin V potassium crushed and administered in the feeding bottle with the babys formula or expressed mothers milk

d.

tetracycline for 14 days

ANS: B

Feedback

A

Incorrect. Finding a baby to have congenital syphilis, the nurse would not expect to see orders for erythromycin IM twice a day for 14 days.

B

Correct. Finding a baby to have congenital syphilis, the nurse would expect to see orders for a single dose of procaine penicillin G IM daily for 10 days or a regimen of aqueous crystalline penicillin G IV.

C

Incorrect. Finding a baby to have congenital syphilis, the nurse would not expect to see orders for penicillin V potassium crushed and administered in the feeding bottle with the babys formula or expressed mothers milk.

D

Incorrect. Finding a baby to have congenital syphilis, the nurse would not expect to see orders for tetracycline for 14 days.

PTS:1REF:p. 493 Future Directions

OBJ: Cognitive Level: Comprehension

53.A mother calls the pediatric nurse. Her child who is in day care has experienced chronic diarrhea that is watery, greasy, and foul smelling. The child complains of stomachache, has flatulence, and is losing weight. Another child in the day care has the same symptoms, and the mother also has some of these symptoms. The pediatric nurse will suspect which of the following causes of the problem?

a.

poor diet

c.

pinforms

b.

food poisoning

d.

giardiasis

ANS: D

Feedback

A

Incorrect. Poor diet will not cause all these symptoms.

B

Incorrect. Food poisoning will present with more severe symptoms more quickly.

C

Incorrect. Pinforms will present with nocturnal anal itching and sleeplessness.

D

Correct. Giardia (a protozoan) ingested, if symptomatic, will present as chronic or relapsing diarrhea (may be watery or greasy, foul smelling), crampy abdominal pain, anorexia leading to weight loss and failure to thrive, and flatulence. Also known as giardiasis.

PTS:1REF:p. 498 Future Directions

OBJ: Cognitive Level: Comprehension

54.The treatment of giardiasis is which of the following medications?

a.

furazolidone (Furoxone) or metronidazole (Flagyl)

b.

mebendazole or piperazine

c.

penicillin

d.

chlorine added to the water

ANS: A

Feedback

A

Correct. The drugs of choice for the treatment of giardiasis are furazolidone (Furoxone) or metronidazole (Flagyl).

B

Incorrect. Mebendazole or piperazine are not the drugs of choice for the treatment of giardiasis.

C

Incorrect. Penicillin is not the drug of choice for the treatment of giardiasis

D

Incorrect. Chlorine added to the water is not the means for the treatment of giardiasis

PTS:1REF:p. 498 Future Directions

OBJ: Cognitive Level: Comprehension

MULTIPLE RESPONSE

1.A nurse is providing education to the parents of a school-aged child. The parents are asking the nurse about the potential illnesses or infections associated with allowing their child to attend a sleepover at a friends house. Which of the following responses made by the nurse would accurately identify illnesses or infections associated with sharing bed linens? Select all that apply.

a.

scleroderma

c.

tinea corporis

b.

scabies

d.

tinea capitis

ANS: B, C, D

Feedback

Correct

The sharing of beds or linens can result in outbreaks of scabies.

The sharing of beds or linens can result in outbreaks of tinea corporis.

The sharing of beds or linens can result in outbreaks of and tinea capitis.

Incorrect

Scleroderma is not an infection and is not associated with the sharing of beds or linens.

PTS: 1 REF: p. 472 Developmental Stages and the Risk of Infection

OBJ: Cognitive Level: Application

2.A 6-month-old infant presents to the clinic for routine immunizations. Prior to this visit, the infant has remained up-to-date with immunizations. The nurse anticipates the infant will need which of the following immunizations recommended at 6 months? Select all that apply.

a.

diphtheria, tetanus, and pertussis (DTaP)

c.

measles, mumps, rubella (MMR)

b.

Haemophilus influenzae type b (Hib)

d.

pneumococcal

ANS: A, B, D

Feedback

Correct

At 6 months, the recommended immunizations include DTaP, Hib, and pneumococcal.

Incorrect

MMR is administered between 12 and 15 months of age.

PTS: 1 REF: p. 476 Infectious Diseases in Day Care and School Settings

OBJ: Cognitive Level: Comprehension

3.The nurse is providing education to the parent of a child who has received the polio immunization. The parent has asked how polio is transmitted. Which of the following responses made by the nurse would be accurate? Select all that apply.

a.

fecal-oral route

c.

through a bite from an infected tick

b.

respiratory

d.

discharge from eyes and skin lesions

ANS: A, B

Feedback

Correct

The transmission of polio is associated with the fecal-oral route.

The transmission of polio is associated with the respiratory route.

Incorrect

Polio transmission is not associated with tick bites.

Polio transmission is not associated with discharge from eyes or skin lesions.

PTS:1REF:p. 480 Immunizations

OBJ: Cognitive Level: Comprehension

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