Deck 15: Emerging Infectious Diseases

Question 1

The clinic clients respond negatively to the need for a yearly flu shot. They ask why the medical communities don't just create one shot that will last for several years. Which is the best response from the nurse?

A) Genetic changes in the bacteria that cause the flu require a rotating course of antibiotics
B) Genetic changes make the flu virus resistant to the flu shot from year to year
C) There is more than one strain of the flu virus and you must be protected from all of them
D) The shots last only for 3 to 6 months and must be renewed on a yearly basis

Answer 1

Genetic changes make the flu virus resistant to the flu shot from year to year

Question 2

Nursing students in an enclosed classroom begin to become ill with a gastrointestinal illness. The public health department identifies this occurrence as an emerging epidemic and isolates the population that is ill. Which factor will become apparent among those who survive this disease?

A) Recover with adaptive organism reintroduction into the environment
B) Develop improved defenses against reinfection
C) Become hosts to the organism, which is symbiotic in nature
D) Become carriers of the infection, ultimately leading to an epidemic

Answer 2

Develop improved defenses against reinfection

Question 3

Three years after exposure to a virulent form of the flu, a population faces the same flu strain. The public health department determines that there are members of the population who have not been exposed to the flu strain. Which will the public health department predict will occur next?

A) The unexposed population will contract the illness
B) The unexposed population is not likely to contract the illness
C) The unexposed population will contract the illness and reinfect others
D) The flu will reach epidemic proportions and both populations will become ill

Answer 3

The unexposed population is not likely to contract the illness

Question 4

The public health department is conducting research in an area where medical resources are limited. Which environmental factors should the department most consider when evaluating the likelihood of a disease outbreak? (Select all that apply.)

A) Temperature
B) Geology
C) Precipitation
D) Humidity
E) Amount of daylight

Question 5

Tent communities are constructed in a rural community by the American Red Cross after a disaster. Because of overcrowding, surrounding states create accommodations for the displaced and homeless. The survivors are accommodated in the cities of four Southern states. Which factors will most likely increase the possibility of disease emergence in these cities? (Select all that apply.)

A) Poor hygiene
B) Decreased socialization
C) Poor sanitation
D) Decreased viral load
E) Increased violence

Question 6

An 80-year-old client is being treated for chronic urinary tract infections with multiple antibiotics in the past 6 months. The healthcare provider orders a urine culture. The results of the urine culture reveals Staphylococcus aureus >100,000 colonies and demonstrated resistance to sulfamethoxazole and trimethoprim, penicillin, methicillin, and erythromycin. The client is diagnosed with methicillin-resistant S. aureus (MRSA) on the basis of the findings of her urine test. The nurse would predict this is the result of which microbial action?

A) Rejection
B) Assimilation
C) Adaptation
D) Stagnation

Question 7

The community health nurse works in a region where severe acute respiratory syndrome (SARS) has just been reintroduced into the environment. Which measure is imperative for the nurse to take to prevent spread of the disease?

A) Prophylactic antibiotics
B) Enhanced infection control measures
C) Use of alcohol cleansers
D) Report of clusters to the CDC

Question 8

There is an outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in the community. The nurse is responsible for the dissemination of the education plan adopted by the public health department. Which key components of the plan should the nurse include? (Select all that apply.)

A) Quarantining infected families in their homes
B) Respiratory hygiene
C) Hand hygiene
D) Droplet precautions for visitors in contact with affected clients
E) Contact precautions for all cases

Question 9

International health experts have determined that the avian flu is the virus most likely to cause the next pandemic. Which factor will most likely improve its transmissibility to the public?

A) Increase in consumption of chicken
B) Increase in autoimmune disease incidence
C) Shift to zoonotic transmission
D) Antigenic shift

Question 10

The nurse is responsible for the construction of an isolation unit during an H5N1 outbreak. The unit is designated for only those clients with a confirmed diagnosis of H5N1. Which unit should the nurse prioritize to fulfill this need?

A) 12-room unit with negative air pressure units
B) 15-room unit with a portable supply of PPEs
C) 8-room unit with four code carts
D) 12-room unit with four to six air changes per hour

Question 11

Ten documented cases of West Nile virus (WNV) have occurred recently in the community. Which points should the nurse prioritize when educating the community about this outbreak? (Select all that apply.)

A) Avoid contact with birds
B) Avoid contact with mosquitoes
C) Avoid those with a confirmed diagnosis
D) Eliminate standing water
E) Avoid exposure to the environment during the daylight hours

Question 12

The client is diagnosed with Lyme disease. He states that he is not a hiker and does not remember being bitten by a tick. Which is the best response from the nurse?

A) "You must have been bitten by a tick and didn't recognize it as such."
B) "Did you spend time in a brushy or grassy area in the last 90 days?"
C) "Conduct a full-body tick check once a week during the summer."
D) "A history of a tick bite is not required."

Question 13

The nurse admits a client to the hospital with the diagnosis of Escherichia coli O157:H7. The client is dehydrated and febrile. During the history phase of the admission, the client states that he doesn't know how he could have gotten sick at the local county fair---the hamburger he bought was well done. Which factor would the nurse predict was most responsible for the transmission of the bacteria?

A) Use of a gas barbecue
B) Improper cleaning of the cooking tools
C) Use of wood instead of charcoal to cook the meat
D) Animals roaming in the fair grounds

Question 14

Four employees at a local restaurant have positive purified protein derivative (PPD) tuberculin skin tests and have been diagnosed with latent tuberculosis (TB) infection. Which employee would the nurse predict to be at the greatest risk for contracting active TB disease?

A) Works two jobs
B) Vacations in South America
C) Cooks the food
D) Takes immunosuppressants

Question 15

The nurse assesses a client in the local neighborhood clinic. He exhibits signs and symptoms of tuberculosis (TB) yet has a negative tuberculin skin test result. Which factor will lead the nurse to predict the healthcare provider will order additional tests?

A) Visited Central America recently
B) Is recovering from jet lag
C) Is HIV positive
D) Works in a factory setting

Question 16

The nurse is responsible for the directly observed therapy (DOT) program in the community. Which represent the best methods to ensure compliance with clients' drug regimens? (Select all that apply.)

A) Social service support
B) Housing assistance
C) Hospitalization
D) Isolation until treatment is complete
E) Treatment enablers

Question 17

As the occupational health nurse in a factory finds that five employees out of 30 have positive tuberculin skin test results. One employee on the 3-to-11 shift has been diagnosed with active tuberculosis (TB). She asks if this means that the whole factory has been exposed. Which factor would the nurse point out would most likely increase the possibility of infecting others? (Select all that apply.)

A) Concentration of infectious droplet nuclei in the air
B) Duration of exposure to the infected person
C) Proximity to the infected person
D) The use of safety gloves by employees
E) Physical exertion required in the job

Question 18

A man who lives in a homeless shelter is diagnosed with active tuberculosis (TB). The shelter keeps a list of those who are assigned beds, and the majority of those sleeping there are regulars. Which finding would indicate a positive tuberculin skin test result using a two-step process?

A) 4-mm induration
B) 2-mm induration
C) 6-mm induration
D) 3-mm induration

Question 19

Each employee in a small community hospital is informed that he or she needs a tuberculin skin test and of the date that the test is due. The kitchen employees tell the nurse that they don't need the test and never had to have it before. Which is the best response by the nurse?

A) The test does not need to be given if you do not have client contact.
B) Tuberculosis guidelines require testing of an entire healthcare setting.
C) The test will not hurt; we won't fire you if you test positive.
D) The tuberculosis guidelines state kitchen workers are at risk.

Question 20

A nurse is studying the Institute of Medicine's convergence model to learn how four types of interrelated and overlapping microbe--human interactions can lead to emerging/reemerging infectious diseases. Which four types of interactions will the nurse be to point out as essential after learning about this model? (Select all that apply.)

A) Genetic and biologic
B) Physical/environmental
C) Spiritual and psychological
D) Ecologic
E) Social, political, and economic

Question 21

The nurse prepares to enter the room of a client with suspected Ebola virus disease (EVD). Which PPE items should the nurse ensure is in place before entering the room? (Select all that apply.)

A) Fluid-resistant gown
B) Gloves
C) Respirator
D) Mask
E) Goggles