COMMUNICABLE DISEASES

1. After business trip to an underdeveloped country 3 weeks ago, Chris is diagnosed with hepatitis A. In completing the assessment, the nurse might expect which of the following responses to be most likely associated with the client's contracting of the disease? a) I went hunting to forests and swarmed by mosquitoes b) three months ago, I ate oysters in Kenya c) I drank lemonade from the roadside while on this trip d) my business partner is a hepatitis carrier 2. A client with viral hepatitis has no appetite, and food makes the client nauseated. Which of the following nursing interventions are appropriate? a) explain that high fat diets are usually better tolerated b) encourage foods high in protein c) explain that the majority of calories need to be consumed in the evening hours d) monitor of fluid and electrolyte imbalance 3. Which of the following outcomes would the nurse expect to find in the client who has developed no complications from viral hepatitis? a) decreased absorption of Vitamin K in intestine b) increasing prothrombin time values c) presence of asterexis d) decrease in AST 4. The client has an order to receive purified protein derivatives (PPD) 0.1ml intradermally. The nurse administers the medication utilizing a tuberculin syringe with a: a) 26G, 5/8 inch needle inserted almost parallel to the skin with the bevel side up b) 26G, 5/8 inch needle inserted at a 45deg. angle with bevel side up c) 20G, 1 inch needle inserted almost parallel to the skin with the bevel side up d) 20G, 1 inch needle inserted at a 45deg. angle with bevel side up 5. The nurse reading the PPD skin test for a client with no documented health problems. The site has no induration and a 1mm area of ecchymosis. The nurse interprets that the result is: a) positive b) negative c) needs to be repeated d) borderline 6. The client who is HIV positive has had a Mantoux test. The result shows a 7mm area of induration. The nurse evaluates that this result as: a) negative b) borderline

c) positive d) needs to be repeated 7. The nurse reads the client's Mantoux skin test as positive. The nurse notes that the previous tests were negative. The client becomes upset and asks the nurse what this means. The nurse response is based on the understanding that the client has: a) no evidence of tuberculosis b) client has systemic tuberculosis c) pulmonary tuberculosis d) exposure to tuberculosis 8. The nurse is caring for the client diagnosed with tuberculosis. Which of the following assessments, if made by the nurse, are not consistent with the usual clinical presentation of tuberculosis? a) nonproductive or productive cough b) anorexia and weight loss c) chills and night sweats d) high grade fever 9. The nurse is teaching the client with TB about dietary elements that should be increased in the diet. The nurse suggests that the client increase intake of: a) meats and citrus fruits b) grains and broccoli c) eggs and spinach d) potatoes and fish

10. The client with TB, whose status is being monitored in an ambulatory care clinic, asks the nurse when it is permissible to return to work. The nurse replies that the client may resume employment when: a) two sputum cultures are negative b) five sputum cultures are negative c) a sputum culture and a chest x-ray is negative d) a sputum culture and a PPD test are negative 11. The client with TB is being started on anti-TB therapy with Isoniazid (INH). The nurse assesses that which of the following baseline studies has been completed before giving the client the first dose? a) coagulation times b) electrolytes c) serum creatinine d) liver enzymes 12. The nurse has given the client with tuberculosis instructions for proper handling and disposal of respiratory secretions. The nurse evaluates that the client understands the instruction if the client verbalizes to:

a) wash hands at least four times a day b) turn the head to the side if coughing or sneezing c) discard the used tissues in the plastic bag d) brush the teeth and rinse the mouth once a day

13. The client has been taking Isoniazid for month and a half. The client complains to the nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing: a) small blood vessel spasm b) impaired peripheral circulation c) hypercalcemia d) peripheral neuritis 14. The client with AIDS is diagnosed with cutaneous Kaposi's sarcoma. Based on this diagnosis, the nurse understands that his has been determined by which of the following? a) appearance of reddish blue lesions noted on the skin b) swelling in the lower extremities c) punch biopsy of the cutaneous lesions d) swelling in the genital area 15. Which of the following individuals is least likely at risk for the development of Kaposi's sarcoma? a) a man with a history of same sex partners b) a renal transplant client c) a client receiving antineoplastic medications d) an individual working in an environment where exposure to asbestos exists 16. The clinic nurse assesses the skin of the client with a diagnosis of psoriasis. Which of the following characteristics is not associated with this skin disorder? a) discoloration and pitting of the nails b) silvery white, scaly patches on the scalp, elbows, knees, and sacral regoins c) complaints of pruritus d) red purplish, scaly lesions 17. The nurse is assigned to care for a client with herpes zoster. Which of the following characteristics does the nurse expect to note when assessing the lesions of this infection? a) a generalized body rash b) small, blue-white spots with a red base c) a fiery red, edematous rash on the cheeks d) clustered skin vesicles 18. The nurse manager is panning in the clinical assignments for the day. Which of the following staff members would not be assigned to the client with herpes zoster?

a) the nurse who had chicken fox during child hood b) the new nurse who never had german measles c) the nurse who never had enteric fever d) the new nurse who had flu vaccine 19. The nurse plans to instruct a client with candidiasis (thrush) of the oral cavity about how to care for the disorder. Which of the following is not a component of instructions? a) to rinse the mouth four times daily with a commercial mouthwash b) to avoid spicy foods c) to avoid citrus fruits and hot liquids d) to eat foods that are liquid 20. The clinic nurse inspects the skin of client suspect of having scabies.Which of the following assessment findings would the nurse note if this disorder were present? a. the appearance of vesicles or pustules with a thick, honey colored crust b) the presence of white patches scattered about the trunk c) multiple straight or wavy, threadlike lines beneath the skin d) patchy hair loss and round neck macules with scales

ANSWERS 1) C ..... 2) D ..... 3) D ..... 4) A ..... 5) B 6) C ..... 7) D ..... 8) D ..... 9) A ..... 10) A 11) D ..... 12) C ..... 13) D ..... 14) A ..... 15) C 16) D ..... 17) D ..... 18) B ..... 19) A ..... 20) C

21. The home health nurse visits a client suspected of having scabies. Which of the following precautions will the nurse institute during the assessment of the client? a) wear a mask and a gloves b) wear gloves only c) wear gown and gloves d) avoid touching the client's home furnishings 22. The school nurse prepares a list of home care instructions for the parents of a school children diagnosed with pediculosis. Which of the following is included in the list? a) use antilice sprays on all bedding and furniture b) take all bedding and linens to the cleaners to be dry cleaned c) boil combs and brushes and hot water for 1 hour d) vacuum floors, play areas, and furniture to remove hairs that might carry 23. The nurse educator provides a teaching session to staff nurses regarding the BCG vaccine. Which of the following is included in the teaching? a) it is used for children with a positive Mantoux test b) it is used for children with both positive Mantoux test and chest x-ray c) it is used for all children to prevent tuberculosis d) it is used for asymptomatic HIV infected children who are at risk for developing TB 24. An adolescent is diagnosed with conjunctivitis. The child asks the nurse if it is okay to wear contact lenses. Which of the following is not an appropriate instruction? a) contacts can be worn if they are cleansed as directed b) contact lenses should not be worn c) new contact lenses should be obtained d) old contact lenses should be discarded 25. A child with measles (rubeola) is being admitted to the hospital. In preparing for the admission of the child, which of the following will the nurse include in the plan of care? a) contact precautions b) enteric precautions c) respiratory isolation d) protective isolation 26. The pediatric nurse is caring for a hospitalized child with diagnosis of rubella (german measles). The nurse reviews the physician's progress notes and reads that the child has developed Forcheimer's sign. Based on this documentation, which of the following would the nurse expect to note in the child? a) petechial spots located on the palate b) small blue spots noted on the buccal mucosa c) a fiery red edematous rash in the cheeks

d) swelling of the parotid gland 27. The pediatric nurse specialist provides an educational session to nursing students about the childhood communicable diseases. A nursing student asks the pediatric nurse specialist to describe the signs and symptoms associated with the most common complication ofmumps.Which of the following signs and symptoms is indicative of the most common complication of this communicable disease? a) a red, swollen testicle b) nuchal rigidity c) pain d) deafness 28. The parents of a child with mumps express that their child will develop orchitis as a result of having mumps. The parents ask the nurse about the complication and about the signs that may indicate this complication. Which of the following would not be a part of the nurse's response to the parents? a) abrupt onset of pain b) headache and vomiting c) fever and chills d) difficulty in urinating 29. The nurse provides home care instructions to the parents of a child hospitalized withpertussis. The child in the covalescent stage and is being prepared for discharge. Which of the following will not be a component of the teaching plan? a) maintain respiratory isolation and a quiet environment for at least two weeks b) coughing spells may be triggered by noises or episodes of fright c) encourage fluid intake d) good handwashing techniques must be instituted to prevent spreading the disease to others 30. A 6-month old infant receives DPT immunization at the clinic. The mother returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. The most appropriate suggestion to the mother is: a) apply a warm pack to the injection site b) bring the infant back to the clinic c) apply an ice pack to the injection site d) monitor the infant for a fever 31. The clinic nurse of a well baby clinic prepares to administer immunizations. Which of the following conditions, if present in a child, would be a contradiction for receiving an immunization? a) cold b) otitis media c) diarrhea d) fever 32. The clinic nurse obtains a health history from a mother of a 15 month old child prior to administering an MMR vaccine. Which of the following assessment findings would be of highest priority prior to the

administration of this vaccine? a) allergy to eggs b) a recent cold c) presence of diarrhea d) any recent ear infection 33. A contagious disease is one that is mainly transmitted through: a) vectors b) fomites c) objects d) direct exposures 34. When a contagious disease suddenly increases in incidence it is said to be: a) pandemic b) epidemic c) endemic d) sporadic 35. A person who has direct association with an infected individual is classified as a: a) susceptible b) contact c) carrier d) suspect 36. Contamination implies that which of the following is present? a) erythema b) desquamation c) pathogenic organism d) mosquitoes 37. Pathognomonic means: a) pathology of disease b) untoward symptoms c) prodromal signs d) characteristic of a disease 38. An antigen is a substance which: a) renders bacteria harmless b) neutralizes certain toxins c) produces local erythema d) stimulates antibody production

39. The term enanthem refers to: a) the toxin produced by a causative agent b) the systemic symptoms of a disease c) therash on the skin d) th eruption on the mucosa 40. A weaken toxin is called: a) toxicide b) toxoid c) toxicoid d) toxicant

ANSWERS 21) C ..... 22) D ..... 23) C ..... 24) D ..... 25)C

26) A ..... 27) A ..... 28) B ..... 29) B ..... 30) D 31) C .....32) A ..... 33) D ..... 34) B ..... 35) B 36) C ..... 37) D ..... 38) D ..... 39) C ..... 40) B

41. The term fomite refers to: a) insects, capable of transmitting an etiological agent b) fresh bodily secretions of a contagious patient c) objects upon which pathogen may be found d) germs causing contagious disease 42. An isolation unit is an area contaminated by: a) parasites b) pathogen c) bacteria d) microbes 43. The best physical unit in a hospital for isolation for a person with an air-borne infection is: a) any ward that provides a distance barrier of six feet between beds b) an open ward with cubicles c) a private room with a bath d) a mixed infection floor with adequate ventilation

44. The reason why medical personnel wear isolation gowns when caring for a person with an airborne infection is to: a) minimize atmospheric contamination b) protect patient from secondary infection c) keep one's uniform free from gross contamination d) complete the isolation technique

45. Of what value is cleaning the hands with soap and water? a) the germicidal effect is high b) the bacterial flora is reduced to zero c) many microorganisms are removed d) protective sebaceous material is removed

46. In teaching a mother with isolation precautions, which of the following should be stressed? a) detailed gown technique b) disinfection of linen c) use of paper barriers d) frequent handwashing

47. Immunity means: a) presence of red blood cells b) protection against disease for life c) resistance of the host to a disease d) resistance to pathogenic organism

48. A foreign substance which stimulates the formation of antibodies after a given length of time is called an: a) agglutin b) allergen c) antigen d) antisera 49. Frequent small exposure to a specific disease may give to you: a) active acquired immunity b) active natural immunity c) passive natural immunity d) passive acquired immunity Situation: A four year old child is admitted to the hospital with the following signs: maculo-papular eruptions with a few "dew-drop" lesions on the body. The doctor makes the diagnosis of chickenfox. 50. In describing the rash to the student nurse, the doctor said that the lesions are found mainly on the : a) soles of the feet b) trunk c) forearm d) palms 51. The physician orders calamine lotion to: a) prevent spread of infection b) dry up the lesions c) allay pruritus d) shorten infectious period

52. Itching of the lesions on this patient may be effectively relieved by: a) applying elbow restraints b) bathing with baking soda solution c) sponging the skin with hot water d) giving an alcohol sponge 53. This patient should be considered contagious until:

a) the scabs have fallen off b) two negative nose and throat cultures are obtained c) 24 hours after afebrile period d) the lesions have crusted completely 54. A synonym for measles is: a) rubeola b) rubella c) herpes simplex d) herpes zoster 55. What is the descriptive term for the typical rash on the skin of a measles patient? a) maculo-vesicular b) maculo-bullosus c) maculo-pustular d) maculo-papular 56. The enanthem in measles is called: a) forcscheimer's spots b) koplik's spots c) rose spots d) petechial spots

57. A complication of measles which might lead to personality changes is: a) chorea b) myelitis c) encephalitis d) conjunctivitis 58. Diphtheria is caused by: a) hansen's bacillus b) corynebacterium diptheroid c) klebs-loeffler bacillus d) bacillus athracis 59. Nurses who care for diphtheria patients should be Schick tested because: a) they may be carriers b) they may be sensitive to toxoid c) they may be susceptible to diphtheria d) they may be incubating the disease

60. The moloney test is used to indicate: a) sensitivity to diphtheria antitoxin b) susceptibility to diphtheria c) sensitivity to diphtheria toxoid d) the effectiveness of diphtheria toxoid

ANSWERS 41) C ..... 42) B ..... 43) C ..... 44) C ..... 45) C 46) D ..... 47) D ..... 48) C ..... 49) A ..... 50) B 51) C ..... 52) B ..... 53) A ..... 54) A ..... 55) A 56) A ..... 57) C ..... 58) C ..... 59)B ..... 60) B

Situation: Bobby, 3 years old, from a family of four older siblings, a mother and a father, was admitted to the hospital with a temperature of 101 F, a sore throat of four days duration, with difficulty of swallowing, and a moderate cervical adenitis. A diagnosis of pharyngeal diphtheria was made. 61. The best means for providing complete bed rest for the child include: a) feeding the patient b) giving sedation c) providing quiet diversion d) giving complete physical care 62. A positive nose and throat culture in a member of the family in whom no signs of the disease are present would indicate: a) that he is developing diphtheria b) that he is a carrier c) that he is susceptible to diphtheria d) that he is immune to diphtheria Situation: Charles, an 8 year old boy, one of several siblings in the family, is kept home by his mother because he has a temperature of 100.2F and a history of hacking cough for two weeks. A definite whoop has been heard and the doctor made a diagnosis of whooping cough. The visiting nurse is to instruct the mother in proper care of this patient. 64. This young boy should be: a) kept in warm, dry room b) placed in a sunny room c) kept in a room with a temperature of 60F d) allowed free run of the house 65. The organism causing whooping cough is: a) hemolytic streptococcus b) hemophilus influenza c) hemophilus pertussis d) streptococcus albus 66. Whooping cough is most contagious: a) in the paroxysmal stage b) in the catarrhal stage c( in the febrile stage d) in the incubation stage 67. During the second stage of the disease the characteristic paroxysm is frequently accompanied by:

a) involuntary micturation b) spontaneous epistaxis c) inspiratory whoop d) expulsion of mucous from the trachea 68. The diagnosis of pertussis is confirmed by which of the following tests? a) nose and throat culture b) nasopharyngeal culture c) "rapid" culture of nose and throat organism d) sputum culture 69. Oxygen is used in whooping cough for which of the following reasons: a) prevents the pertussis organism from multiplying b) seems to lessen the occurrence of paroxysms c) reduces the danger of convulsions d) prevents atelectasis 70. One of the first signs of mumps is: a) pain in the back b) diarrhea c) pain in the region of the parotid gland d) otitis media 71. A nurse should suspect meningitis if a patient exhibited characteristic position which would be: a) knees pulled up b) joints of hands flexed c) backward arching of the spine d) head pulled forward onto the chest 72. The nurse should be alert for complications of meningitis. Which of the following are the most common? a) hydrocephalus b) damage of the optic nerve c) deafness d) myocarditis 73. Which of the following is not a part of the role of the infection control department? a) reviewing infection control policies and procedures b) performing venipunctures on clients to obtain blood cultures c) investigating outbreaks of infection d) providing input regarding the selection of patient care products

74. The primary human reservoir for Staphylococcus aureus is: a) adult genitalia b) blood c) skin d) feces 75. The best example of medical asepsis is: a) hand washing b) use of sterile instruments c) drawing medication into syringe d) autoclaving 76. Which of the following is not a symptom of localized infection? a) redness b) edema c) restricted movement of the affected body part d) lymph node enlargement 77. All of the following are part of the nurse's role in infection control except: a) recognizing the signs and symptoms of infection b) collecting specimens of drainage from infected wound sites c) deciding upon the appropriate to be antibiotic to be administered to the client d) supporting the client's body defense mechanisms 78. When giving a history, the patient reports that he had discharge from his penis and burning when he urinates. A nurse should recognize these as indicative of: a) herpes b) chlamydia c) syphilis d) HIV infection 79. When insect serves as the host for transmission, this is called a) airborne b) vectorborne c) vehicle d) contact 80. When a health care worker is washing her/his hands, which of the following observations made by the nurse would indicate that the worker understands the principle of proper hand washing? a) washes hands prior to removing gloves b) wash hands for 5 seconds c) rinses hands with fingers pointed up

d) removes rings before washing

ANSWERS 61) B ..... 62) B ..... 63) ..... 64) A .....65) C 66) B .....67) C ..... 68) A ..... 69) B ..... 70) C 71) D ..... 72) C ..... 73) D ..... 74) C ..... 75) A

76) D ..... 77) C ..... 78) A ..... 79) B ..... 80) D

81. When the nurse teaches about "safe sex" practices, it should be stated that the proper use of condom includes: a) using petroleum jelly as a lubricant b) using saliva as lubricant c) leaving space at condom tip d) all of the above 82. Mr. C come to the clinic after having been notified of exposure to gonorrhea. He states that his exposure occurred 11 days ago. If he is infected, signs and symptoms you would expect are: a) headache, rash, stiff neck, irritability, joint pain and stiffness b) urinary frequency and burning with purulent discharge from the urethra c) nausea, diarrhea, fever, and urinary frequency and urgency d) burning sensation on the penis and swollen lymph nodes in the groin 83. A common opportunistic infection that affects AIDS patient and causes white patches on the tongue and oral mucosa is: a) histoplasmosis b) herpes simplex c) toxoplasmosis d) candida albicans 84. Kaposis's sarcoma often presents as a) lung infection b) a CNS infection c) blister on the skin d) a "bruise" or large area of plaque in the skin 85. Confidentiality must be presented for HIV positive patients because a) it is an ethical requirement for health care professional b) only those working with the patient need to know the HIV status c) insurance companies might not continue their insurance d) families may not know about the routes of possible exposure to patient had

86. The best method for you to prevent exposure to HIV while at work is to: a) know the HIV status of every patient b) keep yourself in good health c) always use gloves when likely to come into contact with body fluids d) use personal protective equipment exactly as recommended at all times 87. Unmarried elderly people may be at high risk fro contracting HIV because

a) they are most likely to have multiple partners b) because they are less inclined to use condoms because pregnancy is not an issue c) they do not think they are risk for AIDS d) sexuality is often not assessed by health care providers for this group 88. When considering engaging in an intimate relationship, a person should insist on a) abstinence from intercourse b) mutual HIV testing c) use of barrier techniques for intercourse d) both HIV testing and use of barrier technique for intercourse 89. The stage of HIV present in an individual is determined by: a) HIV testing b) physical examination c) CD4 lymphocyte count d) the presence of opportunistic infections 90. Antiretroviral therapy is begun when a) the first opportunistic infection occurs b) an individual is found to be HIV positive c) weight loss begins to occur along with fatigue d) CD4 cell count drops to 500 cells/mL

91. The cause of AIDS is: a) the presence of HIV in the body b) suppression of the immune response by HIV c) a defect in a person's immune system d) replication of HIV 92. Contagious disease may be transmitted to susceptible persons by contact with any of the following except: a) persons carrying the organisms b) food containing the organism c) persons with infected body substances d) ordinary dust particles in the air 93. CD4+ T-cell levels tend to be elevated in a client with which of the following conditions? a) an autoimmune disorder b) cancer c) AIDS d) allergies

94. Which of the following actions of the nurse would be least likely to result in a client comfort when attending an STD clinic? a) addressing the client by name b) standing with your arms crossed as you talk with the client c) making eye contact appropriate for client's culture d) asking the nature of the problem in an area that maintains privacy 95. Which of the following actions would be the least effective STD risk reduction strategy? a) taking oral contraceptives for family planning b) lifelong monogamy of both partners c) using a male condom with spermicide d) using a female condom with spermicide 96. Which of the following is a method of a sterile technique? a) use of antiseptics b) steam under pressure c) frequent hand washing d) use of gloves when coming in contact with body fluids

97. Nosochomial infections are those that are acquired by which of the following? a) after another infectious process b) from a sexual partner c) as a result of hospitalization d) from poor habits of hygiene

98. Which of the following is a sign of an acute inflammatory process a)skin blanching b) decreased temperature c) loss of sensation d) localized swelling 99. What is the most common and serious complication of gonorrhea infection among women? a) pelvic inflammatory disease b) acute septicemia c) sterility d) kidney failure 100. What is the test done to verify the presence of gonorrhea in women? a) pelvic exam

b) cervical culture c) cervical biopsy d) ultrasound of the reproductive organs

ANSWERS 81) D ..... 82) B ..... 83) B ..... 84) D ..... 85) A 86) D ..... 87) D ..... 88) D ..... 89) A ..... 90) B 91) B ..... 92) D ..... 93) C ..... 94) B ..... 95) A 96) A ..... 97) C ..... 98) D ..... 99) A ..... 100) B