Communicable Diseases(NLE 1-20)

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

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