Infectious Disease Practice Questions And Answers With Correct Rationales 2023 Exam Review Update

Infectious Disease Practice Questions And Answers With Correct Rationales 2023 Exam Review Update Sam's mother has telephoned the clinic because chicken pox has been "going around" at Sam's school and she has noticed a few red spots along the hairline of his face. She asks if there is anything to shorten the duration or severity of the illness. Which of the following is the most accurate? a. Diphenhydramine elixir has been shown to shorten the duration and severity of the rash b. Acyclovir has been shown to shorten the duration and severity of the illness. c. Aspirin taken 4 times a day has been shown to shorten the duration and severity of the illness d. There is no medication known to alter the course of the illness - ANS-b. Acyclovir has been shown to shorten the duration and severity of the illness *Acyclovir has been shown to slightly shorten the duration of fever and new lesion formation. Aspirin is not given to children with chicken pox because of its association with Reye's syndrome. A 14-year-old adolescent has been diagnosed with mononucleosis. The PNP should teach the adolescent and the parents that which of the following should be avoided? a. Strenuous exercise if the spleen is palpable b. Weight-bearing activities until lab tests show resolution of the disease c. Unnecessary activity until lymph nodes return to normal size d. Stretching and reaching activities during acute stage of illness - ANS-a. Strenuous exercise if the spleen is palpable *To avoid splenic rupture, strenuous exercise and contact sports should be avoided as long as the spleen is palpable A well-nourished 10-year-old girl presents to the clinic with low-grade fever, sore throat, fatigue and malaise, and left upper abdominal pain. Based on clinical presentation and laboratory results, a diagnosis of infectious mononucleosis is made. Which of the presenting signs and symptoms would require further investigation immediately? a. Low-grade fever b. Sore throat with lymphadenopathy c. Fatigue and malaise d. Left upper abdominal pain - ANS-d. Left upper abdominal pain *LUQ pain should alert the PNP to the possibility of splenic rupture. Sore throat should be cultured for strep if this has not been done but the need to culture is not urgent Initial treatment for a child with uncomplicated infectious mononucloesis should include: a. Home care with bed rest progressing to activity as tolerated b. Home care with complete bed rest until afebrile c. Hospitalization with complete bed rest until lab values return to normal d. Hospitalization with daily, planned physical therapy - ANS-a. Home care with bed rest progressing to activity as tolerated *Bed rest and activity as tolerated are recommended in the initial treatment of uncomplicated infectious mononucleosis You are performing a physical exam on a 12-year-old boy who is planning to go to summer camp in a primitive wooded area. What teaching is appropriate for the prevention of Rocky Mountain spotted fever? a. Inspect the body several times daily and remove ticks immediately b. Inspect the skin while taking a shower and apply soap to ticks before removing c. Ticks should be removed only after they have been killed with alcohol d. Tick removal should be performed by a healthcare professional - ANS-a. Inspect the body several times daily and remove ticks immediately *Ticks must be attached for 4-6 hours or more before they can transmit Rocky Mountain spotted fever; frequent removal of ticks is valuable. Ticks do not need to be treated with soap or alcohol before removal, and do not need to be removed by a healthcare provider. The mother of 8-year-old John telephones to tell you that John developed chicken pox 3 days ago. She wants to know if there is anything she can do to make him more comfortable. You should tell John's mother to: a. Apply topical calamine lotion b. Apply at topical antibiotic to the new vesicles c. Give aspirin for fever and discomfort d. Keep John out of bright light - ANS-a. Apply topical calamine lotion *Itching causes discomfort in children with chicken pox. Calamine lotion may be applied liberally for relief of itching caused by vesicular lesions. Neosporin does not decrease itching. Steroids may weaken the immune system and should not be used on a child with a herpes virus. Photophobia frequently occurs in rubeola (measles) but not chicken pox. The mother of 8-year-old John telephones to tell you that John developed chicken pox 3 days ago. She wants to know if there is anything she can do to make him more comfortable. You should also tell John's mother to: a. Avoid getting the lesions wet b. Encourage John to take a bath every day c. Have John take a bath only if he develops fever and sweats d. Encourage John to take only sponge baths until all lesions are healed - ANS-b. Encourage John to take a bath every day *There are no restrictions on bathing. Children with chicken pox should be encouraged to take daily baths to prevent secondary bacterial infection, which is the most common complication of chicken pox. The mother of 8-year-old John telephones to tell you that John developed chicken pox 3 days ago. She wants to know if there is anything she can do to make him more comfortable. John's mother calls you again 10 days after onset of initial rash to report that John has had a severe headache since yesterday and that he is very irritable. Which of the following would be advised? a. Ask the mother if John has had a bowel movement since he has been ill b. Tell John's mother that these symptoms are common when chicken pox is resolving c. Ask the mother if there is a family history of severe headaches d. Ask John's mother to bring him to the office today for evaluation - ANS-d. Ask John's mother to bring him to the office today for evaluation *Cerebellar complications or cerebral infectious may occur as a complication associated with chicken pox. These complications may occur 4 days preceding the rash until 3 weeks after the appearance of the rash. John's headache and irritability are signs that there may be an encephalopathy. John should be evaluated in the office to rule out this possibility. A 16-year-old boy has been diagnosed with measles (rubeola). He is also complaining of ear pain. His TMs are red and bulging. Appropriate management of the ear problem is to treat the ears with: a. Pain medication until the virus has run its course b. The same medication used to treat any case of otitis media c. Liquid topical antibiotics and topical steroids d. Acyclovir given by mouth - ANS-b. The same medication used to treat any case of otitis media *Otitis media is common with measles. It is treated as any acute otitis media. The mother of 7-year-old Bob has brought him to the clinic because he has a rash. Physical exam reveals vesicles on the hands, feet, and in the mouth. Hand, foot, and mouth disease is diagnosed. Treatment is based on: CONTINUES...