Chapter 26: Communicable Disease Nies: Community/Public Health Nursing, 7th Edition

Communicable Disease Nies: Community/Public Health Nursing, 7th Edition: Chapter 26.. Chapter 26: Communicable Disease Nies: Community/Public Health Nursing, 7th Edition MULTIPLE CHOICE 1. Which infection continues to increase in the United States? a. Measles b. Pertussis c. Hepatitis A, B, and C d. Sexually transmitted diseases (STDs) ANS: D Treatable STDs, such as gonorrhea, chlamydia, and syphilis, are still occurring at significant rates. Gonorrhea had plateaued or declined until 2009 but increased steadily since that time. Chlamydia, the most commonly reported bacterial disease in the United States, reached 1,441,789 cases in 2014, although some of this increase is thought to be the result of improved screening for the infection, DIF: Cognitive Level: Remember (Knowledge) 2. Which best describes what is happening with infectious diseases in the United States? a. There is a continuing decrease in vector-borne infections. b. There is a continuing increase in food-borne and waterborne infections. c. Many airborne diseases are being spread by bioterrorists. d. The rate of infection varies extensively by income and ethnic groups. ANS: D NURSINGTB.COM Probably one of the most profound failures in infectious disease control in the United States and elsewhere is that the successes are not equally distributed in the general population. Infectious diseases continue to be differentially distributed by income and ethnic groups, and the poor and minorities continue to experience the greater burden. There continues to be an increase in vector-borne infections, but there has been a decrease in food-borne and waterborne infections. There is concern that deadly pathogens will be weaponized by terrorists. DIF: Cognitive Level: Understand (Comprehension) 3. Which is a fairly recent surprise regarding infectious diseases in the United States? a. Cervical cancer and coronary artery disease may be caused by infectious agents. b. Epidemics such as the H1N1 flu continue to occur. c. Mortality caused by infectious diseases continues to rise. d. Some infectious diseases remain endemic in our society. ANS: A Recent scientific discoveries on the infectious etiology of stomach ulcers, coronary artery disease, and cervical cancer, for example, suggest that infectious agents may be responsible for more morbidity and mortality than previously recognized. Mortality caused by infectious diseases has decreased. Endemic refers to a disease that is regularly found among people in a certain area. In our society today, there are no endemic infectious diseases. Advances in public health and health care have made it easier to control infectious diseases such as H1N1 flu. DIF: Cognitive Level: Understand (Comprehension) 4. A female client develops a fungal vaginal infection after being treated with antibiotics for strep throat. Which component of the epidemiological triangle is primarily responsible? a. Agent b. Environment c. Host d. Interaction of agent and environment ANS: C Infectious diseases are the result of interaction among the human host, an infectious agent, and the environment, which surrounds the human host and where transmission is occurring. This interaction is pictured in the epidemiological triad of agent, host, and environment also discussed in Chapter 5. The antibiotic therapy eliminated a specific pathological agent, but it also may alter the balance of normally occurring organisms in the woman’s body, which caused a change in the vaginal environment, allowing normally present fungi to proliferate, resulting in a yeast infection. DIF: Cognitive Level: AnalyzN e (AR nalyI sis)G B.C M U S N T O 5. Which statement is true concerning tuberculosis (TB) infections in the United States? a. Subclinical cases of TB can occur in patients who fight off the infection and thus are not a danger to themselves or others. b. TB can be cured by a 6-month period of treatment with INH. c. TB can only be caused by the Mycobacterium bovis bacillus. d. Under certain conditions, susceptible hosts may be infected by the TB bacillus. ANS: D The principle of multicausation emphasizes that an infectious agent alone is not sufficient to cause disease; the agent must be transmitted within a conducive environment to a susceptible host. Mycobacterium tuberculosis kills cells. M. tuberculosis has low infectivity, low pathogenicity, but high virulence if untreated. DIF: Cognitive Level: Understand (Comprehension) 6. One child in a kindergarten room had a slight fever and did not eat lunch. Otherwise, the child seemed OK. Three days later, several children were absent from kindergarten. Which best describes what happened? a. Another nursery school was offering the same child care at a much lower price. b. Infectious diseases can be contagious before any diagnostic symptoms occur. c. No way to tell; there are many reasons why parents keep children home. d. Parents chose to protect their children from the child with a fever, so they kept their children home for a few days. ANS: B Frequently, the communicable period begins before symptoms are present. The communicable period, or communicability, follows latency and begins with shedding of the agent. The incubation period is the time from invasion to the time when disease symptoms first appear. Thus, even if parents kept their children away from the child with the fever, this could possibly be ineffective because their children may have already been exposed before the child exhibited symptoms. It is unlikely that the children suddenly changed schools. Although, there may be many reasons why parents keep their children home from school, in this situation there is a specific reason that can be identified. DIF: Cognitive Level: Apply (Application) 7. A daycare center asked the nurse to come because they had several children out as a result of chickenpox. Which statement should the nurse make to the staff? a. “Chickenpox has low infectivity, so few children will get sick.” b. “Chickenpox has low pathogenicity, so the children won’t be sick enough to stay home if the parents really need to go to work.” c. “Chickenpox has low virulence, so the children will be back at the daycare center in a week or so.” d. “Adults never catch chickenpox, so the staff are safe and may continue working.” ANS: C Other considerations for understanding the action of agents include their power to invade and infect large numbers of people (infectivity), their ability to produce disease in those infected with the agent (pathogenicity), and their ability to produce serious disease in their hosts (virulence). When the above concepts are applied, the chickenpox virus has high infectivity, high pathogenicity, and veryNloUwRvSirIulNenGcTe.B.COM DIF: Cognitive Level: Apply (Application) 8. A city that depended on tourist dollars had feedback that tourists were saying they were never returning because of the constant mosquito bites. Which action should be taken by the city? a. Do not have any tourist events at dawn or dusk. b. Have everyone in town search for and remove any standing stagnant water. c. Give free bug repellent to each tourist. d. Tell tourists to avoid wearing bright colors. ANS: B Knowing the reservoirs for infectious agents is important, because, in some cases, transmission can be controlled by eliminating the reservoir, such as eliminating the standing water where mosquitoes breed. The other interventions, not having events at dusk or dawn, providing bug repellent, and wearing bright colors are ways the tourists can cope with the mosquitos that are present, but they do not eliminate the breeding and presence of the mosquitos. DIF: Cognitive Level: Apply (Application) 9. The daily patrons of a local town restaurant became ill with nausea, vomiting, and diarrhea. Without knowing the cause, which action should be taken immediately to help avoid future problems? a. Establish a series of cooking classes for all citizens b. Have a citywide campaign to cover your mouth when sneezing c. Use bleach to clean the entire restaurant d. Strongly emphasize the importance of proper hand washing to staff ANS: D Agents leave the human host through a portal of exit and invade through a portal of entry. Portals of exit include respiratory secretions, vaginal secretions, semen, saliva, lesion exudates, blood, and feces. Portals of entry are associated with the portal of exit and include the respiratory passages, mucous membranes, skin and blood vessels, oral cavity, and the placenta. Because it was food poisoning of some sort, until the cause is known, it can be assumed to probably be a fecal-oral transmission. Thus, the interventions of cooking classes, covering your mouth when sneezing, and using bleach to clean the entire restaurant would be ineffective. Therefore, staff need to again be reminded of the importance of careful hand washing after using the facilities. DIF: Cognitive Level: Apply (Application) 10. Which best describes why clinical areas are so careful t