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

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.”