A client arrives at the clinic reporting vaginal discharge after having sexual intercourse 1 week ago. The client is diagnosed with gonorrhea and given a prescription for treatment. What type of infection transmission does the nurse understand occurred?
- A. Direct contact
- B. Droplet
- C. Airborne
- D. Vehicle
Correct Answer: A
Rationale: The route of transmission for a sexually transmitted disease is by direct contact. An infected person transmits the infection to a susceptible person. A droplet transmission is a spray of moist particles within a 3-foot radius of an infected person. An airborne transmission is suspension and transport on air currents beyond 3 feet. An infection transmitted by vehicle is on or in contaminated food, water, objects, or equipment.
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The nurse is caring for a client with breast cancer who has been receiving chemotherapy. The client was admitted with an infected lesion on their left leg. The health care provider has ordered filgrastim. What will filgrastim do for this client? Select all that apply.
- A. Increase platelet count
- B. Boost the immune system
- C. Increase white blood cell production
- D. Boost red blood cell production
- E. Increase hematocrit level
Correct Answer: B,C
Rationale: Bone marrow transplantation or administration of drugs that boost white blood cell production, such as filgrastim, may help immunosuppressed clients. Neupogen does not increase the platelet count, hematocrit level, or boost red blood cell production.
The nurse is teaching a health class in the local public health center. What instructions should the nurse provide as the single most important measure to prevent the spread of infection?
- A. Minimal social contact
- B. Regular immunizations
- C. Thorough handwashing
- D. Sufficient food intake
Correct Answer: C
Rationale: Hand hygiene remains the single most important measure to prevent the spread of infection. It reduces the number of transient and resident microorganisms. Sufficient food intake helps restore biologic defense mechanisms but does not prevent spread of infections. Although minimal social contact and regular immunizations may help prevent the spread of infection, especially community-acquired infections, these are not practical measures.
A client comes to the clinic reporting fever, chills, and coughing. The client is found to be positive for influenza. The nurse is aware that influenza is transmitted from one infected person to another. What type of infectious disorder is this considered?
- A. Localized
- B. Generalized
- C. Communicable disease
- D. Health-care-associated
Correct Answer: C
Rationale: Communicable diseases are infectious disorders that are transmitted from one infected species to another. Common signs and symptoms are the same as generalized plus organ-specific or disease-specific manifestations. Examples of the infections transmitted are influenza, chickenpox, and tuberculosis. Localized infection is confined to a small area such as a furuncle (boil). Generalized infection is a systemic or widespread infection in one or two organs such as urosepsis. A health-care-associated infection is acquired in a health care agency.
A nurse is having a yearly employee tuberculin skin test. Which skin test results would indicate a positive result?
- A. An induration of 12 mm
- B. An uneven erythemic area
- C. An induration of less than 1 mm
- D. An induration of 4 mm
Correct Answer: A
Rationale: The size of the induration, not including the surrounding area of erythema, is measured in millimeters. The measurement determines whether the reaction is significant. For example, a tuberculin skin test is considered positive if the induration is 10 mm or greater in persons with no known risk factors for TB; smaller measurements are significant in certain risk groups, such as immunocompromised clients. The other answers are not indicative of positive results.
The intensive care unit nurse is caring for a client with a transmissible spongiform encephalopathy. The nurse knows that this type of encephalopathy is caused by what type of infectious agent?
- A. Prion
- B. Protozoa
- C. Helminth
- D. Rickettsia
Correct Answer: A
Rationale: A prion is a protein that does not contain nucleic acid. Research suggests that normal prions present in brain cells protect against dementia. When a prion mutates, however, it is capable of becoming an infectious agent and altering other normal prion proteins into similar mutant copies. The mutant prions, which can be formed by genetic predisposition or acquired by transmission between the same or similar infected animal species, cause transmissible spongiform encephalopathies. Transmissible spongiform encephalopathies are not caused by protozoa, helminths, or rickettsias.
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