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A client has received a diagnosis of Lyme disease. What does the nurse understand about the transmission of infection resulting in this disease?
- A. The disease is spread by a prion.
- B. The disease is spread by single-celled fungi-like microorganisms
- C. The disease is spread by helminths
- D. The disease is spread by arthropods.
Correct Answer: D
Rationale: Example of arthropods includes fleas, ticks, lice, mosquitoes, and mites. Some rickettsial diseases that are spread by arthropods include Lyme disease. Prions may mutate and can be formed by genetic predisposition or acquired by transmission between the same or similar infected animal species and are not the same as arthropods. The disease is not spread by single-celled fungi-like microorganisms or helminths.
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A client informs the nurse of having been using a douche to cleanse the vagina on a daily basis and is now experiencing itching and burning in the vaginal area. What should the nurse explain to the client that occurs when the vaginal pH is changed?
- A. It causes destruction of the normal flora of the vagina and allows the development of vaginal infections.
- B. The bottle must be contaminated with bacteria, and when the pH is changed, it allows the bacteria to enter the vaginal area.
- C. It will cause an allergic reaction in the vaginal area.
- D. When the vaginal pH is changed, it allows cancer cells to spread from the vagina to the cervix.
Correct Answer: A
Rationale: The acid environment is unfavorable for the multiplication of pathogenic bacteria and fungi. A change in vaginal pH or destruction of the normal flora, however, can promote the development of a vaginal infection. Bacteria do not cause the vaginal pH to change; the pH change allows bacteria to grow. Change in vaginal pH does not cause an allergic reaction and does not allow the development of cancer cells.
A client informs the nurse, 'I think I am getting sick.' The chief symptoms of the client are low-grade fever, headache, and having no energy. What stage of the infection does the nurse recognize the client is experiencing?
- A. Incubation period
- B. Prodromal stage
- C. Acute stage
- D. Convalescent stage
Correct Answer: B
Rationale: In the prodromal stage, the initial symptoms appear; they may be vague and nonspecific. Possible symptoms include mild fever, headache, and loss of usual energy. The incubation period does not exhibit any recognizable symptoms. The acute stage is when the symptoms become severe and specific to the affect tissue or organ. The convalescent stage is when symptoms subside as the host overcomes the infectious agent.
The nurse has admitted a new client to the unit. This client has an open draining sore on the leg. What diagnostic test would the nurse anticipate being ordered?
- A. Platelet count
- B. Culture and sensitivity
- C. Sputum culture
- D. Urinalysis
Correct Answer: B
Rationale: A culture identifies bacteria in a specimen taken from a person with symptoms of an infection. The source of the specimen may be body fluids or wastes, such as blood, sputum, urine, or feces, or the purulent exudate, collection of pus, from an open wound. A platelet count would not tell the nurse about the infection. A sputum culture would not be indicated for a leg wound, nor would a urinalysis.
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 family member of a client in a long-term care facility asks why the nurse cannot insert a catheter so the client will not develop skin breakdown from being wet. What should the explanation include when the nurse responds to the family member?
- A. Catheters are no longer used for treatment of incontinence.
- B. Older adult residents are able to have catheters inserted if the family requests them.
- C. The invasive nature of the catheter provides a portal for infection.
- D. If a catheter is inserted, it must be flushed with normal saline daily.
Correct Answer: C
Rationale: Catheters provide a portal for infection because they are invasive. Although catheters are not used as frequently in older adults for the control of urinary incontinence, there are some bed-confined clients who use them. Family requests for catheters may be considered, but physicians make the decision if it will benefit the client. Catheters are not flushed daily with anything.