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A client with a Staphylococcus aureus infection present in a sacral pressure ulcer has received treatment with three courses of antibiotics without eliminating the infection. What does the nurse understand has occurred with the client?
- A. The client has a multidrug-resistant strain of bacteria.
- B. The client has been misdiagnosed and has another type of microorganism present.
- C. Staphylococcus aureus cannot be treated by antibiotics.
- D. Staphylococcus aureus is a fungus and must be treated with an antifungal agent, not an antibiotic.
Correct Answer: A
Rationale: Some bacteria, such as Staphylococcus aureus, Streptococcus pneumoniae, and Escherichia coli, are developing multidrug resistance, the ability to remain unaffected by antimicrobial drugs such as antibiotics. There are no facts to indicate the client has been misdiagnosed. Staphylococcus aureus is treated with antibiotics and is a bacterium, not a fungus.
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The nurse is caring for a client with an abscess on the back. The nurse observes purulent drainage coming from the abscess. What type of specimen does the nurse anticipate the physician will order to determine the type of bacteria present in the exudate?
- A. A sensitivity test
- B. Test for ova and parasites
- C. White blood cell (WBC) count
- D. A culture
Correct Answer: D
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 test for ova and parasites is a stool specimen that is examined for evidence of any forms in the infecting microorganism's life cycle. A WBC count may determine that infection is present in the body but does not isolate the bacteria. A sensitivity test is done to determine which antibiotic inhibits the growth of a nonviral microorganism and will be most effective in treating the infection.
A client is admitted to an acute care facility with a diagnosis of appendicitis. Which laboratory results demonstrate the client's leukocytosis?
- A. Hemoglobin of 12 mg/dL
- B. Lymphocytes 1,500
- C. Neutrophils of 3,150/mms
- D. White blood cell (WBC) count of 22,000 cells/mm
Correct Answer: D
Rationale: The body manufactures more WBCs as needed, a process referred to as leukocytosis. The WBC of 22,000 cells/mms indicates an abundance of white blood cells. Hemoglobin does not represent the presence of infection. The lymphocytes and neutrophils are within normal range and do not demonstrate leukocytosis.
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.
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.
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.