COMMUNICABLE DISEASE | NOTES 8. A child is seen in the health care clinic, and testing for human 16.

ild is seen in the health care clinic, and testing for human 16. The nurse is planning discharge teaching for a client diagnosed and treated for
immunodeficiency virus (HIV) is performed because of the child's exposure to tuberculosis (TB). Which instruction should be included in order to minimize
1. The pediatric nurse specialist provides an educational session to the nursing HIV infection. Which home care instruction should the nurse provide to the the spread of TB? Select all that apply.
students about childhood communicable diseases, mumps. The pediatric nurse parents of the child? ● The mouth should always be covered when coughing.
informs the students that which clinical manifestation is indicative of the most ● Avoid sharing toothbrushes. ● Close contacts should be tested for TB.
common complication of this communicable disease? ● Soiled tissues should be disposed of properly.
● Nuchal rigidity 9. A hospitalized client with active pulmonary tuberculosis has been receiving ● The mouth should always be covered when coughing.
multidrug therapy for the past month and is being prepared for discharge.
2. The nurse provides home care instructions to the mother of a child with Which indicates that respiratory isolation is no longer required and that 17. The nurse caring for a child diagnosed with rubeola (measles) notes that the
chickenpox about preventing the transmission of the virus. Which instruction medication therapy has been effective? health care provider has documented the presence of Koplik's spots. On the
should the nurse include? ● Sputum cultures are negative. basis of this documentation, which observation is expected?
● Isolate the child until the skin vesicles have dried and crusted. ● Small, blue-white spots with a red base found on the buccal mucosa
10. The home care nurse visits a child with scarlet fever who is being treated with
3. An emergency department nurse is a member of an All-Hazards Disaster penicillin G potassium (Pfizerpen). The mother tells the nurse that the child has 18. The nurse is performing an assessment of a child who is to receive a measles,
Preparedness planning group. The group is developing a specific emergency only voided a small amount of tea-colored urine since the previous day. The mumps, and rubella (MMR) vaccine. The nurse notes that the child is allergic
response plan in the event that a client with smallpox arrives in the emergency mother also reports that the child's appetite has decreased and that the child's to eggs. Which intervention has priority?
department. Which interventions should be included in the plan? Select all that face was swollen this morning. How should the nurse interpret these new ● Taking a careful history about the allergy and reporting this to the
apply. symptoms? health care provider before administering the MMR vaccine
● Isolate the client. ● Signs/symptoms of acute glomerulonephritis
● Don protective equipment immediately. 19. A mother of a child with mumps calls the health care clinic to tell the nurse
● Notify infectious disease specialists, public health officials, and the 11. A nursing instructor asks a nursing student to describe live or attenuated that the child has been lethargic and vomiting. What instruction should the
police. vaccines. What should the student tell the instructor about these types of nurse give to the mother?
● Identify all client contacts, including transport services to the vaccines? ● To bring the child to the clinic to be seen by the health care provider
emergency department and clients in the waiting room. ● Live or attenuated vaccines have their virulence (potency) diminished
so as to not produce a full-blown clinical illness. 20. A newborn infant receives the first dose of hepatitis B vaccine (Recombivax
4. The nurse places a hospitalized client with active tuberculosis in a private, HB, Engerix-B) within 12 hours of birth. The nurse instructs the mother
well-ventilated isolation room. In addition, which action should the nurse take 12. The nurse is performing an assessment on a 3-year-old child with chickenpox. regarding the immunization schedule for this vaccine and should tell the
before entering the client's room? The child's mother tells the nurse that the child keeps scratching at night, and mother that the second vaccine is administered at which time periods?
● Wash the hands and place a high-efficiency particulate the nurse teaches the mother about measures that will prevent an alteration in ● 1 to 2 months of age and then 6 months after the initial dose
air(HEPA)respirator over the nose and mouth. skin integrity. Which statement by the mother indicates that teaching was
effective? 21. A child is brought to the emergency department after being bitten in the arm by
5. Which clients require contact precautions? Select all that apply. ● "I need to place white gloves on my child's hands at night." a neighborhood dog. The nurse performs a focused assessment, cleanses the
● A client with scabies wound as prescribed, and continues to perform a thorough assessment on the
● A child with respiratory syncytial virus (RSV) 13. A preschooler has just been diagnosed with impetigo. The child's mother tells child. Which is the priority question for the nurse to ask the mother of the
● A client infected with a multidrug-resistant the nurse, "But my children take baths every day." Which therapeutic response child?
should the nurse make to the mother? ● "Are the child's immunizations up-to-date?"
6. A hospitalized child develops exanthema (rash) that covers the trunk and ● "You are concerned about how your child got impetigo?"
extremities. The nurse reviews the child's health history and notes that the child 22. The parents of a child with mumps express concern that their child will
was exposed to varicella 2 weeks ago. Which nursing intervention is most 14. The nurse is planning care for a child with an infectious and communicable develop orchitis as a result of having mumps and ask the nurse about the signs
appropriate to implement? disease. The nurse should identify which as the primary goal? of this complication. What should the nurse tell the parents is a sign of this
● Place the child in a private room on strict isolation. ● The child will not spread the infection to others. complication?
7. The nurse is caring for a client diagnosed with brain death who is a potential ● Fever
organ donor. Before approaching the family to discuss organ donation, the 15. The nurse in the postpartum unit checks the temperature of a client who
nurse reviews the client's medical record for potential contraindications to delivered a healthy newborn 4 hours ago. The mother's temperature is 100.8 °F. 23. The clinic nurse provides home care instructions to an adult client diagnosed
organ donation. Which finding is a contraindication to organ donation? The nurse provides oral hydration to the mother and encourages fluid intake. with influenza. Which instructions should the nurse provide to the client?
● Hepatitis B infection Four hours later, the nurse rechecks the temperature and notes that it is still Select all that apply.
100.8 ° F. Which appropriate nursing action should the nurse take at this time? ● Practice frequent hand washing.
● Notify the health care provider. ● Remain at home until feeling better.
● Sneeze or cough into the upper sleeve.
 ● Take acetaminophen (Tylenol) for myalgia. 35. Treatment regimen for Category I TB patient on the continuation phase 47. Based on the National Tuberculosis Control Program patients with TB are
includes which Anti-TB drugs? recommended to seek hospitalization if they have the following condition:
24. Malcolm is newly assigned as a triage nurse, on his first day of work, the ● Isoniazid and Rifampicin Massive hemoptysis
following clients arrive at the ED. Which among the clients require the most Pleural effusion
rapid action to protect other clients in the ED from infection? 36. Rumpel Leads Test for DHF is positive when: With complications
● A pregnant woman with a blister-like rash on the face and is possibly ● 20 or more petechiae per 2.5 cm square or 1 inch square are observed ● All of these
having varicella.
37. A client with TB has been treated before with Anti-TB drug, however the 48. During the fastidial stage of typhoid fever 3 cardinal symptoms are observed to
25. Nurse Kelly is teaching the parents of a young child how to handle poisoning. treatment failed. The client is under which category of TB patient? the client. These cardinal symptoms include the following except:
If the child ingests poison, what should the parents do first? ● Category II ● Hematochezia
● Call the poison control center
38. The child presents with high fever and less hemorrhage. The child's DHF is 49. Clinical manifestations of DHF are divided into 3 stages. Which of the
26. While working in a pediatric clinic, you receive a telephone call from the classified as: following is least likely observed during the toxic stage?
parent of a 10-year-old who is receiving chemotherapy for leukemia. The ● Moderate ● High fever
client's sibling has chickenpox. Which of these actions will you anticipate
taking next? 39. Prevention of TB includes the following measures: 50. A person who harbors the microorganism but does not manifest the signs and
● Administer varicella-zoster immune globulin to the client BCG vaccination newborns symptoms of the disease is called:
Public education about TB and its mode of transmission, methods of control and early ● Carrier
27. To prevent whooping cough, which of the following vaccines should be given diagnosis.
to infants? Availability and accessibility of medical, laboratory and x-ray facilities for 51. The mother of an infant with pertussis should be instructed of the following
● DPT examination. except:
● All of these ● Feed the child during an attack
28. Treatment for filariasis includes the administration of which drug?
● Diethylcarbamazine Citrate 40. Pertussis is becoming communicable during which stage of illness? 52. Infectivity of chicken pox lasts for?
● Catarrhal stage ● 6days after onset of rash
29. The most hazardous period for development of clinical disease is how many
months after infection with Mycobacterium Tuberculosis? 41. Nematode parasites Brugia Malayi and Wuchereria Bancrofti causes the 53. Secondary attack rate of chicken pox is?
● 6-12 months communicable disease called: ● 90
● Filariasis
30. Mang Jose is Category III TB patient. He asked the nurse about the duration of 54. Shingles is caused by?
his treatment regimen during the intensive phase. Intensive phase in Category 42. The drug of choice for Schistosomiasis that kills all types of microorganisms ● Varicella zoster virus
III patients lasts for: that can cause this communicable disease is:
● 2 months ● Praziquantel 55. Kolpiks spots are seen in?
● Prodromal period
31. Preventive measures for malaria least likely include: 43. Klebs-Loeffler Bacillus is the etiologic agent of which communicable disease?
● Wearing of clothing that covers the arms and legs at daytime. ● Diphtheria 56. Most common cause of death due to measles?
● Secondary bacterial infection
32. Prodromal period is best described as: 44. Direct sputum smear microscopy (DSSM) is the primary diagnostic tool in
● premonition of an impending attack of a disease tuberculosis case finding. Which of the following conditions does a DSSM is 57. Recommended vaccination strategy for rubella is to vaccinate first and
contraindicated? foremost?
33. A client with TB who is taking anti-TB drugs who calls the nurse because of ● Hemoptysis ● Women 15-49 yrs
urine discoloration. According to the client his urine turned reddish-orange.
The nurse told the client that the reddish-orange discoloration of urine is the 45. A child is diagnosed with dengue fever. The etiologic agent for Dengue 58. Treatment of choice for diphtheria is?
side effect of which anti-TB drug? Hemorrhagic Fever (DHF) is: ● Erythromycin
● Rifampicin ● Chikungunya virus
59. Most serious complication of measles?
34. Which of the following term refers to the degree of pathogenicity of a microbe, 46. The time interval between the first exposure to the appearance of the first signs ● Meningoencephalitis
or in other words the relative ability of a microbe to cause disease? and symptoms is called:
● Virulence ● Incubation period 60. Most common complication of mumps in children is?
 ● Aseptic meningitis 76. Among the possible inhalation exposures that must be considered in the
management of this patient, which of these is the most likely? 86. Which clinical manifestation would cause the nurse to suspect that the client is
61. Incubation period of mumps? ● Ticks or small rodents ground up by the lawn mower diagnosed with systemic lupus erythematosus?
● 18 days ● Joint edema and tenderness
77. Jessie, a young man with newly diagnosed acquired immune deficiency
62. Which type of sample can be used to isolate poliovirus earliest? syndrome (AIDS) is being discharged from the hospital. The nurse knows that 87. April is diagnosed with systemic lupus erythematosus. Which instruction
● Stool teaching regarding prevention of AIDS transmission has been effective when would be included in the teaching plan for the client?
the client: ● "Wear large-brimmed hats when exposed to the sun."
63. Incubation period of typhoid fever? ● verbalizes the role of sexual activity in spread of the disorder.
● 10-14 days 88. Which discharge instruction would be included in the care plan for a client
78. For Mikael who is diagnosed of having allergic rhinitis, which nursing diagnosed with atopic dermatitis?
64. Best disinfectant for cholera is? intervention is the most appropriate? ● "Add humidity to the dry air caused by dry heat during the winter."
● Cresol ● Encouraging the client to use nasal saline sprays
89. Theon was stung by a bee now exhibits redness and edema in the hand and
65. Urban malaria is due to? 79. Which intervention should Nurse John Joe discuss with Elena who has an forearm. The nurse's actions would be based on which scientific rationale?
● Anopheles stephensi allergic disorder and is requesting information for allergy symptom control? ● Hypersensitivity is possible; the client may need to buy an anti-sting
(Select all that apply.) kit.
66. Rabies free country? ● Instructing the client to cover the mattress with a hypoallergenic cover
● Australia ● Instructing the client to wear a mask when cleaning 90. Which condition would Nurse Jade suspect when a client complains of a runny
● Instructing the client to avoid using sprays, powders, and perfumes nose, itching and burning eyes, and sneezing since visiting a friend who had a
67. Bite of which of the following animals does not result in human rabies? cat in the home?
● Mouse 80. Which intervention should the nurse implement when caring for a client ● Allergic rhinitis
diagnosed with Pneumocystis carinii pneumonia related to acquired
68. Which vius is used to produce rabies vaccine? immunodeficiency syndrome who is crying over the loss of friends and family 91. During the past 6 months, a client diagnosed with acquired immunodeficiency
● Fixed members because they will not talk to him anymore? syndrome has had chronic diarrhea and has lost 18 pounds. Additional
● Sitting down and listening to the client's concerns and frustrations assessment findings include tented skin turgor, dry mucous membranes, and
69. HIV post prophylaxis should be started within? listleness. Which nursing diagnosis focuses attention on the client's most
● 72 hr 81. For Aubrey Anne who has allergies, which client statement indicates that the immediate problem?
nurse's teaching about her condition has be successful? ● Deficient fluid volume related to diarrhea and abnormal fluid loss
70. Most effective to prevent HIV vertical transmission? ● "I should avoid any types of spray, powders, and perfumes."
● HAART 92. For a male client who has acquired immunodeficiency syndrome with chronic
82. Mr. Mc Princeton who is diagnosed with rheumatoid arthritis (RA) complains diarrhea, anorexia, a history of oral candidiasis, and weight loss, which dietary
71. Which of the following is used to prevent transmission of HIV from infected about joints that always hurt, saying, "I just feel like staying in bed all day." instruction would be included in the teaching plan?
pregnant mother to new born child? Which discharge instruction would be aimed at maintaining as such function as ● "Follow a low-protein, high-carbohydrate diet."
● Nevirapine possible?
● “Promote aquatic (water) exercises to enhance joint mobility." 93. Nurse Mary Jean is assisting in administering immunizations at a health care
72. True about post exposure prophylaxis of HIV? clinic. The nurse understands that an immunization will provide:
● Single dose of nevirapine prevent mother to child transmission 83. Nurse Vince sustained a dirty needle stick injury. Which diagnostic test would ● Acquired immunity from disease
be ordered on a client?
73. Average incubation period of HIV to AIDS transformation is? ● SUDS screening test 94. Nurse Ruffa is providing dietary instructions to the client with systemic lupus
● 10 yrs erythematosus. Which of the following dietary items would the nurse instruct
84. After the first injection of an immunotherapy program, the nurse notices a the client to avoid?
74. In an HIV infected child which vaccine should not be given? large, red wheal on the client's arm, coughing, and expiratory wheezing. Which ● Steak
● OPV intervention should the nurse implement first?
● Administering I.M. epinephrine per protocol 95. A client with acquired immunodeficiency syndrome has a respiratory infection
75. Window period for HIV infection? from Pneumocystis jiroveci and a nursing diagnosis of Impaired Gas Exchange
● 3-12 weeks 85. Slater is using a steroidal cream for allergic dermatoses. Which intervention written in the plan of care. Which of the following indicates that the expected
should Nurse Rachel implement for the client? outcome of care has not yet been achieved?
● Washing hands before and after applying the cream ● Client now limits his fluid intake
 96. Human Papilloma Virus in AIDS patients is manifested as: 108. Situation: Charles, an 8 year old boy, one of several siblings, is kept home by 120. The primary human reservoir for Staphylococcus aureus is:
● Genital warts, flat warts, skin warts, neoplasm of cervix, vagina and his mother because he has a temp of 100.2 & a history of hacking cough for 2 ● skin
penis weeks. A definite whoop has been heard & doctor made diagnosis of whooping
cough. Nurse is to instruct the mother in proper care of this patient. This young 121. The best example of medical asepsis is:
97. A client is diagnosed with oral candidiasis. Nurse Tina knows that this boy should be: ● hand washing
condition in AIDS is treated with: ● kept in warm, dry room
● Fluconazole 122. Which of the following is not a symptom of localized infection?
109. Situation: Bobby, 3 years old, from a family of 4 older siblings, a mother & a ● lymph node enlargement
98. The decision to begin antiretroviral therapy is based on: father, was admitted to the hospital w/temperature of 101 F, a sore throat of 4
The CD4 cell count days duration, w/ difficulty swallowing, & a moderate cervical adenitis. A 123. All of the following are part of the nurse's role in infection control except:
The plasma viral load diagnosis of pharyngeal diphtheria was made. The best means for providing ● deciding upon the appropriate to be antibiotic to be administered to the
The intensity of the patient's clinical symptoms complete bed rest for the child include: client
● All of the above ● giving sedation
124. When insect serves as the host for transmission, this is called
99. Which client problem relating to altered nutrition is a consequence of AIDS? 110. A positive nose and throat culture in a member of the family in whom no signs ● vectorborne
● Decreased protein absorption of the diptheria are present would indicate:
● that he is a carrier 125. When a health care worker is washing her/his hands, which of the following
100. As a knowledgeable nurse, you know that the primary goals of antiretroviral observations made by the nursewould indicate that the worker understands the
therapy (ART) include all, EXCEPT: 111. The organism causing whooping cough is: principle of proper hand washing?
● Elimination of HIV entirely from the bod ● hemophilus pertussis ● removes rings before washing

101. Which is the most common HIV-related neurological complication? 112. Whooping cough is most contagious: 126. When an 8-year-old asks the nurse how she got the antibodies that kept her
● Toxoplasmosis ● in the catarrhal stage from getting whooping cough, the nurse explains that those shots:
● gave her a tiny case of whooping cough and then she made her own
102. A client with pemphigus is being seen in the clinic regularly. The nurse plans 113. During the second stage of pertussis, the characteristic paroxysm is frequently antibodies.
care based on which of the following descriptions of this condition? accompanied by:
● An autoimmune disease that causes blistering in the epidermis ● inspiratory whoop 127. The nurse would document a rash that has erythematous circular raised lesions
as:
103. An appropriate intervention to provide comfort for a child itching from 114. The diagnosis of pertussis is confirmed by which of the following tests? ● papular.
chickenpox is to: ● nose and throat culture A papule is a circular, reddened elevated area on the skin.
● give an antipruritic medication such as diphenhydramine (Benadryl)
115. Oxygen is used in whooping cough for which of the following reasons: 128. The nurse would delay the administration of DTaP when the mother says that
104. The causative agent for erythema infectiosum, fifth disease, is: ● seems to lessen the occurrence of paroxysms her infant:
● parvovirus B19 ● had a temperature of 40.5° C (105° F) from the previous inoculation.
116. One of the first signs of mumps is: A contraindication to giving the DTaP vaccine is a 40.5° C (105° F) temperature
105. The office nurse is taking a history on a child's illness from parents. The nurse ● pain in the region of the parotid gland following the previous vaccination.
notes that the parents treated their 7-year-old child appropriately for a fever
when they report that they:\ 117. A nurse should suspect meningitis if a patient exhibited characteristic position 129. The type of precautions necessary when caring for a toddler with varicella is:
● gave fluids at frequent intervals. which would be: ● airborne infection.
● head pulled forward onto the chest Airborne-infection precautions are used for patients with conditions such as
106. The time interval between early manifestations of disease and the overt clinical tuberculosis, varicella, and rubeola. Small airborne particles caught on floating dust in
syndrome is called the: 118. The nurse should be alert for complications of meningitis. Which of the the room can be inhaled from anywhere in the room.
● prodromal period. following are the most common?
● deafness 130. A parent is concerned because her son was exposed to varicella at preschool.
107. Standard Precautions for infection control include: The nurse would tell this parent that the incubation period for varicella is
● gloves are worn to change diapers when there are loose or explosive 119. Which of the following is not a part of the role of the infection control _____ days.
stools. department? ● 14 to 21
● providing input regarding the selection of patient care products The incubation period for varicella is 2 to 3 weeks, usually 13 to 17 days.
 131. The mother of a newborn asked the nurse, "When will my baby get the 138. A nurse is caring for an adolescent who has mono. The nurse assesses fever,
hepatitis B vaccine?" The nurse bases a response on the knowledge that the fatigue, swollen lymph nodes, sore throat, & sore upper abdomen. Which of
first dose of Comvax should be given to infants born to a hepatitis B-positive following instructions should nurse discuss w/adolescent & parents? Select all
mother within _____ after birth. that apply.
● 12 hours ● drink plenty of liquids
● avoid participating in strenuous activities
132. The American Academy of Pediatrics recommends that Comvax, the only ● allow for periods of rest
thimerosal-free hepatitis B vaccine, should be used for infants born to ● gargle w/ salt water every 2 to 3 hours
HBsAg-positive mothers within 12 hours of birth.
139. A nurse is assessing a pt who has pertussis. Which of following are clinical
133. A child was sent to the school nurse because of a rash. The nurse noted the manifestations of pertussis? Select all that apply.
rash was present on the trunk, extremities, and face. The child's cheeks were ● runny nose
bright red. The nurse is aware this type of rash is consistent with: ● mild fever
● fifth disease. ● whooping sound cough
In fifth disease, the child has a generalized rash and the cheeks have a slapped-cheek
appearance. 140. A nurse is planning care for a child who is admitting with mumps. Which of
following is appropriate action for nurse to take?
134. The nurse determined the parent understood the information related to tick ● initiate droplet precautions
bites when he stated:
● “We will wear long pants and long-sleeved shirts in the woods." 141. A nurse is preparing to administer the first MMR immunization to a 15 month
People should keep skin covered by wearing protective clothing in wooded areas to old. Which of the following findings is a contraindication to this
prevent tick bites. immunization?
● the child has a congenital immunodeficiency
135. The nurse explains to the parents that their child is in the prodromal stage of
varicella. This means that the child: 142. A nurse is caring for a child diagnosed w/pertussis. Nurse should respond w/
● has varicella but has not yet broken out. which of following when asked by pt what the common name for this disorder
The prodromal stage is the initial stage of the communicable disease in which the is?
child is infected and contagious but does not yet have outward signs of the disease. ● whooping cough

136. The well-child clinic nurse will prepare to give which inoculation(s) to a 143. A nurse is providing care to a group of children at a pediatric clinic. Which of
healthy 2-month-old? Select all that apply. following clients meets the criteria to receive a varicella vaccine?
● DTaP ● child who has a cold and runny nose
● .Hib
● IPV 144. A nurse is caring for a 6 month old child. The child's provider has ordered
● PCV DTaP vaccine to be administered. Which of following should cause nurse to
All the options are the expected inoculations of a healthy 2-month-old with the question the administration of this vaccine?
exception of MMR. Mumps, measles, rubella are not expected until the child is ● temperature of 104.9 after last DTaP
1-year-old.
145. A nurse is collecting data from a client who was bitten by a tick. The nurse
137. A nurse is teaching a group of parents about complications of communicable should check the client for the common early manifestations of Lyme disease,
diseases. Which of the following communicable diseases may lead to including flu-like symptoms, fever, and
pneumonia? Select all that apply. ● an expanding circular rash
● rubeola (measles)
● pertussis (whooping cough)
● varicella (chicken pox)