13 - Infectious Disease Prevention and Control

Question 1

A nurse is discussing the role of a vector in the spread of disease. Which of the following is the nurse most likely referring to?

a. ) Contaminated water
b. ) A tick
c. ) A dirty needle
d. ) An infected person

Answer 1

b.) A tick

Vectors are arthropods such as ticks and mosquitoes that transmit the infectious agent by biting or depositing the infective material near the host. Contaminated water, a dirty needle, and an infected person would be common vehicles.

Question 2

A community health nurse is caring for a client with methicillin-resistant Staphylococcus aureus (MRSA). Which of the following should the nurse be aware of?

a. ) Persons with MRSA usually have a chronic illness.
b. ) MRSA is a hospital-acquired infection and not often seen in the community.
c. ) Vancomycin-resistant Staphylococcus aureus (VRE) follows MRSA.
d. ) MRSA is becoming more common in the community.

Answer 2

d.) MRSA is becoming more common in the community.

MRSA is being seen more and more in the community with outbreaks frequently associated with school athletic programs and prison populations. MRSA is still largely a health care- associated infection, but it is becoming more common. VRE was found before MRSA. MRSA is not associated with chronic illness.

Question 3

One case of smallpox occurs in a population in which it was considered to be previously eliminated. Which of the following best describes what has occurred?

a. ) Endemic
b. ) Epidemic
c. ) Pandemic
d. ) Infectivity

Answer 3

b.) Epidemic

The occurrence of one case of smallpox in a population in which it was considered to be previously eliminated is an epidemic.

Endemic refers to the constant presence of a disease within a geographic area or population.

Pandemic refers to an epidemic occurring worldwide and affecting large populations.

Infectivity is the ability to enter and multiply in the host.

Question 4

A nurse administers a rabies immunization post-exposure to an animal bite. Considering the interventions used with infectious disease, which of the following levels of prevention is being used?

a. ) Primary prevention
b. ) Secondary prevention
c. ) Tertiary prevention
d. ) Assessment

Answer 4

b.) Secondary prevention

Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Primary prevention seeks to reduce the incidence of disease by preventing occurrence. Tertiary prevention reduces complications through treatment and rehabilitation. Assessment refers to the systematic collection of data.

Question 5

A public health nurse (PHN) understands that the emergence of new infectious diseases is influenced by the:

a. ) increased availability of immunizations.
b. ) globalization of food supplies.
c. ) decreased use of child care facilities.
d. ) creation of sanitation systems in third world countries.

Answer 5

b.) globalization of food supplies.

Globalization of food supplies is one of the many factors that can influence the emergence of infectious diseases. The increased use of childcare facilities could contribute to the emergence of new infectious diseases. The lack of sanitation systems in third world countries could contribute to the emergence of new infectious diseases. The increased availability of immunizations should decrease the emergence of diseases.

Question 6

Requirements for disease reporting in the United States are mandated by:

a. ) the Centers for Disease Control and Prevention (CDC).
b. ) federal laws.
c. ) state laws and regulations.
d. ) the World Health Organization (WHO).

Answer 6

c.) state laws and regulations.

Requirements for disease reporting in the United States are mandated by state laws and regulations. These diseases are then reported to the CDC. State public health officials collaborate with the CDC to determine which diseases should be nationally notifiable. The federal government and WHO are not involved in disease reporting.

Question 7

Which elements of surveillance does a nurse use? (Select all that apply.)

a. ) Mortality registration
b. ) Epidemic field investigation
c. ) Laboratory reporting
d. ) Individual case investigation
e. ) Application of research

Answer 7

a.) Mortality registration

b.) Epidemic field investigation

c.) Laboratory reporting

d.) Individual case investigation

There are 10 basic elements of surveillance. Mortality registration, epidemic field investigation, laboratory reporting, and individual case investigation are among them. Application of research is not part of the 10 basic elements of surveillance.

Question 8

The nurse teaches food handlers to wash utensils after contact with raw meat. Which of the following best describes the focus of this education?

a. ) Agent
b. ) Host
c. ) Environment
d. ) Food handler

Answer 8

c.) Environment

Environmental factors facilitate the transmission of an infectious agent from an infected host to other susceptible hosts. Teaching food handlers to wash utensils after contact with raw meat is a prevention that focuses on the environment. An agent is described by its ability to cause disease and the nature and the severity of the disease. The four major categories of agents are: (1) bacteria, (2) parasites, (3) fungi, and (4) viruses. A food handler is an example of a host, which is a human or animal that can harbor an infectious agent.

Question 9

The ability of an agent to produce a severe pathologic reaction is known as:

a. ) antigenicity.
b. ) invasiveness.
c. ) toxicity.
d. ) virulence.

Answer 9

d.) virulence.

The ability of an agent to produce a severe pathologic reaction is known as virulence. Antigenicity is the ability to stimulate an immunological response. Invasiveness is the ability to penetrate and spread throughout a tissue. Toxicity is the ability to produce a poisonous reaction.

Question 10

A nurse is caring for a client who has been diagnosed with West Nile Virus. Which of the following types of illness does the client have?

a. ) Food-borne
b. ) Vector-borne
c. ) Water-borne
d. ) Zoonoses

Answer 10

b.) Vector-borne

West Nile virus is carried by a mosquito, which is a vector. Food-borne illnesses are carried by food. Water-borne illnesses are transmitted through water. Zoonoses are infections that are transmitted from vertebrate animal to a human under natural conditions.

Question 11

A nurse is providing information to a local newspaper about the presence of infectious diseases in the United States. Which of the following statements by the nurse is accurate?

a. ) “It is the goal of the WHO to prevent the transmission of the plague by avoiding direct contact with inflicted individuals.”
b. ) “Rabies is easily spread by contact with animals.”
c. ) “The United States is a certified polio free country.”
d. ) “The onset of tularemia is characterized by a distinct skin lesion often called a bull’s-eye lesion.”

Answer 11

c.) “The United States is a certified polio free country.”

The Americas are certified polio free. The plague is a vector-borne disease and cannot be spread by direct contact with inflicted individuals. Rabies is a rare event because of the widespread vaccination of dogs in the 1950s. The Americas were certified as polio free in 1994. The onset of Lyme’s disease is characterized by a bull’s-eye lesion.

Question 12

Food intoxication is caused by:

a. ) toxins produced by bacterial growth and chemical contaminants.
b. ) bacterial, viral, or parasitic invasion of food.
c. ) overcooking of meat and produce.
d. ) adding too many spices or ingredients to food.

Answer 12

a.) toxins produced by bacterial growth and chemical contaminants.

Food intoxication is caused by toxins produced by bacterial growth, chemical containments, and a variety of disease-producing substances found naturally in certain foods such as mushrooms and some seafood. Bacterial, viral, or parasitic invasion of food is not a cause of food intoxication. Food intoxication is not caused by overcooking meat or adding too many ingredients to food.

Question 13

A community health nurse has recently become involved in surveillance. Which of the following describes the situation that the nurse is in?

a. ) Educating clients about influenza immunizations
b. ) Collecting information about occurrence of measles
c. ) Evaluating the effectiveness of an HIV/AIDS prevention program
d. ) Advocating for changes in the national disease reporting requirements

Answer 13

b.) Collecting information about occurrence of measles

Surveillance gathers the “who, when, where, and what”; these elements are then used to answer “why.” Nurses are frequently involved in surveillance by collecting data, making diagnoses, investigating and reporting cases, and providing information to the general public. Client education, program evaluation, and advocating for changes are not part of the surveillance process.

Question 14

A nurse promotes the use of universal precautions by all health care workers. Which of the following best describes the action that was taken by the nurse?

a. ) Primary prevention
b. ) Secondary prevention
c. ) Tertiary prevention
d. ) Health care-associated infection

Answer 14

a.) Primary prevention

Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Secondary prevention seeks to prevent the spread of infection and/or disease once it occurs. Tertiary prevention reduces complications through treatment and rehabilitation. Health care-associated infections are prevented through the use of good hand washing.

Question 15

A nurse is presenting information to the county health department about potential bioterrorism threats. Which of the following agents would the nurse discuss in this presentation?

a. ) Smallpox
b. ) West Nile Virus
c. ) Severe acute respiratory syndrome (SARS)
d. ) Novel influenza A (H1N1)

Answer 15

a.) Smallpox

Susceptibility to smallpox is 100% in the unvaccinated and fatality rate is estimated at 20- 40% or higher. The agents of highest concern are anthrax, plague, smallpox, botulism, tularemia, and selected hemorrhagic viruses. West Nile Virus, SARS, and H1N1 are not viruses that would be used for bioterrorism.

Question 16

A PHN would like to increase the immunization coverage of infants and toddlers. Which of the following strategies would be appropriate for the nurse to use?

a. ) Read the Mortality and Morbidity Weekly Report to learn about vaccinations
b. ) Require that children have all their immunizations before going to public school
c. ) Track children known to be at risk for underimmunization
d. ) Lead teams of health care workers to enforce laws related to immunizations

Answer 16

c.) Track children known to be at risk for underimmunization

Tracking children known to be at risk for underimmunization is a function of PHNs who work in health departments where immunizations are given and tracked. Reading the Mortality and Morbidity Weekly Report, requiring that children have all of their immunizations before attending school, and leading teams of health care workers would not be as effective in increasing immunization coverage for this population.

Question 17

The time interval between invasion by an infectious agent and the first appearance of signs and symptoms of the disease is called:

a. ) communicable period.
b. ) incubation period.
c. ) infectiousness.
d. ) endemic.

Answer 17

b.) incubation period.

The incubation period is the time interval between invasion by an infectious agent and the first appearance of signs and symptoms. The communicable period is the interval during which an infectious agent may be transferred directly or indirectly from an infected person to another person. Infectiousness is the measure of the potential ability of an infected host to transmit the infection to other hosts. Endemic refers to the constant presence of a disease within a geographic area or a population.

Question 18

A nurse is caring for a client who has been diagnosed with a parasitic infection. Which of the following information should the nurse know when caring for this client?

a. ) The medication to prescribe to treat these infections
b. ) The nature and symptoms of all parasitic illnesses
c. ) What specimens to collect and how and when to collect them
d. ) Public policy about parasitic infections

Answer 18

c.) What specimens to collect and how and when to collect them

Nurses need to be cognizant about what specimens to collect, how and when to collect, and what laboratory techniques to use. Proper specimen collection is necessary so that the clinical diagnosis can be confirmed. It is not necessary for the nurse to know the signs and symptoms for all parasitic infections in order to provide care for the client. Public policy about parasitic infections is not important to know when providing care for the client.

Question 19

The nurse provides footwear and gloves to leprosy clients to prevent trauma to their insensitive and deformed hands and feet. Which of the following best describes the intervention used by the nurse?

a. ) Primary level of prevention
b. ) Secondary level of prevention
c. ) Tertiary level of prevention
d. ) Primary health care

Answer 19

c.) Tertiary level of prevention

Tertiary prevention reduces complications through treatment and rehabilitation. Primary prevention seeks to reduce the incidence of disease by preventing occurrence. Secondary prevention seeks to prevent the spread of infection and/or disease once it occurs. Primary health care is considered to be the essential health care services provided by physicians and other health care providers.

Question 20

A nurse is working in a health department when a patient arrives who has been traveling to South America and has been diagnosed with malaria. Which of the following considerations should be made by the nurse?

a. ) The Morbidity and Mortality Weekly Report should be consulted to investigate the rate of malaria in the United States.
b. ) This is a disease that must be reported to the state health department.
c. ) The nurse should take precautions to wear a mask and gown to avoid exposure.
d. ) The patient is very ill and should be sent to the hospital immediately.

Answer 20

b.) This is a disease that must be reported to the state health department.

Malaria is on the list of infectious diseases notifiable at the national level. The Morbidity and Mortality Weekly Report is published weekly with the rates of disease; however, this would not be the first consideration by the nurse. Malaria is not spread by direct contact, rather from a bite from an infected mosquito. Malaria begins with flu-like symptoms, or the client may have very few symptoms.

Question 21

A community health nurse investigates an outbreak of pinworm at a local day care center. In order to minimize the spread of infection, which of the following suggestions would the nurse provide to the day care workers?

a. ) Close the day care until all surfaces are cleaned.
b. ) No action is necessary because it is easily treated with oral vermicides.
c. ) Using good hand washing is important to prevent the transmission.
d. ) Every child in the day care should be treated because they all are probably infected.

Answer 21

c.) Using good hand washing is important to prevent the transmission.

Transmission of pinworm occurs through the fecal-oral route, so good hand washing after toileting is essential. It is not necessary to treat all children or close the day care. It is necessary that action be taken, as without any action being taken, the pinworm outbreak will continue.

Question 22

A nurse is investigating the role of the agent in the cause of an illness. Which of the following best describes what the nurse is examining?

a. ) Host resilience
b. ) Virus
c. ) Infectiousness
d. ) Bug bite

Answer 22

b.) Virus

An agent is described by its ability to cause disease and the nature and the severity of the disease. The four major categories of agents are: (1) bacteria, (2) parasites, (3) fungi, and (4) viruses. Host resilience is a host factor. Infectiousness is the measure of the potential ability of an infected host to transmit the infection to other hosts. Environmental factors facilitate the transmission of an infectious agent from an infected host to other susceptible hosts, such as a bug bite.

Question 23

A nurse is providing education to a mother about the importance of having her infant immunized for measles, mumps, and rubella. Which of the following best describes the type of immunity that will be provided?

a. ) Active
b. ) Passive
c. ) Natural
d. ) Acquired

Answer 23

a.) Active

Active immunity refers to the immunization of an individual by administration of an antigen (infectious agent or vaccine) and is usually characterized by the presence of an antibody produced by the individual host. Passive immunity refers to immunization through the transfer of a specific antibody from an immunized individual to a non-immunized individual. Natural immunity refers to species-determined, innate resistance to an infectious agent. Acquired immunity is the resistance acquired by a host as a result of previous natural exposure to an infectious agent.

Question 24

The most common vector-borne disease in the United States is:

a. ) malaria.
b. ) yellow fever.
c. ) Lyme disease.
d. ) Rocky Mountain spotted fever.

Answer 24

c.) Lyme disease.

Lyme disease is the most common vector-borne disease in the United States, with over 30,000 confirmed cases and probable cases reported to CDC in 2012. Yellow fever and Rocky Mountain spotted fever are both vector-borne diseases, but are not the most common. Malaria is most prevalent vector-borne disease worldwide.

Question 25

Immunity is a characteristic of the:

a. ) agent factor.
b. ) host factor.
c. ) environmental factor.
d. ) epidemiologic triad.

Answer 25

b.) host factor.

Immunity refers to species-determined resistance to an infectious agent and is determined by the characteristics of the host. The agent is the infection that is causing the infection/disease. Environmental factors may influence the susceptibility of the host. The epidemiologic triad involves the interaction of the host, agent, and environment.

Question 26

A nurse is teaching members of the community about vertical transmission of a disease. Which of the following would the nurse most likely discuss?

a. ) Transmission through breast milk
b. ) Transmission through sexual contact
c. ) Transmission from mosquito bites
d. ) Transmission through contaminated food

Answer 26

a.) Transmission through breast milk

Vertical transmission is the passing of infection from parent to offspring via sperm, placenta, milk, or contact in the vaginal canal at birth. Transmission through sexual contact is horizontal transmission. Transmission from mosquito bites is vector transmission. Transmission from contaminated food is common vehicle transmission.

Question 27

What is the best method for preventing health care-associated infections?

a. ) Perform good hand washing before and after approaching every patient.
b. ) Prevention is almost impossible due to the high infection rates in hospitals.
c. ) Isolate every patient having surgery.
d. ) Use contact isolation for every patient at risk.

Answer 27

a.) Perform good hand washing before and after approaching every patient.

Hand washing is the best way to prevent infection. If good hand washing is in place, it is not necessary to isolate patients or implement contact isolation. Prevention is possible with the use of good hand washing.