Group 3: HAND, FOOT, and MOUTH DISEASE

Question 1

What is the cause of hand, foot, and mouth disease?

Answer 1

coxsackievirus A type
16

Question 2

True or False

Hand, foot,
and mouth disease (HFMD) takes about two weeks to incubate before symptoms such as a sore
throat or mouth manifest.

Answer 2

False

It takes about a week

Question 3

_________________ is characterized by a high fever and sores that resemble blisters in
the mouth and throat. Children who are close to one another in daycare facilities and educational
settings are susceptible to the illness, which spreads quickly among them. This is similar to hand, foot,
and mouth disease.

Answer 3

Viral herpangina

Question 4

Medical professionals refer to a raised area of skin that is filled with fluid as a _______ or
vesicle. Vesicles are produced by this frequent cause of blistering when friction between your
skin’s layers causes the skin layers to separate and fill with fluid.

Answer 4

Blisters

Question 5

___________an inflammation (swelling) of the linings that surround the spinal cord and brain.
The swelling is typically brought on by a bacterial or viral infection of the fluid surrounding the
brain and spinal cord.

Answer 5

Meningitis

Question 6

Sources of spread of infection could be through the following

Answer 6

● Nose and throat secretions, such as saliva, drool, or nasal mucus
● Fluid from blisters or scabs
● Feces (poop)

Question 7

True or False

Viral infections are what cause hand, foot, and mouth disease. When a person has one of these
viruses, they are contagious, which means they can spread it to other people

Answer 7

True

Question 8

True or False

The first week of illness is typically the most contagious period for those with hand, foot,
and mouth disease. Sometimes, even after symptoms subside or even in the absence of any
symptoms, people can still transmit the virus to others for days or even weeks.

Answer 8

True

Question 9

True or False

Indirect transmission like touching surfaces and items that are infected with the virus, such as toys or doorknobs, and then
touching your eyes, nose, or mouth are not a cause how HFMD spreads.

Answer 9

False

Question 10

True or False

HFMD could spread through if a sick person coughs or sneezes, contact with respiratory droplets containing virus particles
occurs.

Answer 10

True

Question 11

True or False

HFMD could spread through changing diapers, for example, and then touching your eyes, nose, or mouth after touching
someone else’s infected feces.

Answer 11

True

Question 12

Give the three common viruses that causes HFMD

Answer 12

1.Coxsackievirus A16
2.Coxsackievirus A6
3. Enterovirus 71 (EV-A71)

Question 13

True or False

Coxsackievirus A6 is typically the most common cause of hand, foot, and mouth disease in the United States. Other coxsackieviruses can also cause the illness.

Answer 13

False

Coxsackievirus A16

Question 14

True or False

Coxsackievirus A16 can also cause HFMD and the symptoms may be more severe.

Answer 14

False

Coxsackievirus A6

Question 15

True or False

Enterovirus 71 (EV-A71) has been associated with cases and outbreaks in East and Southeast Asia. Although rare, EV-A71 has been associated with more severe diseases such as encephalitis (swelling of the brain).

Answer 15

True

Question 16

True or False

Most people with hand, foot, and mouth disease get better on their own in 10 to 14 days.

Answer 16

False

7 to 10 days

Question 17

True or False

There is no specific medical treatment for hand, foot, and mouth disease.

You can take steps to relieve symptoms and prevent dehydration while you or your child are sick.

Answer 17

True

Question 18

True or False

Hand, foot, and mouth disease is common in infants and children younger than 5 years old

Answer 18

True

Question 19

Signs and symptoms of HFMD (CDC)

Answer 19

1. Fever and flu-like symptoms (symptoms inclunding fever, eating or drinking less, sore throat, feeling unwell)
2. Mouth sores
3. Skin rash (The rash is commonly found on the hands and feet. It can also show up on the buttocks, legs, and arms)

Question 20

Signs that swallowing might be painful for a child:

Answer 20

-Not eating or drinking
-Drooling more than usual
-Only wanting to drink cold fluids

Question 21

True or False

Back of the mouth and throat sores could be signs of herpangina, a virus-related illness.
Herpangina also includes sudden, high fever and, in some cases, seizures. On the hands, feet, or other parts of the body, sores can occasionally appear.

Answer 21

True

Question 22

True or False

Typically, it takes 3 to 6 days from the time of initial infection until the onset of
symptoms (incubation period). It’s possible for kids to get a fever and a sore throat. They
occasionally feel unwell and lose their appetite.

Answer 22

True

Question 23

True or False

In diagnosing hand, foot, and mouth disease,
healthcare providers can usually tell if someone has hand, foot, and mouth disease by examining the patient and the rash appearance while considering the patient’s age and other symptoms.

Answer 23

True

Question 24

In diagnosing HFMD, healthcare providers might collect samples from the patient’s _________ or __________ and send them to a laboratory to test for the virus. However, these tests are rarely done.

Answer 24

throat or feces (poop)

Question 25

True or False

Take over-the-counter medications to relieve fever and pain caused by mouth sores. Give aspirin to children.

Answer 25

False

Never give aspirin to children.

Question 26

True or False

If symptoms do not improve after 10 days and child is very young, especially younger than 6 months, you must seek a healthcare provider.

Answer 26

True

Question 27

True or False

Avoid giving lemonade, cranberry juice, and other acidic fruit juices to the child with HFMD. They might aggravate the mouth sores.

Answer 27

True

Question 28

True or False

If your child is younger than one year
old, keep giving him or her formula, breastmilk, or both. The alternative is Pedialyte®. Offer
soft, simple-to-swallow foods like eggs, mashed potatoes, applesauce, or oatmeal. If swallowing
causes pain, your child might not want to eat much.

Answer 28

True

Question 29

The nurse is assigned to a client who has been diagnosed with hand, foot, and mouth disease. Which PPE will the nurse plan to use when preparing to assess the client? (Select all that apply.)

1. Gloves
2. Goggles
3. Gown
4. N95 respirator
5. Surgical face mask
6. Shoe covers

A. 1, 2, and 3
B. 1, 2, and 4
C. 1, 3, and 4
D. 1, 4, 5, and 6
E. 1, 2, 3, 4, 5, and 6

Answer 29

1. Answer: C. 1, 3, and 4.

Option C: Prioritization. The nurse should don an N95 respirator or high-efficiency particulate air filter respirator, a gown, and gloves because HFMD is spread through airborne means and by direct contact with lesions.
Options A, B, D, and E: Surgical face masks filter particularly large particles and will not render protection from HFMD. Goggles and shoe covers are not required for airborne or contact precautions.

Question 30

2. The school nurse is asked which action will take to have the most impact on the incidence of infectious diseases in school. The correct response is:

A. Grant written information about infection control to all parents
B. Ensure that students are immunized according to national guidelines
C. Make soap and water easily accessible in the classrooms
D. Educate students on how to cover their mouths when coughing

Answer 30

Answer: B. Ensure that students are immunized according to national guidelines.

Option B: Prioritization. The incidence of once-common infectious diseases like measles, chickenpox, and mumps has been most effectively reduced by immunization of all school-aged children.
Option A, C, and D: The other options are also important but will not have much impact as immunization.

Question 31

You are the charge nurse on the pediatric unit when a pediatrician calls wanting to admit a child with hand, foot, and mouth disease. Which of these factors is of most concern in determining whether to admit the child to your unit?

A. There are several children receiving chemotherapy on the unit.
B. The infection control nurse liaison is not on the unit today.
C. The unit is not staffed with the usual number of RNs.
D. No negative-airflow rooms are available on the unit.

Answer 31

Answer: D. No negative-airflow rooms are available on the unit.

Option D: Because clients with HFMD require implementation of airborne precautions, which include placement in a negative airflow room, this child cannot be admitted to the pediatric unit.
Option A, B, and C: The other circumstances may require actions such as staff reassignments but would not prevent the admission of a client with HFMD.

Question 32

A client has hand, foot, and mouth disease. Contact precautions are initiated. Which rule must be observed to follow contact precautions?

A. A clean gown and gloves must be worn when in contact with the client.
B. Everyone who enters the room must wear an N-95 respirator mask.
C. All linen and trash must be marked as contaminated and send to biohazard waste.
D. Place the client in a room with a client with an upper respiratory infection.

Answer 32

Answer: A. A clean gown and gloves must be worn when in contact with the client.

Option A: A clean gown and gloves must be worn when any contact is anticipated with the client or with contaminated items in the room.
Option B: A respirator mask is required only with airborne precautions, not contact precautions.
Option C: All linen must be double-bagged and clearly marked as contaminated.
Option D: The client should be placed in a private room or in a room with a client with an active infection caused by the same organism and no other infections.

Question 33

Which element in the circular chain of infection can be eliminated by preserving skin integrity?

A. Host
B. Reservoir
C. Mode of transmission
D. Portal of entry

Answer 33

Answer: D. Portal of entry

Option D: In the circular chain of infection, pathogens must be able to leave their reservoir and be transmitted to a susceptible host through a portal of entry, such as broken skin.

Question 34

Hand-foot-and-mouth disease is a febrile disorder usually caused by pathogens such as:

a.Coxsackievirus A16

b.Enterovirus 71

c.A or B

Answer 34

A or B

Question 35

All of the following statements regarding hand-foot-and-mouth (HFMD) disease are true EXCEPT:

a. The disease is more common among young children

b. Fever is an uncommon symptom

c. Infection causes a vesicular eruption on the hands, feet and oral mucosa

Answer 35

B

Question 36

True or False. Onychomadesis (painful nail shedding) is common during convalescence of HFMD.

Answer 36

True

According to a chapter about hand-foot-and-mouth disease published online in the Merck Manual Professional Version, “onychomadesis (painless nail shedding) is common during convalescence.”

Question 37

True or False. Morbidity and mortality are significantly higher with coxsackievirus A16 than with enterovirus 71 for HFMD.

Answer 37

False

According to a chapter about hand-foot-and-mouth disease published online in the Merck Manual Professional Version, “infection with EV-71 may be accompanied by severe neurologic manifestations (eg, meningitis, encephalitis, polio-like paralysis). Morbidity and mortality are significantly higher with EV-71 [enterovirus 71] than with coxsackievirus A16 [coxsackivirus 16] or other enteroviruses.”

Question 38

Which of the following is not recommended for children with HFMD?

a. Salt-water rinses

b. Salty foods

c. Acidic foods

d. A and B

e. B and C

Answer 38

“Treatment of HFMD is symptomatic. It includes meticulous oral hygiene (using a soft toothbrush and salt-water rinses), a soft diet that does not include acidic or salty foods, and topical measures,” according to a chapter about hand-foot-and-mouth disease published online in the Merck Manual Professional Version.