Communicable Disease Answers II

31. C.

A and B. There is no known vaccination and prophylactic antivirals for Dengue fever.

D. Eliminating the breeding sites of mosquitoes is better than killing the mosquitoes.

32. B

33. B. There is no known vaccination for Dengue fever.

34. A. Patient should be observed closely for signs of deterioration (shock) such as hypotension, tachycardia, tachypnea, cold clammy perspiration and prostration.

B. This is not necessary.

C. There is no known antivirals for Dengue fever.

D. Platelet administration is done to prevent bleeding, but this is a dependent function.

35. B. This promotes vasoconstriction.

A. Aspirin is contraindicated. It may worsen the bleeding.

C. Patient should be placed in dorsal recumbent to facilitate blood circulation.

D. Diet should be low fiber, low fat, non-irritating, and non-carbonated.

36. C. Tuberculin/Mantoux test only indicate exposure to the mycobacterium, not active infection.

A and D. After obtaining three sputum negative results, chest x-ray can be done to assess parenchymal involvement. Diagnosis of TB through x-ray can be made by the TB

Diagnostic Center (TBDC).

B. Direct Sputum Smear Microscopy (DSSM) is the primary diagnostic tool for TB.

37. C. Hemoptysis is the only contraindication for sputum collection.

A, B and D are indications for hospitalization of clients with TB.

38. B. The Isoniazid in the treatment regimen causes peripheral neuropathy. Client should be advised to increase intake of Vitamin B6, which is commonly found in green leafy vegetables, such as kangkong.

39. D. Yellowish palms may indicate liver problem. Anti-tuberculous drugs, particularly Pyrazinamide, are hepatotoxic drugs.

A. Hemoptysis is not a side effect, but must be reported immediately to the physician. Massive hemoptysis requires hospitalization.

B and C are side effects of Isoniazid. Clients should be advised to increase oral fluid intake. Paracetamol is given to manage the fever.

40. A. Strict compliance to the treatment regimen is a must while undergoing treatment for TB, to avoid relapses and prevent the development of multi-drug resistant strain of TB.

B, C and D are part of the health teaching to clients with tuberculosis, but strict compliance to treatment regimen should be given utmost emphasis.

41. A. The incubation period for SARS is 2-10 days but may be long as 13 days.

42. C.

A. Rhabdovirus causes rabies infection.

B. Togavirus causes German measles.

D. The family of paramyxovirus is responsible for measles and mumps.

43. B.

A. This pertain to isolation precaution.

C. This pertain to transmission-based precaution.

D. Handwashing is a universal precautionary measure.

44. A. During the prodromal phase, infectivity is none to low. Infectivity is highest during the respiratory phase (within 2-7 days).

B and D are seen during the respiratory stage.

C. Fever during the prodromal phase of SRAS is above 380C.

45. A. Handwashing is performed before and after client contact

B. Handwashing is performed before eating.

C. Handwashing is performed before food preparation.

D. Handwashing is performed after using the toilet.

46. B. There is no known vaccination for Filariasis. Diethycarbamezine Citrate (DEC) is given to patients with clinical manifestations and/or microfilariae.

47. B. A. This is the causative agent for filariasis. Other causative agents include Brugia malayi and Brugia timori.

C. This is the vector for Malaria.

D. This is the vector for Dengue.

48. D. Incubation period ranges from 8-16 months.

49. A. The clinic is only open from 8am to 5pm. The ICT is an antigen test that can be done in daytime. Nocturnal blood smear is also a diagnostic test for Filariasis, but the patient's blood is taken at the patient's residence or in the hospital after 8pm.

50. A. The clinic is only open from 8am to 5pm. The ICT is an antigen test that can be done in daytime. Nocturnal blood smear is also a diagnostic test for Filariasis, but the patient's blood is taken at the patient's residence or in the hospital after 8pm.

51. A. Lymphangitis, lymphadenitis, epidydimitis, funiculitis and orchotis are acute clinical manifestations of Filariasis. Hydrocele, lymphedema, and elephantiasis are clinical manifestations of Chronic Filariasis.

52. Answer: C Rationale: Passive immunity provides immediate protection, it is short-lived, is limited in effectiveness, and does not stimulate the body to produce antibodies. (NSNA NCLEX-RN Review, 4th Edition)

53. Answer: B

Rationale: Tetanus antitoxin provides antibodies, which confer immediate passive artificial immunity, the same with antiserums and immune globulins. Option A is incorrect because antitoxins doesn't stimulate production of antibodies. Option C is incorrect because it provides passive, not active, immunity. Option D is incorrect because passive immunity, by definition, is not long-lasting. (Mosby's, 18th Edition)

54. Answer: B

Rationale: Gamma globulin, an immune globulin, contains most of the antibodies circulating in the blood. When injected into an individual, it prevents a specific antigen from entering a host cell. Options A and D are incorrect because this does not stimulate antibody production. Option C is incorrect because this does not affect antigen-antibody function. (Mosby's, 18th Edition)

55. Answer: C

Rationale: The effectiveness of a natural passive immunity lasts for 6 months to 1 year. Option B is for natural active immunity. Option A is for artificial passive immunity. Option C is for artificial active immunity.

56. Answer: B

Rationale: Blocking the movement of the organism from the reservoir will succeed in preventing the infection of any other persons. In option A, since the carrier person is the reservoir and the condition is chronic, it is not possible to eliminate the reservoir. Option C and D are incorrect because blocking the entry into a host or decreasing the susceptibility of the host will be effective for only that one single individual and, thus, is not effective as blocking exit from the reservoir.

57. Answer: A Rationale: Since the hands are frequently in contact with clients and equipment, they are the most obvious source of transmission. Regular and routine hand cleansing is the most effective way to prevent movement of potentially infective materials. Option B is incorrect because personal protective equipment (PPE) such as gloves and masks is indicated for situations requiring Standard Precautions. Option C is incorrect because Isolation precautions are used for clients with known communicable diseases. Option D is incorrect because use of antibiotics is not effective and can be harmful due to the incidence of superinfection and development of resistant organisms.

58. Answer: C Rationale: Standard Precautions include all aspects of contact precautions with the exception of placing the client in a private room. In option A, a mask is indicated when working over a sterile wound rather than an infected one. Option B is incorrect because disposable food trays are not necessary for clients with infected wounds unlikely to contaminate the client's handstion D is incorrect because sterile technique (surgical asepsis) is not indicated for all contact with the client. The nurse would utilize clean technique when dressing the wound to prevent introduction of additional microbes.

59. Answer: A Rationale: Unless overly contaminated by material that has splashed in the nurse's face and cannot be effectively rinsed off, goggles may be worn repeatedly. In option B, since gowns are at high risk for contamination, they should be used only once and hen discarded or washed. Option C and D are incorrect because surgical mask and clean gloves are never washed or reused.

60.Answer: B Rationale: Raw foods touched by human hands can carry significant infectious organisms and must be washed or peeled. Option A is incorrect because antimicrobial soap is not indicated for regular use and may lead to resistant organisms. Hand cleansing should occur as needed. Hot water can dry and harm skin, increasing the risk of infection. In option C, clients should learn all the signs of inflammation and infection (e.g., redness, swelling, pain and heat) and not rely on the presence of pus to indicate this. Option D is incorrect because persons should not share washcloths or towels.