Chapter 15: Infection

Chapter 15: Infection

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. To educate patients on health promotion measures to minimize the effect of normal age-related changes in immunity, the geriatric nurse:

a.	describes the effects of low-dosage antibiotic therapy on opportunistic infections.
b.	reinforces the usefulness of lymphocyte counts to detect new infections.
c.	discusses the need for yearly flu immunization.
d.	stresses the importance of maintaining intact skin and mucous membranes.

 

 

ANS:  D

The skin is the largest immunologically active system of the body and the body’s first line of defense. With aging, the skin becomes more fragile and susceptible to breakdown or abrasion, thus negatively impacting the natural defenses. A yearly flu vaccination is important, but is too narrow in scope to be the best answer. Using antibiotics for current infections is not health promotion. Lab work is used after infection is present or suspected.

 

DIF:    Understanding (Comprehension)      REF:   Page 271        OBJ:   15-6

 

2. An older adult patient who is generally in good health starts experiencing numerous colds and now pneumonia. What factor from the nursing history most likely has placed the patient at increased risk for the development of these infections?

a.	A beloved pet died 6 months ago.
b.	The patient was diagnosed with osteoarthritis 5 years ago.
c.	The patient worked as an oncology nurse before retiring.
d.	The patient’s spouse is immunosuppressed.

 

 

ANS:  A

Psychosocial factors may impact the immune status. These factors include chronic and acute stress, depression, bereavement, and social relationships. The other factors would not increase the patient’s risk for infection.

 

DIF:    Remembering (Knowledge)             REF:   Page 272        OBJ:   15-3

TOP:   Nursing Process: Assessment           MSC:  Physiologic Integrity

 

3. An older patient smoked tobacco most of the adult life. When planning health promotion education for this patient, the nurse includes information that such smoking:

a.	may produce alterations in the immune response.
b.	is a risk factor for community-acquired pneumonia.
c.	decreases the production of an immunoglobulin called IgA.
d.	increases the risk of gastric cancer.

 

 

ANS:  B

Although the major host factor associated with community-acquired pneumonia is advanced age, smoking, alcohol abuse, chronic lung disease, recent history of viral upper respiratory tract infection, and neurologic disease are other contributing factors.

 

DIF:    Remembering (Knowledge)             REF:   Page 273        OBJ:   15-4

TOP:   Teaching-Learning                          MSC:  Physiologic Integrity

 

4. An older adult patient is experiencing problems with chewing while recovering from extensive oral surgery. The nurse best affects this patient’s risk for infection by:

a.	ordering a mechanical soft diet for the patient.
b.	monitoring the patient regularly for any low-grade fever.
c.	providing regular oral care with an antibiotic mouthwash.
d.	asking which flavors of protein supplement drink the patient would prefer.

 

 

ANS:  D

Nutritional supplements for a patient with an eating disorder or dysfunction can decrease the patient’s susceptibility to infection by providing protein. The patient still may not be able to chew a mechanically soft diet. Oral care will help but will not decrease the problem. The patient needs protein, and it is best made available as a drink because of the chewing problems.

 

DIF:    Applying (Application)                    REF:   N/A                OBJ:   15-6

TOP:   Nursing Process: Assessment           MSC:  Physiologic Integrity

 

5. The nurse caring for a cognitively impaired older adult admitted to an acute care facility best minimizes this particular patient’s risk for developing a nosocomial infection by:

a.	proper hand washing after each patient contact.
b.	admitting the patient to a private room.
c.	assigning staff to assist the patient with eating meals.
d.	screening visitors to minimize contract with pathogens.

 

 

ANS:  C

Poor nutrition can contribute to a patient’s risks for developing a nosocomial infection, particularly among the older immunocompromised population. Many of the cognitively impaired older adults are already malnourished, so improving nutrition is a priority. Hand washing should occur before and after patient contact. A private room is not necessary. Screening visitors is not the best option; good nutrition will improve the patient’s immune status, although obviously ill visitors should not visit.

 

DIF:    Applying (Application)                    REF:   N/A                OBJ:   15-2

TOP:    Nursing Process: Implementation          MSC:   Physiologic Integrity