Medical Surgical Nursing An Integrated Approach 3rd Edition by Lois White -Test Bank

Medical Surgical Nursing An Integrated Approach 3rd Edition by Lois White -Test Bank

 

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Sample Questions Are Posted Below

 

Chapter 5—Inflammation and Infection

 

MULTIPLE CHOICE

 

1. The definition of inflammation is the:

a.	specific response to cellular injury
b.	nonspecific cellular response to tissue injury
c.	complex progression of tissue changes in response to injury
d.	invasion and multiplication of pathogenic microorganisms in body tissue

 

 

ANS:  B

Inflammation is a nonspecific cellular response to tissue injury. Tissue injury caused by bacteria, trauma, chemicals, heat, or any other occurrence releases substances, produces dramatic secondary changes in the injured tissue.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

2. What produces the characteristic redness and warmth associated with Stage 2 of the inflammatory response?

a.	release of chemicals (histamine, bradykinin, serotonin, prostaglandins, lymphokines)
b.	increased blood flow to the area
c.	plasma leaking into damaged tissue
d.	leukocytes infiltrating damaged tissue

 

 

ANS:  B

In Stage 2 of the Inflammatory Process, blood flow increases to the injured area causing the characteristic redness and warmth.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

3. What is typically ordered by a physician, for an area of inflammation, for 24-72 hours to control the inflammation, especially when pain and edema are present?

a.	compression	c.	dry heat
b.	warm, moist heat	d.	cold (ice)

 

 

ANS:  B

Heat, cold, or both may be applied to an inflamed area and need an order. Typically, physicians order cold (ice) on the affected area for 24-72 hours to control the inflammation, especially when pain and edema are present. After that time, heat is ordered to assist in quickly removing the accumulated waste products.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

4. Various agents are capable of causing disease. Heat is which type of agent?

a.	biological	c.	chemical
b.	physical	d.	environmental

 

 

ANS:  B

Physical agents are factors in the environment that are capable of causing disease, such as heat, light, noise, and radiation.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

5. Which of the following is a common bacterial infection?

a.	measles	c.	common cold
b.	urinary tract infection	d.	chickenpox

 

 

ANS:  B

Common bacterial infections include diarrhea, pneumonia, sinusitis, urinary tract infections, cellulitis, meningitis, gonorrhea, otitis media, and impetigo. Common viral infections include influenza, measles, common cold, chickenpox, hepatitis B, genital herpes, and HIV.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

6. Sexually transmitted diseases are transmitted by which type of contact?

a.	vector borne	c.	vehicle
b.	airborne	d.	direct contact

 

 

ANS:  D

The most important and frequent mode of transmission is contact transmission. This involves the transfer of an agent from an infected person to a host by direct contact with the infected person, indirect contact with the infected person through a fomite, or close contact with contaminated secretions. Sexually transmitted diseases are spread by direct contact.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

7. Lyme disease is spread by which type of transmission?

a.	direct contact	c.	vehicle
b.	airborne	d.	vector-borne

 

 

ANS:  D

Vector-borne transmission occurs when an agent is transferred to a susceptible host by animate means such as mosquitoes, fleas, ticks, lice, and other animals. Lyme disease, malaria, and West Nile virus are examples of diseases spread by vectors.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

8. A mother spreading HIV to a fetus is through which portal of entry?

a.	integumentary	c.	circulatory
b.	genitourinary	d.	transplacental

 

 

ANS:  D

A portal of entry is the route by which an infectious agent enters the host. A transplacental portal of entry is the transfer of microorganisms from mother to fetus via the placenta and umbilical cord (including HIV, and hepatitis B).

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

9. Which of these statements are true?

a.	As a person ages, immunity increases.
b.	Individuals who are not fully immunized are the same risk for infection.
c.	Lifestyle practices do not have an impact on an individual’s potential for illness.
d.	Individuals who maintain targeted weight for height and body frame are less prone to illness.

 

 

ANS:  D

Nutritional status does affect one’s susceptibility and severity of infection. Individuals who maintain the targeted weight for height and body frame are less prone to illness.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

10. The Centers for Disease Control and Prevention recommend which age group to receive the pneumococcal vaccine each year?

a.	children under age 1	c.	college age young adults
b.	individuals 65 and older	d.	elderly over 80

 

 

ANS:  B

The Centers for Disease Control and Prevention (CDC) (2010b) recommends that individuals 65 years of age and older receive the Influenza (flu) vaccine annually, the Pneumococcal vaccine, Tetanus (lockjaw), Herpes Zoster (shingles), and Diphtheria vaccine.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

11. What is the single most important practice in preventing the spread of infection?

a.	respiratory precautions	c.	using aseptic technique
b.	hand hygiene	d.	using bleach to break chain of infection

 

 

ANS:  B

Hand hygiene is the first line of defense against infection and is the single most important practice in preventing the spread of infection.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

12. What is the elimination of pathogens, except spores, from inanimate objects?

a.	antiseption	c.	sterilization
b.	disinfection	d.	cleansing

 

 

ANS:  B

Disinfection is the elimination of pathogens, except spores, from inanimate objects. Disinfectants are chemical solutions used to clean inanimate objects.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

13. Which are examples of barrier protection?

a.	hand cream	c.	gloves, gowns, goggles, and masks
b.	negative pressure rooms	d.	wound dressings

 

 

ANS:  C

To break the chain of infection between the mode of transmission and the portal of entry, asepsis must be ensured and barrier protection worn when the care of clients involves contact with body secretions. Gloves, masks, gowns, and goggles are barrier protection that can be used.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

14. Which of these statements are TRUE about antibiotics?

a.	Antibiotics are effective against viruses
b.	Antibiotics do not destroy normal flora
c.	Client should take all antibiotics prescribed
d.	Individuals can not develop resistance to antibiotics if they take a partial dose of the medication

 

 

ANS:  C

There are several key points when administering antibiotics. The physician or nurse practitioner should not be pressured to prescribe antibiotics for every illness. Antibiotics are not always appropriate. They are not effective against viruses. When antibiotics are prescribed, the client should take all of the medication as directed. Antibiotics taken only until the client feels better allow the microorganisms to become resistant to the antibiotic, and the antibiotic will no longer be effective. Antibiotics also destroy normal flora microorganisms, and other illnesses may ensue.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

15. Normal vaginal flora prevent the growth of several pathogens. What else prevents pathogenic growth of bacteria?

a.	monthly menses	c.	pubic hair
b.	endometriosis	d.	acidic environment of the vagina

 

 

ANS:  D

Normal vaginal flora prevent growth of several pathogens. At puberty, lactobacilli ferment and produce sugars in the vagina that lower the pH to an acidic range. The acidic environment of the vagina prevents pathogenic growth.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

16. What protects an individual against future invasions of already experienced antigens such as lethal bacteria, viruses, toxins and even foreign tissues?

a.	acquired immunity	c.	antibody immunity
b.	host immunity	d.	antioxidant immunity

 

 

ANS:  A

When the antigen enters the body again, the immune response occurs faster by rapidly producing antibodies. The formation of these antibodies is referred to as acquired immunity, which protects the individual against future invasions of already experienced antigens such as lethal bacteria, viruses, toxins, and even foreign tissues.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

17. Which stage in the infectious process can be characterized by the onset of nonspecific symptoms until specific symptoms begin to manifest?

a.	incubation	c.	illness
b.	prodromal	d.	convalescence

 

 

ANS:  B

The prodromal stage is the time from the onset of nonspecific symptoms until specific symptoms begin to manifest. The infectious agent continues to invade and multiply in the host. A client may also be infectious to other persons during this time period. In the client with chickenpox, a slight elevation in temperature will occur during this stage, followed within 24 hours by eruptions on the skin.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

18. A female client is being treated with an antibiotic for pneumonia. The antibiotic destroys normal flora of the genital tract and the client develops a vaginal yeast infection. This type of infection is called:

a.	ultra infection	c.	complementing infection
b.	type 2 infection	d.	super-infection

 

 

ANS:  D

A super-infection is an infection caused when the anti-infective used to treat the initial infectious process also destroys the body’s natural flora, that is present to protect against certain diseases.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

19. Which of the following are elevated with TB?

a.	neutrophils	c.	monocytes
b.	lymphocytes	d.	eosinophils

 

 

ANS:  C

Monocytes are increased in some protozoan and rickettsial infections as well as with tuberculosis.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

20. Which of the following is an infection control practice used to prevent the transmission of pathogens?

a.	aseptic technique	c.	sterile technique
b.	surgical asepsis	d.	medical asepsis

 

 

ANS:  A

Aseptic technique is the infection-control practice used to prevent the transmission of pathogens. The use of aseptic technique decreases the risk and spread of hospital-acquired infections.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

MULTIPLE RESPONSE

 

1. The primary signs of inflammation and infection are:

a.	redness	e.	loss of function
b.	heat	f.	loss of sensation
c.	pain	g.	purulent exudate
d.	swelling

 

 

ANS:  A, B, C, D, E, G

The primary signs of inflammation and infection are as follows: redness (erythema) results from increased blood flow to the area, heat results from increased blood flow and metabolism in the area, pain results from increased pressure on pain sensors in the area, swelling (edema, a detectable accumulation of increased interstitial fluid) results from fluid and leukocytes entering the tissues from the circulatory system, loss of function results from both pain and swelling and is the body’s way of resting the injured part, and pus (purulent exudate), resulting from infection, is a secretion made up of white blood cells, dead cells, bacteria, and other debris.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)

 

2. The older adult may be at increased risk for infection because of the normal aging process.  Which of the following increase an older client’s risk for infection? (Select all that apply.)

a.	inadequate nutrition	e.	lethargy
b.	delayed inflammatory response	f.	nearsightedness
c.	malaise	g.	incontinence
d.	unsteadiness leading to falls

 

 

ANS:  A, B, D, E, G

The older adult may be at increased risk for infection because of the normal aging process.  As a person ages, the skin, respiratory tract, kidneys, immune system and GI system decrease in function. The systems function adequately during periods of homeostasis. However, when physiological stress is placed on the person, the systems are unable to adequately protect the person from an infection. Other factors that increase an older adults risk for infection include: inadequate nutrition (especially inadequate protein intake), a delayed inflammatory response, disorientation, agitation, incontinence, unsteadiness leading to falls, lethargy and general fatigue. An older adult client may present with acute confusion when infection is present. Additional factors include living in group settings where the older adult is exposed to many people who may have infections, and taking medications which may decrease the already-reduced immune system’s ability to respond adequately.

 

PTS:   1                    DIF:    Comprehension                               REF:   White (2013)