Fundamentals Of Nursing : Infection, Asepsis, Basic concept of stress and Illness

Correct Answers and Rationales

Fundamentals Of Nursing : Infection, Asepsis, Basic concept of stress and Illness
By : Budek
http://www.pinoybsn.tk
FUNDAMENTALS OF NURSING TEST II CONTENT OUTLINE
1. Illness
2. Infection and Asepsis
3. Basic concept of Stress and Adaptation
1. When the General adaptation syndrome is activated, FLIGHT OR FIGHT response sets
in. Sympathetic nervous system releases norepinephrine while the adrenal medulla
secretes epinephrine. Which of the following is true with regards to that
statement?
A. Pupils will constrict
B. Client will be lethargic
C. Lungs will bronchodilate D. Gastric motility will increase
* To better understand the concept : The autonomic nervous system is composed of
SYMPATHETIC and PARASYMPATHETIC Nervous system. It is called AUTONOMIC Because it
is Involuntary and stimuli based. You cannot tell your heart to kindly beat for 60
per minute, Nor, Tell your blood vessels, Please constrict, because you need to
wear skirt today and your varicosities are bulging. Sympathetic Nervous system is
the FIGHT or FLIGHT mechanism. When people FIGHT or RUN, we tend to stimulate the
ANS and dominate over SNS. Just Imagine a person FIGHTING and RUNNING to get the
idea on the signs of SNS Domination. Imagine a resting and digesting person to get
a picture of PNS Domination. A person RUNNING or FIGHTING Needs to bronchodilate,
because the oxygen need is increased due to higher demand of the body. Pupils will
DILATE to be able to see the enemy clearly. Client will be fully alert to dodge
attacks and leap through obstacles during running. The client's gastric motility
will DECREASE Because you cannot afford to urinate or defecate during fighting nor
running.
2. Which of the following response is not expected to a person whose GAS is
activated and the FIGHT OR FLIGHT response sets in?
A. The client will not urinate due to relaxation of the detrusor muscle
B. The client will be restless and alert
C. Clients BP will increase, there will be vasodilation
D. There will be increase glycogenolysis, Pancrease will decrease insulin secretion
* If vasodilation will occur, The BP will not increase but decrease. It is true
that Blood pressure increases during SNS Stimulation due to the fact that we need
more BLOOD to circulate during the FIGHT or FLIGHT Response because the oxygen
demand has increased, but this is facilitated by vasoconstriction and not
vasodilation. A,B and D are all correct. The

liver will increase glycogenolysis or glycogen store utilization due to a

heightened demand for energy. Pancrease will decrease insulin secretion because
almost every aspect of digestion that is controlled by Parasympathetic nervous
system is inhibited when the SNS dominates.
3. State in which a person’s physical, emotional, intellectual and social
development or spiritual functioning is diminished or impaired compared with a
previous experience.
A. Illness
B. Disease C. Health D. Wellness
* Disease is a PROVEN FACT based on a medical theory, standards, diagnosis and
clinical feature while ILLNESS Is a subjective state of not feeling well based on
subjective appraisal, previous experience, peer advice etc.
4. This is the first stage of illness wherein, the person starts to believe that
something is wrong. Also known as the transition phase from wellness to illness.
A. Symptom Experience
B. Assumption of sick role C. Medical care contact D. Dependent patient role
* A favorite board question are Stages of Illness. When a person starts to believe
something is wrong, that person is experiencing signs and symptoms of an illness.
The patient will then ASSUME that he is sick. This is called assumption of the sick
role where the patient accepts he is Ill and try to give up some activities. Since
the client only ASSUMES his illness, he will try to ask someone to validate if what
he is experiencing is a disease, This is now called as MEDICAL CARE CONTACT. The
client seeks professional advice for validation, reassurance, clarification and
explanation of the symptoms he is experiencing. client will then start his
dependent patient role of receiving care from the health care providers. The last
stage of Illness is the RECOVERY stage where the patient gives up the sick role and
assumes the previous normal gunctions.
5. In this stage of illness, the person accepts or rejects a professionals
suggestion. The person also becomes passive and may regress to an earlier stage.
A. Symptom Experience
B. Assumption of sick role
C. Medical care contact
D. Dependent patient role
* In the dependent patient role stage, Client needs professionals for help. They
have a choice either to accept or reject the professional's decisions but patients
are usually passive and accepting. Regression tends to occur more in this period.
6. In this stage of illness, The person learns to accept the illness.
A. Symptom Experience
B. Assumption of sick role
C. Medical care contact

D. Dependent patient role

* Acceptance of illness occurs in the Assumption of sick role phase of illness.
7. In this stage, the person tries to find answers for his illness. He wants his
illness to be validated, his symptoms explained and the outcome reassured or
predicted
A. Symptom Experience B. Assumption of sick role C. Medical care contact D.
Dependent patient role
* At this stage, The patient seeks for validation of his symptom experience. He
wants to find out if what he feels are normal or not normal. He wants someone to
explain why is he feeling these signs and symptoms and wants to know the probable
outcome of this experience.
8. The following are true with regards to aspect of the sick role except
A. One should be held responsible for his condition
B. One is excused from his societal role
C. One is obliged to get well as soon as possible D. One is obliged to seek
competent help
* The nurse should not judge the patient and not view the patient as the cause or
someone responsible for his illness. A sick client is excused from his societal
roles, Oblige to get well as soon as possible and Obliged to seek competent help.
9. Refers to conditions that increases vulnerability of individual or group to
illness or accident
A. Predisposing factor B. Etiology
C. Risk factor
D. Modifiable Risks
10. Refers to the degree of resistance the potential host has against a certain
pathogen
A. Susceptibility
B. Immunity C. Virulence D. Etiology
* Immunity is the ABSOLUTE Resistance to a pathogen considering that person has an
INTACT IMMUNITY while susceptibility is the DEGREE of resistance. Degree of
resistance means how well would the individual combat the pathogens and repel
infection or invasion of these disease causing organisms. A susceptible person is
someone who has a very low degree of resistance to combat pathogens. An Immune
person is someone that can easily repel specific pathogens. However, Remember that
even if a person is IMMUNE [ Vaccination ] Immunity can always be impaired in cases
of chemotherapy, HIV, Burns, etc.
11. A group of symptoms that sums up or constitute a disease

A. Syndrome
B. Symptoms C. Signs
D. Etiology
* Symptoms are individual manifestation of a certain disease. For example, In
Tourette syndrome, patient will manifest TICS, but this alone is not enough to
diagnose the patient as other diseases has the same tic manifestation. Syndrome
means COLLECTION of these symptoms that occurs together to characterize a certain
disease. Tics with coprolalia, echolalia, palilalia, choreas or other movement
disorders are characteristics of TOURETTE SYNDROME.
12. A woman undergoing radiation therapy developed redness and burning of the skin
around the best. This is best classified as what type of disease?
A. Neoplastic B. Traumatic C. Nosocomial D. Iatrogenic
* Iatrogenic diseases refers to those that resulted from treatment of a certain
disease. For example, A child frequently exposed to the X-RAY Machine develops
redness and partial thickness burns over the chest area. Neoplastic are malignant
diseases cause by proliferation of abnormally growing cells. Traumatic are brought
about by injuries like Motor vehicular accidents. Nosocomial are infections that
acquired INSIDE the hospital. Example is UTI Because of catheterization, This is
commonly caused by E.Coli.
13. The classification of CANCER according to its etiology Is best described as
1. Nosocomial 2. Idiopathic 3. Neoplastic 4. Traumatic 5. Congenital 6. Degenrative
A. 5 and 2
B. 2 and 3
C. 3 and 4 D. 3 and 5
* Aside from being NEOPLASTIC, Cancer is considered as IDIOPATHIC because the cause
is UNKNOWN.
14. Term to describe the reactiviation and recurrence of pronounced symptoms of a
disease
A. Remission
B. Emission
C. Exacerbation D. Sub acute
15. A type of illness characterized by periods of remission and exacerbation

A. Chronic
B. Acute
C. Sub acute D. Sub chronic
* A good example is Multiple sclerosis that characterized by periods of remissions
and exacerbation and it is a CHRONIC Disease. An acute and sub acute diseases
occurs too short to manifest remissions. Chronic diseases persists longer than 6
months that is why remissions and exacerbation are observable.
16. Diseases that results from changes in the normal structure, from recognizable
anatomical changes in an organ or body tissue is termed as
A. Functional B. Occupational C. Inorganic
D. Organic
* As the word implies, ORGANIC Diseases are those that causes a CHANGE in the
structure of the organs and systems. Inorganic diseases is synonymous with
FUNCTIONAL diseases wherein, There is no evident structural, anatomical or physical
change in the structure of the organ or system but function is altered due to other
causes, which is usually due to abnormal response of the organ to stressors.
Therefore, ORGANIC BRAIN SYNDROME are anatomic and physiologic change in the BRAIN
that is NON PROGRESSIVE BUT IRREVERSIBLE caused by alteration in structure of the
brain and it's supporting structure which manifests different sign and symptoms of
neurological, physiologic and psychologic alterations. Mental disorders manifesting
symptoms of psychoses without any evident organic or structural damage are termed
as INORGANIC PSYCHOSES while alteration in the organ structures that causes
symptoms of bizaare pyschotic behavior is termed as ORGANIC PSYCHOSES.
17. It is the science of organism as affected by factors in their environment. It
deals with the relationship between disease and geographical environment.
A. Epidemiology
B. Ecology
C. Statistics D. Geography
* Ecology is the science that deals with the ECOSYSTEM and its effects on living
things in the biosphere. It deals with diseases in relationship with the
environment. Epidimiology is simply the Study of diseases and its occurence and
distribution in man for the purpose of controlling and preventing diseases. This
was asked during the previous boards.
18. This is the study of the patterns of health and disease. Its occurrence and
distribution in man, for the purpose of control and prevention of disease.
A. Epidemiology
B. Ecology
C. Statistics D. Geography
* Refer to number 17.

19. Refers to diseases that produced no anatomic changes but as a result from
abnormal response to a stimuli.
A. Functional B. Occupational C. Inorganic D. Organic
* Refer to number 16.
20. In what level of prevention according to Leavell and Clark does the nurse
support the client in obtaining OPTIMAL HEALTH STATUS after a disease or injury?
A. Primary
B. Secondary
C. Tertiary
D. None of the above
* Perhaps one of the easiest concept but asked frequently in the NLE. Primary
refers to preventions that aims in preventing the disease. Examples are healthy
lifestyle, good nutrition, knowledge seeking behaviors etc. Secondary prevention
are those that deals with early diagnostics, case finding and treatments. Examples
are monthly breast self exam, Chest X-RAY, Antibiotic treatment to cure infection,
Iron therapy to treat anemia etc. Tertiary prevention aims on maintaining optimum
level of functioning during or after the impact of a disease that threatens to
alter the normal body functioning. Examples are prosthetis fitting for an amputated
leg after an accident, Self monitoring of glucose among diabetics, TPA Therapy
after stroke etc.
The confusing part is between the treatment in secondary and treatment in tertiary.
To best differentiate the two, A client with ANEMIA that is being treated with
ferrous sulfate is considered being in the SECONDARY PREVENTION because ANEMIA once
treated, will move the client on PRE ILLNESS STATE again. However, In cases of
ASPIRING Therapy in cases of stroke, ASPIRING no longer cure the patient or PUT HIM
IN THE PRE ILLNESS STATE. ASA therapy is done in order to prevent coagulation of
the blood that can lead to thrombus formation and a another possible stroke. You
might wonder why I spelled ASPIRIN as ASPIRING, Its side effect is OTOTOXICITY [ CN
VIII ] that leads to TINNITUS or ringing of the ears.
21. In what level of prevention does the nurse encourage optimal health and
increases person’s susceptibility to illness?
A. Primary
B. Secondary
C. Tertiary
D. None of the above
* The nurse never increases the person's susceptibility to illness but rather,
LESSEN the person's susceptibility to illness.
22. Also known as HEALTH MAINTENANCE prevention. A. Primary

B. Secondary
C. Tertiary
D. None of the above
* Secondary prevention is also known as HEALTH MAINTENANCE Prevention. Here, The
person feels signs and symptoms and seeks Diagnosis and treatment in order to
prevent deblitating complications. Even if the person feels healthy, We are
required to MAINTAIN our health by monthly check ups, Physical examinations,
Diagnostics etc.
23. PPD In occupational health nursing is what type of prevention?
A. Primary
B. Secondary
C. Tertiary
D. None of the above
* PPD or PERSONAL PROTECTIVE DEVICES are worn by the workes in a hazardous
environment to protect them from injuries and hazards. This is considered as a
PRIMARY prevention because the nurse prevents occurence of diseases and injuries.
24. BCG in community health nursing is what type of prevention?
A. Primary
B. Secondary
C. Tertiary
D. None of the above
25. A regular pap smear for woman every 3 years after establishing normal pap smear
for 3 consecutive years Is advocated. What level of prevention does this belongs?
A. Primary
B. Secondary
C. Tertiary
D. None of the above
26. Self monitoring of blood glucose for diabetic clients is on what level of
prevention?
A. Primary
B. Secondary
C. Tertiary
D. None of the above
27. Which is the best way to disseminate information to the public?
A. Newspaper
B. School bulletins
C. Community bill boards D. Radio and Television
* An actual board question, The best way to disseminate information to the public
is by TELEVISION followed by RADIO. This is how the DOH establish its IEC Programs
other than publising posters, leaflets and brochures. An emerging new way to
disseminate is through the internet.

28. Who conceptualized health as integration of parts and subparts of an

individual?
A. Newman
B. Neuman
C. Watson D. Rogers
* The supra and subsystems are theories of Martha Rogers but the parts and subparts
are Betty Neuman's. She stated that HEALTH is a state where in all parts and
subparts of an individual are in harmony with the whole system. Margarex Newman
defined health as an EXPANDING CONSCIOUSNESS. Her name is Margaret not Margarex, I
just used that to help you remember her theory of health.
29. The following are concept of health:
1. Health is a state of complete physical, mental and social wellbeing and not
merely an absence of disease or infirmity.
2. Health is the ability to maintain balance
3. Health is the ability to maintain internal milieu
4. Health is integration of all parts and subparts of an individual
A. 1,2,3
B. 1,3,4
C. 2,3,4 D. 1,2,3,4
* All of the following are correct statement about health. The first one is the
definition by WHO, The second one is from Walter Cannon's homeostasis theory. Third
one is from Claude Bernard's concept of Health as Internal Milieu and the last one
is Neuman's Theory.
30. The theorist the advocated that health is the ability to maintain dynamic
equilibrium is
A. Bernard B. Selye
C. Cannon D. Rogers
* Walter Cannon advocated health as HOMEOSTASIS or the ability to maintain dynamic
equilibrium. Hans Selye postulated Concepts about Stress and Adaptation. Bernard
defined health as the ability to maintain internal milieu and Rogers defined Health
as Wellness that is influenced by individual's culture.
31. Excessive alcohol intake is what type of risk factor?
A. Genetics
B. Age
C. Environment D. Lifestyle
32. Osteoporosis and degenerative diseases like Osteoarthritis belongs to what type
of risk factor?

A. Genetics
B. Age
C. Environment D. Lifestyle
33. Also known as STERILE TECHNIQUE
A. Surgical Asepsis
B. Medical Asepsis C. Sepsis
D. Asepsis
* Surgical Asepsis is also known as STERILE TECHNIQUE while Medical Asepsis is
synonymous with CLEAN TECHNIQUE.
34. This is a person or animal, who is without signs of illness but harbors
pathogen within his body and can be transferred to another
A. Host
B. Agent
C. Environment D. Carrier
35. Refers to a person or animal, known or believed to have been exposed to a
disease.
A. Carrier
B. Contact
C. Agent D. Host
36. A substance usually intended for use on inanimate objects, that destroys
pathogens but not the spores.
A. Sterilization
B. Disinfectant
C. Antiseptic D. Autoclave
* Disinfectants are used on inanimate objects while Antiseptics are intended for
use on persons and other living things. Both can kill and inhibit growth of
microorganism but cannot kill their spores. That is when autoclaving or steam under
pressure gets in, Autoclaving can kill almost ALL type of microoganism including
their spores.
37. This is a process of removing pathogens but not their spores
A. Sterilization
B. Auto claving
C. Disinfection D. Medical asepsis
* Both A and B are capable on killing spores. Autoclaving is a form of
Sterilization. Medical Asepsis is a PRACTICE designed to minimize or reduce the
transfer of pathogens, also known as your CLEAN TECHNIQUE. Disinfection is the
PROCESS of removing pathogens but

not their spores.

38. The third period of infectious processes characterized by development of
specific signs and symptoms
A. Incubation period B. Prodromal period
C. Illness period
D. Convalescent period
* In incubation period, The disease has been introduced to the body but no sign and
symptom appear because the pathogen is not yet strong enough to cause it and may
still need to multiply. The second period is called prodromal period. This is when
the appearance of non specific signs and symptoms sets in, This is when the sign
and symptoms starts to appear. Illness period is characterized by the appearance of
specific signs and symptoms or refer tp as time with the greatest symptom
experience. Acme is the PEAK of illness intensity while the convalescent period is
characterized by the abatement of the disease process or it's gradual
disappearance.
39. A child with measles developed fever and general weakness after being exposed
to another child with rubella. In what stage of infectious process does this child
belongs?
A. Incubation period
B. Prodromal period
C. Illness period
D. Convalescent period
* To be able to categorize MEASLES in the Illness period, the specific signs of
Fever, Koplik's Spot and Rashes must appear. In the situation above, Only general
signs and symptoms appeared and the Specific signs and symptoms is yet to appear,
therefore, the illness is still in the Prodromal period. Signs and symptoms of
measles during the prodromal phase are Fever, fatigue, runny nose, cough and
conjunctivitis. Koplik's spot heralds the Illness period and cough is the last
symptom to disappear. All of this processes take place in 10 days that is why,
Measles is also known as 10 day measles.
40. A 50 year old mailman carried a mail with anthrax powder in it. A minute after
exposure, he still hasn’t developed any signs and symptoms of anthrax. In what
stage of infectious process does this man belongs?
A. Incubation period
B. Prodromal period
C. Illness period
D. Convalescent period
* Anthrax can have an incubation period of hours to 7 days with an average of 48
hours. Since the question stated exposure, we can now assume that the mailman is in
the incubation period.
41. Considered as the WEAKEST LINK in the chain of infection that nurses can
manipulate to prevent spread of infection and diseases
A. Etiologic/Infectious agent B. Portal of Entry

C. Susceptible host
D. Mode of transmission
* Mode of transmission is the weakest link in the chain of infection. It is easily
manipulated by the Nurses using the tiers of prevention, either by instituting
transmission based precautions, Universal precaution or Isolation techniques.
42. Which of the following is the exact order of the infection chain?
1. Susceptible host 2. Portal of entry 3. Portal of exit
4. Etiologic agent 5. Reservoir
6. Mode of transmission
A. 1,2,3,4,5,6 B. 5,4,2,3,6,1 C. 4,5,3,6,2,1 D. 6,5,4,3,2,1
* Chain of infection starts with the SOURCE : The etiologic agent itself. It will
first proliferate on a RESERVOIR and will need a PORTAL OF EXIT to be able to
TRANSMIT irslef using a PORTAL OF ENTRY to a SUSCEPTIBLE HOST. A simple way to
understand the process is by looking at the lives of a young queen ant that is
starting to build her colony. Imagine the QUEEN ANT as a SOURCE or the ETIOLOGIC
AGENT. She first need to build a COLONY, OR the RESERVOIR where she will start to
lay the first eggs to be able to produce her worker ants and soldier ants to be
able to defend and sustain the new colony. They need to EXIT [PORTAL OF EXIT] their
colony and crawl [MODE OF TRANSMISSION] in search of foods by ENTERING / INVADING
[PORTAL OF ENTRY] our HOUSE [SUSCEPTIBLE HOST]. By imagining the Ant's life cycle,
we can easily arrange the chain of infection.
43. Markee, A 15 year old high school student asked you. What is the mode of
transmission of Lyme disease. You correctly answered him that Lyme disease is
transmitted via
A. Direct contact transmission B. Vehicle borne transmission
C. Air borne transmission
D. Vector borne transmission
* Lyme disease is caused by Borrelia Burdorferi and is transmitted by a TICK BITE.
44. The ability of the infectious agent to cause a disease primarily depends on all
of the following except
A. Pathogenicity
B. Virulence
C. Invasiveness
D. Non Specificity
* To be able to cause a disease, A pathogen should have a TARGET ORGAN/S. The
pathogen should be specific to these organs to cause an infection. Mycobacterium
Avium is NON SPECIFIC to human organs and therefore, not infective to humans but
deadly to birds. An

immunocompromised individual, specially AIDS Patient, could be infected with these

NON SPECIFIC diseases due to impaired immune system.
45. Contact transmission of infectious organism in the hospital is usually cause by
A. Urinary catheterization
B. Spread from patient to patient
C. Spread by cross contamination via hands of caregiver D. Cause by unclean
instruments used by doctors and nurses
* The hands of the caregiver like nurses, is the main cause of cross contamination
in hospital setting. That is why HANDWASHING is the single most important procedure
to prevent the occurence of cross contamination and nosocomial infection. D refers
to Nosocomial infection and UTI is the most common noscomial infection in the
hospital caused by urinary catheterization. E.Coli seems to be the major cause of
this incident. B best fits Cross Contamination, It is the spread of microogranisms
from patient o patient.
46. Transmission occurs when an infected person sneezes, coughs or laugh that is
usually projected at a distance of 3 feet.
A. Droplet transmission
B. Airborne transmission
C. Vehicle transmission
D. Vector borne transmission
47. Considered as the first line of defense of the body against infection
A. Skin
B. WBC
C. Leukocytes D. Immunization
* Remember that intact skin and mucus membrane is our first line of defense against
infection.
48. All of the following contributes to host susceptibility except
A. Creed
B. Immunization
C. Current medication being taken D. Color of the skin
* Creed, Faith or religious belief do not affect person's susceptibility to
illness. Medication like corticosteroids could supress a person's immune system
that will lead to increase susceptibility. Color of the skin could affect person's
susceptibility to certain skin diseases. A dark skinned person has lower risk of
skin cancer than a fair skinned person. Fair skinned person also has a higher risk
for cholecystitis and cholelithiasis.
49. Graciel has been injected TT5, her last dosed for tetanus toxoid immunization.
Graciel asked you, what type of immunity is TT Injections? You correctly answer her
by saying Tetanus toxoid immunization is a/an
A. Natural active immunity

B. Natural passive immunity

C. Artificial active immunity
D. Artificial passive immunity
* TT1 ti TT2 are considered the primary dose, while TT3 to TT5 are the booster
dose. A woman with completed immunization of DPT need not receive TT1 and TT2.
Tetanus toxoid is the actual toxin produce by clostridium tetani but on its WEAK
and INACTIVATED form. It is Artificial because it did not occur in the course of
actual illness or infection, it is Active because what has been passed is an actual
toxin and not a ready made immunoglobulin.
50. Agatha, was hacked and slashed by a psychotic man while she was crossing the
railway. She suffered multiple injuries and was injected Tetanus toxoid
Immunoglobulin. Agatha asked you, What immunity does TTIg provides? You best
answered her by saying TTIg provides
A. Natural active immunity
B. Natural passive immunity
C. Artificial active immunity
D. Artificial passive immunity
* In this scenario, Agatha was already wounded and has injuries. Giving the toxin
[TT Vaccine] itself would not help Agatha because it will take time before the
immune system produce antitoxin. What agatha needs now is a ready made anti toxin
in the form of ATS or TTIg. This is artificial, because the body of agatha did not
produce it. It is passive because her immune system is not stimulated but rather, a
ready made Immune globulin is given to immediately supress the invasion.
51. This is the single most important procedure that prevents cross contamination
and infection
A. Cleaning
B. Disinfecting
C. Sterilizing
D. Handwashing
* When you see the word HANDWASHING as one of the options, 90% Chance it is the
correct answer in the local board. Or should I say, 100% because I have yet to see
question from 1988 to 2005 board questions that has option HANDWASHING on it but is
not the correct answer.