COMMUNICABLE DISESE EXAM

1.

A nursing instructor asks a nursing student to describe live or attenuated vaccines. The student tells the instructor that these types of vaccines are: a. vaccines that have their virulence (potency) diminished so as to not produce a full-blown clinical illness. b. vaccines that contain pathogens made inactive by either chemical or heat. c. bacterial toxins that have been made inactive by either chemicals or heat. d. vaccines that have been obtained from the pooled blood of many people and provide antibodies to a variety of diseases.

2. Passive immunization is given as a preventive measure when a. Routine immunization is given b. Clinical recovery is on the way c. Exposure to a frank case has been observed d. Symptoms of the disease is manifested by the patient 3. A nursing student is assigned to administer immunizations to children in a clinic. The nursing instructor asks the student about the contraindications to receiving an immunization. The student responds correctly by telling the instructor that a contraindication to receiving an immunization is if a child has a. a cold c. otitis media b. mild diarrhea d. a severe febrile illness 4. A 12-month-old received immunizations at his well-child visit. Fourteen days later, the mother reports that the child has red maculopapular rash on the trunk & extremities. This rash is most likely due to which of the following vaccines? a. DPT b. OPV c. MMR d. Hib 5. When a woman receives rubella vaccination, a nurse would give her which of the following instructions? a. “Don’t get pregnant for at least 3 months.” b. “Refrain from eating eggs & egg products for 48 hours.” c. “Limit contact with visitors for at least one week.” d. “Avoid breast-feeding the baby for at least 24 hours.” 6. A 12 years old child comes into the clinic for the MMR vaccines for entry into the 6 th grade the nurse asks the mother if the child had changes in health since last seen. Which statement by the mother would indicate a potential contraindication to MMR immunization? a. “ My child had neomycin sulfate for acne and develop hives and difficulty in breathing” b. After the last MMR my child developed a low grade and had a rash for the couple of days c. My child’s brother is taking corticosteroids for juvenile rheumatoid arthritis d. My child just had a tuberculin TB test. 7. The parents of an 18-month-old baby who developed signs of tetanus are concerned about how the disease will affect their child’s intellectual ability in the future. The nurse’s best response will be a. “The child’s intellectual functioning may be damaged.”

b. “The child’s intellectual functioning should remain intact.” c. “The child’s intellectual functioning may be temporarily retarded.” d. “The child’s intellectual functioning depends on the severity of complications.”

8. A 7 day old child is brought to the health center because of inability to suck since yesterday. You suspect that this is a case of neonatal tetanus. As you asses the child which of the questions will you ask the mother in order to confirm your suspision? a. Did the child normally suck and cry 2-4 days before she was brought to the center ? b. Did the child have convulsion? c. Have you observed stiffness of the child’s body d. all of these questions 9. Which of these statements about tetanus is wrong? a. immunity last for 5 months in infants born to immune mother b. Immunity can be obtained after two primary doses of toxoid in mothers one moth before delivery. c. recovery from tetanus does not result in solid immunity d. tetanus bacillus is directly transmitted from man to man. 10. Prevention of tetanus neonatorum can be achieved through: a. increasing the immunization coverage of women of child-bearing age with tetanus toxoid. b. immunizing newborns c. increasing the proportions of deliveries attended by midwife against the traditional birth attendants d. all of the above 11. If you were to conduct on the seminar on the prevention and control of tetanus neonatorium for your new midwives, which of the following should be given emphasis? a. Methods equipments and techniques of asepsis in childbirth b. Education of mothers on the practice of asepsis in the care of umbilical stamp. c. Education of birth attendants on the practice of strict aseptic technique d. All of these measures Situation: A 7 year old boy was admitted in the hospital because of convulsion 6 hours ago. A week ago the child experienced on and off cough and low grade fever. On examination, the nurse observes nuchal rigidity. 12. The most common cause of bacterial meningitis in children is a. Haemopilus influenzae B c. Neisseria meningitides b. Streptococcus pnemoniae d. Meningococcus 13. To confirm the diagnosis, the doctor performed lumbar puncture. The result that would indicate that the cause of the disease is more of bacterial in origin would be a. Increased pressure, glucose, and protein b. Increased pressure, protein and decreased glucose c. Increased protein, low glucose, and pressure d. Cloudy CSF, increased protein and glucose
e. A mother brings the child to the health care clinic. 14. The child has been complaining of severe headaches and has been vomiting. The child has a high fever, and the nurse notes the presence of nuchal rigidity in the child. The nurse suspects a possible diagnosis of bacterial meningitis. The nurse continues to assess the child for the presence of Kernig’s sign. Which finding would indicate the presence of this sign. a. Inaability of the child to extend the legs fully when lying supine b. Flexion of the hips when the neck is flexed from a lying position c. Pain when the chin is pulled down to the chest

d.

Calf pain when the foot is dorsiflexed

15. A patient who is diagnosed with encephalitis is being treated with mannitol. Which of the following patient outcomes should indicate to a nurse that treatment with mannitol has been effective for a patient who has increased intracranial pressure? a. Decreased level of consciousness b. Increased urinary output c. Elevated body temperature d. Slowed papillary response 16. Maria Victoria, a 26-year-old female equestrian, developed fever, chills & body malaise for 5 days. On the 7th day of illness, she developed convulsions & was rushed to a tertiary hospital. As an ER nurse in that hospital, you noticed that the patient’s upper & lower extremities are in a flexed position. You very well know that this is a. decorticate rigidity c. nuchal rigidity b. decerebrate rigidity d. opisthotonus Situation: Mrs. Ferrer delivered a healthy baby girl weighing 6.8 lb. Due to knowledge deficit, the mother was not able to bring the neonate for immunization. When the child reached 3 years old, she developed pain on both knees & discomfort during standing and walking prompting her to prefer to sit or lie down. The child started having fever on the 3 rd day after the leg pain. When the child was brought to a hospital, a diagnosis of Poliomyelitis was made. 17. During the early symptoms of poliomyelitis, the client usually suffers from a. coryza b. headache c. seizures d. vomiting Situation : Cristina, an 8-year-old girl was never given any kind of immunization because the family had never visited a health care unit. Now she is diagnosed to have acute poliomyelitis. 18. The major route of transmission of polio virus in poor sanitation environment is: a. Sewage disposal b. Water system c. Fecal- oral d. Food stuff 19. When the virus is ingested, where does it multiply? a. Gastro- intestinal tract b. Integumentary system c. Urinary tract d. Reproductive tract 20. As a rural health nurse, your most important function in polio prevention is to: a. Educate the public on the advantages of immunization b. Distribute leaflets about the causes of polio c. Call all mother for lecture d. Refer all children to the doctor 21. Your health teaching to Cristina, the polio victim includes: a. Proper waste disposal b. Proper eating habits c. Regular health check-up d. Advocacy in health 22. The best nursing intervention in the case of Cristina with paralysis of lower extremity due to poliomyelitis is: a. Letting Cristina attend mother class

b. Rendering physical comfort c. Rendering physical therapy exercises to limit atrophy d. Diet instruction 23. Sight & sound of water as well as drip of the faucet disturb a patient with rabies. Which of the following should the nurse do first in taking care of a patient with rabies? a. Place patient near the window b. Cover IV bottle with brown paper bag c. Give tepid sponge bath d. Place the patient near a utility room 24. If a dog bites a person, it should be a. Leashed immediately & observed for 10 days b. Killed immediately c. Brought to a veterinarian for examination to determine the presence of rabies in the blood d. punished by not giving food & water 25. A 10-year-old boy arrives with his mother at the emergency department after being bitten by a stray dog. There is a bleeding soft tissue injury on the inner aspect of the left forearm. The first nursing action would be a. Notify the barangay tanod to capture the dog b. Ask the mother if her son is allergic to horse serum c. assess the injury, vital signs, and past health history d. inoculate the child with human rabies immune globulin 26. Emilie Lopamia, a 35-year-old female was bitten by a stray dog on the left hand. She sought an advice of the nurse in the health center. The best response of the nurse is a. “You should observe the dog for changes in behavior so you will know if the dog is possibly rabid or not.” b. “You should receive immunization for rabies immediately.” c. “You don’t have to worry because it’s just a minor wound.” d. “You should receive immunization for rabies & tetanus as soon as possible.” 27. Emilie asked the nurse regarding the incubation period of rabies. Which of the following statements made by the nurse is appropriate? a. “The incubation period is about 2 weeks.” b. “The incubation period varies depending on the site of the bite.” c. “The incubation period is about 1 month.” d. “The incubation period is about 1 year.” Situation: Mariel Balio, a 12-year-old girl was told by her mother to clean their backyard & burn the leaves of the jackfruit tree. After 5 days, Mariel experienced fever, body malaise & occasional petechial hemorrhages. She was brought to the Rural health unit. 28. Upon seeing Mariel, which of the following questions would the nurse ask to obtain history of the illness? a. “Why didn’t you show to your mother the skin lesions right away?” b. “Don’t you have a maid to clean your backyard?” c. “Do you have a communicable disease?” d. “Were you bitten by mosquitoes when cleaning your backyard?” 29. What is the vector of the patient’s illness? a. Female anopheles mosquito b. housefly c. cockroaches d. Aedes aegypti

30. Which of the following is immediately performed to Mariel which serves as the screening test for dengue hemorrhagic fever? a. ELISA b. Rumpel-leede test c. Complete blood count d. Sedimentation rate 31. The nurse’s primary concern during her care to Mariel is one of the following. a. report to authority b. monitor vital signs c. conduct research d. case finding 32. The community physician ordered CBC to Mariel. As the nurse taking care of the patient, your expected CBC finding in patients with dengue hemorrhagic fever is a. Increased WBC & decreased RBC b. Decreased hematocrit & increased platelet c. Decreased platelet & increased hematocrit d. Increased hematocrit & decreased hemoglobin 33. The best measure to control spread of Mariel’s illness is to a. avoid hanging clothes in the backyard b. keep water container open c. spay insecticides once a month d. eliminate breeding places of vector 34. Mr. Michael Bautista had a recent travel to Palawan & is suspected to have malaria. The most important diagnostic test in malaria is a. Erythrocyte sedimentation rate b. WBC count c. Peripheral blood smear d. Culture 35. The nurse is reviewing the chart of Mr. Bautista. Which of the following objective cue can be seen in the patient’s chart? a. splenomegaly b. Leucocytosis c. Increased platelet count d. Erythrocytosis 36. Nursing care of patients with Malaria include provision of comfort, avoidance of chills, proper elimination & accurate medication. Which of the following is most important in preventing spread of infection? a. eradicating breeding sites of vector b. educate patient regarding compliance with drug regimen c. isolation of patient d. avoid sharing utensils 37. A community health nurse teaches a mother comfort measures for her six-year-old child who has varicella-zoster virus. Which of the following actions, if taken by the mother, requires further intervention? a. Applying cortisone-based cream to the child’s lesion b. Patting the child’s lesions with calamine lotion c. Bathing the child with tepid sponge bath d. Trimming the child’s fingernails very short 38. When teaching a mother about communicable diseases, the nurse informs her that chickenpox is a. communicable until all the vesicles have dried

b. no longer communicable after a high fever has subsided c. not communicable as long as the vesicles are intact and surrounded by a red areola d. not communicable at all 39. The nurse manager is planning the clinical assignments for the day. The nurse manager avoids assigning which of the following staff members to the client with herpes zoster? a. the nurse who never had mumps b. an experienced nurse who never had chickenpox c. the nurse who never had roseola d. the nurse who never had german measles

40. A nurse is performing an assessment on a 3 year old child with chicken pox. The child’d mother tells the nurse that the child keeps scratching at night, and the nurse teaches the mother about measures that will prevent an alteration in skin integrity. Which statement by the mother indicates that teaching was effective? A. “ I will apply generous amounts of a cortisone cream to prevent itching.” B. “ I need to place white gloves on my child’s hands at night.” C. “I need to keep my child ia a warm room at night so that covers will not cause my child to scratch.” D. “ I will give my child a glass of warm milk at bedtime to help my child sleep.”
42. A nurse is assessing a 12-month-old infant who recently had fever, runny nose, cough, and white spots in the mouth for 3 days. A rash developed that started on the face and spread to the whole body. The nurse should suspect that the child has a. rubella b. rubeola c. varicella d. scarlet fever 43. The nurse is aware that rubeola often causes children to have a. a maculopapular rash b. a paroxysmal cough c. an enlarges parotid gland d. a generalized vesicular lesion 44. A child with rubeola (measles) is being admitted to the hospital. In preparing for the admission of the child, a nurse plans to place the child on which precautions? a. contact c. respiratory b. enteric d. protective

45. A nurse is caring for a child diagnosed with rubeola. The nurse notes that the physician has documented the presence of Koplik spots. Based on this documentation, which of the following would the nurse expect to note on assessment of the child. A. petechiae spots that are reddish and pinpoint on the soft palate. B. Whitish vesicles located across the chest C. Small, blue-white spots with a red base found on the buccal mucosa D. Pinpoint petechiae noted on both legs
Situation: James, a 4-year-old boy is brought to the Rural Health Unit for cough, fever and rashes. The doctor diagnosed him with measles infection. 46. Which of the following should you do first? a. Perform nursing procedures c. Assess the patient b. Plan for your care regimen d. Identify nursing diagnosis

47. Which of the following is the most common complication? a. Meningitis c. Otitis media b. Pneumonia d. Laryngitis 48. Which nursing consideration must be rendered to avoid complication of pneumonia? a. Protect eyes from glare of sunlight c. Ventilated room but free from drafts b. Correct technique of sponge bath d. Check prescribed medications faithfully Situation: Madam Auring, a 25-year-old female sought consultation to a health center after having missed one menstrual cycle period. It is confirmed that she is 6 weeks pregnant. 49. Further examination showed that Madam Auring is susceptible to rubella. When would it be most appropriate for her to receive rubella immunization? a. Immediately c. within 2 weeks before EDC b. during 2nd trimester d. During her postpartum hospitalization 50. Rubella, if acquired by a pregnant patient during the pregnancy may result in congenital defects in newborn which includes: 1. deaf-mutism 2. congenital cataract 3.microcephally 4. congenital heart defect 1,2 & 4 2,3& 4 1, 3, & 4 1, 2, 3 & 4 51. The following diseases are characterized by the appearance of skin rashes caused by a virus except: a. measles c. variola b. chickenpox d. scarlet fever
a. b. c. d.

52. A child with rubella should be isolated from a/an a. 20-year-old brother living in the same house b. 3-year-old girl who lives next door c. 12-year-old sister who had rubeola during childhood d. 18-year-old female cousin who recently got married Situation: The patient has a sore that does not heal. Upon examination it reveals leprosy. 53. Mode of transmission of leprosy is a. Sharing food c. Borrowing utensils b. Sexual contact d. Prolonged skin to skin contact 54. Late sign of leprosy in male patients is enlargement of the breast known as: a. Clawing c. Madarosis b. Lagopthalmos d. Gynecomastia 55. Your role in prevention of leprosy is a. Health Education c. Personal Hygiene b. Proper nutrition d. BCG vaccination 56. Multi-drug therapy is being implemented by DOH. Where is the initial treatment done? a. Midwife residence c. baranggay captain office b. barangay health center d. rural health unit 57. Which of the following is/are mild leprae reaction? 1. Edema 2. Sudden increase in the number of lesions 3. Tenderness on the nerve

4. Sudden paralysis a. 1, 2 & 3 are correct b. 1 & 3 are correct c. 2 & 4 are correct d. 4 only e. all of the above 58. A community health nurse is conducting an educational session with community members regarding tuberculosis. The nurse tells the group that one of the first symptoms associated with tuberculosis is a. a bloody, productive cough b. a cough with the expectoration of mucoid sputum c. chest pain d. dyspnea 59. A nurse performs an admission assessment on a client with a diagnosis of tuberculosis. The nurse reviews the results of which diagnostic test that will confirm this diagnosis? a. bronchoscopy c. sputum culture b. chest x-ray film d. tuberculin skin test 60. A client who is HIV (+) has had Mantoux skin test. The nurse notes a 7-mm area of induration at the site of the skin test. The nurse interprets the result as what? a. positive c. inconclusive b. negative d. it needs repeat testing 61. A nurse in the out-patient department performed Mantoux skin test today (Tuesday) to an adult client. What statement made by the client indicates that he understood the instruction well? a. “I will come back on Saturday for you to read the result.” b. “I will come back on Thursday, same time, for you to read the result.” c. “I don’t need to come back anymore.” d. “I will come back anytime.” 62. A client exposed to tuberculosis is taking isoniazid (INH) and develops signs & symptoms of the disease. The client is instructed to add rifampicin & pyrazinamide to the medication regimen. A nurse explains to the client that the purpose of adding this second medication is a. that rifampicin offsets the side effects of isoniazid b. to be certain that resistant organisms are eliminated c. that these medications potentiate each other d. that isoniazid offsets the side effects of rifampicin 63. A nurse is caring for a client diagnosed with tuberculosis. Which assessment, if made by the nurse, would not be consistent with the usual clinical presentation of tuberculosis and may indicate the development of a concurrent problem? a. productive cough c. chills & night sweats b. anorexia & weight loss d. high-grade fever 64. A nurse has conducted discharge teaching with a client who was diagnosed with tuberculosis. The client has been taking medication for a week and a half. The nurse evaluates that the client has understood the information if the client makes which of the following statements? a. “I need to continue drug therapy for 2 months.” b. “I should not be contagious after at least 2 weeks of medication therapy.” c. “I can’t shop at the mall for the next 6 months.” d. “I can return to work if a sputum culture comes back negative.” 65. A client has been taking isoniazid (INH) for a month and a half. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing a. small blood vessel spasm c. impaired peripheral circulation b. hypercalcemia d. peripheral neuritis

66. A client will start a 6-month course therapy with isoniazid (INH). A nurse plans to teach the client to a. use alcohol in small amounts only b. report yellow eyes or skin immediately c. increase intake of cheese & milk d. avoid vitamin supplements during therapy 67. A nurse has given a client taking ethambutol information about the medication. The nurse determines that the client understands the instructions if the client states to immediately report a. gastrointestinal side effects b. impaired sense of hearing c. orange-red discoloration of body secretions d. difficulty in discriminating the color red from green Situation: Mang Romy is malnourished living in a squatter’s area. He came in the health center due to loss of weight easy, fatigability, chronic cough and low grade fever. 68. The main source of infection pulmonary tuberculosis is: a. crowded living quarters b. unavailability of potable drinking water a. direct contact with infected person d. unsanitary surroundings 69. A physician orders an X-ray examination for patient. What is the purpose for this? a. To check if patient have relatives with TB b. To see the evidence of having the disease c. Determine severity of the lesions in the lungs d. To aid in doctors prescriptions. 70. The nurse notes 12 mm of induration at the site of a Mantoux test when a client returns to the health office to have it read. The nurse should explain to the client that this is a. Test result is negative, & no follow-up is needed. b. Test was used for screening and a TINE test will now be given. c. Skin test is inconclusive and will have to be repeated in six weeks. d. The result is positive and a need for further tests, including chest x-ray is indicated 71. Staff nurses learn that a patient they have been caring for during the last few weeks has just been diagnosed with tuberculosis. When the nurses express concern about contracting tuberculosis themselves, the charge nurse’s response should be based on which of the following statements? a. Tuberculosis is easily treated with short course of antibiotics b. The Mantoux test is used to confirm diagnosis of tuberculosis c. Tuberculosis is not highly infectious when standard precautions are followed d. Vaccination with BCG will be used to immunize the nurses against infection 72. Before returning a child who is being treated for tuberculosis to his home, the community health nurse determines a. that the child has a private room b. that all family members have been tested c. proper room ventilation d. home school placement 73. Which of the following statements, if made by a patient who has tuberculosis, would indicate a correct understanding of disease transmission? a. “The disease can be acquired from breast milk.” b. “The disease does not spread beyond the lungs.” c. “I contracted the disease through bird droppings.” d. “I can be infected more than once with this disease.”

74. Which of the following instructions should a nurse give to a patient who has tuberculosis and is receiving rifampicin? a. “Stay out of the sun while you are taking the medication.” b. “Expect your urine to turn reddish-orange.” c. “Take your medication on an empty stomach.” d. “Take your medication until your skin test is negative.” 75. A patient who is taking INH, Rifampicin, PZA and pyridoxine for the treatment of tuberculosis asks a nurse why the Vitamin B6 (pyridoxine) is necessary. The nurse would respond that a. “Vitamin B6 is necessary for the absorption of INH.” b. “Vitamin B6 activates the metabolism of INH.” c. “INH leads to Vitamin B6 depletion, which leads to neurotoxic effects.” d. “INH can cause anorexia, which leads to vitamin B6 depletion.”

76. What is the rationale that supports multidrug treatment for clients with tuberculosis? a. Multiple drugs potentiate the drug actions b. Multiple drugs reduce undesireable side effects c. Multiple drugs allow reduced dosages to be given d. Multiple drugs reduce development of resistant strains of the bacteria 77. The client with TB is to be discharged home with community health nurse follow-up. Of the following interventions, which would have the highest priority? a. offering the client emotional support b. teaching the client about the disease and its treatment c. coordinating various agency services d. Assessing the client’s environment for sanitation 78. The nurse should caution sexually active female clients taking INH that the drug has which of the following effects? a. Increases the risk of vaginal infection b. Has mutagenic effects on ova c. Decreases the effectiveness of oral contraceptives d. Inhibits ovulation 79. Clients who have had active TB are at risk for recurrence. Which of the following conditions increases that risk? b. Cool and damp weather c. Active exercise and exertion d. Physical and emotional stress e. Rest and inactivity 80. The nurse should include which of the following instructions when developing a teaching plan for clients who are receiving INH and rifampicin for treatment of TB? a. Take the medications with antacids b. Double the dosage if a drug dose is forgotten c. Increase intake of dairy products d. Limit alcohol intake

81. A delivery room nurse was unable to perform newborn care to a neonate. In the history of the postpartum mother, she recently was diagnosed with gonococcal infection that was untreated. Which of the following will most likely to occur in the neonate? a. The neonate will have bleeding problems due to lack of vitamin K b. The neonate will develop ophthalmia neonatorum c. The neonate will not have any medical problems d. The neonate will develop respiratory failure 82. Cristina Yap, a 30-year-old female came to a clinic due to burning sensation in the genital area. The physician diagnosed her with non-gonococcal urethritis. The nurse knows that the most likely etiologic agent of non-gonococcal urethritis is a. Neiserria gonorrhea c. Chlamydia trachomatis b. Trichomonas vaginalis d. Haemophilus ducreyi Situation: A 24-year-old male presents to the OPD with a 3 day history of burning sensation on urination which progressed to the development of purulent, yellowish-to-greenish urethral discharge. The nurse suspects of STD. 83. On laboratory examination, the diagnosis of gonorrhea is confirmed by which of the following on the report of the staining result? a. Gram negative intracellular diplocci c. Numerous spirochetes b. Gram positive extracellular diplococci d. Gram negative extracellular diplococci 84. The nurse knows that the easiest factor to break in the infectious process to prevent STD spread would be a. Reservior c. Agent b. Mode of transmission d. Portal of entry 85. The prevention and control of STD is made difficult by a. Lack of drugs specific for STD c. No government program on STD b. Self-medication of infected persons d. Lack of better laboratory facility 86. Nurse is very active in contact tracing and epidemiologic treatment of all gonococcal identified contacts to prevent a. Development of resistant strain c. Non venereal transmission b. Asymptomatic infection d. Re-infection 87. The patient made the following statement to the nurse. Which statement would need reinforcement of health teachings? a. I need to take drugs for prophylaxis the next time I do it b. Gonorrhea does not confer lifelong immunity c. The disease can also be transmitted through other means d. I will finish the prescribed medication to prevent resistance of microorganism 88. A female client with gonorrhea informs the nurse that she had sexual intercourse with her boyfriend and asks the nurse “Would he experience any symptoms? The nurse responds that in males, the initial manifestation is a. Impotence b. Scrotal swelling c. Sterility d. Dysuria Situation: Mr. Larry Hipolito, a 25 y/o male came to an out-patient clinic complaining of pain over the hypogastrium & yellowish discharge from his urethra. A diagnosis of gonorrhea is made. 89. Since Larry has gonorrhea, he most likely has which of these symptoms?

a. a maculo-papular rash on the pubic area b. a painless ulcer on the penis c. wart-like lesions on the scrotum d. pain upon urination 90. Larry was instructed to remain in the clinic for at least 30 minutes so that adverse reactions to the medication can be detected. Which of these comments made by Larry is indicative of an adverse reaction to the specific drug? a. “My chest feels tight” b. “I need to go to the bathroom.” c. “I need a glass of water.” d. “My hands are shaky.” 91. Characteristic lesion of primary syphilis is a. chancroid b. condyloma lata c. gumma d. chancre 92. A client is suspected of having late-stage syphilis. When obtaining a health history, the nurse recognizes that the statement by the client that would most support this diagnosis would be a. “I noticed a wart on my penis.” b. “I have sores all over my mouth.” c. “I have been losing a lot of hair lately.” d. “I’m having trouble keeping my balance.” Situation: Mark Smith, a 37 y/o male has 19 years history of IV drug abuse. He has poor appetite, nausea, & weight loss of 10 kg in the past 6 months. A diagnosis of HIV was made. 93. To initiate a nursing care plan for Mr. Smith, the nurse should consider that a depressed immune system is caused by which of these pathophysiological alterations? a. Decreased leucocyte count b. low platelet count c. reduction of nucleated RBC d. Increased sedimentation rate 94. Lesions that will characterize Mr. Smith is in the advanced stage of the illness is a. condyloma lata b. gumma c. Kaposis sarcoma d. Pneumocyctis carinii pneumonia 95. A patient who is HIV positive is admitted to an isolation unit for treatment of tuberculosis. The nurse observes that the patient has difficulty following instructions, short-term memory loss & difficulty concentrating. The nurse should be aware that these behaviors a. will disappear when isolation is no longer required b. are symptoms of AIDS dementia complex c. are normal for the early stage of infection d. are a result of mycobacterium infection 96 A patient who has AIDS develops Pneumocyctis carinii pneumonia (PCP). The patient asks the nurse, “How did I get this pneumonia?” The nurse’s response should be based on which of these statements about PCP? a. It occurs in immunosuppresed persons from proliferation of organisms that are normally present in the body b. It is transmitted from close contact with an infected individual who has a suppressed immune system. c. It results from exposure to a carrier of the organism who has not taken appropriate

precautions. d. It is most often acquired from unprotected sex with an infected individual. 97. HIV-positive patient is prescribed zidovudine and ganciclovir. The nurse should be aware that both drugs have which of the following side effects? a. Peripheral neuropathy b. Insomnia c. Anticholinergic effects d. Bone marrow suppression 98. Blood screening tests of the immune system of a client with AIDS would indicate a. a decrease in CD4 T cells b. an increase in thymosine (thymic hormone) c. an increase in immunoglobulin E d. a decrease in erythrocytes 99. Santos, a 48-year-old male is an HIV suspect admitted in San Lazaro. In assessing the patient’s condition for possible HIV infection, the least expected symptom to occur is a. Night sweating b. Fever c. Fungal infection in the mouth d. Acute diarrhea 100. The client with AIDS has raised dark purplish-colored lesions on the trunk of the body. The nurse anticipates that which of the following procedures will be done to confirm whether these lesions are due to Kaposi’s sarcoma? a. Enzyme-linked immunosorbent assay c. western blot b. skin biopsy d. lung biopsy

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