Chapter 26 Infectious Diseases Flashcards Preview

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Flashcards in Chapter 26 Infectious Diseases Deck (80)
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1
Q
1.  According to Part G of the Ryan White Comprehensive AIDS Resources Emergency Act, medical facilities are required to notify emergency responders of potentially infectious diseases involving patients they transported no longer than \_\_\_ hours from the time they have a suspect case.
A)  6
B)  12
C)  24
D)  48
A

Ans: D
Page: 1288
Type: General Knowledge

2
Q
  1. Which of the following examples provides the BEST description of indirect contact with a microorganism?
    A) Becoming infected with West Nile virus from a mosquito bite
    B) Touching a bloody stretcher railing with an open wound on your hand
    C) Inhaling infected droplets from a person after he or she sneezes or coughs
    D) Making brief physical contact with a person who has an infectious disease
A

Ans: B
Page: 1290
Type: General Knowledge

3
Q
3.  Which of the following is NOT a factor in determining a person's risk of contracting an infectious disease following exposure?
A)  The organism's mode of entry
B)  The virulence of the organism
C)  The age and sex of the patient
D)  Host resistance of the individual
A

Ans: C
Page: 1295
Type: General Knowledge

4
Q
  1. Unlike bacteria, viruses:
    A) can only multiply outside a host.
    B) die when exposed to the environment.
    C) can only be contracted by direct contact.
    D) are larger and reproduce outside the cell.
A

Ans: B
Page: 1296
Type: General Knowledge

5
Q
5.  When a disease infects large numbers of people and spreads all over the world, it is considered a(n):
A)  endemic.
B)  epidemic.
C)  outbreak.
D)  pandemic.
A

Ans: D
Page: 1289
Type: General Knowledge

6
Q
  1. Virulence is defined as the:
    A) severity of infection once an organism enters the body.
    B) degree of difficulty that it takes to destroy an organism.
    C) ability of an organism to invade and create disease in a host.
    D) amount of time that it takes for an organism to infect the host.
A

Ans: C
Page: 1295
Type: General Knowledge

7
Q
7.  An individual's ability to fight off infection is called:
A)  virulence.
B)  immunity.
C)  host resistance.
D)  communicability.
A

Ans: C
Page: 1295
Type: General Knowledge

8
Q
8.  A person is exposed to the mumps virus, is asymptomatic for 16 days, and then becomes ill. The 16-day period is called the:
A)  incubation period.
B)  resistance period.
C)  virulent period.
D)  communicable period.
A

Ans: A
Page: 1295
Type: General Knowledge

9
Q
9.  In the context of a communicable disease, a \_\_\_\_\_\_\_\_\_\_\_ is a place where organisms may live and multiply.
A)  host
B)  reservoir
C)  carrier
D)  contaminant
A

Ans: B
Page: 1296
Type: General Knowledge

10
Q
  1. A health care worker’s fear of contracting a communicable disease is MOST often the result of:
    A) obsessive-compulsive disorder.
    B) statistics published by the media.
    C) a prior history of disease exposure.
    D) a lack of proper education and training.
A

Ans: D
Page: 1289
Type: General Knowledge

11
Q
  1. After an employee who believes he or she has been exposed to an infectious disease notifies the designated infection control officer (DICO), the DICO should:
    A) execute the postexposure plan within 24 to 36 hours.
    B) determine whether an actual exposure occurred.
    C) immediately refer the employee to a designated physician.
    D) obtain the patient’s consent to have his or her blood drawn.
A

Ans: B
Page: 1293
Type: General Knowledge

12
Q
  1. In contrast to body substance isolation precautions, standard precautions:
    A) is a term used to describe infection control practices that reduce the risk of exposure to blood.
    B) describe a universal approach in which all blood and bodily fluids are assumed to be infectious.
    C) emphasize protection from moist body substances that may transmit bacterial or viral infections.
    D) specify that sweat is an effective carrier of infectious diseases, even if the sweat makes contact with intact skin.
A

Ans: C
Page: 1294
Type: General Knowledge

13
Q
13.  Which of the following is NOT included in the Centers for Disease Control and Prevention's list of recommended immunizations and tests for health care providers?
A)  Annual HIV testing
B)  Hepatitis B vaccine
C)  TB testing
D)  Measles, mumps, and rubella
A

Ans: A
Page: 1294
Type: General Knowledge

14
Q
  1. Personal protective equipment:
    A) serves as a secondary protective barrier beyond what your body provides.
    B) is a standardized set of equipment that is used with every patient contact.
    C) is the most effective means of preventing the spread of an infectious disease.
    D) is required by the CDC when a paramedic draws blood or gives an injection.
A

Ans: A
Page: 1290
Type: General Knowledge

15
Q
  1. Which of the following medical procedures would pose the LEAST risk of exposure to an infectious disease?
    A) Administering a subcutaneous injection
    B) Covering a wound that is bleeding minimally
    C) Delivering the baby of an HIV-negative mother
    D) Assessing a patient’s temperature by the oral route
A

Ans: D
Page: 1290
Type: General Knowledge

16
Q
  1. When washing your hands after a call, you should:
    A) wash your hands for at least 10 seconds.
    B) use an antimicrobial, alcohol-based foam or gel.
    C) wash with cold water and let your hands air dry.
    D) scrub your hands vigorously with an antibacterial gel.
A

Ans: B
Page: 1290
Type: General Knowledge

17
Q
17.  Most infectious disease exposures in health care providers occur due to:
A)  indirect contact.
B)  blood splatter.
C)  sharps injuries.
D)  inhaled droplets.
A

Ans: C
Page: 1292
Type: General Knowledge

18
Q
18.  Postexposure prophylaxis is available for all of the following diseases, EXCEPT:
A)  HIV.
B)  hepatitis C.
C)  syphilis.
D)  gonorrhea.
A

Ans: B
Page: 1292
Type: General Knowledge

19
Q
19.  Following a significant exposure, the source patient is routinely tested for all of the following, EXCEPT:
A)  HIV.
B)  HCV antibody.
C)  HBV antigen.
D)  HBV antibody.
A

Ans: D
Page: 1292-1293
Type: General Knowledge

20
Q
  1. According to the Ryan White Comprehensive AIDS Resources Emergency Act, the medical facility must:
    A) release the source patient’s status to the designated infection control officer.
    B) hold the source patient’s laboratory results for 24 hours before releasing them.
    C) avoid releasing the source patient’s status to anyone due to HIPAA regulations.
    D) release the source patient’s HIV and hepatitis B status to the exposed employee.
A

Ans: A
Page: 1293
Type: General Knowledge

21
Q
  1. Work restriction guidelines enforced by OSHA require an employee to use sick time for an illness, unless:
    A) the employee opted to take the hepatitis B vaccine.
    B) a physician deems that the illness was unavoidable.
    C) the illness is the result of an occupational exposure.
    D) the illness occurred after the post-hire probation period.
A

Ans: C
Page: 1294
Type: General Knowledge

22
Q
22.  When obtaining the SAMPLE history of a person suspected of having an infectious disease, you should specifically inquire about:
A)  the patient's HIV status.
B)  a history of recent travel.
C)  any prior hospitalizations.
D)  the last sexual encounter.
A

Ans: B
Page: 1295
Type: General Knowledge

23
Q
23.  A common sign of the measles is:
A)  petechiae.
B)  a blotchy red rash.
C)  severe diarrhea.
D)  a purpuric rash.
A

Ans: B
Page: 1314
Type: General Knowledge

24
Q
24.  The onset of fever commonly occurs as early as \_\_\_ days following exposure to the measles.
A)  2
B)  3
C)  5
D)  7
A

Ans: D
Page: 1314
Type: General Knowledge

25
Q
25.  Rubella is characterized by:
A)  a low-grade fever.
B)  visual disturbances.
C)  abdominal discomfort.
D)  an isolated facial rash.
A

Ans: A
Page: 1314-1315
Type: General Knowledge

26
Q
26.  According to the Centers for Disease Control and Prevention, all children should be immunized against all of the following diseases, EXCEPT:
A)  smallpox.
B)  hepatitis B.
C)  seasonal influenza.
D)  Haemophilus influenzae type b.
A

Ans: A
Page: 1315
Type: General Knowledge

27
Q
  1. When disinfecting the ambulance after transporting a patient with rubella, you should:
    A) use a 1:1 bleach and water mixture.
    B) clean all surfaces with boiling water.
    C) use standard disinfection procedures.
    D) remove all equipment from the ambulance.
A

Ans: C
Page: 1315
Type: General Knowledge

28
Q
  1. Which of the following statements regarding the mumps is correct?
    A) Mumps can cause sterility in males past the age of puberty.
    B) Postexposure vaccination against the mumps is recommended.
    C) Mumps presents with fever and swelling of the parotid glands.
    D) A variety of bacteria have been identified as causing the mumps.
A

Ans: C
Page: 1315
Type: General Knowledge

29
Q
29.  Transmission of mumps occurs by direct contact with the \_\_\_\_\_\_\_\_ of an infected person.
A)  tears
B)  saliva
C)  sweat
D)  blood
A

Ans: B
Page: 1315
Type: General Knowledge

30
Q
30.  In older adults, shingles arises when the \_\_\_\_\_\_\_\_\_ virus resides in the ganglion of a nerve.
A)  rubella
B)  varicella
C)  rubeola
D)  herpes
A

Ans: B
Page: 1315-1316
Type: General Knowledge

31
Q
31.  Which of the following diseases is bacterial in nature, has an insidious onset, and is characterized by an irritating cough that may become paroxysmal in about 1 to 2 weeks?
A)  Tetanus
B)  Bronchitis
C)  Diphtheria
D)  Pertussis
A

Ans: D
Page: 1316
Type: General Knowledge

32
Q
  1. Which of the following statements regarding meningitis is correct?
    A) Most epidemic outbreaks involve meningococcal meningitis.
    B) Neisseria meningitidis is the least common type of meningitis.
    C) The viral form of meningitis is a highly communicable disease.
    D) Meningitis is an acute viral inflammation of the cerebral meninges.
A

Ans: A
Page: 1297
Type: General Knowledge

33
Q
  1. Common signs and symptoms of meningitis include:
    A) irritability, back pain, headache, and hypertension.
    B) slow-onset fever, tinnitus, and an occipital headache.
    C) mental status changes, fever, stiff neck, and headache.
    D) a dark red rash, combativeness, and a low-grade fever.
A

Ans: C
Page: 1297
Type: General Knowledge

34
Q
34.  Antibiotic therapy following exposure to meningitis is NOT appropriate for individuals who are:
A)  taking birth control pills.
B)  older than 45 years of age.
C)  asymptomatic after 24 hours.
D)  severely immunocompromised.
A

Ans: A
Page: 1297
Type: General Knowledge

35
Q
  1. A person with TB infection:
    A) poses a significant health risk to others.
    B) has active TB and is highly contagious.
    C) usually has a negative chest radiograph.
    D) has tested positive for exposure to TB.
A

Ans: D
Page: 1297-1298
Type: General Knowledge

36
Q
36.  Common signs and symptoms of TB include all of the following, EXCEPT:
A)  hemoptysis.
B)  photophobia.
C)  weight loss.
D)  a persistent cough.
A

Ans: B
Page: 1298
Type: General Knowledge

37
Q
  1. A paramedic would MOST likely be infected with TB if he or she:
    A) was close to a coughing patient who had a positive TB skin test.
    B) performed mouth-to-mouth on a patient with active untreated TB.
    C) was exposed to blood-stained vomitus of a patient with active TB.
    D) received a needlestick from a person suspected of having active TB.
A

Ans: B
Page: 1298
Type: General Knowledge

38
Q
  1. A person who is taking antibiotic therapy following a positive TB skin test and chest radiograph should not consume alcohol because:
    A) this increases the risk of active TB.
    B) alcohol can cause a violent reaction.
    C) the antibiotics are toxic to the liver.
    D) alcohol causes immunocompromise.
A

Ans: C
Page: 1298
Type: General Knowledge

39
Q
39.  The leading cause of lower respiratory tract infections in infants, older people, and immunocompromised individuals is the:
A)  rotovirus.
B)  influenza virus.
C)  parainfluenza virus.
D)  respiratory syncytial virus.
A

Ans: D
Page: 1299
Type: General Knowledge

40
Q
  1. Mononucleosis is caused by the ___________________ and grows in the ________________.
    A) Epstein-Barr virus, epithelium of the oropharynx
    B) pneumococcal bacterium, inner lining of the lungs
    C) streptococcus bacterium, epithelial cells of the trachea
    D) cytomegalovirus, nasopharyngeal mucous membranes
A

Ans: A
Page: 1300
Type: General Knowledge

41
Q
  1. The clinical presentation of mononucleosis includes:
    A) fever, swollen lymph glands, and an enlarged spleen.
    B) vomiting, a fever greater than 102°F, and shaking chills.
    C) hemoptysis, low-grade fever, and up to 10% weight loss.
    D) nasal drainage, a dry cough, and right upper quadrant pain.
A

Ans: A
Page: 1300
Type: General Knowledge

42
Q
  1. If you do not receive a flu vaccine and are exposed to a person with the flu:
    A) symptoms of the flu, if you contract it, will become evident within 12 to 24 hours after the exposure.
    B) antiviral drugs may be given within 48 hours after the exposure to reduce the severity of the flu if you contract it.
    C) an injection of immune globulin given within 12 hours after the exposure will prevent you from contracting the flu.
    D) a nasal spray that contains the live flu virus in an attenuated form will be administered to you within 48 hours.
A

Ans: B
Page: 1301
Type: General Knowledge

43
Q
  1. Transmission of gonorrhea occurs when contact is made with:
    A) the infected person’s blood through an area where the skin is not intact.
    B) pus-containing fluid from the mucous membranes of the infected person.
    C) any portion of the infected person’s genitalia during sexual intercourse.
    D) all of the infected person’s bodily fluids, with or without sexual contact.
A

Ans: B
Page: 1301
Type: General Knowledge

44
Q
  1. Gonorrhea in females:
    A) is usually more acute and pronounced than it is in males.
    B) typically manifests as dysuria within 24 hours of infection.
    C) often goes unnoticed until signs of acute abdomen appear.
    D) remains communicable for up to 48 hours after treatment.
A

Ans: C
Page: 1301
Type: General Knowledge

45
Q
  1. The primary infection with syphilis produces:
    A) numerous small pustules on the genitalia.
    B) low-grade fever and pain in the genital area.
    C) an ulcerative chancre at the site of infection.
    D) dysuria and a purulent discharge in the urine.
A

Ans: C
Page: 1301
Type: General Knowledge

46
Q
46.  Secondary syphilitic infection is characterized by all of the following, EXCEPT:
A)  petechiae.
B)  a skin rash.
C)  patchy hair loss.
D)  swollen lymph glands.
A

Ans: A
Page: 1301
Type: General Knowledge

47
Q
  1. Which of the following statements regarding genital herpes is MOST correct?
    A) The lesions of genital herpes remain infectious for 12 to 24 days.
    B) The incubation period for genital herpes often lasts up to 3 weeks.
    C) In females, genital herpes presents as a single vesicle on the vulva.
    D) Acyclovir is used to reduce a herpetic outbreak, but there is no cure.
A

Ans: D
Page: 1302
Type: General Knowledge

48
Q
48.  In males, infection with Chlamydia trachomatis would MOST likely lead to:
A)  hepatitis.
B)  prostatitis.
C)  bladder cancer.
D)  testicular torsion.
A

Ans: B
Page: 1302
Type: General Knowledge

49
Q
49.  Chlamydia trachomatis is caused by a \_\_\_\_\_\_\_\_\_ and is treated with an \_\_\_\_\_\_\_\_\_.
A)  bacterium, antibiotic
B)  virus, antiviral drug
C)  fungus, antifungal drug
D)  virus, immunoglobulin
A

Ans: A
Page: 1302-1303
Type: General Knowledge

50
Q
50.  Nocturnal itching and the presence of a rash involving the hands are indicative of:
A)  lice.
B)  herpes.
C)  scabies.
D)  shingles.
A

Ans: C
Page: 1303
Type: General Knowledge

51
Q
  1. If a paramedic is exposed to lice:
    A) he or she should immediately report to the designated infection control officer for prophylactic antiviral treatment.
    B) permethrin cream treatment may be prescribed and restrictions from patient care may be indicated until the paramedic is free of lice.
    C) infection is unlikely because paramedics have strong immune systems due to exposure to patients with various diseases.
    D) a specially made shampoo that contains a combination of a steroid and an antibiotic should be used within 6 hours after exposure.
A

Ans: B
Page: 1303
Type: General Knowledge

52
Q
52.  Hepatitis B is also referred to as:
A)  CSF hepatitis.
B)  fecal hepatitis.
C)  enteral hepatitis.
D)  serum hepatitis.
A

Ans: D
Page: 1304
Type: General Knowledge

53
Q
53.  Following exposure to the hepatitis B virus, a person may remain asymptomatic for up to:
A)  200 days.
B)  250 days.
C)  300 days.
D)  an entire year.
A

Ans: A
Page: 1304
Type: General Knowledge

54
Q
54.  Early signs and symptoms of hepatitis B infection include all of the following, EXCEPT:
A)  fatigue.
B)  anorexia.
C)  jaundice.
D)  low-grade fever.
A

Ans: C
Page: 1304
Type: General Knowledge

55
Q
  1. The third dose of the three-series hepatitis B vaccine is given:
    A) 6 months after the first dose.
    B) 4 weeks after the second dose.
    C) 12 months after the initial dose.
    D) within 2 to 3 months of the second dose.
A

Ans: A
Page: 1304
Type: General Knowledge

56
Q
  1. If you are exposed to the hepatitis B virus and have a positive titer on file:
    A) the source patient will be retested.
    B) no follow-up treatment is required.
    C) the vaccination series should be repeated.
    D) you will be offered HBV immune globulin.
A

Ans: B
Page: 1305
Type: General Knowledge

57
Q
  1. Occupationally acquired hepatitis C virus infection:
    A) is not possible because an effective one-series vaccine is available.
    B) is most commonly contracted via blood exposure to nonintact skin.
    C) occurs by ingestion of food that is contaminated with infected feces.
    D) is related to a contaminated needlestick with visible blood on the sharp
A

Ans: D
Page: 1305
Type: General Knowledge

58
Q
  1. Most patients infected with the hepatitis C virus are unaware that they acquired the infection because:
    A) a blood test to detect the virus does not exist.
    B) they do not develop phase 2 signs and symptoms.
    C) the incubation period ranges from 15 to 20 years.
    D) hepatitis C does not produce any signs or symptoms.
A

Ans: B
Page: 1305
Type: General Knowledge

59
Q
  1. Which of the following statements regarding the hepatitis D virus (HDV) is MOST correct?
    A) The typical incubation period for HDV infection ranges from 180 to 360 days.
    B) The most common route of transmission of HDV is through sexual contact.
    C) Infection with HDV requires the host to be infected with the hepatitis B virus.
    D) If a documented exposure occurs, testing begins with the person who was exposed.
A

Ans: C
Page: 1304-1305
Type: General Knowledge

60
Q
60.  The primary target of infection with the human immunodeficiency virus is the:
A)  immune system.
B)  lymphatic system.
C)  pulmonary system.
D)  central nervous system.
A

Ans: A
Page: 1305-1306
Type: General Knowledge

61
Q
61.  The communicable period for HIV:
A)  is largely unknown.
B)  ranges from 7 to 10 days.
C)  begins at the onset of infection.
D)  is decreased with antiretroviral therapy.
A

Ans: A
Page: 1306
Type: General Knowledge

62
Q
62.  Signs and symptoms of HIV infection may include all of the following, EXCEPT:
A)  acute febrile illness.
B)  swollen lymph glands.
C)  malaise and a headache.
D)  right upper quadrant pain.
A

Ans: D
Page: 1306
Type: General Knowledge

63
Q
  1. Acquired immunodeficiency syndrome:
    A) occurs in as many as 85% of HIV-infected individuals.
    B) exists when T-helper lymphocytes are dangerously high.
    C) most often occurs within 5 to 10 years of HIV infection.
    D) is characterized by the presence of opportunistic infections.
A

Ans: D
Page: 1306
Type: General Knowledge

64
Q
  1. If the source patient’s blood tests positive for HIV:
    A) the exposed individual will receive a one-time injection of immune globulin and will be tested for HIV in 2 weeks.
    B) the blood will be assessed for viral load and the exposed individual may be offered a 4-week trial of antiretroviral therapy.
    C) the most rapid method for determining if the exposed individual was infected is by assessing his or her lymphocyte count.
    D) federal law requires that the exposed individual be placed on antiretroviral therapy and not be allowed to work in a health care setting.
A

Ans: B
Page: 1306
Type: General Knowledge

65
Q
  1. Hepatitis A is often described as a benign disease because:
    A) people with hepatitis A are typically asymptomatic.
    B) there is an effective vaccination to prevent infection.
    C) lifelong immunity occurs once the disease is acquired.
    D) no known method of transmission has been identified.
A

Ans: C
Page: 1308
Type: General Knowledge

66
Q
  1. In addition to children, the hepatitis A vaccine is recommended for:
    A) any health care worker who functions in an actual patient care setting.
    B) emergency response team members traveling outside the United States.
    C) all Federal Emergency Management Agency response team members.
    D) all health care workers when an outbreak of hepatitis A is documented.
A

Ans: B
Page: 1308
Type: General Knowledge

67
Q
67.  In developing countries, there is a strong association between the hepatitis E virus and:
A)  inadequate hygiene.
B)  sexual intercourse.
C)  infection with HIV.
D)  blood transfusions.
A

Ans: A
Page: 1308
Type: General Knowledge

68
Q
  1. Which of the following statements regarding West Nile virus (WNV) is correct?
    A) It is estimated that approximately 20% to 30% of mosquitoes carry WNV.
    B) The incubation period for WNV is 3 to 14 days following the bite of an infected tick.
    C) Up to 80% of people infected with WNV experience a severe headache, body rash, and fever.
    D) There is no period of communicability because WNV is not transmitted from person to person.
A

Ans: D
Page: 1308-1309
Type: General Knowledge

69
Q
  1. The avian flu:
    A) is caused by a virus that occurs naturally in the bird population.
    B) is typically contracted by people who cook and eat infected chickens.
    C) has been linked directly to the hantavirus found in the feces of rodents.
    D) is preventable if antiviral drugs are given within 48 hours after exposure.
A

Ans: A
Page: 1317
Type: General Knowledge

70
Q
  1. The MOST effective ways to protect your patients from nosocomial infections include:
    A) placing gloves on all patients with drug-resistant infections and placing a mask on yourself.
    B) routinely placing masks on all patients you treat and ensuring that your vaccinations are current.
    C) not reporting to work when you are sick and keeping the interior of the ambulance clean and disinfected.
    D) receiving the hepatitis B vaccine, having a titer drawn every 2 years, and wearing gloves on every EMS call.
A

Ans: C
Page: 1289
Type: General Knowledge

71
Q
  1. You receive a call for a 33-year-old man with difficulty breathing. Upon arrival, you begin to assess the patient, who tells you that he is HIV-positive. During the primary assessment, you should:
    A) immediately place a nonrebreathing mask on the patient.
    B) identify and correct immediately life-threatening conditions.
    C) inquire about any antiretroviral medications he is taking.
    D) apply two pairs of gloves in case you encounter any gross bleeding.
A

Ans: B
Page: 1295
Type: Critical Thinking

72
Q
  1. A 49-year-old woman presents with a severe headache, a temperature of 103.2°F, and photosensitivity. Her blood pressure is 140/76 mm Hg, pulse rate is 120 beats/min and strong, and respiratory rate is 22 breaths/min and regular. While caring for this patient, it is MOST important to:
    A) apply a cardiac monitor and assess her tachycardia.
    B) protect yourself from any nasopharyngeal secretions.
    C) treat her as though she is experiencing viral meningitis.
    D) attempt to assist her ventilations with a bag-mask device.
A

Ans: B
Page: 1297
Type: Critical Thinking

73
Q
  1. While assessing a 59-year-old man with an acute onset of crushing chest pain and diaphoresis, the patient tells you that he recently tested positive to a tuberculin skin test. His vital signs reveal hypertension and tachycardia. You should be MOST concerned with:
    A) applying a mask to the patient to reduce your chance of exposure.
    B) reporting this to your supervisor and receiving a tuberculin skin test.
    C) establishing vascular access and rapidly transporting to the hospital.
    D) the fact that he may be experiencing an acute myocardial infarction.
A

Ans: D
Page: 1297-1298
Type: Critical Thinking

74
Q
74.  You are dispatched to an apartment complex for a 20-year-old woman who is sick. When you arrive at the scene and begin assessing the patient, she tells you that she has been experiencing a purulent vaginal discharge, but denies vaginal bleeding or a fever. Her blood pressure is 104/64 mm Hg, pulse rate is 88 beats/min and strong, and respirations are 14 breaths/min and regular. This patient MOST likely has:
A)  syphilis.
B)  chlamydia.
C)  gonorrhea.
D)  pelvic inflammatory disease.
A

Ans: C
Page: 1301
Type: Critical Thinking

75
Q
  1. A 70-year-old homeless man presents with a rash to his hands, wrists, and ankles. He denies any known allergies and states that the rash itches severely at night. His vital signs are stable, and he is breathing without difficulty. You should:
    A) transport him to the hospital and thoroughly wash your hands after patient care has been completed.
    B) establish vascular access in case he begins to experience signs and symptoms of a severe allergic reaction.
    C) be highly suspicious that he has body lice and use a high-level disinfectant when cleaning the ambulance.
    D) administer 25 mg of diphenhydramine IM and transport him to an appropriate medical facility.
A

Ans: A
Page: 1303
Type: Critical Thinking

76
Q
76.  A known intravenous drug abuser presents with anorexia, body aches, a low-grade fever, and scleral icterus. She is very quiet and is not willing to share her medical history information with you. Which of the following additional clinical signs would reinforce your suspicion regarding the cause of this patient's condition?
A)  Jaundiced skin
B)  Blood-tinged sputum
C)  Swollen lymph glands
D)  Red or purple skin lesions
A

Ans: A
Page: 1304
Type: Critical Thinking

77
Q
  1. You receive a call for an “unresponsive person.” Law enforcement arrives at the scene before you and advises that the scene is secure. When you arrive, you find the patient, a young man, lying supine on the floor of his poorly kept apartment. He is unresponsive and is breathing with a marked reduction in tidal volume. One of the police officers recognizes the patient as a known intravenous drug abuser. During your care of this patient, you should:
    A) apply a nonrebreathing mask and set the flow rate at 15 L/min.
    B) avoid removing his wallet or any other possessions from his pockets.
    C) defer vascular access until the patient is in the emergency department.
    D) establish an IV line of normal saline and administer 2 mg of flumazenil.
A

Ans: B
Page: 1305
Type: Critical Thinking

78
Q
  1. You and your partner are transferring a 76-year-old woman from a local nursing facility to the emergency department for evaluation of an acute onset of fever. While reviewing the transfer record, you note that the patient was recently treated with daptomycin. This patient MOST likely has:
    A) vancomycin-resistant enterococci.
    B) hemorrhagic fever caused by hantavirus.
    C) an infection caused by the hepatitis A virus.
    D) methicillin-resistant staphylococcus aureus.
A

Ans: D
Page: 1311
Type: Critical Thinking

79
Q
  1. After delivering a patient with a high fever and dry cough to the emergency department, you are later informed that the patient was diagnosed with severe acute respiratory syndrome. Reflecting back on the care you provided to the patient, you recall being in close proximity to her because she was hearing impaired, but you do not recall wearing a protective mask. What will MOST likely happen?
    A) There will be no special precautions taken because you did not receive a significant exposure.
    B) You will be tested for HIV and hepatitis B, and will be placed on a 7-day trial of antibiotics.
    C) You may be quarantined for up to 10 days and will be asked to check your temperature daily.
    D) You will receive an immune globulin injection and will not be allowed to return to work for a week.
A

Ans: C
Page: 1317
Type: Critical Thinking

80
Q
  1. You transported a patient with flu-like symptoms to the hospital 4 days ago. Your designated infection control officer advises you that the patient was diagnosed with the avian flu. If you documented an exposure to this patient, you will MOST likely be:
    A) offered an antiviral medication.
    B) referred to an infectious disease physician.
    C) restricted from duty for a 2-week period.
    D) mandated to get a regular flu vaccination.
A

Ans: A
Page: 1317
Type: Critical Thinking