Title EVAL EXAM - CD (KEY) ✅

REFRESHER PHASE EVALUATIVE EXAMINATION COMMUNICABLE DISEASE NOVEMBER 2024 Philippine Nurse Licensure Examination Review 1. Which of the following information about a client who has meningococcal meningitis has the best indicator that you can discontinue droplet precautions? A. Pupils are equal and reactive to light B. Temperature is lower than 100°F (37.8°C) C. Appropriate antibiotics have been given for 24 hours D. Cough is productive of clear, non-purulent mucus 2. You are preparing to care for a 6-year-old who has just undergone allogeneic stem cell transplantation and will need protective environment isolation. Which nursing tasks will you delegate to a nursing assistant? Select all that apply. A. Teaching the client to perform thorough hand washing after using the bathroom. B. Talking to the family members about the reasons for the isolation. C. Stocking the client’s room with the needed PPE items. D. Reminding visitors to wear a respirator mask, gloves, and gown. E. Posting the precautions for protective isolation on the door of the client’s room. A. C, D, E B. A, C, D C. C, D, A D. All of the above 3. You are preparing to insert a PICC line in a client's left forearm. Which solution will be best for cleaning the skin prior to the PICC insertion? A. 70% isopropyl alcohol B. Povidone-iodine (Betadine) C. 0.5% chlorhexidine in alcohol D. Betadine followed by 70% isopropyl alcohol 4. While working in a pediatric clinic, you receive a telephone call from the parent of a 10-year-old who is receiving chemotherapy for leukemia. The client’s sibling has chickenpox. Which of these actions will you anticipate taking next? A. Administer varicella-zoster immune globulin to the client B. Educate the parent about the correct use of acyclovir (Zovirax) C. Prepare the client for admission to a private room in the hospital D. Teach the parents regarding contact and airborne precaution 5. Which action will you take to most effectively reduce the incidence of hospital-associated urinary tract infections? A. Ensure that clients have enough adequate fluid intake B. Teach assistive personnel how to provide good perineal hygiene C. Perform dipstick urinalysis for clients with risk factors for UTI D. Limit the use of indwelling foley catheter (IFC) 6. The drug of choice in filariasis is A. Praziquantel B. Zovirax C. Hetrazan D. Penicillin 7. A client comes to the center consultation with the following complaints: itchiness and eruptive lesions of legs and arms especially body folds like breast groin. History reveals that she is living on a tenement. The nurse will suspect A. Anthrax B. Scabies C. Psoriasis D. Chickenpox 8. Category II treatment regimen is directed towards client with the following condition except A. Extrapulmonary TB B. Previously treated patient with relapses C. Previously treated patients with failures D. None of the above 9. Which of the following is considered chronic signs and symptoms of filariasis A. Splenomegaly B. Chills and fever C. Elephantiasis D. Lymphadenitis 10. Category I treatment regimen is for patients who are considered A. Relapsed cases B. New pulmonary TB sputum positive C. Newly diagnosed by smear negative for 3x D. Not serious extra pulmonary cases 11. Which of the following are the sign and symptoms of schistosomiasis. 1. Diarrhea, bloody stools 2. Splenomegaly and inflamed liver 3. Anemia and weakness 4. Epididymitis and orchitis 5. Lymphangitis and lymphadenitis A. 1, 2, 3 B. 3, 4, 5 C. 2, 4, 5 D. 1, 3, 4 12. Four clients with infections arrive at the emergency department with some existing infection, however, only one private room is available. Which of the following clients is the most appropriate to assign to the private room? A. A client with toxic shock syndrome and a temperature of 102.4°F (39.1°C). B. A client with diarrhea caused by C. difficile. C. A client with a wound infected with VRE. D. A client with a cough who may have Koch disease 13. You are caring for four clients who are receiving IV infusions of normal saline. Which client is at highest risk for bloodstream infections? A. A client who has a non-tunneled central line in the left internal jugular vein. TOPRANK REVIEW ACADEMY, INC. Page 1 | 4
B. A client with an implanted port in the right subclavian vein. C. A client with a peripherally inserted central catheter (PICC) line in the right upper arm. D. A client who has a midline IV catheter in the left antecubital fossa. 14. You are caring for a client who has been admitted to the hospital with a leg ulcer that is infected with vancomycin resistant S. aureus (VRSA). Which of these nursing actions can you delegate to the nurse assistant? A. Assess risk for further skin breakdown B. Plan ways to improve the client’s oral protein intake C. Obtain wound cultures during dressing changes D. Educate the client about home care of the leg ulcer 15. You are the pediatric unit charge nurse today and are working with a new RN. Which action by the new RN requires the most immediate action on your part? A. The new RN wears goggles to change linens of a client who has diarrhea caused by C. difficile. B. The new RN places a child who has chemotherapy induced neutropenia into a negative-pressure room. C. The new RN admits a new client with respiratory syncytial virus (RSV) infection to a room with another child who has RSV. D. The new RN tells the nursing assistant to use an N95 respirator mask when caring for a child who has pertussis. 16. You are a school nurse. Which action will you take to have the most impact on the incidence of infectious disease in the school? A. Provide written information about infection control to all patients. B. Ensure that students are immunized according to national guidelines. C. Make soap and water readily available in the classrooms. D. Teach students how to cover their mouths when coughing. 17. You are caring for a newly admitted client with increasing dyspnea and dehydration who has possible avian influenza (bird flu). Which of these prescribed actions will you implement first? A. Provide oxygen using a non-rebreather mask B. Infuse 5% dextrose in water at 75ml/hr C. Administer the first dose of oseltamivir (Tamiflu) D. Obtain blood and sputum specimens for testing 18. A client comes to the outpatient clinic where you work complaining of abdominal pain, diarrhea, shortness of breath and epistaxis. Which of the following actions would you take first? A. Screening clients for upper respiratory tract symptoms B. Call an ambulance to take the client immediately to the hospital C. Ask the client about any recent travel to Asia or the Middle East D. Determine whether the client has had recommended immunizations 19. What is the drug of choice for schistosomiasis? A. Chloquine phosphates B. Erythromycin C. Hetrazan (diethylcarbamazine citrate) D. Praziquantel (biltricide) 20. The infective stage of the Schistosoma is called A. Cercaria B. Lyssa C. Bilhariasis D. Poecilus 21. The polio vaccine containing live attenuated viruses was developed by A. Salk B. Sabin C. Kock’s D. Saben 22. A client who has recently traveled to China comes to the emergency department (ED) with increasing shortness of breath and is strongly suspected of having a severe acute respiratory syndrome (SARS). Which of these prescribed actions will you take first? A. Obtain blood, urine, and sputum for cultures B. Infuse normal saline at 100ml/hr C. Administer methylprednisolone (Solu-Medrol) 1 gram/IV D. Place the client on contact and airborne precautions 23. The vector responsible for the spread of malaria is A. Culex mosquito B. Anopheles mosquito C. Flies D. Aedes aegypti 24. Which of the following patient is considered at a greater risk of developing splenomegaly? A. Typhoid fever patient B. Malaria patient C. Cholera patient D. H-fever patient 25. The vector of filariasis is known as A. Aedes egypti B. Aedes pocillius C. Plasmodium falciparum D. Oncomelania quadrasi 26. If the sputum is still smear positive at the end of second month of directly observed chemotherapy the midwife will suspect that the patient is A. Defaulter B. Drug sensitive C. Drug resistant D. Delinquent in talking the drugs 27. The continuation phase includes: A. 1 month daily administration of 1 tab inh and 1 cap of rifampicin in one dose B. 3 months daily administration of 2 tab INH and 1 cap rifampicin in one dose C. 2 months administration of 1 tab INH and 1 tab PZA in one dose D. 4 months daily administration of 1 tab of INH and cap Rifampicin in one dose 28. Filariasis patients are advised to observe personal hygiene by A. Washing the affected part with alcohol B. Washing the affected areas with soap and water C. Boiling drinking water D. Cleanliness of the surroundings 29. The modern management of TB patient is A. Confinement in the hospital B. Ambulatory treatment C. Isolation D. Sheltered colony 30. Tuberculosis is spread by the following except. A. Droplet B. Sexual contact C. Direct or indirect contact with person or object contaminated with the organism TOPRANK REVIEW ACADEMY, INC. Page 2 | 4
D. Drinking unpasteurized milk 31. A hospitalized 88-year-old client who has been receiving antibiotics for 10 days tells you that he is having frequent watery stools. Which action will you take first? A. Obtain stool specimens for culture B. Place the client on contact precaution C. Notify the physician about the loose stools D. Instruct the client about correct handwashing 32. You are the charge nurse on the pediatric unit when a pediatrician call wanting to admit a child with rubeola (measles). Which of these factors is of most concern in determining whether to admit the child to your unit? A. No negative-airflow rooms are available on the unit B. The infection control nurse liaison is not on the unit today C. There are several children receiving chemotherapy on the unit D. The unit is not staffed with the usual number of RNs 33. A client who states that he may have been contaminated by anthrax arrives at the ED. The following actions are part of the ED protocol for possible anthrax exposure or infection. Which action will you take first? A. Assess the client for signs of infection B. Notify hospital security personnel about the client C. Escort the client to a decontamination room D. Administer ciprofloxacin (Cipro) 250 mg PO 34. A 26-year-old client is diagnosed with scarlet fever. Which of the following is the most appropriate type of isolation for this client? A. Airborne B. Contact C. Droplet D. Standard 35. Malcolm is newly assigned as a triage nurse, on his first day of work, the following clients arrive at the ED. Which among the clients require the most rapid action to protect other clients in the ED from infection? A. An infant with a runny nose and whose older brother has pertussis. B. A travel blogger who needs tuberculosis testing after an exposure to a person with TB during his trip. C. An elderly woman who has a history of a methicillin resistant Staphylococcus aureus (MRSA) leg wound infection. D. A pregnant woman with a blister-like rash on the face and is possibly having varicella. 36. You are preparing to change the linens on the bed of a client who has a draining sacral wound infected by MRSA. Which PPE items will you plan to use? Select all that apply A. N95 respirator B. Surgical Mask C. Gloves D. Goggles E. Gown A. A & C B. C & E C. B & D D. D & E 37. A client has been diagnosed with disseminated herpes zoster. Which personal protective equipment (PPE) will you need to put on when preparing to assess the client? Select all that apply. A. Goggles B. Gown C. Gloves D. Shoe covers E. N95 respirator F. Surgical face mask A. B, C, E B. A, D, F C. A, B, C D. All of the above 38. A nurse is stuck in the hand by an exposed needle. What immediate action should the nurse take? A. Look up the policy on needle sticks B. Contact employee health services C. Immediately wash the hands with vigor D. Notify the supervisor and risk management 39. A person may become asymptomatic but confirmatory test will reveal the presence of which if the following in the blood? A. Cercariae B. Merozoites C. Microfilariae D. Larvae 40. As the infection control nurse in an acute care hospital, which action will you take to most effectively reduce the incidence of health-care-associated infections? A. Develop policies that automatically start antibiotic therapy for clients colonized by multidrug resistant organisms. B. Screen all newly admitted clients for colonization or infection with MRSA. C. Require nursing staff to don gowns to change wound dressings for all clients. D.Ensure that dispensers for alcohol-based hand rubs are readily available in all client care areas of the hospital. 41. A client with a vancomycin-resistant enterococcus (VRE) infection is admitted to the medical unit. Which action can be delegated to a nursing assistant who is assisting with the client’s care? A. Monitor the results of the laboratory culture and sensitivity test. B. Educate the client and family members on ways to prevent transmission of VRE. C. Implement contact precautions when handling the client. D. Collaborate with other departments when the client is transported for an ordered test. 42. You are preparing to leave the room after performing oral suctioning on a client who is on contact and airborne precautions. In which order will you perform the following actions? 1. Remove N95 respirator 2. Perform hand hygiene 3. Remove gloves 4. Take off goggles 5. Take off the gown A. 1, 4, 5, 3, 2 B. 3, 5, 4, 1, 2 C. 3, 4, 5, 1, 2 D. 3, 4, 1, 5, 2 43. Which of the following infection control activities should be delegated to an experienced nursing assistant? A. Screening clients for upper respiratory tract symptoms B. Disinfecting blood pressure cuffs after clients are discharged C. Demonstrating correct handwashing techniques to client and family D. Asking clients about the duration of antibiotic therapy 44. You happened to glace another client in the health center who appears gaunt looking apprehensive with maculopapular rashes. Upon history taking the patient has been experiencing loss of appetite, marked weight loss, fever, malaise, cough for long duration. History reveals that 2 years ago, the patient TOPRANK REVIEW ACADEMY, INC. Page 3 | 4
received blood transfusion because of surgery. The nurse will suspect A. Hepa A B. Hepa B C. HIV D. Anthrax 45. Which of the following will you advice the client to submit for in order to detect the presence of schistosomiasis organism A. Chest x ray B. Urinalysis C. Stool examination D. Platelet count 46. The mother of a 2-month-old baby calls the nurse 2 days after the first DTaP, IPV, Hepatitis B and HIB immunizations. She reports that the baby feels very warm, cries inconsolably for as long as 3 hours, and has had several shaking spells. In addition to referring her to the emergency room, the nurse should document the reaction on the baby's record and expect which of the following? A. DTaP B. Hepatitis B C. Polio D. Influenza 47. Filiarisis is transmitted to man through bites from A. Snail B. Infected male mosquito C. Infected female mosquito D. Rats 48. The age group with the highest risk for TB of developing the disease is between A. Children under three years old B. Children entering grade one C. 8-12 years old D. 13-15 years old 49. A newly admitted client with streptococcal pharyngitis (tonsillitis) has been placed on droplet precaution. Which of the following statements indicates the best understanding for this type of isolation? A. Must maintain a spatial distance of 3 feet B. The client can be placed in a room with another client with measles (rubeola) C. A special mask (N95) should be worn when working with the client D. Gloves should be only worn when giving direct care 50. This a cutaneous infection that can be contacted uncontaminated wool, fur. The exposed part of skin begins to itch and papules appear in the inoculation sites. The papules become vesicles and developed into black eschars A. Anthrax B. Scabies C. Psoriasis D. Chickenpox TOPRANK REVIEW ACADEMY, INC. Page 4 | 4