infection practice questions (pathopharm)

Which client is at the highest risk for infection?

• The client on aspirin therapy

• The client taking nonsteroidal anti-inflammatory drugs

• The client taking corticosteroids

• The client taking analgesics

the client taking corticosteroids (because it weakens immune response)

What is the body's first line of defense against infection?

• Cytotoxic (killer) T cells

• White blood cells

• Skin

• Neutrophils

skin (physical barrier)

Which intervention can increase a client's risk for infection?

• Taking an axillary temperature

• Changing the client's position

• Inserting an intravenous line

• Taking a blood pressure reading

inserting an IV line (bc it creates break in the skin)

In clinical terms, what defines an infection?

• Immune response without microbes

• Invasion and multiplication of microbes

• Visible tissue damage only

• Any contact with microbes

• Presence of normal flora

• Invasion and multiplication of microbes

What best describes a localized infection?

• Pathogens in bloodstream

• Affects the whole body

• Always chronic in course

• Limited to one body area

• Always asymptomatic

• Limited to one body area

Which are the four main pathogen categories? Select all that apply.

• Helminths

• Fungi

• Parasites

• Prions

• Bacteria

• Viruses

fungi, parasites, bacteria, protozoa

According to the iceberg concept of infection, which group represents the largest for a given infection?

• Fully immune people

• Hospitalized critical patients

• Infected but asymptomatic people

• People with mild symptoms

• Recently vaccinated people

• Infected but asymptomatic people

Which of the following are links "chain of infection" framework? Select all that apply.

• Inflammation

• Pathogen

• Reservoir

• Antibody

• Fever

• Portal of exit

pathogen, reservoir, portal of exit

Which of the following is NOT a classic local sign of the inflammatory response?

• Confusion

• Redness

• Pain

• Heat

• Swelling

confusion

Which finding is a typical infection sign in an older adult?

• Marked leukocytosis

• Profuse local pus

• High spiking fever

• Strong redness and heat

• New confusion

new confusion (older adults have a blunted immune response and do not show typical symptoms)

A patient develops severe muscle paralysis after a bacterial infection. Which type of bacterial toxin is most likely responsible?

• Complement toxins from immune response

• Exotoxins released by living bacteria

• Endotoxins released when bacteria die

• Endotoxins secreted by living bacteria

• Exotoxins released when bacteria die

• Exotoxins released by living bacteria (bc exotoxins have more specific symptoms while endotoxins have more body-wide symptoms like fever or chills due to them being released when the bacteria dies)

A patient recovering from a viral respiratory infection is treated with antibiotics and then develops a new fever. Which explanation best accounts for this clinical picture?

• Antibiotics disrupted normal flora, allowing a secondary infection.

• The inflammatory response caused a fever rebound.

• The complement system overcorrected after the first infection resolved.

• The viral infection relapsed after antibiotic treatment.

• The patient developed an exotoxin reaction to the antibiotic.

• Antibiotics disrupted normal flora, allowing a secondary infection.

How is septic shock distinguished from sepsis alone?

• Sepsis plus elevated white blood cell count

• Sepsis plus circulatory and metabolic dysfunction

• Sepsis plus fever and mild tachycardia

• Sepsis plus a single failing organ

• Sepsis plus localized tissue inflammation

• Sepsis plus circulatory and metabolic dysfunction

In the sepsis cascade, what directly causes hypotension?

• Fluid loss from leaky vessels

• Abrupt slowing of heart rate

• Pulmonary bronchoconstriction

• Increased blood viscosity

• Excess renal fluid excretion

• Fluid loss from leaky vessels

Which bedside pattern most suggests hypoperfusion in an infected patient?

• Low oxygen saturation, high urine output, fever

• Bradycardia, bradypnea, high urine output

• Hypertension, bradycardia, low urine output

• Hypothermia, hypertension, tachycardia

• Tachycardia, tachypnea, low urine output

• Tachycardia (to compensate for lack of nutrients being delivered) and tachypnea (to bring in more o2 since not enough being delivered) and low urine output (to attempt to bring up BP since it is leaking)

Which of the following are individual-level risk factors for developing a serious infection? (Select all that apply.)

• Diabetes

• Access to vaccination

• Invasive lines

• Malnutrition

• Crowded living conditions

• Immunosuppressive medications

diabetes, invasive lines, malnutrition, immunosuppressive meds
(other factors are bigger than the individual)

Which patients are at the highest risk for severe infection progression? (Select all that apply.)

• Patients on corticosteroids

• Patients with well-controlled diabetes

• Older adults with chronic illness

• Adults with recent mild viral infection

• Infants with low birth weight

• Patients on corticosteroids

• older adults w chronic illness

• infants with low birth weights
  (all of these patients have weakened immune systems)

Which question best targets infection risk in the health history?

• Smoking habits

• Alcohol consumption

• Social media use

• Recent travel abroad

• Sleeping patterns

• Recent travel abroad

In an older immunocompromised patient, which finding may be the most reliable sign of infection?

• Weight gain

• New confusion

• Severe thirst

• Profuse sweating

• High blood glucose

• New confusion (bc they have blunted immune response and their symptoms present differently)

A jump in band cells on a WBC differential suggests what?

• Autoimmune flare

• Chronic viral illness

• Acute bacterial infection

• Severe allergic reaction

• Parasitic infestation

• Acute bacterial infection

Why must cultures be collected before the first dose of antibiotics?

• Cultures are less accurate at later time points.

• Antibiotics destroy the culture sample entirely.

• Antibiotics can mask the organism being identified.

• Delays in culture collection increase resistance risk.

• Antibiotics alter the sensitivity results.

• Antibiotics can mask the organism being identified.

When should a nurse use soap and water instead of alcohol-based hand rub? Select all that apply.

• When transitioning between tasks quickly

• Before and after routine patient contact

• When caring for a patient with norovirus

• When hands are visibly soiled

• When caring for a patient with C. difficile

• When caring for a patient with norovirus

• When hands are visibly soiled

• When caring for a patient with C. difficile

(c diff and norovirus are not killed by alc based hand rubs)

Which of the following are examples of primary prevention of infection? Select all that apply.

• Standard precautions with every patient

• Routine immunizations across the lifespan

• Identifying pathogens via culture and sensitivity

• Screening for sexually transmitted infections

• Hand hygiene before patient contact

• Standard precautions with every patient

• Routine immunizations across the lifespan

• Hand hygiene before patient contact

What are the primary drivers of antimicrobial resistance? Select all that apply.

• Patients completing their full prescribed course

• Using antibiotics longer than necessary

• Prescribing antibiotics for viral illnesses

• Using culture and sensitivity to guide treatment

• Using antibiotics when not needed

• Using antibiotics longer than necessary

• Prescribing antibiotics for viral illnesses

• Using antibiotics when not needed

Which microorganism can antibiotics treat?

• Bacteria

• Viruses

• Protozoa

• Fungi

bacteria

Which illness is caused by bacteria?

• Whooping cough

• Bronchitis

• Cold

• Flu

whooping cough

Which illness can be treated with an antibiotic?

• Chickenpox

• Flu

• Strep throat

• Bronchiolitis

• Strep throat

Which bacteria help with digestion?

• Clostridium difficile

• Escherichia coli

• Staphylococcus aureus

• Pseudomonas aeruginosa

• Escherichia coli

Which host defense is a physical barrier?

• Macrophages

• Gastric acid

• Intact skin

• Antibodies

• Intact skin

Which bacteria have a spiral shape?

• Coccus

• Spirochete

• Icosahedral

• Bacillus

• Spirochete
  coccus are spherical, and bacillus are ovular

Which bacteria have a more complex cell wall?

• Gram-positive

• Double stranded

• Single stranded

• Gram-negative

• Gram-negative

What is the goal of keeping clients on the narrowest spectrum of antibiotics?

• To prevent central nervous system toxicity

• To accelerate the medication's excretion rate

• To limit the likelihood of antibiotic resistance

• To promote better distribution of the medication

• To limit the likelihood of antibiotic resistance

Which test can determine a client's responsiveness to an antibiotic?

• Complete blood count

• Culture and sensitivity

• Urinalysis

• Blood chemistry

• Culture and sensitivity

Which antibiotic inhibits bacterial cell wall synthesis?

• Aminoglycosides

• Amphotericin B

• Tetracycline

• Penicillin

• Penicillin

How does fluoroquinolone work?

• Causes lethal inhibition of bacterial protein

• Increases cell membrane permeability

• Inhibits bacterial cell wall synthesis

• Disrupts deoxyribonucleic acid function

• Disrupts deoxyribonucleic acid function

when is prophylactic antibiotic therapy used

pt will undergo situation where they are at increased risk of developing an infection (surgery or dental procedure)
treating it when there is no known infection present

when is empiric antibiotic therapy used

when an infection is present but it is unsure what kind of bacteria is causing it, so a best educated guess is used to treat it while awaiting identification of the bacteria (usually broad spectrum antibiotics)

For which client is prophylactic antibiotic therapy recommended?

• A client with a urinary tract infection

• A client with pus at the incision site

• A client with recurrent fever

• A client who will undergo abdominal surgery

• A client who will undergo abdominal surgery

For which client is empiric antibiotic therapy recommended?

• A client scheduled for tumor removal

• A client who will undergo exploratory laparotomy

• A client with pus draining at the incision site

• A client who will undergo heart transplant

• A client with pus draining at the incision site (sign of infection)

Which sign indicates a resolving infection?

• Erythema

• Swelling

• Decreased pain

• Leukocytosis

• Decreased pain

Which interventions are critical when selecting the best antibiotic? Select all that apply.

• Select a broad-spectrum antibiotic as often as possible.

• Determine the presence of an infection.

• Consider the client's age.

• Perform a culture and sensitivity test.

• Determine if the client is immunocompromised.

• Determine the presence of an infection.

• Consider the client's age.

• Perform a culture and sensitivity test.

• Determine if the client is immunocompromised.

Which parameters indicate the effectiveness of antibiotic therapy? Select all that apply.

• Decreased clinical signs and symptoms

• Normal red blood cell values

• Positive blood culture

• Cloudy cerebrospinal fluid

• Normal white blood cell values

• Decreased clinical signs and symptoms

• Normal white blood cell values