Chapter 10 Infectious Diseases and Sepsis Part 2

43) Which of the following statements about Neisseria meningitidis is TRUE? A) The vaccine is recommended for health care workers. B) It is the bacteria that most often causes serious cases of meningitis. C) It is responsible for 90 percent of patients with a viral meningitis. D) Signs and symptoms of infection can take weeks to develop. Answer: B Diff: 1 Page Ref: 421 Standard: Medicine (Infectious Diseases) Objective: 3, 8 44) Hepatitis E is often associated with: A) HIV infection. B) tuberculosis infection. C) contaminated drinking water. D) HBV infection. Answer: C Diff: 1 Page Ref: 414 Standard: Medicine (Infectious Diseases) Objective: 4, 8 45) Mushrooms and yeasts are examples of: A) parasites. B) fungi. C) helminthes. D) protozoa. Answer: B Diff: 1 Page Ref: 396 Standard: Medicine (Infectious Diseases) Objective: 3 46) To test for Brudzinski's sign you would: A) have the patient take a deep breath while you palpate under the right costal margin. B) check for periumbilical ecchymosis. C) place the patient in a supine position and flex the neck. D) stroke the bottom of the foot from heel to toe with a pen. Answer: C Diff: 1 Page Ref: 422 Standard: Medicine (Infectious Diseases) Objective: 1, 7 184 47) Your patient is a 27-year-old male complaining of difficulty breathing. He states that he has just returned from a month-long backpacking trip across Arizona. He describes a two-week history of fatigue, fever, nausea, vomiting, diarrhea, and abdominal pain. He started experiencing difficulty breathing yesterday. He has no significant medical history and takes no medications. Physical examination reveals hot, moist skin; bilateral lower-lobe rales on auscultation of the lungs; and the abdomen is soft and nontender. Which of the following is most likely? A) Legionnaire's disease B) Hantavirus infection C) Anthrax D) Scorpion bite Answer: B Diff: 3 Page Ref: 428 Standard: Medicine (Infectious Diseases) Objective: 7, 9, 13 48) Which of the following statements about Haemophilus influenzae type B is TRUE? A) It is the leading cause of conjunctivitis in adults. B) It was once the leading cause of meningitis in children aged 6 months to 3 years. C) Vaccines are ineffective against Haemophilus influenzae type B. D) It is a Gram-positive rod. Answer: B Diff: 1 Page Ref: 421 Standard: Medicine (Infectious Diseases) Objective: 8 49) Which of the following findings would be most specific to mumps? A) Swelling and tenderness of the parotid glands B) Temperature of 103°F or higher C) Redness of the face that gives a "slapped cheeks" appearance D) Fluid-filled vesicles on the trunk Answer: A Diff: 2 Page Ref: 424 Standard: Medicine (Infectious Diseases) Objective: 8 185 50) Your patient is a 19-year-old female college student complaining of a low-grade fever, extremely sore throat, tenderness of the cervical lymph nodes, and extreme fatigue. Examination reveals warm, moist, flushed skin. Heart rate = 88, respirations = 12, and blood pressure = 118/78. There is tenderness to palpation of the left upper quadrant of the abdomen. Which of the following is most likely? A) Bacterial meningitis B) Hantavirus pulmonary syndrome C) Mononucleosis D) Fifth disease Answer: C Diff: 2 Page Ref: 426 Standard: Medicine (Infectious Diseases) Objective: 7, 8, 9 51) While on a call you receive a laceration to your thigh from a jagged piece of metal. Which of the following is the correct recommendation for tetanus prophylaxis? A) You must receive a tetanus booster annually to be protected from tetanus. B) You should receive a tetanus booster if you have not had one in the past ten years. C) If you are over the age of 60, you should receive tetanus immune globulin but not a tetanus booster. D) If you received the entire series of tetanus immunizations as a child, you do not need a tetanus booster. Answer: B Diff: 2 Page Ref: 426, 431, 432 Standard: Medicine (Infectious Diseases) Objective: 6, 10 52) A life-threatening medical condition that is caused by systemic inflammatory response syndrome (SIRS) is: A) hypoglycemia. B) thrombocytopenia. C) septicemia. D) pernicious anemia. Answer: C Diff: 2 Page Ref: 439 Standard: Medicine (Infectious Diseases) Objective: 12 186 53) Which of the following is NOT a government organization involved with infectious diseases? A) CDC B) OSHA C) EPA D) FEMA Answer: C Diff: 1 Page Ref: 394-395 Standard: Medicine (Infectious Diseases) Objective: 2 54) Poisonous proteins shed by bacteria growth are called: A) exotoxins. B) endotoxins. C) spores. D) fungi. Answer: A Diff: 1 Page Ref: 395 Standard: Medicine (Infectious Diseases) Objective: 3 55) Which of the following is NOT a common form of pathogen transmission? A) Cough B) Sneeze C) Sexual contact D) Organisms shed into the environment Answer: D Diff: 1 Page Ref: 397 Standard: Medicine (Infectious Diseases) Objective: 4 56) The body will produce antibodies in response to: A) pathogens. B) antigens. C) T cells. D) phagocytes. Answer: B Diff: 1 Page Ref: 399 Standard: Medicine (Infectious Diseases) Objective: 5 187 57) Cell-mediated immunity generates: A) T lymphocytes. B) B lymphocytes. C) inflammation. D) histamine. Answer: A Diff: 1 Page Ref: 400 Standard: Medicine (Infectious Diseases) Objective: 5 58) When the body produces antibodies against itself, this is known as: A) immunology. B) allergy. C) autoimmunity. D) immunocompromise. Answer: C Diff: 1 Page Ref: 400 Standard: Medicine (Infectious Diseases) Objective: 1, 5 59) The lymphatic system is comprised of all of the following EXCEPT: A) spleen. B) lymph nodes. C) thymus. D) liver. Answer: D Diff: 1 Page Ref: 400 Standard: Medicine (Infectious Diseases) Objective: 5 60) Contaminated sharps need to be placed in: A) properly labeled puncture-resistant containers. B) biohazard containers in the dirty-utility room. C) the decontamination room. D) They can be thrown in the trash if they are "self containing." Answer: A Diff: 1 Page Ref: 403 Standard: Medicine (Infectious Diseases) Objective: 6 188 61) You respond to an ill patient. Upon arrival, you find out that the patient has just traveled from an area with active Ebola virus disease (EVD). You should initially: A) examine the patient like any other. B) examine the patient over the phone. C) wait for a hazmat tech who is also a paramedic. D) assess the patient from at least three feet away. Answer: D Diff: 2 Page Ref: 404-405 Standard: Medicine (Infectious Diseases) Objective: 6, 7 62) One of the most effective ways to prevent disease transmission is: A) use of gloves. B) sterilizing all equipment. C) washing your hands. D) using an alcohol-based sanitizer. Answer: C Diff: 1 Page Ref: 404 Standard: Medicine (Infectious Diseases) Objective: 6 63) According to the 2009 extension of the Ryan White Care Act, an employee who has been exposed to an infectious disease has the right to: A) demand that the patient be tested for infectious disease. B) ask about the source patient's infection status. C) have the receiving ED draw a sample of the patient's blood for testing. D) nothing; HIPAA is in effect. Answer: B Diff: 1 Page Ref: 408 Standard: Medicine (Infectious Diseases) Objective: 6 64) In response to fever, the patient's metabolic needs will: A) increase. B) decrease. C) remain the same. D) become anaerobic. Answer: A Diff: 1 Page Ref: 409 Standard: Medicine (Infectious Diseases) Objective: 5 189 65) HIV uses the host cell to copy itself by: A) carrying its genetic material in its RNA. B) replicating its genetic material in its DNA. C) infiltrating the mitochondria. D) glucogenolysis. Answer: A Diff: 1 Page Ref: 410 Standard: Medicine (Infectious Diseases) Objective: 8 66) As hepatitis progresses, the patient may become: A) edematous. B) jaundiced. C) more infectious. D) less Infectious. Answer: B Diff: 1 Page Ref: 412 Standard: Medicine (Infectious Diseases) Objective: 8 67) Hepatitis A is can exist on unwashed hands for: A) 5 days. B) 4 days. C) 6 hours. D) 4 hours. Answer: D Diff: 1 Page Ref: 412 Standard: Medicine (Infectious Diseases) Objective: 4, 8 68) Hepatitis B is stable on surfaces with dried visible blood for: A) 3 days. B) 3 hours. C) 8 hours. D) 8 days. Answer: D Diff: 1 Page Ref: 413 Standard: Medicine (Infectious Diseases) Objective: 4, 8 190 69) You are caring for a patient who is complaining of chills, fever, night sweats, sudden weight loss, and hemoptysis. You suspect: A) AIDS. B) hepatitis B virus. C) tuberculosis. D) Ebola virus disease (EVD). Answer: C Diff: 2 Page Ref: 415 Standard: Medicine (Infectious Diseases) Objective: 7, 8, 9 70) You are caring for a patient you suspect of having an active TB infection. Your personal protective equipment (PPE) should include: A) Tyvek suit. B) hazmat level B protection. C) powered air-purifying respirator (PAPR) mask. D) N-95 mask. Answer: D Diff: 2 Page Ref: 416 Standard: Medicine (Infectious Diseases) Objective: 6, 10 71) The most common complication in adults contracting the varicella virus is: A) chickenpox. B) pneumonia. C) respiratory syncytial virus (RSV). D) paranoia. Answer: B Diff: 1 Page Ref: 420 Standard: Medicine (Infectious Diseases) Objective: 8 72) You respond to an ill patient. Upon your arrival, the patient's caregivers state that the patient has been complaining of lethargy, vomiting, and nuchal rigidity. You suspect: A) pertussis. B) meningitis. C) varicella. D) pneumonia. Answer: B Diff: 2 Page Ref: 421 Standard: Medicine (Infectious Diseases) Objective: 7, 9 191 73) While examining a patient, you note that he exhibits a positive Brudzinski's sign. You suspect: A) meningitis. B) pertussis. C) varicella. D) tuberculosis. Answer: A Diff: 2 Page Ref: 422 Standard: Medicine (Infectious Diseases) Objective: 7, 9 74) You and your partner have just been notified by the infection control officer that you have been exposed to an active meningitis case. You would expect to receive prophylactic: A) Cipro. B) Zithromax. C) penicillin. D) nothing, just self-monitor. Answer: A Diff: 2 Page Ref: 422 Standard: Medicine (Infectious Diseases) Objective: 6, 10 75) Whooping cough is also known as: A) meningococcus. B) pertussis. C) varicella. D) pneumonia. Answer: B Diff: 1 Page Ref: 425 Standard: Medicine (Infectious Diseases) Objective: 1 76) You are called to evaluate an ill child. The mother states that the child was fine a few hours ago but now is exhibiting, dysphonia, drooling, dysphagia, and distress. You suspect: A) croup. B) epiglottitis. C) bronchitis. D) influenza A. Answer: B Diff: 2 Page Ref: 427 Standard: Medicine (Infectious Diseases) Objective: 7, 9 192 77) You respond to a 2-year-old child who has a seal-like cough and stridor. You suspect: A) laryngotracheobronchitis. B) influenza. C) pneumonia. D) pharyngitis. Answer: A Diff: 2 Page Ref: 427 Standard: Medicine (Infectious Diseases) Objective: 7, 9 78) One area in which paramedics have a chance to assume leadership is: A) public education and infectious disease prevention. B) FEMA studies. C) CDC studies. D) hospital advisory boards. Answer: A Diff: 2 Page Ref: 438 Standard: Medicine (Infectious Diseases) Objective: 11 79) You respond to a patient who has been having trouble with his indwelling urinary catheter. Vital signs are: pulse, 110; respiration rate, 22; ETCO2, 28; temperature, 101.2°F. You suspect: A) sepsis. B) urinary tract infection (UTI). C) renal failure. D) rhabdomyolysis. Answer: A Diff: 2 Page Ref: 439, 440 Standard: Medicine (Infectious Diseases) Objective: 7, 9 80) You are treating a patient you suspect may be suffering from septic shock. You should consider fluid and pressor therapy to maintain a mean arterial pressure (MAP) of: A) above 90 mmHg. B) above 60 mmHg. C) below 120 mmHg. D) below 60 mmHg. Answer: B Diff: 1 Page Ref: 440 Standard: Medicine (Infectious Diseases) Objective: 9, 12, 13 193