Situation 1: Information dissemination is an integral element of health promotion, and disease prevention.

The nurse is in the best position to do health education activities. 1. A nurse is providing instructions to a pregnant client with genital herpes about measures that need to be implemented to protect the fetus. The nurse tells the nurse that: a. Daily administration of acyclovir (Zovirax) is necessary during the entire pregnancy b. Total abstinence from sexual intercourse is necessary during the entire pregnancy c. Sitz baths need to be taken every 4 hours while awake if vaginal lesions are present d. A cesarean section will be necessary if vaginal lesions are present at the time of labor

2. While the nurse is counseling a group of mothers about sexually transmitted diseases, one mother asks the nurse which sexually transmitted disease is most detrimental to their baby's safety during pregnancy? The nurse should respond that it would be: a. Gonorrhea c. Genital herpes b. Syphilis d. Trichomonas vaginalis 3. During an infection control seminar, the speaker specified that prevention of the spread of HIV include the following measures EXCEPT: a. Patients with AIDS should be isolated b. Blood and other specimens should be labeled AIDS Precaution c. Needles should be disposed into a puncture resistant container d. Blood spills should be cleaned with chlorox 4. A nurse is giving health education to a client diagnosed with HIV. The nurse determines that the client does not need further teaching if the client states that the most effective method known to control the spread of HIV infection is: a. Premarital serologic screening b. Prophylactic treatment of exposed people c. Laboratory screening of pregnant women d. Sex education about preventive behaviors. 5. The following are preventions of gonorrhea transmission EXCEPT: a. Sex education b. Case finding c. Incidence to be reported to health authorities d. Administration of ophthalmic prophylaxis, as ordered

Situation 2: The nursing process is applied in any health care setting. 6. A child is diagnosed with scarlet fever. The nurse assesses the child knowing that which of the following is not a clinical manifestation associated with this disease? a. Pastia's sign b. White strawberry tongue c. Edematous and beefy, red colored pharynx d. Koplik spots 7. A nurse provides instructions to the mother of a child with mumps regarding respiratory precautions. The mother asks the nurse the length of time required for the respiratory precautions. The nurse most appropriately responds that: a. Respiratory precautions are necessary for the entire time of illness. b. Respiratory precautions are necessary until the swelling is gone. c. Respiratory precautions are indicated during the period of communicability. d. Respiratory precautions are indicated for 18 days after the onset of parotid swelling. 8. A 6-month-old infant receives DPT immunization at the well-baby clinic. The mother returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. The nurse tells the mother to: a. Apply a warm pack to the injection site b. Bring the infant back to the clinic c. Apply an ice pack to the injection site d. Monitor the infant for fever 9. A nurse is preparing the plan of care for a patient with herpes genitalis. What would be the priority nursing diagnosis for the patient? a. Disturbed Sleep pattern b. Imbalance in Nutrition: Less than Body Requirements c. Alteration in Comfort: Pain d. Ineffective Breathing Pattern 10. The nurse on duty, based on her assessment findings suspects the presence of diphtheria. Which of the following will confirm her suspicion? a. Pharyngotonsilar congestion b. Grayish membrane at hard palate c. Whitish plaque at buccal mucosa d. Increased lacrimation

Situation 3: There are 170 Bilhariasis endemic municipalities. You are assigned in one of these municipalities. 11. In order to confirm the diagnosis of Snail fever, you advise patient to have, which of these examination: a. X-ray of the abdomen b. Urinalysis c. Stool examination d. CBC 12. You know that the mode of transmission of Katayama fever is: a. Contact with affected stray animals b. Contact with water infected with cercaria c. Infected flies and rodent d. Use of sanitary toilets

13. Which among the following is the drug of choice for Bilhariasis? a. Biltricide c. Chloramphenicol b. Hetrazan d. Tetracycline

14. The following are preventive measures for Schistosomiasis EXCEPT: a. Use of safe water b. Avoid bathing and washing in infested waters c. Use of sanitary toilets d. Elimination of breeding sites of mosquitoes

15. Which of the following is NOT a complication of Bilhariasis? a. Liver cirrhosis and portal hypertension b. Cor pulmonale, pulmonary hypertension c. Meningitis and hepatomegally d. Ascitis and renal failure

Situation 4: Endemic malaria occurs in the topic and subtopic areas where socioeconomic condition is very poor. 16. During your assessment, which among the following signs and symptoms need referral to a secondary or tertiary facility? a. Sweating and headache b. Icterus and shock c. Fever and chills d. Renal or liver failure 17. Laboratory confirmation of malaria is done on a blood film. What do you expect to see in the film? a. Antibodies c. Malarial purinates b. Malarial parasites d. Antigen

18. The mode of transmission of this disease is through the bite of an infected female mosquito called: a. Aminophylline c. Anopheles b. Aedes poecillus d. Aedes egypti 19. Which of the following is NOT an anti-malarial drug? a. Sulfadoxine c. Tetracycline b. Amoxicillin d. Quinidine 20. As a preventive measure for malarais, you ecucate people living in malaria endemic areas to do which of the following? A. Avoid going out between 12nn to 3am B. Take chloroquine tablets once a day C. Apply insect repellant on house walls D. Use long sleeved shirts when going out at night E. Plant neem tree in their backyards F. Clear hanging branches nears rivers a. A, B, C, D, E, F c. B, C, D, E, F b. C, D, E, F d. B, C, D, E

Situation 5: A nurse is having her duty in a public health clinic. She encounters multiple cases of sexually transmitted diseases. 21. A nurse is collecting data from a prenatal client. The nurse determines that which of the following places the client into the high risk category for contracting human immunodeficiency virus? a. Living in an area where HIV infections are minimal b. A history of IV drug use in the past year c. A history of one sexual partner within the past 10 years d. A spouse who is heterosexual and had only 1 sexual partner in the past 10 years

22. Which among the following informations is true of HIV? a. It can be transmitted via body fluids such as blood, semen, urine, and perspiration. b. Blood, semen, and breast milk have higher concentrations of HIV than urine, saliva, vomitus and stool c. A client who by history may be exposed to HIV but test negative for HIV antibodies can no longer infect others d. Enzyme-linked immunosorbent assay (ELISA) is the confirmatory test for HIV

23. Hepatitis B infection is established by the presence of hepatitis B antigen-antibody systems in the blood. Which of the following is NOT true? a. Presence of HBsAG is the serological marker to establish the diagnosis of hepatitis B. b. If the serological marker is present in the blood after 3 months, it indicates a carrier state or chronic hepatitis. c. The presence of anti-HBS indicates recovery and immunity to hepatitis B. d. Presence of HbeAG determines the infective state of the client

24. The nurse is talking to a young female client in the health clinic who is concerned she may have sexually transmitted disease. The nurse commends her for seeking medical care. The nurse explains that the major reason treatment of majority of STDs is delayed because: a. Client is embarrassed b. Symptoms are though to be caused by something else c. Symptoms are ignored d. The client does not manifest signs and symptoms

25. The nurse is very active in contact tracing and epidemiologic treatment of all gonococcal identified contacts to prevent: a. Development of resistant strains b. Asymptomatic infections c. Non-venereal transmission d. Reinfection Situation 6: Avian Influenza is an infectious disease of birds that can cause serious illness in humans. 26. The importation of chicken from countries with outbreak of avian flu is banned by which law? a. RA 280 c. PD 280 b. EO 280 d. AO 280

27. The major causes of death in avian flu are the following except: a. Severe viral pneumonia b. Respiratory distress c. Multiple organ failure d. Dehydration from severe vomiting and diarrhea

28. A suspected case of avian flu would be identified if a person exhibits which of the following manifestations? a. Body weakness, fever, vomiting, diarrhea, cough, and anorexia b. Fever, body weakness cough, dyspnea, and sore throat c. Fever, cough, sore throat, diarrhea, bloody stool, and hematemesis d. Hemoptysis, difficulty breathing, sore eyes, vomiting and diarrhea 29. It is necessary to institute which of the following measures to birds suspected of being exposed to the virus? a. Vaccination of poultry b. Killing of all infected or exposed birds c. Mixing antiviral to feeds and water supplied to poultry suspected of being exposed to avian flu d. All of the above 30. Incubation period for avian influenza is: a. 10 days c. 21 days b. 3 days d. 7 days

ANSWERS:

1. D. In mothers with genital herpes, the fetus can be contaminated after membranes rupture or with vaginal delivery. Therefore, for women with active lesions, either recurrent or primary at the time of labor, delivery should be by cesarean to prevent the fetus from coming into contact with the genital herpes. A. The safety of acyclovir had not been established during pregnancy and should only be used when life-threatening infection is present. C. Abstinence should be advised while the lesions are present, until they become culturenegative. D. This promotes healing. 2. A. Syphilis may cross the placenta, causing congenital syphilis. It usually leads to spontaneous abortion, and it increases the incidence of mental subnormality and physical deformities in fetus. B. In gonorrhea, the fetus is contaminated at the time of delivery. It places the neonate at risk for ophthalmia neonatorum, pneumonia and sepsis, but these can be avoided via cesarean delivery. C. In genital herpes, fetus is contaminated after membranes rupture or with vaginal delivery. Mother should deliver via cesarean section. 3. A. Patients with AIDS are immunocompromised. Reverse isolation is required. But this does no prevent the spread of AIDS. B, C and D are universal preventive measures for AIDS. 4. D 5. D. This does not prevent transmission of gonorrhea. It prevents the occurrence of ophthalmia neonatorum. 6. D. Koplik spots are associated with rubeola. A. Pastia's sign describes a rash that is seen in scarlet fever that will blanch with pressure except in areas of deep creases and folds of the joints. B The tongue is initially coated with a white furry covering with red projecting papillae (white strawberry tongue). C. The pharynx is edematous and beefy red in color. 7. A. Mumps is transmitted via direct contact or droplet spread from an infected person and possibly by contact with the urine. Respiratory precautions are indicated during the period of communicability.

8. C. Occasionally, tenderness, redness, or swelling may occur at the site of the injection. This can be relieved with ice packs for the first 24 hours followed by warm compresses if the inflammation persists. 9. C. Genital herpes is characterized by painful vesicles affecting the external genitalia, vagina and cervix. 10. B. The presence of a grayish membrane on the hard palate, or pseudomembrane is a pathognomonic sign of diphtheria. Whitish plaque at buccal mucosa, or koplik spots, are seen in a rubeola infection (measles). 11. C. The male and female parasites live in blood vessels of intestines and liver, but the eggs are laid in the terminal capillary vessels in the submucosa of the intestines, and through the ulcerations reach the lumen of the intestines and pass out with the feces. 12. B. Infection occurs when skin comes in contact with contaminated fresh water where cercariae (free swimming larval forms of schistosomes) are living. 13. A. Praziquantel (Biltricide) is the drug of choice for Schistosomiasis. B. Hetrazan is the drug of choice for Filiariasis C. Chloramphenicol is the drug of choice for Typhoid fever D. Tetracycline is the drug of choice for Cholera 14. D. This is a preventive measure for vector-borne diseases. Schistosomiasis is a waterborne disease. A. Drinking water should be free of cercariae. B. Schistosomiasis can be transmitted through exposure to contaminated water. C. The use of sanitary toilets prevents viable eggs from reaching bodies of water containing intermediate snail host. 15. C. Meningitis is not a complication of Bilhariasis. 16. B. Malarial parasites invade and destroy red blood cells. 17. B. As sporozoites from the salivary gland of a female Anopheles mosquito are injected under the skin, they travel into the bloodstream to the liver and mature within hepatocytes. Up to 30,000 parasites are then released into the bloodstream as merozoites and produce a symptomatic infection as they invade and destroy red blood cells. 18. C. B. This is the vector for Filariasis.

D. This is the vector for Dengue. 19. B. A. Sulfadoxine (Sulfalene) 50 mg C. Tetracycline hydrochloride 250mg/capsule D. Quinidine sulfate 300 mg table; Quinidine hydrochloride 300 mg/mL, 2 ML ampule 20. B. A and b are not included. The vector's peak biting hours are 9pm to 3am. Chloroquine is taken at weekly intervals. 21. B. Women who fall into the high-risk category for HIV infection include those with persistent and recurrent sexually transmitted diseases or a history of multiple sexual partners, and those who use or have used IV drugs. A, C and D do not contribute to the incidence of contracting HIV. 22. B. This is true of HIV. A. Perspiration does not contain the virus. C. This is not always true for HIV. Clients may be infected with the virus, but has not yet produced antibodies, thereby testing negative, but being capable of infecting others. It usually takes 6 to 12 weeks (other books: 1 to 3 months) for a host to manufacture detectable HIV antibodies. D. Western blot is the confirmatory test for HIV. 23. B. Presence of hepatitis B surface antigens (HBsAG) in the blood after 6 months indicates a carrier state or chronic hepatitis. A, C and D are true.Hepatitis B early antigen is detected in the blood about 1 week after the appearance of HBsAG. Its presence determines the infective state of the clien 24. A 25. B. 80% of gonoccocal infection particularly in females have no symptoms. 26. B 27. D. Avian flu is not associated with vomiting and diarrhea. 28. B A and D. Vomiting and diarrhea are not associated with bird flu. C. Diarrhea, bloody stool, and hematemesis not associated with bird flu.

29. B. One control measure for Avian flu is the rapid destruction (culling or stamping out) of all infected or exposed birds. Other control measures include proper disposal of carcasses; quarantining; rigorous disinfection of farms; and restriction on the movement of live poultry. 30. B. The incubation period ranges 2-4 days