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3 bad bugs

doi: 10.1097/01.NURSE.0000368814.82228.93
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3 bad bugs

GENERAL PURPOSE To provide nurses with an overview of three dangerous infections that are prevalent in hospitalized patients. LEARNING OBJECTIVES After reading this article and taking this test, you should be able to: 1. Identify prevention strategies for specific multidrug-resistant bacterial infections. 2. List clinical manifestations of specific multidrug-resistant bacterial infections. 3. Describe the management of patients with specific multidrug-resistant bacterial infections.

1. PVL toxin is most likely to cause which type of infection?

a. bloodstream infections

b. skin infections

c. urinary tract infections

d. neurological infections

2. The most commonly used drug for PVL-positive MRSA infections is

a. vancomycin.

b. cefazolin.

c. tobramycin.

d. penicillin.

3. Which signs or symptoms most likely suggest necrotizing pneumonia?

a. vomiting and absent bowel sounds

b. bloody diarrhea and fever

c. weakness and lethargy

d. hemoptysis and hypotension

4. Diagnostic studies for a patient with necrotizing pneumonia will most likely demonstrate

a. marked leukocytosis.

b. multilobar infiltrates.

c. normal C-reactive protein level.

d. Gram-negative rods.

5. Which statement is correct aboutA. baumannii?

a. It's a Gram-positive bacterium.

b. It can be reliably treated with aminoglycosides.

c. It can thrive inside and outside hospital equipment.

d. It requires a moist environment to thrive.

6. Care of the patient with resistantA. baumanniiinfection includes allexcept

a. ensuring that the patient's environment is thoroughly cleaned.

b. performing meticulous hand hygiene.

c. placing the patient on contact precautions.

d. placing the patient on respiratory precautions.

7. The antibiotics used to treatA. baumanniiinfections vary depending on the

a. infection severity.

b. infection duration.

c. organism's degree of drug resistance.

d. infection site.

8.A. baumanniiinfections resistant to imipenem or tobramycin may be treated with

a. linezolid.

b. colistin.

c. piperacillin/tazobactam.

d. vancomycin.

9. The most widely identified risk factor for CDI is

a. antibiotic use.

b. smoking.

c. old age.

d. gastrointestinal disease.

10.C. difficile isn'tconsidered a pathogen in which patient population?

a. neonates

b. school-age children

c. young adults

d. older adults

11. Which statement is correct aboutC. difficile?

a. CDI is less severe than CDAD.

b. All colonized patients will develop CDI.

c. C. difficile, BI/NAP1, produces toxins intermittently.

d. Prolonged colonization is protective against CDI.

12. CDI is generally categorized from mild to severe by allexceptthe

a. amount and type of diarrhea.

b. presence of fever.

c. degree of abdominal pain.

d. level of C-reactive protein.

13. When collecting a stool specimen for CDI testing,

a. collect only solid stool.

b. collect only watery or loose stools.

c. don't refrigerate the specimen.

d. submit it within 30 minutes after collection.

14. Which isolation precautions are indicated for patients with CDI?

a. airborne

b. droplet

c. contact

d. standard only

15. The CDC indicates that use of alcohol-based hand rubs

a. is effective against C. difficile spores.

b. is preferable to soap and water.

c. will effectively eliminate C. difficile transmission.

d. isn't recommended during a C. difficile outbreak.

16. Which statement is correct about treatingC. difficile?

a. No consensus exists on the best treatment for CDI.

b. Resistance to metronidazole is high.

c. Piperacillin/tazobactam remains the treatment of choice.

d. Antiperistaltics shorten the disease course.

17. The typical clinical response to CDI therapy is

a. reduction in fever within 8 hours.

b. resolution of all symptoms within 48 hours.

c. discontinuation of diarrhea in 2 to 5 days.

d. toxin-negative stool specimens.

18. Which statement is correct about nonpandemic (seasonal) influenza?

a. Educational levels drive immunization rates.

b. Immunization rates are lowest among nurses compared with other healthcare workers.

c. It kills 6,000 Americans annually.

d. It accounts for 20,000 hospitalizations each year.



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