COMMUNICABLE DISEASE NURSING

SITUATION: Bobby, 11 years old, was admitted because of hematuria. Diagnosis was Dengue Fever.
1. Which of the following was MOST likely the description of Bobby’s fever prior to onset of hematuria that supports the physician’s diagnosis of
dengue fever?
A. Intermittent fever for 4 days
B. Onset of fever was abrupt and remained elevated for 4 days
C. Abrupt onset of fever and sudden drop on the 4th day
D. Gradual increase of body temperature and sudden drop on the 4 th day
2. The nurse understands that the cycle of transmission of the Dengue Fever virus begins during which of the following?
A. Infected mosquito bites an uninfected human
B. Virus multiply in the midgut of the mosquito
C. Mosquito feeds on an infected human
D. Mosquito’s saliva is invaded by the virus during subsequent biting of infected human
3. The nurse noted that aspirin and NSAIDs are contraindicated for Bobby. Which of the following is the rationale behind this order?
A. Patient may be allergic C. Due to stomach upset effects of the drugs
B. Drug contains anticoagulant properties D. Drugs enhance production of maculopapular rashes
4. The condition of Bobby is closely watched for signs of hypovolemic shock. Which of the following should the nurse report as EARLY signs of
hypovolemic shock?
1. Lethargy 4. Cyanosis
2. Rapid pulse 5. Restlessness
3. Clammy skin 6. Hematemesis
A. 2,3,4,5 B. 1,2,3,5 C. 1,2,5,6 D. 1,3,4,6
5. To prevent transmission of the virus to others, which of the following is the MOST appropriate isolation measure that the nurse should
implement in the care of Bobby?
A. Screen the environment C. Use gown, gloves and mask
B. Blood and body secretion isolation D. Use strict universal isolation technique
SITUATION: You are caring for Rolando, 58 years old, who was admitted because of difficulty of swallowing and stiffening of the neck. He has a
history of a wound laceration on his right hand sustained while gardening. Physician suspects Tetanus infection.
6. While you were preparing to administer oxygen inhalation, Rolando had seizures and assumed an opisthotonic position. Which of the following
correctly describes this position?
A. Head retracted, back arched and feet extended
B. Neck, hip, knee flexed and feet plantar flexed
C. Head flexed forward, jaw clenched, arms pronated and feet plantar flexed
D. Head hyperextended, hip flexed and feet extended
7. Taking into consideration the incubation period, which of the following data in Rolando’s health history will you consider relevant?
A. Positive for type 2 diabetes mellitus C. Wound laceration, sustained a week ago, was treated at home
B. Immunization status uncertain; no booster dose administered D. Wound pain, unbearable and unrelieved by analgesic
8. To decrease stimuli that cause muscle spasms and seizures, which of the following nursing intervention is the LEAST relevant for you to do?
A. Maintain a quiet, well-ventilated and darkened room C. Monitor for hazards of immobility
B. Administer sedatives as prescribed D. Perform physical care during time of maximal sedation
9. The priority nursing diagnosis for Rolando is “Risk for ineffective airway clearance” related to which of the following?
A. Stiffness of the jaw B. Seizures C. Back muscle spasms D. Infection
10. During a seizure, which of the following are you expected to do FIRST?
A. Monitor vital signs especially the respiratory rate
B. Place a padded tongue blade in the patient’s mouth
C. Provide mechanical ventilation
D. Turn patient to his side
SITUATION: Maricris, a 6-year-old girl, was not given any immunization at all since her family never visited a health care facility. She was diagnosed
with Heine-Medin disease.
11. The major route of transmission of polio virus in an environment with poor sanitation would be:
A. Feco-Oral B. Water System C. Sewage Disposal D. Droplet
12. When the polio virus enters the system, it multiplies in the:
A. Gastrointestinal tract B. Central Nervous system C. Urinary Tract D. Reproductive tract
13. A client who was exposed to hepatitis A is given gamma globulin to provide passive immunity which:
A. Increases the production of short lived antibodies
B. Provides antibodies that neutralize the antigen
C. Accelerates antigen-antibody union at the hepatic sites
D. Stimulates the lymphatic system to produce large number of antibodies
14. A nursing instructor asks his student about the administration of human immunoglobulin. The student correctly states that these types of
vaccine are:
A. Vaccines that had their virulence diminished so as not to produce a full blown disease condition
B. Vaccines that contain pathogens made inactive by either chemicals or heat
C. Vaccines collected from pooled human blood and provide antibodies to a variety of diseases.
D. Bacterial toxins that have been made inactive by either chemicals or heat
15. Mode of transmission of leprosy aside from skin contact is by:
A. Oral fecal B. Sexual contact C. Fomite D. Droplet infection

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SITUATION: HIV/AIDS information campaign is very vital in reaching people and creates awareness of this pandemic disease. Increasing cases of
AIDS has been reported in the country for the short span of 10 year only
16. You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is best course of
action that you may take?
A. Get a thorough history of the client, focusing on the practice of high risk behaviors
B. Ask the client to be accompanied by a significant person before revealing the result
C. Refer the client to the physician since he is the best person to reveal the result to the client
D. Refer the client for a supplementary test, such as western blot, since the ELISA result may be false
17. Which is the best control measure for AIDS?
A. Being faithful to a single sexual partner C. Avoid sexual contract with commercial sex worker
B. Using a condom during each sexual contact D. Making sure that one’s sexual partner does not have signs of AIDS
18. Which of the following opportunistic infections is the most common infection in people with AIDS?
A. Respiratory candidiasis C. Cytomegalovirus disease
B. Infectious mononucleosis D. Pneumocystis carinii pneumonia
19. To determine possible sources of sexually transmitted infections, which is the best method that may be undertaken by the public health nurse?
A. Contact tracing B. Community survey C. Mass screening tests D. Interview of suspects
20. Antiretroviral agents, such as AZT, are used in the management of AIDS. Which of the following is not an action expected of these drugs?
A. They prolong the life of the client with AIDS C. They shorten the period of communicability of the disease
A. They reduce the risk of opportunistic infections D. They are able to bring about a cure of the disease condition
SITUATION: Sexually Transmitted Diseases are important to identify during pregnancy because of their potential effect on the mother, fetus and
newborn. The following questions pertain to STD’s.
21. Desiree is a promiscuous woman in Manila who submits herself to the clinic for certain examinations. She is experiencing vaginal irritation,
redness and a thick cream cheese vaginal discharge. As a nurse, you will suspect that she is having which disease?
A. Gardnerella vaginalis B. Candida albicans C. Treponema pallidum D. Chlamydia trachomatis
22. As a knowledgeable nurse, you know that the doctor may prescribe a certain medication for Desiree. Which would be the drug of choice for her
infection?
A. Haloperidol B. Miconazole C. Benzathine Penicillin G D. Metronidazole
23. Joyce, another client in the Maternal Clinic, is on her first trimester of pregnancy. She was diagnosed with Trichomoniasis. The drug of choice
for her treatment would be:
A. Metronidazole B. Clotrimazole C. Zovirax D. Mebendazole
24. Syphilis is another infection that may impose risk during pregnancy. Since we are under the practice of health science, the nurse knows that
Syphilis is caused by:
A. Treponema syphilis C. Chlamydia trachomatis
B. Neisseria gonorrheae D. Treponema pallidum
25. Under the second level of prevention, you know that one of the focuses of care is the screening disease. Which is the screening test of syphilis?
A. VDRL B. Western blot C. PSA D. ELISA
26. Jarisch-Herxheimer reaction may be experienced by the client with syphilis after therapy with Benzathine Penicillin G. The characteristic
manifestations of Jarisch-Herxheimer reaction are:
A. Rashes, itchiness, hives and pruritus
B. Confusion, drowsiness and numbness of extremities
C. Sudden episode of hypotension, fever, tachycardia and muscle aches
D. Episodes of nausea and vomiting, with bradypnea and bradycardia
27. The causative agent of venereal warts is:
A. Chlamydia trachomatis B. Staphylococcus aureus C. Herpes simplex virus D. Human Papilloma Virus
28. As a nurse-in-charge for this woman, you anticipate that the doctor will prescribe which medication for this type of infection?
A. Podophyllum B. Flagyl C. Monistat D. Trichloroacetic acid
29. Cryosurgery may also be used to remove large lesions. The healing period after cryosurgery may be completed in 4-6 weeks but may cause
some discomfort to the woman. Which measures can alleviate these discomforts?
A. Kegel’ s Exercise C. Topical steroids
B. Sitz baths and lidocaine cream D. Cool Air
30. In order to prevent acquiring sexually transmitted diseases, which is the BEST way to consider?
A. Condom use B. Withdrawal C. Vasectomy D. Abstinence
SITUATION: Normie is a 6-year-old preschooler reported by her mother having fever, coughing, runny nose and white spots in his mouth.
31. Rubeola is an Arabic term meaning “red”, referring to the rashes that appear on the face and cheeks of the client during the eruptive stage prior
to its full development by the end of the second day. As a nurse, your physical examination must determine complications, especially:
A. Otitis Media B. Bronchial pneumonia C. Inflammatory conjunctiva D. Membranous laryngitis
32. To render comfort measures is one of the priorities of the nurse. This includes care of the skin, eyes, ears, mouth and nose. To clean the
mouth, your antiseptic solution is in some form of which one below?
A. Water B. Sulfur C. Alkaline D. Salt
33. As a public health nurse, you are teaching the mother and family members the prevention of measles’ complication. Which of the following
should be closely watched?
A. Temperature fails to drop B. Inflammation of the conjunctiva C. Inflammation of the nasopharynx D. Ulcerative stomatitis
34. One source of infection for measles is secretions from the nose and throat from an infected person. Filterable virus of measles is transmitted by:
A. Water supply B. Droplet C. Food Ingestion D. Sexual Contact
35. All of the following are necessary household management in preventing the spread of measles at home, except:
A. Explain proceedings in proper disposal of nose and throat discharges
B. Teach concurrent and terminal disinfection
C. The patient should be isolated when the fever subsides
D. Children should be watched out for complication of the disease

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SITUATION: The Philippines ranks ninth among the 22 high-burden countries for pulmonary tuberculosis (PTB). However, there has been a
significant decline in the tuberculosis burden ten years after the DOTS therapy was initiated.
36. A client exposed to tuberculosis is taking Isoniazid (INH) and develops signs and symptoms of the disease. The client is instructed to add
Rifampicin and Pyrazinamide to the medication regimen. A nurse explains to the client that the purpose of adding this second medication is:
A. Rifampicin offsets the side effects of Isoniazid C. These medications potentiate each other
B. To be certain that resistant organisms are eliminated D. Isoniazid offsets the side effects of Rifampicin
37. A nurse has given a client, who is taking Ethambutol, information about this medication. The nurse determines that the client understands the
instructions if the client states and immediately reports:
A. Epigastric pain C. Orange-red discoloration of body secretions
B. Impaired sense of hearing D. Difficulty in discriminating the color red from green
38. Staff nurses learn that a client they have been caring for during the last few weeks has just been diagnosed with tuberculosis. When the nurse
expresses concern about contracting tuberculosis themselves, the charge nurse’s response should be based on which of the following
statements?
A. Tuberculosis is easily treated with short course of antibiotics.
B. The Mantoux test is used to confirm diagnosis of tuberculosis.
C. Tuberculosis is not highly infectious when standard precautions are followed.
D. Vaccination with BCG will be used to immunize the nurses against infection.
39. A client who is taking INH, Rifampicin, PZA and Pyridoxine for the treatment of tuberculosis asks a nurse why the Vitamin B6 (pyridoxine) is
necessary. The nurse would respond that:
A. “Vitamin B6 is necessary for the absorption of INH.”
B. “Vitamin B6 activates the metabolism of INH.”
C. “INH competes with the absorption of Vitamin B6, which leads to depletion.”
D. “INH causes nausea and vomiting which leads to inadequate intake of Vitamin B6.”
40. The client with TB is to be discharged home with community health nurse follow-up. Of the following interventions, which would be the highest
priority?
A. Offering the client emotional support C. Coordinating various agency services
B. Teaching the client about the disease and its treatment D. Assessing the client’s environment for sanitation
SITUATION: The newly hired nurses were assigned to the communicable disease floor of the hospital wherein they are task to care for various
clients. The following questions apply.
41. A child is scheduled to receive immunizations. The child’s mother reports to the nurse that the child has been receiving long-term
immunosuppressive therapy. The nurse prepares the scheduled immunizations knowing that which of the following is contraindicated?
A. Hepatitis B C. Hib (Haemophilus influenzae type b)
B. MMR (measles-mumps-rubella) D. DTaP (diphthena—tetanus—acellular pertussis)
42. A nurse is reviewing the physician’s prescription for a child who has been diagnosed with scabies. Lindane has been prescribed for the child.
The nurse questions the prescription if which of the following is noted in the child’s record?
A. The child is 18 months old. C. A sibling is using lindane for the treatment of scabies.
B. The child is being bottle-fed. D. The child has a history of frequent respiratory infections.
43. The mother of a preschooler who attends day care calls a clinic nurse and tells the nurse that the child is constantly scratching the perianal area
and that the area is irritated. The nurse suspects the possibility of pinworm infection (enterobiasis). The nurse instructs the mother to obtain a
rectal specimen by a tape test and tells the mother to obtain the specimen:
A. After bathing C. When the child is put to bed
B. After toileting D. In the morning, when the child awakens
44. Water is a common vehicle of transmission for communicable diseases. How far should toilet facilities be away from water sources?
A. 5-15 meters B. 15-25 meters C. 25-35 meters D. 35-45 meters
45. A client suspected of having tetanus asks the nurse about immunization against the disease. The nurse explains that the major benefit in using
tetanus antitoxin is that it:
A. Stimulates plasma cells to produce antibodies C. Provides immediate active immunity
B. Provides a high titer of immunoglobulins D. Stimulates long-lasting passive immunity
SITUATION: MERS-CoV (Middle East Respiratory Syndrome Coronavirus), previously known as the Novel Coronavirus or SARS-like virus, is a
condition known to be caused by a microorganism from the family of the coronavirus.
46. The first confirmed case of MERS-Cov was reported:
A. In Jeddah, Saudi Arabia on June 2012 C. In Kuwait on June 2013
B. In Jordan on June 2012 D. In the Philippines on February 2014
47. MERS-CoV is transmitted via:
A. Animal-to-human transmission C. Human-to-Human transmission
B. Vector transmission D. Body fluid transmission
48. The following statement is true regarding the MERS-CoV (Middle East Respiratory Syndrome Coronavirus)?
A. Currently, there is a vaccine that will prevent the transmission of this new viral disease.
B. MERS-CoV and SARS are just the same, the only difference is the incubation period.
C. Common symptoms of MERS-CoV are acute, serious respiratory illness with fever, cough, shortness of breath, and other breathing
difficulties. Some clients have pneumonia and gastrointestinal symptoms like diarrhea. In clients who are immunocompromised, renal
failure may occur.
D. It was detected that male Anopheles mosquitoes are the ones which carry the virus that is responsible for MERS-Cov.
49. In clients who are suspected of having the MERS-CoV virus, which laboratory test would provide an accurate diagnosis of MERS-CoV?
A. Polymerase chain reaction (PCR)
B. Currently, there are no laboratory test that will help in confirming this viral disease; diagnosis is based on the travel history and
manifestations of the client.
C. Sputum Acid-fast bacilli (AFB)
D. Chest X-ray, Urinalysis, and Blood test can be used to detect the presence of MERS-CoV
50. The nurse in the community is planning to educate the people regarding the prevention of the MERS-CoV, which of the following if stated by the
nurse would be considered inaccurate?

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A. Frequent hand washing
B. Cover mouth and nose when sneezing and coughing.
C. Increase immune resistance by eating nutritious foods, drinking ample amount of fluids, sleeping enough and exercise.
D. Currently, there is a vaccine that will prevent a person from contracting the viral condition, it is available in the city hall of every
municipalities.

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