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4n051a Volume 4 CDC Study Questions


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What are two ways that a causative agent may cause diseases?
By producing toxins or destroying cell parts
Where do normal flora originate?
At birth in various parts of the body
What type of relationship develops when a host is exposed repeatedly to a pathogen, but is never successful in eliminating it?
A host tolerance can develop
How do carriers differ from individuals who actually develop an infectious disease?
They are not affected but they can transmit the diseases
What type of pathogen uses parts of the host's tissues as nutrients?
Infectious Agent
What is the average rate of reproduction for bacterial cells?
Divide every 30-120 minutes
What physical characteristics are used to determine their classification?
Size, Shape and Attachments
What are the three basic bacterial shapes
Spherical, Rod, Spiral
What type of organism causes Rocky Mountain Spotted fever?
List three useful functions of fungi?
The creation of mushrooms, breads and in fermentation
List the components of the chain of infection.
Infectious Agent, Resevoir, Portal of entry, portal of exit, and host.
What are the normal exit portals for infectious agents?
Respiratory, GI Tract, skin breaks and mucous membranes
Describe indirect contact?
Indirect contact is touching contaminated objects such as forks, spoons, coffee cups, and medical equipment.
Describe droplet transmission?
Transmitted through air by coughing, sneezing or talking
What are the stages of an infectious agent?
Incubations, prodromal, illness, and convalescense
How much can the prodromal period vary for different diseases?
A few hours or a few days
Define hepatitis.
Inflammation of the liver not caused by trauma
What is meningitis, and what is the most serious type?
Inflimation of the meninges, Bacterial Meningitis
What is the most common type of meningitis?
Briefly describe the AIDS disease and the virus known to cause it.
A retrovirus known as HIV
What is the most common/serious complication of gonorrheal infectious in women
List the five stages fo syphilis.
Primary, Secondary, Latent, Late and Congenial
What directive discusses how reportable disease lists must be updated?
AF 48-105
How does a physician notify Public Health of a reportable disease?
AF form 570
Who ensures civilian agencies are notified of reportable diseases?
Public Health Office
What does the term "asepsis" mean?
Reducing or eliminating microorganisms. Freedom from infection
What is another term use for medical asepsis?
Clean technique
What is another term use for surgical asepsis?
Sterile Technique
What procedure is designed to destroy pathogens, but usually does not affect spores?
What is the difference between disinfectants and antiseptics?
Disinfectants are designed to destroy pathogenic organisms and usually are used on inanimate objects. Antiseptics are designed to inhibit the growth of microorganisms.
What are two recommended tiers of isolation precautions developed by the Centers for Disease Control?
Standard precautions and transmission-based precautions
Why were standard precautions developed?
To prevent nosocomial infection
When is it important to use masks, goggles, or face shields?
When splattering or splashing of blood or body fluids if possible
Waht are the three types of transmission-based precautions?
Airborne, droplet and contact precautions
Describe how to reduce the risk of spreading infectious agents by the "airborne" route.
Place a patient in a private room that has monitored negative air pressure; the door is kept closed
If droplet precautions are in effect, when should you wear a mask.
Wear masks when working within 3 ft. of the patient
What is the purpose of isolation precautions?
Prevent the spread of microorganisms among staff, patients, and visitors
What are three reasons nonmedical individuals contaminate themselves when attempting to deal with isolation?
They refuse to believe that they could be contaminated and ignore the precautions; they don't understand the precautions and become contaminated accidentally; or they don't understand English and can't read the precautions
Why do medical staff members violate isolation precautions?
Haste, not unerstanding precautions, or thinking precautions don't apply to them
Under what conditions can a roomate be placed with an isolation patient?
If both patients are cooperative, understand the infectious process, and have been taught how to do the isolation technique
Why are contaminated articles bagged before they are taken out of the isolation?
To prevent contamination of the environment and other people.
Define routine and terminal cleaning
Routine cleaning is general cleaning that's done every day and usually is performed the same as in other areas of the hospital; terminal cleaning is directed primarily toward objects the patient has actually had contact with
What additional precautions should be taken with cleaning equipment if the patients's condition requires a private room?
The cleaning equipment should be disenfected with an approved solution before going to another room
How is the solution that is used for terminal cleaning selected?
They are selected by the local infection control committee according to EPA standards
What should infectious patients wear when they are being transported through the hospital?
Gown, Mask and Gloves
Why is a private room the most effective type of isolation unit?
The patient is physically seperated from other people and personnel are more likely to remember to wash their hands before going on to other patients
How do masks protect the wearer?
They prevent inhalation of large droplets and small droplet nuclei. Th eymight also prevent personnel from touching their mucous membranes and contaminating themselves
When should you put on and take off a mask?
Put it on before you enter the room and take it off before you leave
For what reasons are gloves worn?
To provide a protective barrier and prevent gross contamination of the hands when touching blood, body fluids, secretions, excretions, mucous membranes, and nonintact skin; to reduce the likelihood of microorganisms being transmitted during steril procedures; and to reduce transmission of microorganisms to other patients.
What should you do with disposable equipment when it becomes contaminated?
Bag, label, and dispose of it according to local policy
What should you do with an isolation patient's food tray?
No special precautions are needed; hospital dishwashers are capable of decontaminating dishes
What general tasks are included in the sterilization process?
Cleaning, disinfecting, wrapping, and sterilizing
List three examples of semicritical process?
Fiber-optic endoscopes, endotracheal tubes, and cystoscopes
What factors determine the cleaning method to be used for equipment?
Local policy, type of object to be cleaned, and amount and type of organic material on the object
When cleaning equipment, what things should you do to prevent self-contamination?
Avoid splashing, wear gloves, eye protectins, and adhere to local requirements
Breifly describe ultrasonic cleaning.
An ultrasonic device cleans by passing ultrasonic waves through a fluid. This produces submicroscopic bubbles, which collapse and pull dirt from objects by suction
What are three types of disinfection?
Pasteurization, exposure to chemical germicdes, and ultraviolet irradiation
For what purpose is low-level disinfection useful?
General cleaning
What type of disinfection is done by placing small items in the boiling water for a specified period of time?
What special precaution must you take when using ultraviolet irradation?
Wear protective garments to prevent injury
What characteristics should wrapping material for sterile packs have?
The wrapper must be constructed so that it allows the sterilizing agent to enter and leave, but does not allow microorganisms or dust particles to enter. It must be durable enough to withstand conditions in the sterilizer and in storage, and it must provide physical protection for delicate items. The wrapper must also be flexible enough to adapt to the shape of the object and allow the package to be opened without contaminating the contents. Finally, the wrapper must be cost-effective
Why should you avoid adding extra supplies or equipment to a sterile pack?
Sterile packs are designed for one-time use. Adding materials is a waste of time and space
Which wrapping method is used for most packages?
Why should you avoid using pins, clips, or staples to secure sterile packages?
Such objects make holes in the wrapper that allow microorganisms to enter
What type of instrument should you use to label a sterile package?
Indelible-ink, felt-tipped marker
What information should be included on the label?
Contents, preparer's initials, preparing date, designation for receiving unit, sterilization control number, and expiration date
What are the three basic methods of sterilization?
Physical sterilization, chemical sterilization, and ionizing radiation
Which method of sterilization includes gravity displacement sterilizers, prevacuum sterilizers, and washer-sterilizers?
Pressurized steam sterilization
When does a steam sterilizer begin timing the actual sterilzation cycle?
When all the air is removed and the heat reaches a preset point
What are the disadvantages fo steam sterilizers?
They produce great amounts of heat and cannot be used for delicate items made of plastics and rubber
What is the primary function of washer-sterilizers?
Decontaminate/terminally sterilize used instruments after a procedure or operation
How should packages be arranged in an ethylene oxide sterilizer?
To allow penetration of the gas to all surfaces
What are some advantages of ethyl oxide sterilizers?
Ethylene oxide is effective against all microorganisms, is noncorrosive, and can be used for delicate items; it is readily available, penetrates dry material easily, and eliminates the need for high pressure, humidity, and temperature
For what purpose is ionizing radiation primarily used?
Bulk sterilization of commercial products
How is heat lost from the body?
Through the process of conduction, convection, radiation, and evaporation
how do you obtain relative skin temperature on a patient?
By observing the patient and feeling his or her forehead
What are the advantages of using glass thermometers?
They can be reused and are not affected by moisture or power outages. They are extremely accurate as long as they are used correctly
What method of temperature assessment should be reserved for general assessment purposes, or as a last resort?
The axillary method
What aspect of electronic thermometers minimizes the risk of a contamination?
The disposable probe covers
What are the disadvantages associated with the use of chemical dot thermometers?
They are unstable when exposed to moisture and temperature extremes, and cannot be used for rectal temperatures
What causes the expansion and contraction of the arterial wall (pulse)?
Expansion occurs because of the increase in blood flow that occurs when the left ventricle contracts. Contraction occurs when the flow returns to normal
Why is the carotid artery preferred for pulse checks in emergency situations?
Because it is easiy accessible, has a very strong pulse, and persists when the stroke volume is too low to palpate peripheral pulses
Where would you place the diaphragm of the stethescope if you were trying to auscultate an apical pulse?
Near the level of the fourth or fifth intercostal space at the midclavicular line, or just beneath the left nipple.
What type of pulse irregularity may be associated with increased intracranial pressure, excessive vomiting, or tracheal suctioning.
What pulse characteristic is associated with conduction abnormalities such as atrial fibrillation?
What are the characteristics of respiration?
Quality, Rate, Depth and Pattern
What can you determine about a patient's respiratory effort if he or she insists on remaining in a sitting or standing position and there appears to be an excessive amount of chest movement during respirations?
The patient is experiencing dyspnea and is in respiratory distress
What diseases may produce rales?
Pulmonary edema, pulmonary fibrosis, and pneumonia
How would a brain tumor affect a patient's respiratory rate?
Decrease it
How does hypoventilation affect the carbon dioxide supply of the blood?
Causes excessive retention of carbon dioxide in the blood
Briefly describe the Cheyne-Stokes breathing pattern.
Cheyne-Stokes breathing is characterized by cycles in which the respirations gradually increase and then decrease in rate and depth. These cycles alternate with short periods of apnea. At their longest, the respirations may last up to 30-45 seconds. The periosds of apnea usually last 20 seconds or less.
What breathing pattern is associated with metabolic acidosis and renal failure?
Kussmaul's breathing
What type of sputum is produced by a patient with a pulmonary infection or pneumonia?
Thick, green, purulent sputum
What is a diastolic pressure?
Head Trauma
What type of reading wil be produced if the BP cuff is too big?
A false low
Describe the procedure for palpating the blood pressure
Palpate either the brachial or the radial pulse as you inflate the cuff, and continue to inflate the cuff for approximately another 20 mm hg after the pulse disappears. Continue to palpate for the pulse as you slowly deflate the cuff. The point where the pulse reappears is the systolic pressure.
In what positions should the patient be placed while taking orthostatic vital signs?
Lying, sitting, and standing
What are two possible treatments for postural/orthastatic hypotension?
Intravenous therapy, and blood transfusion therapy
This check is performed at regular intervals on patients who may have:
A head injury or who have had a brain surgery
What is consensual reflex?
When both pupils are smaller when either eye is stimulated with light
How will pupils react when viewing far objects?
Dilate while viewing far objects
What does an oximetry machine measure?
Arterial hemoglobin oxygen saturiation
What medical diagnosis will cause a pulse oximeter to give false high readings
Patients with carbon monoxide poisoning
Peak expiratory flow is also referred to as what?
Expiratory reserve volume
What are the two most useful purposes of the pulmonary function test?
Evaluating losses in respiratory function and following the course of certain respiratory diseases
Which of the four respiratory capacities represents the total amount of exchangeable air?
Vital capacity (VC)
Define anatomical dead space.
The volume of the conducting respiratory passageways (areas in and around the nose, pharynx, larynx, trachea, and bronchial tree) which fills with inspired air but never contributes to gas exchange in the alveoli
Before administering the PFT, what information must you find out from the patient that may have an effect on the test?
If the patient has smoked or administered a bronchodilator within the past hour, eaten a meal within the past 2 hours, or is acutely ill or has experienced an upper or lower respiratrory tract infection during the past 3 weeks
How long must an examinee blow into the PFT machine before a tracing can be considered accceptable?
For at least 5 seconds, or until an obvious plateau in the volume-time curve has occured
When using the appropriate nomogram to determine predicted values, what two factors must be known?
Height and age
What must you do to the predicted FEV1 and FVC values for non-caucasian examinees and why?
Multiply them by 0.85; to adjust for the lower (15 percent differences)predicted normals
What initiates electrical impulses in the heart?
The sinoatrial (SA) node
Explain the progression of the electrical impulse through the heart.
Initiating in the SA node, the electrical impulse passes through the AV node down the Bundle of His to the left and right bundle brances, and then through the Purkinje fibers which terminate in the ventricular walls
Where in the heart is the Purkinje fiber network most elaborate?
The left ventricle
What are the three distinguishable waves of an ECG called?
Deflection waves
What does the QRS complex represent?
Ventricular depolorization
Define artifact
Any artificial product or feature which appears on an ECG tracing
Define arrhythmia
Any variation from the normal electrical rate and/or sequence of cardiac activity
When applying limb leads on the fleshy portion of an extremity, where must you ensure that the electrodes do not lie?
Directly on a bone
By measuring the various waves, complexes, interval, and electrical voltage, what can a trained person determine from an ECG?
The rate, rhythm, and axis of the heart, along with any evidence of myocardial hypertrophy or infarction
How many pounds are in one kilogram?
Of the two methods used to measure standing height, which is most preferred
The back to hard surface method
How should the patients hips, knees, and ankles be flexed while measuring a sitting height
At 90 degrees
What type of patient may have daily abdominal girth measurements?
Patients with cirrhosis of the liver
What special test is used to detect occult blood in the urine?
What test is used to determine the hydration level of the patient?
Specific gravity
If you find calculi when straining urine, what should you do?
Save it and send it to the laboratory for analysis
Stool samples are obtained for what reasons?
To check for occult blood, parsites, fat, and other abnormalities
List all equipment needed to perform venipuncture
Needle (20 gauge or larger), syringe 9size depends on amount of blood needed) antiseptic, 2x2 gauge sponges, vacutainer nedle (if using vacutainer system), test tubes with proper color for tests ordered by the physicican, tourniquet, and non-sterile gloves
What is the purpose of a tourniquet when performing venipuncture?
To distend the veins and allow you to visualize and palpate the vein
When performing venipuncture , how is the needle inserted
Bevel up at 45 degrees into the vein
How long is pressure maintained over a venipuncture site?
2-3 minutes
When performing a skin puncture, why is the first drop of blood wiped away?
It contains epithelial cells that may interfere with test results
What is the purpose of a glucose meter?
For diabetics to quickly obtain blood glucose levels

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