Introduction to Bacterial, Viral/COVID-19, and Fungal Infections

Every question here, with the answer

1. A client receiving chemotherapy has a temperature of 98.6°F but reports new malaise and a cough. What is the nurse's best interpretation?

   1. The client may have an infection without a typical fever, so the nurse should investigate further.
   2. Chemotherapy makes the immune response stronger, so symptoms will be severe if infection is present.
   3. Infection is unlikely because the client has no fever.
   4. Malaise is an expected effect of chemotherapy and needs no follow-up.

   Answer: The client may have an infection without a typical fever, so the nurse should investigate further.

   Immunocompromised clients, including those receiving chemotherapy, may not mount typical signs such as fever, which can delay recognition of infection. The nurse should take particular care to investigate. A normal temperature does not rule out infection, and chemotherapy weakens rather than strengthens immune defense.

2. The nurse is reviewing a client's history for factors that make the client immunocompromised. Which findings apply? Select all that apply.

   1. Daily prednisone use
   2. Human immunodeficiency virus (HIV) infection
   3. Recent influenza vaccination
   4. Seasonal allergies
   5. Current chemotherapy for cancer

   Answer: Daily prednisone use, Human immunodeficiency virus (HIV) infection, Current chemotherapy for cancer

   HIV/AIDS, chemotherapy for cancer, and corticosteroids such as prednisone are listed reasons a client can be immunocompromised. Seasonal allergies and vaccination are not listed as causes.

3. A student nurse asks which part of the immune system acts first and does not need prior exposure to the organism. Which answer is correct?

   1. Acquired immunity
   2. Innate immunity
   3. Immune memory
   4. Adaptive immunity

   Answer: Innate immunity

   Innate immunity is the first line of defense, works within minutes to hours, and does not require prior exposure. Adaptive (acquired) immunity and its memory are specific and slow on first exposure.

4. A client asks why a vaccine can protect against an infection years later. Which explanation by the nurse is accurate?

   1. Adaptive immunity has a memory that allows a fast response on repeated exposure to the same pathogen.
   2. The skin becomes a stronger barrier after vaccination.
   3. Innate immunity learns to recognise only that one organism.
   4. The vaccine keeps killing the organism in the blood for years.

   Answer: Adaptive immunity has a memory that allows a fast response on repeated exposure to the same pathogen.

   Adaptive immunity has a memory that mounts fast responses on repeated exposure, and this same process is how some vaccines induce immunity. The vaccine does not keep killing organisms, and innate immunity is not specific to any organism.

5. A provider plans to start an anti-infective for a client with suspected pneumonia. According to the principle of anti-infective stewardship, what is the first step in drug selection?

   1. Determine the most likely organism causing the infection.
   2. Choose the drug that covers the most organisms.
   3. Wait until the fever is gone before choosing a drug.
   4. Start an antifungal and antiviral together to be safe.

   Answer: Determine the most likely organism causing the infection.

   Because many drugs are specific to the organisms they treat, the first step is to determine the most likely organism. This avoids unnecessary use of drugs to treat organisms that are not present, so broad or combined coverage by default goes against stewardship.

6. Which diagnostic findings can help identify an infection? Select all that apply.

   1. A normal temperature in an immunocompromised client
   2. Absence of pain
   3. Influenza viral antigens on a swab
   4. White blood cell abnormalities on a complete blood count
   5. Pneumonia seen on a chest x-ray

   Answer: Influenza viral antigens on a swab, White blood cell abnormalities on a complete blood count, Pneumonia seen on a chest x-ray

   The section lists blood tests such as a complete blood count, imaging such as a chest x-ray, and organism tests such as an influenza swab. A normal temperature does not rule out infection in an immunocompromised client, and absence of pain is not a diagnostic test.