Test Bank Docx Ch11 Interactions Between Microbes And Humans

Microbiology Fundamentals: A Clinical Approach, 3e (Cowan)

Chapter 11 Interactions Between Microbes and Humans

1) Infection occurs when

A) contaminants are present on the skin.

B) a person swallows microbes in/on food.

C) a person inhales microbes in the air.

D) pathogens enter and multiply in body tissues.

E) All of the choices are correct.

2) The term infection refers to

A) microorganisms colonizing the body.

B) contact with microorganisms.

C) contact with pathogens.

D) pathogens penetrating host defenses.

E) None of the choices are correct.

3) Which terminology is not used to describe members of the resident biota?

A) Pathogenic biota

B) Normal biota

C) Indigenous biota

D) Normal microbiota

E) Commensals

4) Endogenous infectious agents arise from microbes that are

A) in food.

B) the patient's own normal biota.

C) on fomites.

D) in the air.

E) transmitted from one person to another.

5) The human body typically begins to be colonized by its normal biota

A) before birth, in utero.

B) during and immediately after birth.

C) when a child first goes to school.

D) when an infant gets its first infectious disease.

E) during puberty.

6) Resident biota are found in/on the ________.

A) skin

B) mouth

C) nasal passages

D) large intestine

E) All of the choices are correct.

7) Normal biota includes each of the following except ________.

A) bacteria

B) fungi

C) protozoans

D) viruses

E) All of the choices are correct.

8) Each of the following bring about inoculation of normal biota to a newborn except ________.

A) the birth process through the birth canal

B) bottle feeding

C) breast feeding

D) contact with hospital staff

E) All of the choices are correct.

9) The effect of "good" microbes against invading microbes is called ________.

A) microbial antagonism

B) endogenous infection

C) infectious disease

D) axenic

E) gnotobiotism

10) Opportunistic pathogens

A) cause disease in every individual.

B) cause disease in compromised individuals.

C) are always pathogens.

D) have well-developed virulence factors.

E) None of the choices is correct.

11) Pathogenic microbes that cause disease in healthy people are called ________.

A) opportunistic pathogens

B) normal biota

C) indigenous biota

D) true pathogens

E) micropathogens

12) Which of the following is not a factor that weakens host defenses against infections?

A) Genetic defects in immunity

B) Physical and mental stress

C) Strong, healthy body

D) Chemotherapy

E) Old age

13) The greatest number of pathogens enter the body through the ________.

A) respiratory system

B) gastrointestinal system

C) urinary system

D) genital system

E) skin

14) An infectious agent that originates from outside the body is called ________.

A) exogenous

B) an exotoxin

C) an enterotoxin

D) endogenous

E) axenic

15) An infectious agent already existing on or in the body is called ________.

A) exogenous

B) an exotoxin

C) an enterotoxin

D) endogenous

E) axenic

16) The minimum amount of microbes in the inoculating dose is the ________.

A) virulence factor

B) indigenous biota

C) infectious dose

D) endotoxin

E) minimal dose

17) Which of the following is not a method of adhesion?

A) Fimbriae

B) Surface proteins

C) Specialized receptors

D) Adhesive slime or capsules

E) Cilia

18) Once a microbe has entered a host, what process performed by certain white blood cells will attempt to destroy the microbes?

A) Phagocytosis

B) Adhesion

C) Encapsulation

D) Margination

E) Exocytosis

19) Which of the following is not an antiphagocytic factor?

A) Secretion of slime

B) Production of leukocidins

C) Adhering to the host

D) Secretion of a capsule

E) Ability to survive intracellularly

20) Virulence factors include all the following except ________.

A) capsules

B) ribosomes

C) exoenzymes

D) endotoxins

E) exotoxins

21) Microbial hyaluronidase, coagulase, and streptokinase are examples of ________.

A) adhesive factors

B) exotoxins

C) hemolysins

D) antiphagocytic factors

E) exoenzymes

22) Exotoxins are ________.

A) proteins.

B) only released after a cell is damaged or lysed.

C) antiphagocytic factors.

D) secretions that always target nervous tissue.

E) lipopolysaccharides.

23) Enterotoxins are ________.

A) virulence factors

B) toxins that target the intestines

C) proteins

D) exotoxins

E) All of the choices are correct.

24) Which of the following pairs is mismatched?

A) Fimbriae - adherence to substrate

B) Capsules - antiphagocytic factor

C) Coagulase - dissolve fibrin clots

D) Leukocidins - damage white blood cells

E) Hemolysins - damage red blood cells

25) Mucinase has the greatest effect on the ________.

A) respiratory system

B) gastrointestinal system

C) urinary system

D) genital system

E) skin

26) Exotoxins

A) are secreted by pathogenic organisms.

B) are bound to the membrane of pathogenic organisms.

C) are bound to the cell wall of pathogenic organisms.

D) cause more damage than endotoxins.

E) are host specific.

27) An endotoxin is

A) secreted by pathogenic organisms.

B) indicative of gram-negative organisms.

C) indicative of gram-positive organisms.

D) indicative of fungal infections.

E) indicative of viral infections.

28) ________ are toxins that are the lipopolysaccharide of the outer membrane of gram-negative cell walls.

A) Exotoxins

B) Endotoxins

C) Enterotoxins

D) Leukocidins

E) Hemolysins

29) ________ are bacterial enzymes that dissolve fibrin clots.

A) Coagulases

B) Mucinases

C) Keratinases

D) Kinases

E) Hyaluronidases

30) Which of the following is the endotoxin?

A) Hemolysin

B) Hyaluronidase

C) Streptokinase

D) Collagenase

E) Lipopolysaccharide

31) Hyaluronidase is a virulence factor in ________.

A) amoebic dysentery

B) ringworm

C) clostridia

D) cold virus

E) diphtheria

32) The suffix -emia means ________.

A) blood

B) a disease or morbid process

C) an inflammation

D) tumor

E) pertaining to

33) The stage of an infectious disease when specific signs and symptoms are seen and the pathogen is at peak activity is the ________.

A) prodromal stage

B) convalescent stage

C) incubation period

D) period of invasion

E) None of the choices are correct.

34) The time from when pathogen first enters the body and begins to multiply, until symptoms first appear is the ________.

A) prodromal stage

B) convalescent stage

C) incubation period

D) period of invasion

E) None of the choices are correct.

35) The initial, brief period of early, general symptoms such as fatigue and muscle aches is the ________.

A) prodromal stage

B) convalescent stage

C) incubation period

D) period of invasion

E) None of the choices are correct.

36) Which of the following pairs is mismatched?

A) Secondary infection - infection spreads to several tissue sites

B) Mixed infection - several agents established at infection site

C) Acute infection - rapid onset of severe, short-lived symptoms

D) Local infection - pathogen remains at or near entry site

E) Toxemia - pathogen's toxins carried by the blood to target tissues

37) The subjective evidence of disease sensed by the patient is termed a(n) ________.

A) syndrome

B) symptom

C) sign

D) pathology

E) inflammation

38) The objective, measurable evidence of disease evaluated by an observer is termed a(n) ________.

A) syndrome

B) symptom

C) sign

D) pathology

E) inflammation

39) Local edema, swollen lymph nodes, fever, soreness, and abscesses are indications of ________.

A) toxemia

B) inflammation

C) sequelae

D) a syndrome

E) latency

40) A symptom is ________.

A) an objective indication of disease

B) a subjective indication of disease

C) measurable by health care personnel

D) temperature

E) None of the choices are correct.

41) A sign is

A) an objective indication of disease.

B) a subjective indication of disease.

C) measurable by health care personnel.

D) temperature.

E) Both objective indication of disease and measurable by health care personnel are correct.

42) Leukopenia is the ________ in the level of white blood cells in a patient.

A) elevation

B) stabilization

C) decrease

43) A ________ is the presence of small numbers of bacteria in the blood.

A) bacteremia

B) septicemia

C) viremia

D) toxemia

E) None of the choices are correct.

44) Infections that go unnoticed because there are no symptoms are called ________.

A) syndromes

B) malaises

C) inflammation

D) asymptomatic

E) secondary infections

45) Which of the following is not a normal portal of exit for an infectious disease?

A) Removal of blood

B) Urogenital tract and feces

C) Coughing and sneezing

D) Skin

E) All of these are normal exit portals.

46) Which of the following is an example of sequelae?

A) Headache from meningitis

B) Difficulty swallowing from a Streptococcus infection

C) Arthritis from Lyme disease

D) Diarrhea from Salmonella enteritidis infection

E) All of the choices are correct.

47) Long-term or permanent damage to tissues or organs resulting from a specific disease are called ________.

A) symptoms

B) sequelae

C) infections

D) latencies

E) dormancies

48) The primary, natural habitat of a pathogen where it continues to exist is called the ________.

A) fomite

B) carrier

C) vector

D) reservoir

E) source

49) Someone who inconspicuously harbors a pathogen and spreads it to others is a ________.

A) fomite

B) carrier

C) vector

D) reservoir

E) source

50) An animal, such as an arthropod, that transmits a pathogen from one host to another is a ________.

A) fomite

B) carrier

C) vector

D) reservoir

E) source

51) The intermediary object or individual from which the infectious agent is actually acquired is termed the ________.

A) fomite

B) carrier

C) vector

D) reservoir

E) source

52) Reservoirs include ________.

A) humans

B) animals

C) soil

D) water

E) All of the choices are correct.

53) Animals that participate in the life cycles of pathogens and transmit pathogens from host to host are ________.

A) fomites

B) aerosols

C) mechanical vectors

D) droplet nuclei

E) biological vectors

54) A ________ is an infection indigenous to animals that can, on occasion, be transmitted to humans.

A) secondary infection

B) sequelae

C) nosocomial infection

D) zoonosis

E) None of the choices are correct.

55) ________ carriers are shedding and transmitting pathogens while they are recovering from an infectious disease.

A) Asymptomatic

B) Passive

C) Incubation

D) Chronic

E) Convalescent

56) ________ carriers are shedding and transmitting pathogens a long time after they have recovered from an infectious disease.

A) Asymptomatic

B) Passive

C) Incubation

D) Chronic

E) Convalescent

57) All infectious diseases ________.

A) are contagious

B) occur only in humans

C) are caused by microorganisms or their products

D) are caused by vectors

E) involve viruses as the pathogen

58) An inanimate object that harbors and transmits a pathogen is a ________.

A) fomite

B) carrier

C) vector

D) reservoir

E) source

59) Which of the following is a direct contact method of microbe transmission?

A) Fomites

B) Water

C) Vectors

D) Aerosols

E) Droplets

60) Which of the following is transmission of disease from mother to fetus?

A) Vertical

B) Direct

C) Vector

D) Horizontal

E) Fomites

61) Nosocomial infections involve all the following except

A) they are only transmitted by medical personnel.

B) they often involve the patient's urinary tract and surgical incisions.

C) the patient's resident biota can be the infectious agent.

D) Escherichia coli and staphylococci are common infectious agents.

E) medical and surgical asepsis help lower their occurrence.

62) Which of the following is not a universal precaution used for handling patients and body substances?

A) Mask and gloves

B) Proper disposal of needles

C) Health care worker with active lesions handling patients

D) Hand washing

E) Sterilizing or disinfecting dental hand pieces

63) When would Koch's postulates be utilized?

A) Determination of the cause of a patient's illness in a hospital microbiology lab

B) Development of a new antibiotic in a pharmaceutical lab

C) Determination of the cause of a new disease in a microbiology research lab

D) Formulation of a vaccine against a new pathogen in a genetic engineering lab

E) Whenever the scientific method cannot be used to investigate a microbiological problem

64) The study of the frequency and distribution of a disease in a defined population is ________.

A) pathology

B) clinical microbiology

C) medicine

D) immunology

E) epidemiology

65) The principal government agency responsible for tracking infectious diseases in the United States is the ________.

A) Centers for Disease Control and Prevention

B) World Health Organization

C) National Institutes of Health

D) United States Department of Agriculture

E) Infection Control Committee

66) The number of new cases of a disease in a population over a specific period of time compared with the healthy population is the ________.

A) mortality rate

B) morbidity rate

C) incidence rate

D) prevalence rate

E) epidemic rate

67) A disease that has a steady frequency over time in a particular geographic location is ________.

A) an epidemic

B) endemic

C) pandemic

D) sporadic

E) chronic

68) The total number of deaths in a population due to a disease is the ________ rate.

A) morbidity

B) mortality

C) incidence

D) endemic

E) pandemic

69) The number of persons afflicted with an infectious disease is the ________ rate.

A) morbidity

B) mortality

C) incidence

D) endemic

E) pandemic

70) What is one goal of the Human Microbiota Project?

A) To sequence the DNA of all microorganisms

B) To study the prevalence of disease

C) To study microorganisms in their natural habitat

D) To provide comprehensive characterization of microbiota relating to human health and disease

E) To discover new organisms in extreme habitats

71) Under certain circumstances, members of a person's resident biota can become opportunistic pathogens.

72) Most of the skin's resident biota are found in the uppermost, superficial layers of the epidermis.

73) The virulence factors of a pathogen are established by how strong or weak a patient's body defenses are at the time of infection.

74) The Centers for Disease Control and Prevention assigns the most virulent microbes known to cause human disease to biosafety level 4.

75) A fetus can get an infection when a pathogen in the mother's blood is capable of crossing the placenta to the fetal circulation and tissues.

76) When an infected person is in the incubation period, that person cannot transmit the pathogen to others.

77) Septicemia means that a pathogen is present and multiplying in the blood.

78) Latency is a dormant state of an infectious agent.

79) Fomites, food, and air serve as indirect transmission routes of pathogens.

80) Koch's postulates are easily satisfied for viral diseases.

81) All of the following statements are true regarding discoveries made by the Human Microbiome Project except

A) the genes coded by our microbiome number in the millions, whereas human cells contain approximately 21,000 genes.

B) areas of the body once believed to be sterile, are now known to harbor microbes.

C) the microbiota does not contain pathogens; all of the microbes in our microbiome are non-pathogenic.

D) the composition of the microbiome has implications for the development of other, non-infectious diseases such as diabetes, obesity and asthma.

E) bacteria, as well as viruses and fungi, make up the microbiome.

82) While one person's microbiome differs when compared to another person, one individual's microbiome is uniform throughout the body; for example, the organisms on the left hand will be the same as the organisms on the right.

83) The virus that causes rabies, and the rhinovirus that causes the common cold are both considered true pathogens; the degree of pathogenicity is determined by their ________.

A) virulence

B) protein coat

C) envelope

D) infectivity

84) Virulence differs from pathogenicity in that pathogenicity describes the ability of an organism to cause disease, whereas virulence describes the degree of pathogenicity as the disease develops.

85) Tooth decay develops when human saliva and proteins aggregate on the tooth and provide a hospitable surface for a range of microbial species to develop into a biofilm.  These organisms ferment carbohydrates and the acid byproducts erode the enamel, forming caries.  Tooth decay is therefore considered to be  ________.

A) a polymicrobial infection

B) a state of well-being

C) nonharmful

D) noninfectious

86) It is important to understand the extent and significance of polymicrobial infections, since treating an infection with a single antibiotic for an assumed causative organism may not adequately eliminate the infection.

87) In an experiment to determine the infectious dose for a specific organism, 50% of the test subjects must develop the disease following a specific dose.  This is quantified as the (ID50) and is a measure of the pathogenicity of that organism.  Assess the following data from an experiment involving 200 mice and determine the ID50 for the infectious agent.

Infectious Dose        Living Mice                  Dead Mice

103                                190                                 10

104                                 150                                 50

105                                 120                                 80

106                                 100                                100

107                                    0                                 200 

A) 103 organisms

B) 104 organisms

C) 105 organisms

D) 106 organisms

88) In a comparison of two pathogens, organism A has an infectious dose of 200,000 organisms, whereas organism B has an infectious dose of 15 organisms.  This means that organism A is much more pathogenic than organism B.

89) Robert Koch is credited with proving the germ theory of disease; that infectious diseases are caused by specific microorganisms.  In developing a series of proofs (Koch's Postulates), he was able to determine the causative organism of anthrax was the bacteria Bacillus anthracis.  Which of the following statements does not contribute to Koch's Postulates and the germ theory of disease?

A) The causative organism must be evidenced in each subject presenting with the disease manifestations.

B) Inoculating a healthy subject with the isolated organism must result in the reported disease manifestations.

C) The organism must be isolated, purified and characterized from an infected individual.

D) Each organism from a polymicrobial infection must be isolated and inoculated into a single host.

E) The same species of organism must be isolated from the second inoculated individual.

90) If an infectious disease emerged that was highly contagious and virulent, resulting in certain death with no known cure, epidemiological data would show

A) a high incidence and low prevalence.

B) a low incidence and high prevalence.

C) both incidence and prevalence to be high.

D) both incidence and prevalence to be low.

91) Nowadays, HIV infection is considered a chronic disease, rather than the death sentence it was when it first emerged in the 1980s.  Educational strategies to limit transmission, coupled with advances in treatment, means that compared to 1985, 

A) the incidence has dropped and the prevalence has increased.

B) the incidence has increased and the prevalence has dropped.

C) both incidence and prevalence have increased.

D) both incidence and prevalence have dropped.

92) 87 people developed diarrhea, fever and abdominal cramps in the aftermath of a wedding.  On diagnosis it was determined that they were suffering from salmonella, and after taking their histories, they all reported that they had eaten the chicken at the reception.  This is an example of ________.

A) a point-source epidemic

B) a propagated epidemic

C) a pandemic

D) an endemic disease

93) In 2003 over 500 people throughout the United States became ill with hepatitis A that was traced to green onions grown in Mexico.  This is an example of ________.

A) a common-source epidemic

B) a propagated epidemic

C) a pandemic

D) an endemic disease

94) The spread of influenza, which is particularly widespread during the winter months, is an example of a propagated epidemic.

NCLEX Prep - Test Bank Question:  Please read the clinical scenario, and then answer the questions that follow to become familiar with the traditional NCLEX question format.

A 78-year-old male presents to the emergency department reporting a 2-day history of difficulty breathing, cough, and chest pain. Upon triage assessment, the patient is found to have a fever, rapid rate of breathing, low oxygen saturation, and crackles upon auscultation of the lungs. A chest X-ray reveals consolidation in the right upper lung field. The patient is diagnosed with pneumonia, initiated on oxygen therapy, and admitted for observation and treatment.

95) As the emergency department RN, you document the care and assessment of the patient in the chart prior to transfer to an inpatient unit. What is the most appropriate term for the clinical manifestations of disease as reported by the patient? 

A) Signs

B) Symptoms

C) Syndromes

D) Signs and symptoms

96) As the RN, you document the care and assessment of the patient in the chart prior to transfer to an inpatient unit. What is the most appropriate term for the clinical manifestations of disease as noted in your assessment?  

A) Signs

B) Symptoms

C) Syndromes

D) Signs and symptoms

97) Upon admission to the inpatient unit, a respiratory sputum culture and blood culture are sent. Prior to obtaining the blood culture, you provide education to the patient. Which of the following statements, by the patient, best demonstrates understanding of the rationale for the blood culture?

A) "The blood culture will be able to determine which bacterium is causing the infection in my lungs."

B) "The blood culture will be able to determine which virus is causing the infection in my lungs."

C) "The blood culture will be able to determine if the microbe causing the infection is present and multiplying in my blood, putting me at risk for septicemia."

D) "The blood culture will be able to determine if the infection has infected other body tissues."

98) The patient's sputum culture returns a positive result for Streptococcus pneumoniae. As the RN, you are aware this capsule-forming bacterium possesses virulence factors to make it difficult to treat. In providing education to the patient regarding the disease process, which of the following statements is most appropriate?  

A) "Fluid is building up in your lungs because of the body's persistent inflammatory response to the microbe."

B) "This bacterium secretes toxins that directly damage your lungs."

C) "Fragments of this bacterium's cell wall directly harm your lungs."

D) "Fluid is building up in your lungs because white blood cells are effectively lysing the encapsulated bacteria."

99) You are diligent to prevent the spread of disease to other patients. Which of the following is the most appropriate type of isolation for this patient, considering the portal of exit for the pathogen in this case?  

A) Standard isolation (gloves)

B) Contact isolation (gown and gloves)

C) Droplet isolation (gown, gloves, and mask)

D) Airborne isolation (gown, gloves, mask, and negative airflow room)

NCLEX Prep - Test Bank Question:  Please read the clinical scenario, and then answer the questions that follow to become familiar with the traditional NCLEX question format.

 As an RN with the infectious disease team, you are providing an education course to new graduate nurses regarding the process of infection control and prevention.

100) Which of the following statements by a new nurse demonstrates understanding of the cause of infectious disease?  

A) "All contact with infectious material leads to colonization."

B) "All colonization leads to infection."

C) "All infections lead to disease."

D) "Host resistance and organism pathogenicity determine the type and severity of infection an individual will experience."

101) As the RN, you educate the new nurses about the prevalence of healthcare-associated infections. All of the following are frequent sources of patient infection, except ________.

A) urinary catheter

B) endotracheal tube

C) surgical incision

D) hospital beds

102) The infectious disease RN discusses scenarios that require hand washing with germicidal soap and water instead of alcohol-based hand cleanser. Which of the following statements by a new nurse is most accurate regarding when hands should be washed with soap and water?  

A) "I should wash my hands when they are visibly contaminated."

B) "I should wash my hands before applying gloves."

C) "I should wash my hands after removing gloves."

D) "I should wash my hands when they are visibly contaminated, but also before and after using gloves."

103) As the infectious disease RN, you are familiar with the concept of normal biota. A positive Escherichia coli culture would be unremarkable for which of the following samples? 

A) Stool

B) Sputum

C) Blood

D) Cerebrospinal fluid

NCLEX Prep - Test Bank Question:  Please read the clinical scenario, and then answer the questions that follow to become familiar with the traditional NCLEX question format.

A 36-year-old female is bit by a raccoon and presents to the emergency department with mild trauma to her right lower extremity. Following a triage assessment, the patient's wound is cleaned and dressed. The physician verbalizes concern that the patient may have been exposed to rabies from the bite. One role of the RN is to provide education to the patient regarding rabies infection and its transmission.

104) Rabies is an example of this type of infection, which is indigenous to animals but naturally transmissible to humans ________.

A) mixed infection

B) focal infection

C) zoonotic infection

D) latent infection

105) Which of the following terms most appropriately describes the role of the raccoon in the patient's exposure to infection?  

A) Living reservoir

B) Nonliving reservoir

C) Carrier

D) Biological vector

106) If the patient develops rabies infection, the time from the bite to the appearance of symptoms is referred to as the ________.

A) incubation period

B) prodromal stage

C) period of invasion

D) convalescent period

107) If the patient develops rabies infection, you know that it must be reported to local and state public health officials. Which of the following diseases is also reportable in the United States?

A) Pinworm infection

B) Fifth disease

C) EBV infection

D) Cholera