CCN CCN Communicable Disease Management & Public Health 2 — Questions and Answers
Question 1: Which sexually transmitted infection is most commonly reported in correctional facilities and requires mandatory reporting to public health authorities?
- Chlamydia (Correct answer)
- Herpes simplex virus (HSV)
- Human papillomavirus (HPV)
- Trichomoniasis
Correct answer: Chlamydia
Chlamydia is the most reported STI in correctional settings and is a nationally notifiable condition requiring reporting to state and local public health departments.
Question 2: An inmate with HIV has a CD4 count of 180 cells/mm³ and a detectable viral load. The nurse's priority is to:
- Ensure antiretroviral therapy (ART) is initiated or continued and educate on adherence (Correct answer)
- Place the inmate in isolation to prevent transmission
- Report the finding to custody staff without the inmate's consent
- Recommend deferring treatment until the inmate is released
Correct answer: Ensure antiretroviral therapy (ART) is initiated or continued and educate on adherence
A CD4 count below 200 indicates advanced HIV disease with AIDS-defining risk, making immediate ART initiation and adherence support the nursing priority.
Question 3: Which of the following correctional nursing actions best supports a public health approach to managing MRSA outbreaks in a jail?
- Implement contact precautions, wound care, and educate inmates on hand hygiene and not sharing personal items (Correct answer)
- Place all inmates in isolation until cultures clear
- Use prophylactic systemic antibiotics for all inmates on the affected unit
- Rely solely on environmental cleaning without addressing individual hygiene
Correct answer: Implement contact precautions, wound care, and educate inmates on hand hygiene and not sharing personal items
Contact precautions combined with hygiene education and restriction of personal item sharing are the cornerstone of MRSA outbreak control in congregate settings.
Question 4: An inmate presents with a painless genital ulcer and bilateral inguinal lymphadenopathy. Which STI should the correctional nurse suspect first?
- Syphilis (primary stage) (Correct answer)
- Genital herpes (HSV-2)
- Lymphogranuloma venereum (LGV)
- Chancroid
Correct answer: Syphilis (primary stage)
A painless indurated genital ulcer (chancre) is the hallmark of primary syphilis, which must be ruled out first given its systemic complications and public health implications.
Question 5: A correctional nurse is administering directly observed therapy (DOT) for an inmate with active TB. What is the primary benefit of DOT in this setting?
- It ensures medication adherence and reduces the risk of drug-resistant TB development (Correct answer)
- It allows the inmate to manage their own medication schedule
- It minimizes nursing time spent on TB cases
- It replaces the need for monthly sputum cultures
Correct answer: It ensures medication adherence and reduces the risk of drug-resistant TB development
DOT guarantees each dose is taken as prescribed, which is essential to achieving cure and preventing the emergence of multidrug-resistant TB (MDR-TB).
Question 6: Which infection control precaution category is appropriate for an inmate diagnosed with influenza in a correctional facility?
- Droplet precautions with surgical mask for anyone within 3 feet (Correct answer)
- Airborne precautions in a negative-pressure room
- Standard precautions only
- Contact precautions with gown and gloves only
Correct answer: Droplet precautions with surgical mask for anyone within 3 feet
Influenza spreads primarily through respiratory droplets and requires droplet precautions, including masking within 3 feet and housing separation when possible.
CCN CCN Communicable Disease Management & Public Health 2
Which sexually transmitted infection is most commonly reported in correctional facilities and requires mandatory reporting to public health authorities?