CCN CCN Communicable Disease Management & Public Health 1 — Questions and Answers
Question 1: Which bloodborne pathogen poses the highest transmission risk in a correctional facility due to the prevalence of injection drug use history among the incarcerated population?
- Hepatitis C virus (HCV) (Correct answer)
- HIV
- Hepatitis B virus (HBV)
- Hepatitis D virus (HDV)
Correct answer: Hepatitis C virus (HCV)
HCV prevalence in correctional settings is disproportionately high, primarily driven by injection drug use history, with estimates of 12–35% of inmates infected.
Question 2: Upon intake, an inmate has a positive tuberculin skin test (TST) but no symptoms. Chest X-ray is negative. What is the correct classification and management?
- Latent TB infection (LTBI) — offer treatment with isoniazid or rifampin regimen (Correct answer)
- Active TB — initiate airborne isolation immediately
- False positive — no further action needed
- Pulmonary TB — begin four-drug RIPE therapy
Correct answer: Latent TB infection (LTBI) — offer treatment with isoniazid or rifampin regimen
A positive TST with negative CXR and no symptoms indicates LTBI, which should be treated to prevent progression to active disease, especially in congregate settings.
Question 3: A correctional nurse identifies an inmate with active pulmonary tuberculosis. What is the immediate infection control priority?
- Place the inmate in airborne infection isolation in a negative-pressure room (Correct answer)
- Place the inmate in droplet precautions with a surgical mask
- Transfer to a community hospital without isolation
- Begin treatment and allow return to general population within 24 hours
Correct answer: Place the inmate in airborne infection isolation in a negative-pressure room
Active pulmonary TB is transmitted via airborne droplet nuclei and requires negative-pressure airborne isolation to prevent spread in the congregate correctional environment.
Question 4: Which vaccine is recommended by the CDC for all incarcerated adults who lack documented immunity to hepatitis B?
- Hepatitis B vaccine series (3-dose or 2-dose) (Correct answer)
- Hepatitis A vaccine only
- Combined hepatitis A/B vaccine series
- No hepatitis B vaccination is recommended in corrections
Correct answer: Hepatitis B vaccine series (3-dose or 2-dose)
CDC recommends offering the hepatitis B vaccine series to all unvaccinated or non-immune adults in correctional settings due to elevated transmission risk.
Question 5: An inmate reports a productive cough for 3 weeks, night sweats, and a 10-pound weight loss. Which nursing action takes priority?
- Isolate the inmate and notify the provider for TB workup immediately (Correct answer)
- Schedule a routine sick call appointment for next week
- Administer cough suppressant and reassess in 72 hours
- Obtain a throat culture and return the inmate to their cell
Correct answer: Isolate the inmate and notify the provider for TB workup immediately
The classic TB symptom triad of productive cough >2 weeks, night sweats, and weight loss requires immediate isolation and urgent provider notification pending TB evaluation.
Question 6: What is the primary goal of contact tracing when a new case of active TB is identified in a correctional facility?
- Identify and test inmates and staff exposed to the index case to detect additional infections early (Correct answer)
- Determine who to criminally charge for spreading disease
- Restrict all visitation immediately for 90 days
- Transfer all inmates to another facility
Correct answer: Identify and test inmates and staff exposed to the index case to detect additional infections early
Contact tracing identifies exposed individuals for testing and treatment, preventing further TB transmission within the facility and into the community.
CCN CCN Communicable Disease Management & Public Health 1
Which bloodborne pathogen poses the highest transmission risk in a correctional facility due to the prevalence of injection drug use history among the incarcerated population?