Vaccine-preventable and Childhood Diseases Practice Questions

25 multiple-choice questions on Vaccine-preventable and childhood diseases for paramedic and EMT students, from Chapter 27 (Infectious Diseases). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. A patient with measles was in a clinic exam room until 30 minutes ago. An unvaccinated person entering the empty room now:

   1. A. Is safe now
   2. B. Can catch it by touching surfaces in the room
   3. C. Is protected by wearing gloves and a gown
   4. D. Can still catch measles
   Show answer

   Answer: D. Can still catch measles

   Measles virus stays infectious in the air of a room for up to 2 hours after the patient leaves. Rooms must stay empty or be ventilated before reuse, and nonimmune people should not enter.

2. Koplik spots are associated with:

   1. A. Measles
   2. B. Mumps
   3. C. Rubella
   4. D. Chickenpox
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   Answer: A. Measles

   These small white spots on the inner cheek appear before the rash.

3. The measles rash typically begins:

   1. A. On the hands and feet
   2. B. On the face and spreads down
   3. C. On the trunk and spreads out
   4. D. On the legs, then the trunk
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   Answer: B. On the face and spreads down

   Fever, cough, coryza, and conjunctivitis precede the rash.

4. Mumps classically causes:

   1. A. Bloody diarrhea and cramps
   2. B. A barking cough
   3. C. Swollen parotid glands
   4. D. Painless jaundice
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   Answer: C. Swollen parotid glands

   Complications include orchitis, meningitis, and hearing loss.

5. Rubella (German measles) is most dangerous to:

   1. A. A fetus in early pregnancy
   2. B. Healthy young adult men
   3. C. School-age children
   4. D. Elderly men
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   Answer: A. A fetus in early pregnancy

   Congenital rubella causes deafness, cataracts, and heart defects.

6. Chickenpox (varicella) is characterized by:

   1. A. A rash limited to the palms and soles
   2. B. Painless purple lesions
   3. C. A sandpaper rash
   4. D. Vesicles in different stages
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   Answer: D. Vesicles in different stages

   New crops of lesions appear over several days, so papules, vesicles, and crusts exist together.

7. Varicella requires which precautions?

   1. A. Droplet precautions
   2. B. Airborne and contact
   3. C. Standard precautions
   4. D. Contact and droplet
   Show answer

   Answer: B. Airborne and contact

   Patients are contagious until all lesions have crusted.

8. Shingles (herpes zoster) results from:

   1. A. A new bacterial skin infection
   2. B. Herpes simplex type 2
   3. C. Reactivated varicella virus
   4. D. A fungal skin infection
   Show answer

   Answer: C. Reactivated varicella virus

   It causes a painful rash in a band along one dermatome.

9. The rash of shingles typically:

   1. A. Covers the whole body evenly
   2. B. Follows one dermatome, one side
   3. C. Appears first on the hands and feet
   4. D. Crosses the midline in a band
   Show answer

   Answer: B. Follows one dermatome, one side

   Lesions near the eye require urgent evaluation.

10. A person who has never had chickenpox can catch it from contact with:

    1. A. A shingles rash
    2. B. A healed scar
    3. C. A vaccinated child
    4. D. A recovered patient's clothes
    Show answer

    Answer: A. A shingles rash

    Fluid from shingles blisters contains live varicella virus.

11. Fifth disease causes a:

    1. A. Vesicular rash
    2. B. Sandpaper-like rash
    3. C. Target rash
    4. D. Slapped-cheek rash
    Show answer

    Answer: D. Slapped-cheek rash

    It is caused by parvovirus B19 and can trigger aplastic crisis in sickle cell patients.

12. Scarlet fever is caused by:

    1. A. The measles virus
    2. B. Staphylococcus aureus
    3. C. Group A streptococcus
    4. D. Parvovirus B19
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    Answer: C. Group A streptococcus

    It causes a sandpaper rash, strawberry tongue, and sore throat.

13. Roseola typically presents with:

    1. A. Rash, then high fever
    2. B. Rash without fever
    3. C. High fever, then rash
    4. D. Jaundice and fever
    Show answer

    Answer: C. High fever, then rash

    The rash appears as the fever breaks. Febrile seizures can occur.

14. Hand, foot, and mouth disease is caused by:

    1. A. Herpes simplex
    2. B. Varicella
    3. C. Staphylococcus
    4. D. Coxsackievirus
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    Answer: D. Coxsackievirus

    It causes painful mouth sores and a rash on the hands and feet.

15. Tetanus is caused by a toxin from:

    1. A. Clostridium difficile
    2. B. Clostridium tetani
    3. C. Staphylococcus aureus
    4. D. Streptococcus
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    Answer: B. Clostridium tetani

    Spores in soil enter through wounds.

16. A patient with tetanus has painful muscle spasms. During transport, which measure helps reduce spasms?

    1. A. Keep noise, light, and touch low
    2. B. Flash the lights to keep him alert
    3. C. Encourage him to walk to the unit
    4. D. Apply cold packs to the jaw muscles
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    Answer: A. Keep noise, light, and touch low

    Tetanus spasms are triggered by stimulation, including noise, light, and touch. Keep the environment quiet and dim, handle gently, and be ready to manage the airway, since spasms can involve the larynx and breathing muscles.

17. A paramedic with no record of chickenpox or varicella vaccine cared for a child with chickenpox yesterday. She should be offered:

    1. A. Nothing unless a rash appears later on
    2. B. Varicella vaccine within 3 to 5 days
    3. C. A tetanus booster given right away
    4. D. Oral antibiotics for the next 10 days
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    Answer: B. Varicella vaccine within 3 to 5 days

    Varicella vaccine given within 3 to 5 days of exposure can prevent or soften the illness in nonimmune people. She will also be excluded from patient care from day 8 to day 21 after the exposure. Antibiotics and tetanus boosters do nothing for varicella.

18. In young children, the most common cause of death from measles is:

    1. A. Pneumonia
    2. B. Kidney failure
    3. C. Liver failure
    4. D. Heart attack
    Show answer

    Answer: A. Pneumonia

    Pneumonia, from the virus itself or a secondary bacterial infection, causes most measles deaths in children. Encephalitis is rarer but serious. Measles is not a minor rash illness.

19. Polio primarily causes:

    1. A. Rash
    2. B. Jaundice
    3. C. Paralysis
    4. D. Hearing loss
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    Answer: C. Paralysis

    Poliovirus attacks motor neurons.

20. The MMR vaccine protects against:

    1. A. Measles, mumps, and rotavirus
    2. B. Meningitis, mumps, and rubella
    3. C. Measles, mumps, varicella
    4. D. Measles, mumps, and rubella
    Show answer

    Answer: D. Measles, mumps, and rubella

    It is a live attenuated vaccine given in two doses. Rotavirus is an oral vaccine, meningitis vaccines are separate, and varicella is added only in the combined MMRV product.

21. Compared with children, adults who get chickenpox are more likely to develop:

    1. A. Milder, shorter illness
    2. B. Varicella pneumonia
    3. C. Immunity without a rash
    4. D. Koplik spots
    Show answer

    Answer: B. Varicella pneumonia

    Varicella is usually mild in children but more severe in adults, who have higher rates of pneumonia, hospitalization, and death; smokers and pregnant women are at highest risk. Koplik spots belong to measles.

22. A toddler with hand, foot, and mouth disease refuses to drink because of painful mouth sores. The main concern is:

    1. A. Airway swelling from the sores
    2. B. Febrile seizures
    3. C. Anaphylaxis
    4. D. Dehydration
    Show answer

    Answer: D. Dehydration

    Painful mouth ulcers make young children refuse fluids, and dehydration is the most common reason they need medical care. Check wet diapers, tears, mucous membranes, and activity, and transport if signs of dehydration are present. The sores are shallow and do not swell the airway, and a febrile seizure is possible but is not the main concern in a child who will not drink.

23. A child with fever, cough, conjunctivitis, and a spreading rash from the face down is most likely to have:

    1. A. Roseola
    2. B. Fifth disease
    3. C. Measles
    4. D. Scarlet fever
    Show answer

    Answer: C. Measles

    Wear an N95 and notify the receiving facility.

24. Pregnant EMS providers should avoid exposure to:

    1. A. Rubella and varicella
    2. B. Head lice and scabies
    3. C. Common colds and pinkeye
    4. D. Norovirus and rotavirus
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    Answer: A. Rubella and varicella

    Both can harm the fetus if the provider is not immune. Lice, scabies, colds, pinkeye, and norovirus or rotavirus are unpleasant but do not cause birth defects.

25. Which statement about live vaccines is correct?

    1. A. They are safe in every patient group
    2. B. They contain killed virus particles
    3. C. They work mainly in adults
    4. D. Avoid in immunosuppressed patients
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    Answer: D. Avoid in immunosuppressed patients

    MMR and varicella vaccines are live and can cause illness in immunocompromised people.