Prep U - Ch 18

A nurse prefers to use an alcohol-based hand rub when providing care for patients. In which case is this practice contraindicated?

The nurse is caring for a client with a C. difficile infection

A nurse is educating a rural community group on how to avoid contracting West Nile virus by using approved insect repellant and wearing proper coverings when outdoors. By what means is the pathogen involved in West Nile virus transmitted?

Vectors

A nurse is collecting contaminated items and depositing the bag in a second bag, held by another nurse, outside the client's room. Which of the following infection control measures are the nurses performing?

Double-bagging

For which of the following clients would the use of Standard Precautions alone be appropriate?

An incontinent client in a nursing home who has diarrhea

Personal protective equipment for use with standard precautions includes which of the following items?

• Eye protection• Fluid-repellent gown• Disposable gloves• Face mask

While setting up a sterile field, a small of amount of water splashes onto the sterile drape. Which action by the nurse would be most appropriate?

Discard the sterile field to start over.

A nurse is providing care to a client who has developed an infection due to Candida. The infection is resistant to several medications. The client asks the nurse how he may have developed this infection. When responding to the client, the nurse would incorporate an understanding of which of the following as contributing to the organism's resistance?

Over-prescription of antibiotics

Which of the following nursing actions carries the greatest likelihood of contributing to the spread of vancomycin-resistant enterococci (VRE)?

Emptying the Foley catheter bag of a patient with VRE and then helping the patient in the next bed transfer to a chair

Two nurses are collecting the contaminated items and soiled linen from the room of an elderly client with a urinary tract infection. The nurses are collecting the contaminated material as per the double-bagging method. Which of the following steps must be followed when using the double-bagging method?

One bag of a contaminated item is placed within another.

An infection-control nurse is discussing needlestick injuries with a group of newly hired nurses. The infection control nurse informs the group that most needlestick injuries result from which of the following?

Recapping a needle

The nurse is setting up a sterile field to perform a catheterization when the patient touches the end of the sterile field. What would be the nurse's next appropriate action?

Discard the sterile field and the supplies and start over.

After changing the bed linens for a client, the nurse uses an alcohol-based handrub to perform hand antisepsis. What is the proper way to use an alcohol-based handrub?

Rub the product between the hands until they are dry

A nurse at health care facility uses a mask to prevent spread of microorganism by droplet or airborne transmission. What care should the nurse take when using masks? Select all that apply.

• Avoid touching the mask once it is in place• Change the mask every 20 or 30 minutes• Touch only the strings of the mask during removal

A nurse is preparing a sterile field and has removed the sterile drape from the outer wrapper. The nurse places the inner drape in the center of the work surface with the outer flap facing in which direction?

Facing away from the body

When is hand hygiene with an alcohol-based rub appropriate, as opposed to using handwashing?

When hands are not visibly soiled

A nurse needs to send the blood and urine specimen of a client with acute diarrhea to the pathology laboratory. Which of the following precautions is of highest priority to be taken by the nurse when collecting and delivering the specimens to the laboratory?

Use sealed containers in a plastic biohazard bag

A nurse who is taking the vital signs of a client with acute diarrhea is ordered to attend to another client. What is the highest priority nursing action the nurse must perform before leaving the client's room?

Thorough handwashing

A woman tests positive for the human immunodeficiency virus antibody but has no symptoms. She is considered a carrier. What component of the infection cycle does the woman illustrate?

A reservoir

The nurse is caring for a client who has active tuberculosis (TB) and is in Airborne Precautions. The primary care provider orders a computed tomography (CT) examination of the chest. Which of the following actions by the nurse is appropriate?

Place a surgical mask on the client and transport to the CT department at the specified time.

A nurse has seen several clients at a community health center. Which of the clients would be most at risk for developing an infection?

An older adult with several chronic illnesses

A nurse working at a health care facility understands the need for providing aseptic care when caring for clients. Which of the following clients is at greatest risk for infections?

Client with burn injuries

A nurse develops conjunctivitis and must remain home from work. At which time would the nurse be safe in returning to work?

Once the discharge has stopped

Nurses wear personal protective equipment to protect themselves and patients from infectious materials. Which examples accurately represent the proper use of personal protective equipment in a health care agency? (Select all that apply.)

• During some care activities for an individual patient, nurses may need to change gloves more than once.• Nurses should remove PPE at the doorway or in an anteroom except for the respirator.• To remove a gown, nurses should unfasten ties, if at the neck and back, and allow the gown to fall away from shoulders.

The nurses on a busy surgical ward use hand hygiene when caring for postsurgical patients. Which action represents the appropriate use of hand hygiene?

The nurse keeps fingernails less than ¼ inch long.

A nurse is performing a sterile dressing change. If new sterile items or supplies are needed, how can they be added to the sterile field?

With sterile forceps or hands wearing sterile gloves

Which of the following statements about glove use and hand hygiene is true?

Artificial fingernails should not be worn by staff involved in direct client care.

An acute medicine unit of a hospital currently has a number of clients who have tested positive for methicillin-resistantStaphylococcus aureus (MRSA). Which of the following measures should the nursing staff prioritize in preventing the spread of MRSA to clients who are currently MRSA-negative?

Diligent handwashing practices

The nurse is preparing to perform handwashing. Arrange the following steps in the correct order.

Turn on the faucet and adjust force and temperature of the water.Wet the hand and wrist areas.Apply soap product.Wash the palms and back of the hands for at least 15 seconds.Pat hands dry with a paper towel.Turn the faucet off with a paper towel.

You have completed an intervention with a patient. There is no visible soiling on your hands. Which of the following techniques is recommended by the Centers for Disease Control (CDC) for hand hygiene?

Decontaminate hands using an alcohol-based hand rub.

A nurse changing the linens of a patient bed is exposed to urine and performs hand hygiene. Which of the following is a guideline for performing this skill properly following this patient encounter?

Keep hands lower than elbows to allow water to flow toward fingertips.

You are donning a pair of sterile gloves. You correctly don the first glove, but inadvertently insert the thumb and index finger into the thumb hole of the second glove. The glove remains intact. Which of the following actions is most appropriate?

Continue to don the glove, then use the other gloved hand to carefully insert the finger into the proper hole.

What are the recommended cleansing agents for hand hygiene in any setting when the risk of infection is high?

Antimicrobial products

A nurse is wearing latex gloves when caring for an elderly client at the healthcare facility. Which of the following are the characteristics of latex gloves? Select all that apply.

• Increase the risk of allergies• Used when fine motor skills are required• More flexible and durable

How long should a healthcare worker scrub hands that are not visibly soiled for effective hand hygiene?

15 seconds

When assisting a physician during a surgery, a nurse is required to wear a cover gown. Which of the following characteristics is common to all cover gowns?

They have close-fitting wristbands to avoid contaminating the forearms.

A nurse is taking care of a client with tuberculosis who has developed resistance to the ordered antibiotic. Which type of client is most likely at increased risk for infection?

Older adult

Which of the following practices is a correct application of infection control practices?

A nurse performs handwashing each time she removes a pair of gloves.

A lead nurse is removing her personal protective equipment after dressing the infected wounds of a client. Which of the following is the highest priority nursing action?

Handwashing before leaving the client's room.

A nurse is changing the soiled bed linens of an older adult client who has urinary incontinence and is hospitalized. The nurse monitors the client closely based on the understanding that this client is at greater risk for which of the following?

Bacteremia

A female client is on isolation because she acquired a methicillin-resistant S. aureus (MRSA) infection after hospitalization for hip replacement surgery. What name is given to this type of infection?

Nosocomial

The following procedures have been ordered and implemented for a hospitalized client. Which procedure carries the greatest risk for a nosocomial infection?

Urinary catheterization

A patient is to have an indwelling urinary catheter inserted. Which precaution is followed during this procedure?

Surgical asepsis technique

Which of the following is an accurate guideline for the use of PPE?

Replace gloves if they are visibly soiled.

A nurse working in a high-risk area of the healthcare facility is receiving an annual vaccination. Employees working in which of the following areas need to prove their immunization status? Select all that apply.

• Transplantation• Dialysis• Pediatrics

A nurse is in charge of patient care for a patient who has MRSA. Which of the following is an accurate guideline for using Transmission-Based Precautions when caring for this patient?

Wear gloves whenever entering the patient's room.

An experienced nurse is teaching a student nurse the proper use of hand hygiene. Which of the following is an accurate guideline that should be discussed?

Hand hygiene must be performed after contact with inanimate objects near the client.

When caring for clients at the health care facility, the nurse knows that clients are susceptible to infections. Which of the following clients are at a greater risk for infection? Select all that apply.

• Client with gastric tube feeding• Client with an indwelling catheter• Client with an IV catheter

The nurse caring for clients at an outpatient clinic determines which of the following clients is at greatest risk for infection?

An 80-year-old woman

A nurse follows surgical asepsis techniques for inserting an indwelling urinary catheter in a client. Which of the following is an accurate guideline for using this technique?

Hold sterile objects above waist level to prevent accidental contamination.

Which of the following statements best explains the rationale for bringing an extra pair of sterile gloves into an adult patient's room before preparing for a sterile procedure?

If the first pair is contaminated and needs to be replaced, the nurse does not need to leave the room for a new pair.

Nurse A. is working her fourth consecutive shift at the hospital, and frequent handwashing over the past 3 days has dried her skin and resulted in a crack in the skin over one of her knuckles. As a result, Nurse A. has applied a small transparent dressing to cover the crack for the duration of this shift. Which of the following components of the infection cycle is Nurse A. addressing by this action?

Portal of entry

A nurse is taking stock of the equipment in the room of an older adult client with pneumonia who has been on parenteral nutrition for a long time. Which of the following equipment can transmit infection to older adult clients?

Indwelling catheter

A nurse is preparing an operation theater for a surgical procedure. Which of the following points regarding the principles of surgical asepsis should the nurse keep in mind when preparing sterilized surgical instruments?

A commercially packaged surgical item is not considered sterile if past expiry date.

A nurse is caring for an elderly client at a long-term health care facility. Which of the following infections poses a risk to long-term care residents and elderly clients admitted to health care facilities? Select all that apply.

• Influenza• Skin infection• Pneumonia

A nurse has completed morning care for a client. There is no visible soiling on her hands. What type of technique is recommended by the CDC for hand hygiene?

Clean hands with an alcohol-based handrub.

A nurse is caring for a client who has influenza and varicella. Which type of transmission precautions should the nurse follow when caring for the client? Select all that apply.

• Contact• Airborne• Droplet

A nurse is caring for a client with ringworm. Which of the following microorganisms causes ringworm in a client?

Fungi

Which of the following patients presents the most significant risk factors for the development of Clostridium difficileinfection?

An 81-year-old patient who has been receiving multiple antibiotics for the treatment of sepsis

What are the recommended cleansing agents for hand hygiene in any setting when the risk of infection is high?

Antimicrobial products

Nurses use medical asepsis, or clean technique, in practice to reduce the number and transfer of pathogens. Which of the following are principles of this practice? Select all that apply.

• Clean the least soiled areas first and then move to the more soiled ones.• Use personal grooming habits, such as shampooing hair often, to prevent spreading microorganisms.

A nurse is caring for a child who is hospitalized for diphtheria. Which one of the following guidelines would be appropriate when caring for this client?

Wear PPE when entering the room for all interactions that may involve contact with the client.

Which of the following is an example of the body's defense against infection?

Immune response

When caring for a client with a suspected systemic infection, the nurse should evaluate for which of the following assessment findings?

• Lethargy• Increased respirations• Enlarged lymph nodes

Which of the following infection control measures is mandated by the Occupational Safety and Health Administration (OHSA)?

Free hepatitis B vaccinations for employees who work in healthcare settings

A nurse is following medical asepsis when caring for patients in a critical care unit. Which nursing actions follow these principles? (Select all that apply.)

• The nurse carries soiled items away from the body.• The nurse moves soiled equipment away from the body when cleaning it.• The nurse cleans least soiled areas first and then moves to more soiled ones.

A nurse is caring for a patient who is diagnosed with tuberculosis. Which nursing intervention promotes infection control based on the QSEN competency of safety?

The nurse places the patient in a private room with monitored negative air pressure.

A nurse is assisting a client scheduled for appendicitis surgery with skin preparation. Which of the following steps are performed during skin preparation of a client?

Washing the surgery site with soap and warm water before the planned procedure

Which of the following is a recommended guideline for maintaining a sterile field?

If the patient touches the sterile field, you should discard the supplies and prepare a new sterile field.

Which of the following patients is most likely to require neutropenic precautions?

A patient recovering from a bone marrow transplant

Which statement is true of health care personnel and good hand hygiene?

Compliance is difficult to achieve.

A group of students are reviewing the various methods of infection transmission. The students demonstrate understanding of the material when they identify which of the following as an example of vectorborne transmission?

Using a nonsterile central venous catheter

You are caring for a patient who has an infection spread by respiratory droplets and is in Droplet Precautions. The patient asks, "Can my spouse visit me?" Which of the following responses is correct?

Yes, as long as your spouse wears a mask and stays at least 3 feet away from you.

A nurse is caring for a client with meningococcal meningitis in a private room located close to the nursing unit of the health care facility. Which of the following infection control measures should the nurse take?

Ask housekeeping personnel to clean the client's room last

A nurse has collected the blood, urine, and stool specimens of a client with meningococcal meningitis. Which of the following precautions should the nurse take when transporting the specimens?

Place the specimens into a plastic biohazard bag.

A nursing student is preparing to return demonstrate the skill of handwashing. Which of the following would indicate that the student needs additional teaching?

Adjusts the water temperature to be hot

When pouring a sterile solution, what care should the nurse take to avoid contamination of the solution?

Pour and discard a small amount of the solution before each use

A nurse has just given an injection to a client and is preparing to dispose of the needle and syringe. Which action would be least appropriate for the nurse to do?

Break the needle off at the hub after recapping it.

An operating room nurse is putting on sterile gloves to assist with patient surgery. Which actions are performed correctly in this procedure? (Select all that apply.)

• The nurse opens the outside wrapper by carefully peeling the top layer back.• The nurse carefully opens the inner package by folding open the top flap, then the bottom and sides.• The nurse lifts and holds the glove up and off the inner package with fingers down and carefully inserts hand palm up into glove.

A client comes to the emergency department with major burns over 40% of his body. Although all of the following are true, which one would provide the rationale for a nursing diagnosis of Risk for Infection?

Intact skin and mucous membranes protect against microbial invasion.

A nurse practitioner is setting up a sterile field to perform a biopsy on a patient. Which actions follow recommended guidelines for this procedure? (Select all that apply.)

• The nurse considers the outer 1-inch edge of the sterile field to be contaminated.• The nurse discards a sterile field when a portion of it becomes contaminated.• The nurse calls for help when realizing a supply is missing.

Which of the following are basic principles of surgical asepsis? Select all that apply.

• Never turn your back on a sterile field.• Consider the outer one inch of a sterile field to be contaminated.• Only a sterile object can touch another sterile object.• Avoid talking, coughing, sneezing, or reaching over a sterile field.

A nurse is administering medication to an elderly client with candidiasis. Which of the following sites are most common for candidiasis? Select all that apply.

• Mouth• Vagina• Skin