Chapter 7: Asepsis and Infection Control

42. A patient is distressed that an antibiotic has not been effective for the control of the infection. The nurse explains that some bacteria are capable of defending against antibiotics by the formation of a .

ANS: capsule Some bacteria can protect themselves by the formation of a capsule of sticky protein that prevents antibiotics from entering the cell. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 118 OBJ: 4 TOP: Bacterial capsules KEY: Nursing Process Step: Implementation

43. The nurse reminds a group of nursing students that the type of asepsis that destroys all microorganisms and their spores is asepsis.

ANS: surgical Surgical asepsis destroys all microorganisms and their spores. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 117 OBJ: 1 TOP: Surgical asepsis KEY: Nursing Process Step: Implementation

2. What action exemplifies a nurse practicing medical asepsis in performing daily care? a. Lifting a sterile swab from a sterile field b. Using disposable sterile gowns c. Washing hands for 5 minutes between patients d. Keeping bed linens off the floor

ANS: D Keeping the bed linens off the floor is an example of medical asepsis; all other options are examples of surgical asepsis.

7. A patient with ringworm asks the nurse if she has worms. What does the nurse inform the patient about the cause of ringworm? a. Bacteria b. Protozoa c. Virus d. Fungi

ANS: D Ringworm is caused by fungi.

37. A nurse is performing an admission assessment on a patient with suspected tuberculosis. What assessment findings by the nurse are consistent with tuberculosis? a. Hemoptysis b. Weight gain c. Night terrors d. Hypothermia

ANS: A Suspicious symptoms consistent with tuberculosis include fatigue, unexplained weight loss, dyspnea, fever, night sweats, and hemoptysis (a cough that can be productive of blood). PTS: 1 DIF: Cognitive Level: Comprehension REF: Pages 137-138 OBJ: 6 TOP: Tuberculosis KEY: Nursing Process Step: Assessment

15. A health care worker is stuck by a needle left on the patient's bedside table. The staff member appropriately reports the needlestick. What will the indicated treatment be combatting? a. Hepatitis B b. Streptococcal infections c. Staphylococcal infections d. Influenza

ANS: A Workers who have had a needlestick need to complete an injury report and seek treatment in the event of exposure to hepatitis B. PTS: 1 DIF: Cognitive Level: Comprehension REF: Pages 126 OBJ: 3 | 5 TOP: Needlesticks KEY: Nursing Process Step: N/A

41. What are some characteristics of microorganisms? (Select all that apply.) a. Involved in a life process of their own b. Pathogens that cause disease c. Nonpathologic organisms that cause disease d. May be infectious e. Can enter the body via skin, air, or blood

ANS: A, B, D, E Microorganisms are involved in a life process of their own, pathogens cause disease, may be infectious, and can enter the body via skin, air, or blood. Nonpathologic organisms do not cause disease. PTS: 1 DIF: Cognitive Level: Comprehension REF: Pages 116-117 OBJ: 3 TOP: Characteristics of microorganisms KEY: Nursing Process Step: Implementation

40. A person can spread a bacterial infection by which actions? (Select all that apply.) a. Kissing others b. Sneezing at work c. Donating blood d. Coming in contact with blood products e. Leaving used tissue on the lavatory

ANS: A, B, E Bacteria can be spread by direct, indirect, or airborne transmission. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 118 OBJ: 14 TOP: Bacterial transmission KEY: Nursing Process Step: Implementation

35. The nurse is providing teaching to elementary students regarding vectors. What example will the nurse provide as an example of a vector? a. Child with measles giving it to his sister b. Tick whose bite causes Lyme disease c. Woman with syphilis infecting her partner d. Dog whose bite causes rabies

ANS: B A vector is a person or animal not sick with the disease harboring an organism that is contagious. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 121 OBJ: 3 TOP: Vector KEY: Nursing Process Step: Implementation

33. The emergency department nurse is assessing a puncture wound of the foot. What is the most likely type of infection in this wound? a. Aerobic bacterial infection b. Anaerobic bacterial infection c. Viral infection d. Fungal infection

ANS: B An anaerobic bacterial infection is one that grows in an oxygenated environment. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 118 OBJ: 6 TOP: Anaerobic infections KEY: Nursing Process Step: Assessment

27. When assessing a patient for signs of an infection, the nurse recognizes which laboratory result as indicative of an infection? a. Lowered red blood cell count b. Increased white blood cell count c. Lowered white blood cell count d. Increased red blood cell count

ANS: B Increased white blood cell count may indicate an infection. PTS: 1 DIF: Cognitive Level: Application REF: Page 124 OBJ: 3 | 4 TOP: Lab results KEY: Nursing Process Step: Assessment

8. What should the nurse be diligent in to provide a safe environment for the patient? a. Keeping a light on at night to prevent falls b. Hand hygiene between patient contacts c. Regulating the temperature to avoid drafts d. Changing the bed linen to diminish microorganisms

ANS: B One of the most important actions is hand hygiene before caring for another patient.

38. A nurse is performing an admission assessment on a patient with suspected tuberculosis. What is the greatest risk of exposure to tuberculosis? a. After a diagnosis is made b. Before a diagnosis is made c. After the patient has begun medication therapy d. After implementation of isolation precautions

ANS: B The risk of exposure to tuberculosis is greatest before a diagnosis is made and isolation precautions are implemented. PTS: 1 DIF: Cognitive Level: Comprehension REF: Pages 137-138 OBJ: 8 TOP: Tuberculosis KEY: Nursing Process Step: Assessment

22. The patient in isolation may experience psychological or emotional deprivation. What should the nurse do to help minimize these feelings? a. Be cheerful b. Spend extra time with the patient c. Protect the patient from additional infection d. Answer the call light quickly

ANS: B To minimize feelings of psychological or emotional deprivation, the nurse should spend extra time with the patient. PTS: 1 DIF: Cognitive Level: Application REF: Page 137 OBJ: 13 TOP: Isolation KEY: Nursing Process Step: Implementation

36. What type of organism causes malaria? a. Bacterium b. Virus c. Protozoan d. Fungus

ANS: C Malaria is caused by the introduction of protozoa from the bite of a mosquito. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 121 OBJ: 4 TOP: Protozoan infections KEY: Nursing Process Step: Implementation

12. The nurse prioritizes the care of four patients. Which patient has a systemic infection? a. 14-year-old with acute appendicitis b. 80-year-old with a urinary tract infection c. 40-year-old with AIDS d. 50-year-old with arthritis

ANS: C AIDS is a systemic viral infection. Acute appendicitis and urinary tract infections are local infections. Arthritis is not an infection. PTS: 1 DIF: Cognitive Level: Application REF: Pages 119-120; 126 OBJ: 6 TOP: Systemic infection KEY: Nursing Process Step: Assessment

16. What technique should the nurse use when disposing of linens contaminated with feces? a. Don gown, gloves, and mask b. Wash hands for 5 minutes after disposal c. Don gloves only d. Double-bag the sheets

ANS: C All health care workers should follow Standard Precautions to prevent infection from pathogens. Standard Precautions for the disposal of ordinary feces require only that the nurse don gloves. PTS: 1 DIF: Cognitive Level: Application REF: Page 135 OBJ: 13 TOP: Standard Precautions KEY: Nursing Process Step: Analysis

20. A major threat to health care workers is blood-contaminated sharps. What should the nurse use to discard the used syringe? a. Wastebasket b. Sink c. Puncture-proof container d. Disinfecting soap

ANS: C All patient care areas where sharps are used require puncture-proof containers. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 135 OBJ: 8 TOP: Sharps KEY: Nursing Process Step: Implementation

34. The nurse is instructing a bioterrorism class regarding anthrax. How can anthrax be transmitted? a. From person to person b. Through microscopic skin punctures c. Through inhalation of the spores d. By exposure to animals that have anthrax

ANS: C Anthrax is contracted by inhaling the spores. PTS: 1 DIF: Cognitive Level: Comprehension REF: Pages 119 OBJ: 3 TOP: Anthrax KEY: Nursing Process Step: Implementation

6. What additional complication does a disease caused by a virus have compared to a disease caused by bacteria? a. Multiplies rapidly b. Returns frequently c. Is not killed by antibiotics d. Is unable to be cultured

ANS: C Antibiotics do not alter the course of a disease caused by a virus.

31. What contribution did Joseph Lister introduce to medical practice? a. Isolation of infected patients b. Iodine and alcohol use as disinfectants c. The autoclave d. Aseptic technique

ANS: D Joseph Lister contributed to medical practice through the introduction of the aseptic technique. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 116 OBJ: 1 TOP: Joseph Lister KEY: Nursing Process Step: N/A

26. The nurse accidently spills blood from a specimen container. The first action the nurse takes is to don gloves. What should the nurse then spray the fluid with? a. Liquid detergent b. 20% bleach solution c. 10% bleach solution d. Warm soapy water

ANS: C Any accidental body fluid spill should be cleaned up as soon as possible. The person cleaning the spill should wear gloves. One cup of bleach diluted with 10 cups of water should be used as a disinfectant to spray over the spill and clean up with paper towels. The paper towels should then be placed in the plastic-lined waste container. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 153 OBJ: 12 TOP: Body fluids KEY: Nursing Process Step: Implementation

10. The nurse observes a patient demonstrating wound cleaning. What action indicates the need for further instruction? a. Using sterile gloves to perform the cleaning b. Applying an antiseptic to the area c. Cleaning the area from the outside in d. Washing hands with soap

ANS: C Cleaning away from the wound prevents entrance of microorganisms.

14. The infection control practitioner plans an in-service on control of health care-associated infections. What should be the focus of this program? a. Observing nurses caring for patients b. Screening patients who are admitted to the hospital c. Educating hospital personnel about aseptic practices d. Discharging infectious patients from the hospital

ANS: C Duties of the infection control practitioner include staff education on infection control. PTS: 1 DIF: Cognitive Level: Application REF: Page 124 OBJ: 5 | 13 TOP: Infection KEY: Nursing Process Step: Planning

28. What can result from the nurse consistently performing hand hygiene and using sterile supplies when caring for patients in the hospital setting? a. Hospital stay is shortened b. Sense of self-worth is improved c. Risk of infection is reduced d. Nursing care needed is reduced

ANS: C Hand hygiene is the most important measure for interrupting the infectious process. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 125 OBJ: 5 TOP: Infection KEY: Nursing Process Step: Implementation

17. The nurse is instructing a patient about the most important preventive technique for breaking the chain of infection. What technique is the patient learning about? a. Sterilization b. Standard Precautions c. Hand hygiene d. Medical asepsis

ANS: C Hand hygiene is the most important preventive measure for interrupting the infection process. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 126 OBJ: 2 | 9 TOP: Infection KEY: Nursing Process Step: Implementation

21. The nurse is transporting a patient in respiratory isolation to the radiology department. What intervention should the nurse implement? a. Cover the patient with a sheet b. Take the patient down the service elevator c. Apply a mask to the patient d. Call x-ray to come and get the patient

ANS: C If a patient requiring respiratory isolation must be transported to another area, the patient must don a mask. PTS: 1 DIF: Cognitive Level: Application REF: Pages 135-136 OBJ: 5 | 8 TOP: Isolation KEY: Nursing Process Step: Implementation

9. What does the nurse describe when giving an example of a fomite vehicle? a. Rabid dog b. Person with AIDS c. Contaminated stethoscope d. Infected wound

ANS: C If a vehicle is an inanimate (nonliving) object, it is called a fomite.

11. The nurse is concerned when a patient admitted with a diagnosis of pneumonia suddenly develops a urinary tract infection (UTI). What type of infection is this UTI considered? a. Viral infection b. Bacterial infection c. Health care-associated infection d. Spore infection

ANS: C More than 40 million people are admitted to hospitals each year and as many as 10% of them acquire a health care-associated infection while there. Criteria for health care-associated infections require that the infection manifest at least 48 hours after hospitalization or contact with another health agency. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 124 OBJ: 2 TOP: Health care-associated infection KEY: Nursing Process Step: Assessment

4. A patient with a respiratory infection reports that he is not yet on an antibiotic. The nurse explains that the physician is waiting on the results of the culture and sensitivity. What does this test determine? a. What media the bacteria requires to grow b. How fast the bacteria grow c. Which antibiotics stop bacterial growth d. When the bacteria colonize

ANS: C Sensitivity tests are done to determine which antibiotics will stop growth.

3. What bacteria can lie dormant when conditions for growth are not favorable? a. Residue b. Capsules c. Spores d. Flagella

ANS: C Spore formation occurs when conditions are unfavorable, causing the bacteria to take a dormant form.

30. What is the most dependable and practical method to use when sterilizing instruments for the operating room? a. Chemical solution b. Boiling water c. Steam under pressure d. Dry heat

ANS: C Steam under pressure is the most practical and dependable method for destruction of all microorganisms. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 152 box 7-3 OBJ: 12 TOP: Sterilization KEY: Nursing Process Step: N/A

23. The infection control officer is observing hospital staff for appropriate use of aseptic technique. What observation demonstrates the need for more instruction on surgical asepsis? a. Facing the sterile field b. Placing a sterile dressing on a sterile field c. Touching the edges of the sterile field with sterile gloves d. Keeping gloved hands above the waist

ANS: C The edges of a sterile field are not considered sterile. PTS: 1 DIF: Cognitive Level: Application REF: Pages 139-141 OBJ: 1 TOP: Sterile technique KEY: Nursing Process Step: Evaluation

19. A nurse is observing isolation precautions by wearing a mask while performing complex patient care. How often should the nurse change masks? a. 5-10 minutes b. 10-20 minutes c. 20-30 minutes d. 30-40 minutes

ANS: C The mask should be changed every 20 to 30 minutes. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 134 OBJ: 8 TOP: Mask KEY: Nursing Process Step: Implementation

29. Recognizing the stages of an infection assists the nurse in identifying the progression of an infection. What is the nonspecific to specific symptom stage of an infection? a. Convalescent b. Illness c. Prodromal d. Incubation

ANS: C The prodromal stage progresses from onset of nonspecific signs and symptoms to more specific signs and symptoms. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 124 Box 7-3 OBJ: 4 | 6 TOP: Infection KEY: Nursing Process Step: Assessment

32. The nurse is providing instruction to an anxious mother of a child with Rocky Mountain spotted fever. When discussing this diagnosis what information will the nurse relay about this disease? a. It is extremely contagious among humans. b. It is contracted from handling unvaccinated animals. c. It is a hemolytic B Streptococcus infection spread by droplet transmission. d. It is a serious disease contracted from the bite of a tick.

ANS: D Rocky Mountain spotted fever is contracted through the bite of a tick vector. It is not contagious among humans. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 119 OBJ: 2 | 3 TOP: Vector transmission KEY: Nursing Process Step: Implementation

13. What assessment does the nurse recognize as an inflammatory response in a surgical wound on the leg of a patient? a. A foul drainage is coming from the wound b. The affected leg is cooler than the other leg c. There are raised, red, pruritic welts on the leg d. Rubor and edema appear around the wound

ANS: D Rubor and edema are two of the cardinal signs of an inflammatory response. Foul drainage suggests infection, the affected leg being cooler than the other leg suggests circulatory disorder, and raised, red, pruritic welts on the leg suggest allergy. PTS: 1 DIF: Cognitive Level: Application REF: Page 124 OBJ: 7 TOP: Inflammatory response KEY: Nursing Process Step: Assessment

25. What is a method used to kill all microorganisms, including spores? a. Disinfecting b. Using an antiseptic c. Using chlorine bleach d. Sterilizing

ANS: D Sterilization refers to methods used to kill all microorganisms and spores. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 152 OBJ: 12 TOP: Pathogens KEY: Nursing Process Step: N/A

1. What is true regarding surgical asepsis? a. It inhibits growth of pathogenic organisms. b. It is known as a cleaning technique. c. It includes hand hygiene. d. It is known as a sterile technique.

ANS: D Surgical asepsis is known as a sterile technique.

5. What bacterium is responsible for more diseases than any other organism? a. Staphylococcus b. Pseudomonas aeruginosa c. Haemophilus influenzae d. Streptococcus

ANS: D The Streptococcus bacterium is responsible for more diseases than any

24. The nurse is pouring a sterile solution from a bottle. What direction should the label on the bottle be in for appropriate technique? a. Facing outward b. Covered c. Facing downward d. In the palm of the hand

ANS: D The bottle should be held with the label in the palm of the hand. PTS: 1 DIF: Cognitive Level: Application REF: Page 146 OBJ: 11 | 12 TOP: Sterile technique KEY: Nursing Process Step: Implementation

18. How long should the nurse perform hand hygiene before beginning care of a patient? a. 5 minutes b. 2 minutes c. 1 minute d. 30 seconds

ANS: D The nurse should wash hands after using the bathroom, after contact with any secretions, before eating, and before and after patient care. The nurse should use warm water, soap, and friction for 15 to 30 seconds, and dry hands thoroughly. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 126 OBJ: 9 TOP: Infection KEY: Nursing Process Step: Implementation

39. Which numbered portion of the illustration below depicts the bacterial class bacilli? a. 1 b. 2 c. 3 d. 4 e. 5

ANS: E Bacilli are elongated microorganisms. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 119, Figure 7-3 OBJ: 3 TOP: Microorganisms KEY: Nursing Process Step: N/A