Ch. 23: Infection Control (NUR 111-fundamentals book)
Upon review of a client's microbiology culture results, the nurse recognizes which organism as indicative of normal flora?
(A) Escherichia coli in the intestinal tract B) Escherichia coli in the urinary tract C) Shigella in the intestinal tract D) Shigella in the urinary tract
The nurse is caring for a client with tuberculosis. Which precautions will the nurse select for this client?
(A) airborne B) standard C) contact D) droplet
The nurse is caring for a patient that has a colonized infection. What assessment findings does the nurse anticipate?
(A) client does not yet show signs & symptoms B) active periods of nausea, vomiting, & diarrhea C) reports feeling better because the infection is resolving D) oral temperature of 101° F
The client is an employee on the medical unit at the local children's hospital. The nurse is an occupational health nurse educating the client on various routes of exposure. The nurse knows that as a hospital employee, the client is most susceptible to infection by what mode of transmission?
(A) contact B) droplet C) vehicle D) airborne
A lead nurse is removing personal protective equipment after dressing the infected wounds of a client. Which is the priority nursing action?
(A) handwashing before leaving the client's room B) make contact between 2 contaminated surfaces C) make contact between 2 clean surfaces D) remove the garments that are most contaminated
A nurse follows surgical asepsis techniques for inserting an indwelling urinary catheter in a client. What is an accurate guideline for using this technique?
(A) hold sterile objects above waist level to prevent inadvertent contamination B) consider the outside of the sterile package to be sterile C) consider the outer 3-inch edge of a sterile field to be contaminated D) open sterile packages so that the first edge of the wrapper is directed toward the nurse
A nurse changing the linens of a client bed is exposed to urine and performs hand hygiene. Which is a guideline for performing this skill properly following this client encounter?
(A) keep hands lower than elbows to allow water to flow toward fingertips B) remove all jewelry, including wedding bands before hand washing C) pat dry with a paper towel, beginning with the forearms & moving down to fingertips D) use an alcohol-based hand rub to decontaminate hands
Standard precautions apply to blood; all body fluids, secretions, and excretions; intact and nonintact skin and mucous membranes.
(A) true B) false
The nurse is caring for a client who is hospitalized and has an indwelling urethral catheter. Which finding would most likely indicate the client has developed an infection?
(A) urine culture is positive for vancomycin-resistant enterococci (VRE) B) the unlicensed assistive personnel (UAP) documents the client's oral temperature as 99 degrees F C) the nurse notes the client's urine is dark yellow with sediment D) the client reports nausea & vomiting
After providing care to a client, the nurse is disposing of waste materials. Which waste would the nurse identify as injurious waste? Select all that apply.
(A) used fingerstick lancet B) blood-soiled dressings C) chemotherapy solution container D) cotton-tipped applicator used for wound cleaning (E) used syringe with attached needle
A nurse is caring for a child who is hospitalized for diphtheria. Which guideline would be appropriate when caring for this client?
(A) wear PPE when entering the room for all interactions that may involve contact with the client B) use a private room with the door closed C) use respiratory protection when entering the room of client with known or suspected diphtheria D) place client in private room that has monitored negative air pressure
what are the 6 components of the cyclic process
-infectious agent -reservoirs -portal of exit -means of transmission -portals of entry -susceptible host
The nurse conducting an in-service on hand hygiene determines that additional education is needed when a participant states which of the following?
A) "I should wash my hands before a clean procedure." B) "I should wash my hands after touching the client's surroundings." C) "I should wash my hands before touching a client." (D) "I do not need to wash my hands if I am using gloves."
The nurse is caring for a client who requires droplet precautions. Which statement made by the client would indicate further teaching is required?
A) "I will tell my visitors to keep a 3-foot distance from me" B) "any staff that enters my room will be wearing PPE" (C) "I can leave my room any time I want as long as I wear a mask" D) "My personal belongings should remain in the room until I am discharged"
A client who has been diagnosed with a cold is upset that antibiotic therapy was not prescribed. Which nursing response is most appropriate?
A) "antibiotics have too many side effects anyway" B) "we can ask the PCP for an antiviral medication" C) "sometimes antibiotics work for colds & sometimes they do not" (D) the common cold is a virus & will not respond to antibiotics
A home health nurse is completing a health history for a client. What is one question that is important to ask to identify a latex allergy for this client?
A) "tell me what you use to wash your hands after toileting" (B) "have you had any unusual symptoms after blowing up balloons?" C) "have you ever had an allergic reaction to shellfish or iodine?" D) "when you were a child, did you have frequent infections?"
A pediatric client's caregiver states, "I will never give my child vaccinations." What is the priority nursing response?
A) "vaccinations prevent disease" B) "transmission of certain diseases is halted with vaccination" C) "has your child received any previous vaccinations?" (D) "help me understand your thoughts about vaccinations"
A nurse is caring for a 55-year-old post-operative client. The client returns to the ICU after surgery intubated and mechanically ventilated with a Salem sump nasogastric tube, a Foley catheter, and a PICC line in place. Based on the nurse's knowledge of the most common hospital-acquired infections, which apparatus is most important to remove first?
A) PICC line B) Salem sump nasogestric tube C) Endotracheal tube (D) Urinary catheter
Which client presents the most significant risk factors for the development of Clostridium difficile infection?
A) a 44-year-old client who is paralyzed & whose coccyx ulcer has required a skin graft (B) an 81-year-old client who has been receiving multiple antibiotics for the treatment of sepsis C) a 3--year-old client who has recently contracted HIV after engaging in high-risk sexual behavior D) a client with renal failure who receives hemodialysis 3 times weekly
For which client would the use of standard precautions alone be appropriate?
A) a client with diphtheria who needs p.m. care B) a child with chickenpox who is treated in the emergency room (C) an incontinent client in a nursing home who has diarrhea D) a client with TB who needs medications administered
Which practice is a correct application of infection control practices?
A) a nurse uses an alcohol-based handrub each time that the nurse's hands are visibly soiled B) a nurse dons a pair of gloves prior to any client contact C) a nurse ensures that the nurse rinses the hands thoroughly after the application of an alcohol-based handrub (D) a nurse performs hand washing each time the nurse removes a pair of gloves
The nurse conducting a hand hygiene in-service determines that the participants need additional education when they state that the use of an alcohol-based handrub is appropriate in which of the following situations?
A) after direct contact with clients B) before direct contact with clients (C) when hands are visibly soiled D) after completing a wound dressing
The nurse is caring for a client who has been placed in strict isolation. Which nursing action is appropriate?
A) allow many family members to visit at once B) no special precautions are required C) deliver flowers & balloons to the room (D) remove fresh fruit from the room
The nurse caring for clients at an outpatient clinic determines that which client is at greatest risk for infection?
A) an 18-month-old infant (B) an 80-year-old woman C) a 12-year-old girl D)a 2-year-old toddler
Which of the following are names of the transmission-based precautions defined by the Centers for Disease Control (CDC)? Select all that apply.
A) body fluid precautions (B) contact precautions (C) airborne precautions D) respiratory precautions (E) droplet precautions F) mibrobial precautions
The nurse is setting up a sterile field to perform a catheterization when the client touches the end of the sterile field. What would be the nurse's next appropriate action?
A) change the sterile field, but reuse the sterile equipment (B) discard the sterile field & the supplies & start over C) call for help & ask for new supplies D) proceed with the procedure since it was only touched by the client
The nurse planning to insert an indwelling urinary catheter into a client should utilize which of the following techniques?
A) contact precautions B) medical asepsis (C) surgical asepsis D) universal precautions
After the nurse has set up a sterile field for a dressing change, the nurse realizes that an essential item has been forgotten. How should the nurse proceed?
A) determine if the item could be added after the completion of the dressing changed B) retrieve the forgotten item & prepare the sterile field again (C) ask another staff member to bring the forgotten item D) continue the dressing change utilizing the equipment at hand
A client is to have an indwelling urinary catheter inserted. Which precaution is followed during this procedure?
A) droplet precautions B) strict reverse isolation (C) surgical asepsis technique D) medical asepsis technique
The nurse working with the hospital's infection control team is attempting to decrease the transmission of health care-associated pathogens. Which of the following will be most effective?
A) encouraging visitors to adhere to isolation precautions B) limiting visitors to family members over the age of 18 C) revising the facility's infection control protocols (D) incentivizing health care workers to utilize hand hygiene
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 equipment can transmit infection to older adult clients?
A) face shields (B) indwelling catheter C) bath blanket D) specimen containers
A nurse is caring for a client with ringworm. Which microorganism causes ringworm in a client?
A) helminths B) protozoans C) rickettsiae (D) fungi
A client has an inguinal hernia repair and later develops a methicillin-resistant Staphylococcus aureus (MRSA) infection. What is the most important factor to prevent this infection?
A) increased T cells B) increased vitamin C (C) surgical asepsis D) decreased antibiotics
The nurse is caring for a client who became very ill after ingesting seafood. How will the nurse document this condition?
A) infectious disease (B) noncommunicable disease C) contagious disease D) communicable disease
Which nursing action is a component of medical asepsis?
A) insertion of an indwelling urinary catheter B) insertion of an intravenous catheter (C) handwashing after removing gloves D) drawing blood from a central line
The nurse is inserting a foley catheter for a client. Which nursing action is appropriate if the sterile field is broken during this procedure?
A) no action is needed B) complete a sentinel event report (C) don another pair of sterile gloves D) notify the primary care provider
The nurse is preparing a sterile field for a dressing change. How would the nurse add paper- wrapped sterile items to the sterile field?
A) open the package away from the field (B) separate the sealed flaps & drop contents onto field C) while wearing sterile gloves, unwrap the package & add to the field D) set up another sterile field for the additional items
What is an accurate guideline for the use of PPE?
A) put on PPE after entering the client's room B) substitute personal glasses for protective eyewear, if desired (C) replace gloves if they are visibly soiled D) when wearing gloves, work from "dirty" areas to "clean" ones.
The nurse is preparing a sterile field for a bedside procedure. During preparation, the client reaches over the field for the water pitcher. What would be the best action by the nurse?
A) remove the supplies from the field & replace with new supplies B) educate the client on sterile fields & continue preparing for the procedure C) give the client the water pitcher & continue preparation (D) discard the supplies & field & prepare a new sterile field
The nurse is caring for an older adult with pneumonia. Which assessment finding requires immediate nursing intervention?
A) reports increased fatigue B) oral temperature 99° F (C) client is more difficult to arouse D) weight loss of 1 pound over 1 month
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 action by the nurse is appropriate?
A) request that the examination be done at the bedside (B) place a surgical mask on the client & transport to the CT department at the specified time C) Notify the CT department in advance so other clients & staff can be removed from the area D) question the need for the examination because the client must remain in Airborne Precautions
The nurse manager for a long-term facility notes an increase in infection rates among residents. Which would be the best to implement?
A) restrict visitors to public places B) all new residents are prescribed antibiotics C) culture all residents & staff (D) review the current infection control protocols
The nurse is preparing discharge instructions for a family member who will be caring for a client with an abdominal incision. Which concept should be the priority in the teaching plan?
A) sterile technique (B) hand washing C) signs of healing D) putting on gloves
The nurse who is caring for a client in contact isolation is preparing to conduct an assessment. How will the nurse listen to the client's heart?
A) stethoscope belonging to the nurse (B) stethoscope that remains in the client's room C) stethoscope that hangs outside the client's room D) stethoscope that has been purchased by the client
A nurse is caring for a client who is diagnosed with tuberculosis. Which nursing intervention promotes infection control based on the QSEN competency of safety?
A) the nurse keeps visitors 3 feet away from the infected person (B) the nurse places the client in a private room with the door open C) the nurse places the client in a private room with monitored negative air pressure D) the nurse uses droplet precautions when providing care for the client
The nurse is teaching a new nurse about preparing a sterile field. Which action made by the new nurse would indicate further teaching is required?
A) the sterile field is set up at waist level B) the top flap of the package is opened away from the new nurse's body (C) the nurse touches 1.5 inches from the outer edges D) direct visualization of the sterile field is maintained
Which is not appropriate regarding the use of gowns as PPE?
A) use a gown when splashing (B) use of one gown per person per shift C) use of a new gown each time the nurse enters the room D) use of paper or cloth gowns
Surgical asepsis is defined as:
A) use of hand washing, gowning, & gloving B) slowed growth of microorganisms (C) absence of all microorganisms D) absence of all virulent microorganisms
When a nurse picks up a client's contaminated tissue without gloves and fails to wash the hands sufficiently, the nurse provides for the client's organisms to be spread by which type of transmission?
A) vector (B) contact C) airborne D) vehicle
A nurse is explaining the different procedures used to break the chain of infection to a nursing student. In which link in the chain of infection should a nurse provide special attention to the respiratory and gastrointestinal tracts?
A) vehicle of transmission B) infectious microorganism (C) exit route D) susceptible host
A nurse is working with a 55-year-old woman diagnosed with human immunodeficiency virus (HIV). This nurse also has another client today who has an upper respiratory infection. What is the most important thing the nurse can do to prevent the client with HIV from acquiring the upper respiratory infection?
A) wear a mask & gown in the client's room (B) perform hand hygiene before & after entering the client's room C) avoid direct contact with the client D) wear gloves when touching the client
The nurse is caring for a client admitted with tuberculosis (TB). What would be the best action by the nurse?
A) wear a mask with face shield during invasive procedures (B) apply a non-particulate (N-95) respirator when entering the room C) have the client wear a mask during care D) wear a protective gown & gloves with any direct contact
When preparing a sterile field, the nurse notes that bottle of sterile saline was opened 48 hours ago and is half full. What should the nurse do?
A)shake the bottle several times (B) discard the bottle C) finish the contents of the bottle D) lip the opening of the bottle twice
-number of organisms -virulence of the organism -competence of the person's immune system -length & intimacy of the contact between the person & the microorganism
an organism's potential to produce disease in a person depends on a variety of factors, including:
rod shaped bacteria
bacilli
spherical shaped bacteria
cocci
plant-like organisms (i.e., molds or yeasts) that also can cause infection, are present in the air, soil, & water, e.g.= athlete's foot, ringworm, & yeast infection, & treated with antiviral meds-BUT many infections caused by this are resistant to treatment
fungi
this type of bacteria has chemically more complex cell walls & can be decolorized by alcohol; thus it does not stain
gram-negative
this type of bacteria has a thick cell wall that resists decolorization (loss of color0 & are stained violet
gram-positive
describes a disease state that results from the presence of pathogens in or on the body
infection
this occurs as a result of a cyclic process consisting of 6 components
infection
organisms that live on or in a host & rely on it for nourishment, e.g. = malaria
parasites
disease-producing microorganisms
pathogens
corkscrew shaped bacteria
spirochetes
the smallest of all microorganisms, visible only with an electron microscope, & cause many infections (e.g., common cold, hep B & C, AIDS). Antibiotics have no effect on this
virus
