Ch. 24 Asepsis and Infection Control Prep U

TRUE OR FALSE: Personal protective equipment (PPE) is used in health care facilities to protect the staff from potentially infected clients.

TRUE

The nurse has admitted a client on airborne precautions onto the medical-surgical unit. When the client asks, "When will these airborne precautions be removed?" what is the appropriate nursing response? a. "When your sputum culture is negative." b. "Only until you begin to feel better." c. "For 2 days as you get settled onto the unit." d. "Until you leave the hospital."

a. "When your sputum culture is negative."

The nurse is providing care for a client whose diagnosis requires the nurse to use PPE. In which order should the nurse's actions be performed? 1. Put on goggles and place over eyes and adjust to fit. 2. Put on the mask or respirator over your nose, mouth, and chin. 3. Put on the gown, with the opening in the back. Tie gown securely at neck and waist. 4. Perform hand hygiene. 5. Put on clean, disposable gloves and extend gloves to cover the cuffs of the gown. 6. Provide instruction about precautions to client, family members, and visitors. a. 4, 6, 3, 2, 1, 5 b. 6, 4, 3, 5, 1, 2 c. 6, 4, 5, 3, 2, 1 d. 4, 3, 2, 1, 5, 6

a. 4, 6, 3, 2, 1, 5

A nurse is preparing an operating room theatre for a surgical procedure. Which point regarding the principles of surgical asepsis should the nurse keep in mind when preparing sterilized surgical instruments? a. A commercially packaged surgical item is not considered sterile if past expiration date. b. Any partially uncovered sterile package need not be considered contaminated. c. When a sterile item touches something that is not sterile, it may not be contaminated. d. Sterility may not be preserved even when one sterile item touches another sterile item.

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

The nurse is caring for a client admitted with tuberculosis (TB). What would be the best action by the nurse? a. Apply a non-particulate (N-95) respirator when entering the room. b. Wear a mask with face shield during invasive procedures. c. Wear a protective gown and gloves with any direct contact. d. Have the client wear a mask during care.

a. Apply a non-particulate (N-95) respirator when entering the room.

The nurse is donning a pair of sterile gloves. The nurse correctly dons the first glove, but inadvertently inserts the thumb and index finger into the thumb hole of the second glove. The glove remains intact. Which action is most appropriate? a. Continue to don the glove, then use the other gloved hand to carefully insert the finger into the proper hole. b. Leave both the thumb and finger in the thumb hole and perform the procedure to the best of the nurse's ability. c. Use only the correctly gloved hand to perform the sterile procedure while making sure the other hand does not contaminate the sterile field. d. Don a second pair of sterile gloves over the first pair.

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

What is the primary purpose for the donning gloves on top of the gown? a. Cover exposed wrist skin b. Help adjust for glove size c. Anchor gown sleeves d. Minimize risk of a glove tear

a. Cover exposed wrist skin

The nurse must assign a room for a client admitted with endocarditis and methicillin-resistant Staphylococcus aureus (MRSA) in the blood. A client with which diagnosis can share a room with this client? a. MRSA in the wound b. Vancomycin-resistant enterococci and urinary tract infection c. Coronary artery bypass grafting d. Clostridium difficile and colitis

a. MRSA in the wound

A client is to have an indwelling urinary catheter inserted. Which precaution is followed during this procedure? a. Surgical asepsis technique b. Medical asepsis technique c. Strict reverse isolation d. Droplet precautions

a. Surgical asepsis technique

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 new nurse touches 1.5 in. (4 cm) from the outer edges. b. The sterile field is set up at waist level. c. The top flap of the package is opened away from the new nurse's body. d. Direct visualization of the sterile field is maintained.

a. The new nurse touches 1.5 in. (4 cm) from the outer edges.

The nurse is caring for a client with tuberculosis. Which precautions will the nurse select for this client? a. airborne b. droplet c. standard d. contact

a. airborne

For which client would the use of standard precautions alone be appropriate? a. an incontinent client in a nursing home who has diarrhea b. a child with chickenpox who is treated in the emergency room c. a client with diphtheria who needs p.m. care d. a client with TB who needs medications administered

a. an incontinent client in a nursing home who has diarrhea

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. contact b. vector c. airborne d. vehicle

a. contact

A client comes to the emergency department reporting becoming very ill after consuming shrimp and lobster. How will the nurse document this condition? a. noncommunicable disease b. infectious disease c. communicable disease d. contagious disease

a. noncommunicable disease

Any microorganism capable of disrupting normal physiologic body processes is a: a. pathogen. b. bacterium. c. virus. d. fomite.

a. pathogen.

Which is not appropriate regarding the use of gowns as PPE? a. use of one gown per person per shift b. use of a new gown each time the nurse enters the room c. use of paper or cloth gowns d. donning a gown when splashing

a. use of one gown per person per shift

A nurse has sustained a puncture wound on the hand from a scalpel blade that was left on a used procedure tray. What is the first action by the nurse? a. wash the area with soap and water b. fill out a risk management form c. find out who left the scalpel blade on the procedure tray d. go to employee health for testing

a. wash the area with soap and water

A pediatric client's caregiver states, "I will never give my child vaccinations." What is the priority nursing response? a. "Transmission of certain diseases is halted with vaccination." b. "Help me understand your thoughts about vaccinations." c. "Has your child received any previous vaccinations?" d. "Vaccinations prevent disease."

b. "Help me understand your thoughts about vaccinations."

A family member with a mild upper respiratory infection comes to visit a client in a long-term care facility. The nurse takes the opportunity to teach the family member about preventing the spread of the cold. What response by the family member indicates that the nurse's teaching was successful? a. "I will not visit my family member in the first 3 days of my cold." b. "I will obtain a mask from the staff and wash my hands before touching my family member." c. "I will use tissue to cover my nose and mouth while I am visiting and will refrain from touching my family member." d. "If I sneeze or cough, I will make sure to cover my mouth with hand or tissue."

b. "I will obtain a mask from the staff and wash my hands before touching my family member."

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 and the supplies and start over. c. Proceed with the procedure since it was only touched by the client. d. Call for help and ask for new supplies.

b. Discard the sterile field and the supplies and start over.

A nurse is caring for a client with ringworm. Which microorganism causes ringworm in a client? a. Rickettsiae b. Helminths c. Protozoans d. Fungi

b. Helminths

The nurse is preparing to apply a prescription ointment to the client's wound. After reviewing the image, what is the most important step for the nurse to take? a. Apply a 1-in (2.5-cm) layer of the ointment to the site using the index finger b. Use a sterile cotton-tipped applicator to apply the prescription to the site c. Place sterile 4 × 4 gauze on the wound and secure the dressing with dressing with paper tape d. Put soiled dressing change supplies in the client's bathroom garbage and double bag

b. Use a sterile cotton-tipped applicator to apply the prescription to the site

A nurse is providing care to a client who has Salmonella food poisoning. The nurse understands that this pathogen was transmitted by which mechanism? a. Direct contact b. Vehicle c. Airborne d. Droplet

b. Vehicle

The nurse is preparing to help mobilize a client with an abdominal wound that is colonized by methicillin-resistant Staphylococcus aureus (MRSA). Which of the shown actions should the nurse perform before assisting the client? a. gown and face mask b. gown and gloves c. just face mask d. gown, face mask, and protective goggles

b. gown and gloves

The nurse is receiving a confused client with a draining wound onto the medical-surgical unit. Which room assignment will the nurse make? a. with another client with a draining wound b. into a private room c. with a client with pneumonia d. with a client with a myocardial infarction

b. into a private room

The nurse manager is developing a plan to decrease the transmission of health care associated infections. What would be the best to implement? a. restricting visitors to those older than 12 years of age b. staff education on utilizing hand hygiene c. providing alcohol-based hand sanitizer to all clients d. having any visitor with a cough or cold wear a mask

b. staff education on utilizing hand hygiene

A client is admitted to the hospital with tuberculosis. Which statement by the nurse explains how to reduce the risk of transmission to others? a. "Under no circumstances should you touch the client." b. "Everyone who enters the room must wear a gown and gloves." c. "All visitors who enter the room must wear special masks." d. "No visitors are allowed in the room to decrease the spread of disease."

c. "All visitors who enter the room must wear special masks."

Several family members are visiting a client with an antibiotic-resistant infection who has been placed on contact precautions. When the nurse teaches the visitors about wearing gloves and gowns, a family member states, "I don't want to wear those. I can't catch anything just by holding my loved one's hand." What is the best response to educate the family about infection transmission? a. "Wearing the gloves and gown prevents sharing additional microorganisms with the client." b. "I understand; wearing these items is not pleasant but it really isn't optional." c. "These barriers help prevent the transmission of infection to you or other people." d. "If you don't come into contact with anything with your body, you may wear gloves only, as long as you wash your hands after removing the gloves."

c. "These barriers help prevent the transmission of infection to you or other people."

Personal protective equipment (PPE) is used in health care facilities for primarily which reason? a. To protect clients from becoming infected by staff members b. To protect staff members from becoming infected by clients c. To protect both the staff and clients from becoming infected by one another d. To protect the hospital from legal liability

c. To protect both the staff and clients from becoming infected by one another

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 hand rub is appropriate in which situation? a. After completing a wound dressing b. After direct contact with clients c. When hands are visibly soiled d. Before direct contact with clients

c. When hands are visibly soiled

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. a 2-year-old toddler c. an 80-year-old woman d. a 12-year-old girl

c. an 80-year-old woman

A client suffers from bloody diarrhea after eating contaminated food at a local restaurant. The client has been infected with a(an): a. protozoa. b. fungi. c. bacteria. d. virus.

c. bacteria.

The nurse is caring for an older adult with streptococcal pneumonia. Which precautions will the nurse begin? a. contact b. none c. droplet d. airborne

c. droplet

The nurse and a colleague have admitted a client who is on contact precautions. The nurse and colleague are removing their personal protective equipment and the nurse sees the colleague remove her gloves from the fingertips. What is the nurse's most appropriate response? a. teach the colleague why the gloves should be removed outside the room b. take no action at this time c. encourage the colleague to remove the glove by grasping the cuff d. maintain a distance of at least 5 ft (1.5 m) from the colleague

c. encourage the colleague to remove the glove by grasping the cuff

A nurse has finished giving care to a client who has a communicable respiratory infection. In which order should the personal protective equipment (PPE) be removed? Gloves, Respirator, Gown, Goggles a. gloves, respirator, goggles, gown b. goggles, respirator, gloves, gown c. gloves, goggles, gown, respirator d. goggles, respirator, gown, gloves

c. gloves, goggles, gown, respirator

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 vitamin C b. decreased antibiotics c. increased T cells d. surgical asepsis

c. increased T cells

A nurse is working with a 55-year-old woman diagnosed with human immunodeficiency virus (HIV). This nurse has another client that day 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 gloves when touching the client b. wear a mask and gown in the client's room c. perform hand hygiene before and after entering the client's room d. avoid direct contact with the client

c. perform hand hygiene before and after entering the client's room

The nurse performs hand hygiene with soap and water before caring for a client. What is the primary rationale for this action? a. to protect the integrity of the nurse's immune system b. to prevent the nurse from developing disease c. to eliminate disease-producing organisms from the nurse's skin d. to sterilize the nurse's hands to prevent infection

c. to eliminate disease-producing organisms from the nurse's skin

A nurse is caring for a 55-year-old postoperative 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. endotracheal tube c. urinary catheter d. Salem sump nasogastric tube

c. urinary catheter

The parent of a pediatric client tells the nurse, "I do not believe in vaccinations." What is the appropriate nursing response? a. "Vaccinations have been shown to contribute to autism." b. "Why do you not want to vaccinate your child?" c. "Vaccines are the only way to halt disease." d. "Help me understand your perspective about vaccinating."

d. "Help me understand your perspective about vaccinating."

The nurse is preparing to don a gown to care for a client requiring contact precautions. When should the nurse don the gown? a. After entering the client's room b. After taking the client's pulse c. Before taking the client's pulse d. Before entering the client's room

d. Before entering the client's room

When preparing to take a client's blood pressure, the nurse notes that the sphygmomanometer is visibly soiled. What is the correct action by the nurse? a. Discard the sphygmomanometer in the trash. b. Send the sphygmomanometer for sterilization. c. Use the sphygmomanometer. d. Cleanse and disinfect the sphygmomanometer.

d. Cleanse and disinfect the sphygmomanometer.

When preparing a sterile field, the nurse notes that the bottle of sterile saline was opened 48 hours ago and is half full. What action does the nurse take to ensure that the saline used is sterile? a. Since the bottle has been open, previously used, and unexpired, "lip" it by pouring a small amount into a waste container or waste cup. b. Pour the saline into a sterile container on the sterile field by holding it 6 in (15 cm) above the container. c. Use the saline for the procedure and discard the remaining amount because it has been 48 hours since opening. d. Discard the bottle and get a new one because the saline has expired.

d. Discard the bottle and get a new one because the saline has expired.

A nurse has been exposed to urine while changing the linens of a client's bed. Which guideline is followed for performing hand hygiene after this client encounter? a. Use an alcohol-based hand rub to decontaminate the hands. b. Pat dry with a paper towel, beginning with the forearms and moving down to fingertips. c. Remove all jewelry, including wedding bands, before hand washing. d. Keep hands lower than elbows to allow water to flow toward fingertips.

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

The nurse is caring for a client with a draining abscess. Which precautions will the nurse begin? a. droplet b. none c. airborne d. contact

d. contact

A nursing student is donning sterile gloves to perform routine tracheostomy care for a client. Which behavior by the student would require immediate intervention from the instructor? a. picks up the glove at the folded edge with the thumb and forefinger b. washes hands for 20 seconds with soap and water c. stretches the glove over the hand without touching the unsterile area d. reaches down to the bed to pick up a sterile drape

d. reaches down to the bed to pick up a sterile drape

The nurse is caring for assigned clients who are all stable. Which client should the nurse see first to minimize the spread of infection? a. the client admitted with a rash who reports recent exposure to measles b. the client admitted with diarrhea who tested positive for Escherichia coli (E. coli) c. the client placed in contact isolation who was admitted with a draining abdominal wound d. the client who is 48-hours postsurgical procedure

d. the client who is 48-hours postsurgical procedure

A nurse is about to enter the room of a client with a strain of influenza A. The nurse prepares to don PPE. Which would be appropriate? Select all that apply. - mask with face shield - gown - respirator - gloves

mask with face shield, gown, gloves

The nurse is providing an in-service educational program for the inter-professional health care team about infection control precautions. What teaching will the nurse include? Select all that apply. - Use standard precautions only for clients with infection. - Practice hand hygiene. - Wear personal protective equipment (PPE). - Use equipment repeatedly on clients with similar conditions. - Keep client's environment clean.

practice hand hygiene, wear PPE, and keep client's environment clean

A student nurse is attending a clinical rotation in the perioperative department and will be allowed to scrub in to observe. What observation made by the clinical instructor requires intervention before the student is allowed to attend the rotation? Select all that apply. - rings on finger - red nail polish - nails that are down to the nail bed - artificial nails with intact clear nail polish - nails that are cut to ½ inch (1.25 cm) beyond the nail bed

rings on finger, red nail polish, and artificial nails with intact clear nail polish