Infection

The nurse notes a break in the skin during the assessment of a patient's abscess. This finding represents which part in the chain of infection? 1 Portal of exit 2 Moist reservoir 3 Susceptible host 4 Way of transmission

1

Which type of specimen is collected by using a sterile tongue blade? Correct1 Stool 2 Urine 3 Blood Incorrect4 Wound

1

While communicating with a patient who has an infection, the nurse says, "Tell me about your recent major lifestyle change that has occurred." Which factor is the nurse trying to assess? 1 Stressors 2 Risk factors 3 Recent travel history 4 Possible existing infections

1

Which clinical manifestation would the nurse expect to indicate a local inflammation? Select all that apply. One, some, or all responses may be correct. Correct1 Swelling Correct2 Redness Correct3 Pain 4 Anorexia 5 Vomiting

1,2,3

Which nonspecific defense system of the body helps to prevent infections? Select all that apply. One, some, or all responses may be correct. 1 Saliva 2 Blinking 3 Erythrocytes 4 Macrophages 5 Thrombocytes

1,2,4

When the nurse is performing surgical hand asepsis, where would the nurse keep his or her hands? 1 Below the elbows 2 Above the elbows 3 At a 45-degree angle 4 In a comfortable position

2

Human immunodeficiency virus (HIV) is transmitted via which major reservoir? Select all that apply. One, some, or all responses may be correct. 1 Feces 2 Blood 3 Semen 4 Mouth lesions 5 Vaginal secretions

2,3,5

Which normal flora of the human colon can cause an infection when it enters the bloodstream? 1 Escherichia coli 2 Candida albicans 3 Bacteroides fragilis 4 Plasmodium falciparum

3

Which precaution would the nurse follow to disinfect his or her hands when they are visibly soiled after cleaning a patient with diarrhea? 1 Wash with water. 2 Clean with tissues. 3 Wash with soap and water. 4 Clean with an alcohol-based product.

3

Tuberculosis is spread through which method of transmission? Select all that apply. One, some, or all responses may be correct. 1 Indirect 2 Vectors 3 Droplet 4 Vehicles 5 Airborne

3,5

Which action is performed by the nurse in the given image? 1 Opening of the last and innermost flap Incorrect2 Opening of the first side flap and pulling aside 3 Opening of the second side flap and pulling it aside Correct4 Opening of the outermost flap of the sterile kit away from body

4

Which disease can be transmitted when a nurse is drawing blood from a patient with an infection? 1 Chickenpox 2 Scarlet fever 3 Tuberculosis 4 Hepatitis B virus

4

Which microorganism causes gas gangrene? 1 Escherichia coli 2 Neisseria gonorrhoeae 3 Staphylococcus aureus 4 Clostridium perfringens

4

A patient admitted to the hospital for fever, diarrhea, and vomiting has a neutrophil count of 20%. A low neutrophil count could be associated with which condition? 1 Sepsis 2 Allergy 3 Viral infection 4 Mild food poisoning

1

A registered nurse evaluates the assistive personnel (AP) who is wearing a mask. Which action made by the AP indicates a need for correction? 1 Having a casual conversation while wearing a mask 2 Changing an unused mask because of a moist feeling 3 Tying the two top ties at the back of the head and above the ears 4 Wearing the mask so that the top of the mask fits below the glasses

1

In which medical unit would the nurse use an N95 respirator? 1 Medical unit I 2 Medical unit II 3 Medical unit III 4 Medical unit IV

1

The nurse is caring for an older adult with suspected pneumonia. Which difference does the nurse expect in the signs and symptoms of such an infection in an older adult compared to someone who is much younger? 1 Increased fatigue 2 Increased pain sensitivity 3 Colored productive sputum 4 Unexplained decrease in heart rate

1

To which patients do standard precautions apply? 1 All patients receiving care 2 Patients with bloodborne infections 3 Patients with infected, draining wounds 4 Patients believed to have an infectious disease

1

Which disease requires contact precautions? 1 Scabies 2 Measles 3 Diphtheria 4 Pharyngitis

1

Which environment would limit bacteria growth? 1 pH of 3.0 2 Under dressings 3 Moist surgical wound 4 Temperature of 38° C

1

Which equipment is used to sterilize surgical instruments? 1 Autoclave 2 Boiling water 3 Chemical sterilants 4 Ethylene oxide (ETO) gas

1

Which method is most effective to break the chain of infection? 1 Hand hygiene 2 Wearing gloves 3 Placing patients in isolation 4 Providing private rooms for patients

1

Which mode of transmission spreads malaria? 1 Vector 2 Vehicle 3 Airborne 4 Direct contact

1

Which nursing action is appropriate in surgical hand asepsis? 1 Scrubbing the hands for 5 minutes 2 Washing over the rings and watch 3 Keeping the hands and arms below the elbows 4 Allowing the water to flow from the elbows to the hands

1

Which statement regarding vascular and cellular responses is true? 1 Vasodilation occurs at the site of injury. 2 Chronic inflammation is an immediate response to cellular injury. 3 Increased blood flow leads to coldness at the site of inflammation. 4 The cellular response involves red blood cells at the site of infection.

1

Which technique is most effective in preventing and controlling the transmission of an infection? 1 Performing hand hygiene 2 Using isolation precautions 3 Performing sterilization procedures 4 Wearing personal protective equipment (PPE)

1

Which type of specimen is collected by using a sterile tongue blade? 1 Stool 2 Urine 3 Blood 4 Wound

1

Which statement made by the nursing student indicates the need for further learning regarding caring for patients with infections? Select all that apply. One, some, or all responses may be correct. 1 "I should use only cleaned equipment." 2 "I only need gloves when there is a risk of a splash." 3 "I should use a mask while touching a patient's mucous membranes." 4 "I should ensure that patients cover their mouths and noses when coughing and sneezing." 5 "I should keep bedside surfaces clean and dry while performing aseptic procedures."

1,2

Which cellular component makes up purulent exudate? Select all that apply. One, some, or all responses may be correct. 1 Bacteria 2 Neutrophils 3 Monocytes 4 White blood cells (WBCs) 5 Red blood cells

1,2,3,4

he nurse provides education about the risk of exposure to pathogens to a group of nursing students. The nurse discusses which item that harbors infectious agents? Select all that apply. One, some, or all responses may be correct. 1 Eating utensils 2 Urinals 3 Bedpans 4 Bath basins 5 Bedclothes

1,2,3,4,5

Arrange the steps of preparing a sterile field chronologically. 1. Place the sterile kit on a work surface above waist level. 2. Open the outside cover and grasp the outer edge of the tip of the outermost flap. 3. Open the outermost flap away from the body. 4. Grasp the outer edge of the first side. 5. Open the side flap by pulling the side, and allow it to lie flat on the table surface. 6. Grasp the outer edge of the second side flap and outer edge of the last and innermost flap. 7. Stand away from the sterile package and pull flap back.

1,2,3,4,5,6,7

Which action would the nurse perform to ensure preparation of a sterile field when performing a dressing change? Select all that apply. One, some, or all responses may be correct. 1 Choose a clean, dry work surface above waist level. 2 Remove bracelets and rings. 3 Perform hand hygiene before handling equipment. 4 Hold the inner edge of the flap when opening the dressing kit. 5 Check the labels and condition of supply packaging and equipment.

1,2,3,5

The nurse is using a chlorine compound at room temperature to clean surgical instruments contaminated by blood, pus, urine, and saliva. Which factor would reduce the efficacy of the disinfectant? Select all that apply. One, some, or all responses may be correct. 1 Pus, blood, urine, and saliva were not rinsed off the instruments before application of the disinfectant. 2 Soap and water were used to clean the instruments before application of the disinfectant. 3 The instruments were thoroughly rinsed with water before application of the disinfectant. 4 The chlorine solution is diluted. 5 The room where the instruments are being disinfected is at a normal temperature.

1,2,4

Which action performed during a sterile aseptic procedure indicates potential contamination? Select all that apply. One, some, or all responses may be correct. 1 The field is lower than the nurse's waist. 2 The package is slightly damp on the bottom. 3 The nurse avoids touching the edges of the field. 4 An instrument is out of the nurse's line of sight. 5 The syringe tip touches the nurse's clean glove.

1,2,4,5

Which information would the nurse include regarding cough etiquette? Select all that apply. One, some, or all responses may be correct. 1 Cover the nose and mouth with a tissue when coughing. 2 Dispose of any contaminated tissue promptly. 3 Maintain a distance of at least 2 feet from persons with respiratory infections. 4 Maintain a distance of greater than 3 feet from persons with respiratory infections. 5 Place a surgical mask on a patient if it does not compromise respiratory function.

1,2,4,5

Which step would the nurse take to prevent contamination when administering medication to a patient with Clostridium difficile? Select all that apply. One, some, or all responses may be correct. 1 Give oral medication using a paper cup. 2 Wash hands with soap and water. 3 Wear a respirator mask while in the room. 4 Discard safety needles into the sharps container. 5 Wear gloves when administering an injection.

1,2,4,5

Place the chain of infection in the correct order. 1. Reservoir 2. Port of exit 3. Port of entry 4. Susceptible host 5. Mode of transmission

1,2,5,3,4

During an infection control surveillance study, the nurse reviews various medical records and identifies that which person is at risk for infection? Select all that apply. One, some, or all responses may be correct. 1 Neonate 2 A 78-year-old 3 Breastfed infant 4 Middle-aged adult 5 High school student 6 Assisted-living resident

1,2,6

Which equipment is required for the preparation of a sterile field? Select all that apply. One, some, or all responses may be correct. 1 Sterile drape 2 Paper face mask 3 Countertop surface 4 Protective eyewear 5 Surgical scrub sponge

1,3

Which piece of equipment is considered a noncritical item that should be disinfected? Select all that apply. One, some, or all responses may be correct. 1 Linens 2 Implants 3 Stethoscopes 4 Blood pressure cuffs 5 Intravascular catheters

1,3,4

Which element is part of the chain of infection? Select all that apply. One, some, or all responses may be correct. 1 An infectious agent 2 A vaccine schedule 3 The source of pathogen growth 4 A clean surrounding 5 A susceptible host

1,3,5

The nurse is going to perform a procedure on a patient who is positive for the human immunodeficiency virus (HIV) infection. The nurse needs to put on personal protective equipment (PPE). Arrange the steps in the appropriate order. 1. Perform hand hygiene. 2. Put on gloves. 3. Put on a mask and eyewear. 4. Put on a gown.

1,4,3,2

Which symptom indicates the presence of a systemic infection? Select all that apply. One, some, or all responses may be correct. 1 Fatigue 2 Redness 3 Swelling 4 Warmth 5 Malaise

1,5

Which vaccination is recommended to reduce the risk of infectious diseases in older adults? Select all that apply. One, some, or all responses may be correct. 1 Flu vaccination 2 DTaP vaccination 3 Rubella vaccination 4 Varicella vaccination 5 Pneumonia vaccination

1,5

The nurse plans to pour a sterile solution in a container. Which action by the nurse may cause contamination? 1 Pouring the contents slowly from the bottle into the container 2 Removing the sterile seal and cap from the bottle in a downward motion 3 Placing the bottle lip 1 to 2 inches above the inside of the receiving container 4 Holding the solution bottle away from the sterile field with the label facing up

2

The nurse provides care for a patient with diabetes who is scheduled for a surgical repair of an open fracture of the femur. The patient states, "I haven't eaten since midnight, and I am worried about having anesthesia." Which priority postoperative nursing diagnosis does the nurse include in the plan of care? 1 Anxiety 2 Risk for infection 3 Social isolation 4 Impaired nutritional status

2

Which action by the student nurse does the registered nurse correct when evaluating the skill of open gloving? 1 The student nurse touches only the inside surface of the gloves while wearing them. 2 The student nurse sets the inner package of gloves on a clean, flat surface just below waist level. 3 The student nurse slips the fingers of the gloved dominant hand underneath the cuff of the second glove. 4 The student nurse avoids touching the exposed part of the nondominant hand with the fingers of the gloved hand.

2

Which can be transmitted directly from one person to another? 1 A susceptible host 2 A communicable disease 3 A port of entry to a host 4 A port of exit from the reservoir

2

Which noncritical item requires a surface disinfection? 1 Endoscope 2 Stethoscope 3 Intravascular catheter 4 Anesthesia equipment

2

Which statement is true regarding the donning and removing of caps, masks, and eyewear? 1 Surgical masks and eyewear should be worn only inside the sterile field. 2 Eyewear should be worn only when the procedure has a risk of splashing. 3 Surgical masks should be worn first and then a clean cap should be worn to cover the hair. 4 Surgical masks should be removed after the completion of the procedure even if it takes several hours.

2

Which type of infection is the nurse trying to prevent when practicing aseptic techniques during a colonoscopy? 1 Localized 2 Iatrogenic 3 Endogenous 4 Suprainfection

2

Which type of medical equipment is cleaned outside the health care agency? 1 Endoscopes 2 Drainage collection devices 3 Respiratory therapy equipment 4 Heat-tolerant surgical instruments

2

Which type of transmission-based precaution requires a gown and gloves? 1 Droplet precautions 2 Contact precautions 3 Airborne precautions 4 Protective environment precautions

2

The nurse is assessing a group of patients in a health screening program. A patient has an abscess under the right arm. The nurse suspects the possibility of a systemic infection. Which sign or symptom may indicate a systemic infection? Select all that apply. One, some, or all responses may be correct. 1 Increased appetite 2 Fatigue and malaise 3 Enlarged lymph nodes 4 Increased blood pressure 5 Elevated body temperature

2,3,5

Which equipment is required for surgical hand asepsis? Select all that apply. One, some, or all responses may be correct. 1 Sterile gloves 2 Paper face mask 3 Protective eyewear 4 Countertop surface 5 Surgical scrub sponge

2,3,5

A patient with a severe, productive cough is diagnosed with tuberculosis (TB). For which reason would the patient be placed in an isolation room? Select all that apply. One, some, or all responses may be correct. 1 To perform a chest x-ray 2 To prevent the spread of infection 3 To provide intravenous (IV) fluids 4 To prevent the patient's exposure to other infections 5 To restrict the patient's movements

2,5

A patient is isolated for pulmonary tuberculosis. The nurse notes that the patient seems to be angry, but he knows that this is a normal response to isolation. Which action would the nurse take? 1 Provide a dark, quiet room to calm the patient. 2 Reduce the level of precautions to keep the patient from becoming angry. 3 Explain the reasons for isolation procedures and provide meaningful stimulation. 4 Limit family and other caregiver visits to reduce the risk of spreading the infection.

3

Which action made by the nursing student may allow the transfer of pathogens when performing hand hygiene? 1 Drying hands with a warm air dryer 2 Discarding a paper towel in the proper receptacle 3 Using wet paper towels to turn off taps after washing 4 Cleaning the area under the fingernails with the fingernails of the other hand3

3

Which is a mode of transmission for the human immunodeficiency virus (HIV) infection? 1 Vectors 2 Droplet 3 Vehicles 4 Airborne

3

Which microorganism exits through a man's urethral meatus during sexual contact? 1 Ebola virus 2 Clostridium difficile 3 Neisseria gonorrhoeae 4 Legionella pneumophila

3

While preparing a sterile field, a nurse opens the outermost flap by stretching his or her arm away from the sterile field. Which statement explains this action? 1 To ensure sterility of the package 2 To prevent a break in the technique 3 To avoid contamination of the sterile field 4 To free the dominant hand for unwrapping

3

Place in order the correct steps for removal of protective barriers after leaving an isolation room. 1. Untie top, then bottom mask strings and remove from face. 2. Untie waist and neck strings of gown. Allow gown to fall from shoulders and discard. Remove gown, rolling it onto itself without touching the contaminated side. 3. Remove gloves. 4. Perform hand hygiene. 5. Remove eyewear or goggles.

3,5,2,1,4

A patient is diagnosed with pulmonary tuberculosis. Which personal protective equipment (PPE) is the most important to wear when entering the patient's room? 1 Gown 2 Gloves 3 Head cap 4 Respirator

4

In which case would the nurse wear a gown? 1 The patient's hygiene is poor. 2 The nurse is assisting with medication administration. 3 The patient has acquired immunodeficiency syndrome (AIDS) or hepatitis. 4 Blood or body fluids may get on the nurse's clothing from a task that he or she plans to perform.

4

The nurse provides education for a group of nursing students about the prevention of health care-associated infections (HAIs). The nurse recognizes that which intervention is the most effective way to break the chain of infection? 1 Placing patients in reverse isolation 2 Using protective eyewear while bathing patients 3 Donning gown and gloves before entering patient rooms 4 Performing hand hygiene before and after patient care

4

When wearing a sterile gown and using closed gloving to care for an immunocompromised patient, which nursing student action indicates a need for further education? 1 Using his or her hands covered by the gown sleeves, the nurse opens the inner sterile glove package. 2 Using the dominant hand inside the gown cuff, the nurse picks up the glove for the nondominant hand. 3 Extending the nondominant forearm with the palm up, the nurse places the palm of the glove against the palm of the nondominant hand. 4 Grasping the back of the glove cuff with the nondominant hand, the nurse turns the glove cuff over the end of the dominant hand and gown cuff.

4

Which microorganism is associated with an exogenous infection? 1 Staphylococci 2 Enterococci 3 Streptococci 4 Salmonella

4

Which objects would require high-level disinfection with phenolics? 1 Stethoscopes 2 Urinary catheters 3 Surgical instruments 4 Anesthesia equipment

4

Which part of a sterile gown is actually considered sterile? 1 Back of the gown 2 Area below the waist 3 Underside of the sleeves 4 Anterior surface of the sleeves

4

Which patient would the nurse evaluate as at the highest risk of health care-associated infections (HAIs)? 1 A 20-year-old patient admitted with gastroenteritis 2 A 24-year-old patient admitted with a fracture of the leg 3 A 34-year-old patient admitted for appendectomy 4 A 53-year-old diabetic patient admitted for herniorrhaphy

4

Which statement describes the rationale for drying hands and forearms after performing a prescrub wash? 1 Preventing accidental contamination 2 Eliminating transient microorganisms 3 Ensuring complete antiseptic coverage 4 Promoting a reduction in microorganisms

4

Which statement is true regarding donning a sterile gown? 1 The circulatory nurse should wear a sterile gown. 2 Nurses should wear sterile gowns before applying masks. 3 The anterior surface of the sleeves of a gown is also considered sterile. 4 The nurse should wear a sterile gown while assisting a health care provider during surgery.

4

Which statement made by the nursing student indicates the need for further learning regarding home care considerations for patients with infections? 1 "I should determine potential sources of contamination." 2 "I should evaluate handwashing facilities in the patient's home." 3 "I should anticipate the need for alternative handwashing products." 4 "I should see if cold-running water faucets are available."

4

Which statement made by the nursing student needs correction regarding the use of standard precautions? 1 "I should stand at least 3 feet away from patients who have a cough." 2 "I should dispose of used, uncapped needles in a puncture-resistant container." 3 "I should perform hand hygiene before, after, and between direct contact with patients." 4 "I should wash my hands with antimicrobial soap and water if my hands are not visibly soiled."

4

Which task cannot be delegated to assistive personnel (AP)? 1 Open gloving 2 Surgical hand asepsis 3 Applying a sterile gown 4 Preparation of a sterile field

4