NUR 215 HYGIENE and INFECTION

A client is admitted to the hospital with bloody sputum and night sweats, signs of tuberculosis. Which precautions must the nurse institute immediately?

Airborne

A nurse is preparing a client's evening dose of risperidone when the tablet falls on the countertop. Which of the following actions should the nurse take?

Discard the tablet and obtain another dose of medication.

The term for a nurse administering a bed bath cleansing the client without assistance from the client is a complete bed bath. T/F

TRUE

Standard Precautions include

hand hygiene, personal protective equipment, sharps injury prevention, cleaning and disinfection, cough etiquette, waste disposal, and safe injection practices.

Which precaution should the nurse use when setting up a client's food tray?

hand washing only

Transmission-Based Precautions,

is designed to supplement Standard Precautions when caring for clients who have or are suspected to have a contagious infection.

Which precaution should the nurse use when giving a shot?

standard

Which example of personal protective equipment is unique to transmission-based precautions?

Respirator mask

While planning care for a client with dyspnea which of the following should the nurse include in the plan of care?

Schedule rest periods during morning care

An experienced nurse is speaking with a client regarding normal changes of skin integrity. Which of these options is the correct course for normal aging skin?

Skin becomes more fragile and thin

A nurse is adhering to standard precautions while caring for a group of clients. For which of the following tasks should the nurse wear protective eye equipment? (Select all that apply.)

Suctioning a client's new tracheostomy tube, Irrigating a client's abdominal wound.

Alice Baker is a frail elderly woman, 93 years old, who lives in a nursing home. She has almost total Self-Care Deficit due to joint issues and dementia. Her mental and physical condition are not likely to improve. When you enter her room with bath supplies and say, "Good morning, Ms. Baker, it's time for your bath," she screams, "Go away from me. I just had a bath. I don't want a bath." You discuss this with the charge nurse, who says, "She has not had a bath, and she needs one today. You will need to do it whether she likes it or not." What are some alternatives to a complete bed bath that would achieve the same purposes?

TOWEL BATH, BAG BATH, PACKAGED BATH

A nurse is caring for a client who has shingles with multiple skin lesions. Which of the following actions by the nurse requires intervention by the nurse's supervisor?

The nurse admits another client who has shingles to the client's double room.

A nurse is caring for a client who has methicillin-resistant Staphylococcus aureus(MRSA) in an abdominal wound. The nurse enters the room to check the client's pulse. Which of the following actions should the nurse take?

Wear clean gloves.

In which situation would standard precautions be adequate? Select all that apply.

While assisting a client with oral care While ambulating a client after a procedure While inserting an intravenous catheter

A nurse is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room assignments should the nurse make for the client?

A room with air exhaust directly to the outdoor environment

How should the nurse deliver the breakfast tray to the bedside of a client in airborne isolation?

Apply respirator mask and gloves, then place the tray on the client's nightstand.

During denture care for a client, which of the following actions should the nurse plan to take?

Brush the dentures with toothbrush and denture cleaner

Which type of drug-resistant infection most commonly impacts the gastrointestinal system?

Clostridium Difficile

Which process in maintaining a clean environment includes the removal of pathogens using chemicals?

Disinfecting

A nurse is beginning a complete bed bath. After removing the client's gown and covering the client with a blanket the nurse should wash the feet first. T/F?

FALSE

When cleaning the eyes the nurse should use a moist washcloth with soap and wipe gently across the eyelids from inner to outer canthus. T/F?

FALSE

A nurse is removing personal protective equipment (PPE) after giving direct care to a client who requires isolation. Which of the following PPE items should the nurse remove first?

Gloves

A newly licensed nurse is educating a client on the benefits of proper hygiene. Which of the following does the nurse include in the education?

Improves skin integrity, Fosters activity and movement, Psychological well being

The client has developed kidney infection following a bladder infection from the urinary catheter. How would the nurse describe this? Select all that apply.

Local, Secondary, healthcare-related

The client has a reddened area around his intravenous site. It is tender to touch. Which type of infection is this?

Localized

A nurse is caring for a client who has had an allogeneic hematopoietic stem-cell transplant. Which of the following infection-control actions should the nurse use while caring for this client?

Protective Environment

Which type of environment best protects a client who is immunosuppressed and at high risk for acquiring an infection?

Protective-Isolation

A nurse is caring for a group of clients in an infectious disease unit. The nurse should wear an OSHA-approved N95 respirator mask when caring for a client with which of the following infectious diseases?

Tuberculosis

A nurse is performing mouth care for a client who is unconscious. Which of the following should the nurse take?

Turn the client's head to the side

A charge nurse is teaching a group of health care workers about hand hygiene to prevent infection. Which of the following information should the charge nurse include in the teaching?

Use chlorhexidine to wash hands if the client is immunosuppressed.

A nurse is instructing a client who has diabetes mellitus about foot care. Which guideline should the nurse include?

Wash the feet with lukewarm water and dry completely

A nurse is caring for a client who requires isolation for active pulmonary tuberculosis. Which of the following precautions should the nurse include when creating a sign to post outside of the client's

close door, wash hands, throw sharps away, mask

Transmission-Based Precautions are divided into three categories:

contact, droplet, and airborne precautions,

Which precaution should the nurse use when starting an IV for a client with a high fever and productive cough of unknown origin?

transmission-based