Asepsis and Infection Control- Gero
The nurse is caring for a client who developed pneumonia while hospitalized. How will the nurse document this condition? infectious disease contagious disease community-acquired infection health care-associated infection (HCAI)
health care-associated infection (HCAI)
To eliminate needlesticks as potential hazards to nurses, the nurse should: place the uncapped needle on a tray and carry it to the medicine room for disposal. immediately deposit uncapped needles into a puncture-proof plastic container. stick the uncapped needle into a Styrofoam block and deposit it in a plastic container. slide the needle into the cap and deposit it in a puncture-proof plastic container.
immediately deposit uncapped needles into a puncture-proof plastic container.
A nurse is explaining the process of infection to a nursing student. Place the process in the most appropriate order. 1infectious agent 2a reservoir 3an exit route 4transmission mode 5entry portal 6susceptible host
infectious agent a reservoir an exit route transmission mode entry portal susceptible host
The nurse is receiving a confused client with a draining wound onto the medical-surgical unit. Which room assignment will the nurse make? into a private room with a client with pneumonia with a client with a myocardial infarction with another client with a draining wound
into a private room
In which order should the following steps for putting the first hand into a sterile glove be performed? 1. Carefully open the inner package. Fold open the top flap, then the bottom and sides. 2. Place the inner package on the work surface with the side labeled "cuff end" closest to the body. 3. With the thumb and forefinger of the nondominant hand, grasp the folded cuff of the glove for the dominant hand, touching only the exposed inside of the glove. 4. Keeping the hands above the waistline, lift and hold the glove up and off the inner package with fingers down. 5. Place the sterile glove package on a clean, dry surface at or above your waist. 6. Carefully insert dominant hand palm up into the glove and pull it on. 7.Carefully open external package
5Place the sterile glove package on a clean, dry surface at or above your waist. 7Carefully open external package 2. Place the inner package on the work surface with the side labeled "cuff end" closest to the body. 1. Carefully open the inner package. Fold open the top flap, then the bottom and sides., 3. With the thumb and forefinger of the nondominant hand, grasp the folded cuff of the glove for the dominant hand, touching only the exposed inside of the glove., 4. Keeping the hands above the waistline, lift and hold the glove up and off the inner package with fingers down., 6. Carefully insert dominant hand palm up into the glove and pull it on.
The nurse is caring for a client admitted with tuberculosis (TB). What would be the best action by the nurse? Wear a protective gown and gloves with any direct contact. Apply a nonparticulate (N-95) respirator when entering the room. Have the client wear a mask during care. Wear a mask with face shield during invasive procedures.
Apply a nonparticulate (N-95) respirator when entering the room.
A veteran nurse is working with a new graduate nurse. The graduate nurse states that she was exposed to a client's blood and that she was not wearing any PPE. Which would be considered significant blood exposures by occupational health? Select all that apply. Hepatitis B Hepatitis C Tuberculosis HIV
Hepatitis B Hepatitis C HIV
What is an accurate guideline for the use of PPE? Put on PPE after entering the client's room. Substitute personal glasses for protective eyewear, if desired. Replace gloves if they are visibly soiled. When wearing gloves, work from "dirty" areas to "clean" ones.
Replace gloves if they are visibly soiled.
The parent of a pediatric client tells the nurse, "I do not believe in vaccinations." What is the appropriate nursing response? "Vaccinations have been shown to contribute to autism." "Help me understand your perspective about vaccinating." "Why do you not want to vaccinate your child?" "Vaccines are the only way to halt disease."
"Help me understand your perspective about vaccinating."
A client is diagnosed with hepatitis C. What statement made by the client indicates that further education is required regarding the transmission of the virus? "I can't transmit the virus other people if I shake their hands." "I probably got the virus when I sat on the toilet seat in a dirty bathroom." "I received a blood transfusion in 1989, which could be a factor in contracting the disease." "I may have gotten the virus when I got a tattoo while I was in prison."
"I probably got the virus when I sat on the toilet seat in a dirty bathroom."
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? "I will not visit my family member in the first 3 days of my cold." "I will use tissue to cover my nose and mouth while I am visiting and will refrain from touching my family member." "I will obtain a mask from the staff and wash my hands before touching my family member." "If I sneeze or cough, I will make sure to cover my mouth with hand or tissue."
"I will obtain a mask from the staff and wash my hands before touching my family member."
The friend of a long-term care client comes to visit despite having an upper respiratory infection. What health teaching will the nurse share with the visitor? "You should not visit your friend if you have an infection of any kind because your friend may also get sick." "If you wash your hands before coming in contact with your friend you will prevent infection during your visit." "As long as you cough and sneeze into the bend of your elbow you won't spread the infection to your friend." "Please get a mask from the staff upon entry and use a mask along with hand hygiene when visiting to prevent the spread of infection to your friend and others."
"Please get a mask from the staff upon entry and use a mask along with hand hygiene when visiting to prevent the spread of infection to your friend and others."
The client presents to the Emergency Department reporting fever, chills, and a productive cough. The chest x-ray shows an area of infiltrate, and the primary care provider prescribes a broad spectrum antibiotic. Which client teaching statement from the nurse is most appropriate regarding the prescribed drug? "This antibiotic is the best choice since the causative organism is not known." "This antibiotic causes fewer side effects than a narrow spectrum antibiotic." "Drug resistance can develop when the wrong antibiotic is used for pneumonia." "Pneumonia is usually caused by multiple organisms."
"This antibiotic is the best choice since the causative organism is not known."
The nurse educator is reminding a group of new nurses about precautions. Which statement by a new nurse requires further teaching by the nurse educator? "I will always wash my hands thoroughly and often." "It is important to refrain from recapping needles." "Masks, gloves, and gowns should be used to protect from infectious agents." "Wearing an N95 respirator is critical when I care for clients in droplet precautions."
"Wearing an N95 respirator is critical when I care for clients in droplet precautions."
A pregnant woman with a history of genital herpes infection who is near term asks the nurse why she must have a cesarean section when she has not had an outbreak in a "long time". The nurse responds: "You will likely have an outbreak due to the stress of labor and delivery." "Have you discussed this with your physician?" "You may have infection in your birth canal that you are unaware of." "A cesarean section will prevent a herpes outbreak."
"You may have infection in your birth canal that you are unaware of."
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? When a sterile item touches something that is not sterile, it may not be contaminated. Any partially uncovered sterile package need not be considered contaminated. A commercially packaged surgical item is not considered sterile if past expiration date. Sterility may not be preserved even when one sterile item touches another sterile item.
A commercially packaged surgical item is not considered sterile if past expiration date.
Which practice is a correct application of infection control practices? A nurse performs hand washing each time the nurse removes a pair of gloves. A nurse dons a pair of gloves prior to any client contact. A nurse uses an alcohol-based hand rub each time that the nurse's hands are visibly soiled. A nurse rinses hands thoroughly after the application of an alcohol-based hand rub.
A nurse performs hand washing each time the nurse removes a pair of gloves.
After meeting with the family to give an update on the surgical client, the nurse shakes their hands before leaving. Which method of hand hygiene is most appropriate following this encounter? Alcohol-based hand rub Soap and water hand washing technique Scrubbing hands with soap, water, and brush Mixture of soap and alcohol-based hand rub techniques
Alcohol-based hand rub
Which client presents the most significant risk factors for the development of Clostridium difficileinfection? An 81-year-old client who has been receiving multiple antibiotics for the treatment of sepsis A 30-year-old client who has recently contracted human immunodeficiency virus (HIV) after engaging in high-risk sexual behavior A 44-year-old client who is paralyzed and whose coccyx ulcer has required a skin graft A client with renal failure who receives hemodialysis three times weekly
An 81-year-old client who has been receiving multiple antibiotics for the treatment of sepsis
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? Discard the sphygmomanometer in the trash. Cleanse and disinfect the sphygmomanometer. Send the sphygmomanometer for sterilization. Use the sphygmomanometer.
Cleanse and disinfect the sphygmomanometer.
What is the primary purpose for the demonstrated glove application? (gloves over top of gown sleeves) Help adjust for glove size Anchor gown sleeves Cover exposed wrist skin Minimize risk of a glove tear
Cover exposed wrist skin
The nurse has completed an intervention with a client. There is no visible soiling on the nurse's hands. Which technique is recommended by infection control practice standards for hand hygiene? Decontaminate hands using an alcohol-based hand rub. Do not wash hands; apply clean gloves. Wash hands with soap and hot water. Wash hands with soap and water, followed by an alcohol-based hand rub.
Decontaminate hands using an alcohol-based hand rub.
Which nursing action carries the greatest likelihood of contributing to the spread of vancomycin-resistant enterococci (VRE)? -Emptying the Foley catheter bag of a client with VRE and then helping the client in the next bed transfer to a chair without washing hands between contact. -removing the staples from a VRE-positive, postoperative client's incision without prior handwashing -sending a VRE-positive client to the radiology department for a chest X-ray without a face mask -delivering a meal tray to a VRE-positive client without first donning gloves and a gown
Emptying the Foley catheter bag of a client with VRE and then helping the client in the next bed transfer to a chair without washing hands between contact.
Which mask should the nurse don when caring for a client with tuberculosis? Low-efficiency particulate air (LEPA) Filtered respirator Surgical mask No mask is needed
Filtered respirator
A nurse is caring for a client with ringworm. Which microorganism causes ringworm in a client? Fungi Rickettsiae Protozoans Helminths
Fungi
An experienced nurse is teaching a student nurse about the proper use of hand hygiene. Which guideline should the nurse provide to the student? The use of gloves eliminates the need for hand hygiene. The use of hand hygiene eliminates the need for gloves. Hand hygiene is needed after contact with objects near the client. Hand lotions should not be used after hand hygiene
Hand hygiene is needed after contact with objects near the client.
A nurse is applying the principles of standard precautions on a hospital unit. In which instances should the nurse perform hand hygiene? Select all that apply. Before touching a surface in a common area Immediately after touching a client Before performing a clean procedure Between each phase of a client's assessment After touching a client's surroundings
Immediately after touching a client After touching a client's surroundings Before performing a clean procedure
The nurse is disposing of an old dressing that is saturated with a client's blood. How should the nurse dispose of the dressing? With the double-bag technique In the client's trash container In a bag marked "biohazards" In the sharps container
In a bag marked "biohazards"
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? Use an alcohol-based hand rub to decontaminate the hands. Remove all jewelry, including wedding bands, before hand washing. Keep hands lower than elbows to allow water to flow toward fingertips. Pat dry with a paper towel, beginning with the forearms and moving down to fingertips.
Keep hands lower than elbows to allow water to flow toward fingertips.
Following a demonstration to a family member on how to insert a straight catheter, the nurse instructs the family member to remove the gloves by inverting one glove into the other. Which step would the nurse instruct the family member to do next? Perform hand hygiene Don a new pair of gloves to dispose of materials Wrap all used materials together and discard in biohazard container Use an appropriate lotion that does not interfere with antimicrobial effect of gloves or soaps
Perform hand hygiene
The nurse is caring for a client who has active tuberculosis and is under airborne precautions. The health care provider prescribes a computed tomography (CT) examination of the chest. Which action by the nurse is appropriate? Place a surgical mask on the client and transport to the CT department at the specified time. Notify the CT department in advance so other clients and staff can be removed from the area. Question the need for the examination, because the client must remain under airborne precautions. Request that the examination be done at the bedside.
Place a surgical mask on the client and transport to the CT department at the specified time.
Nurses working in bed management are assigning clients from the emergency room to semiprivate rooms. Clients with which two diagnoses are appropriate to room together, based on safety and infection control standards? Clostridium difficile and diabetic ketoacidosis Reactive airway disease and exacerbation of chronic obstructive pulmonary disorder (COPD) Tuberculosis and pneumonia Appendectomy and a draining leg ulcer positive for methicillin-resistant Staphylococcus aureus
Reactive airway disease and exacerbation of chronic obstructive pulmonary disorder (COPD)
A client is to have an indwelling urinary catheter inserted. Which precaution is followed during this procedure? Surgical asepsis technique Medical asepsis technique Droplet precautions Strict reverse isolation
Surgical asepsis technique
A client has tested positive for methicillin-resistant Staphylococcus aureus after being swabbed on admission to the hospital. Bacterial resistance to antibiotics is an example of: Means of transmission Spore production Aerobic activity Survival adaptation
Survival adaptation
A nurse is following medical asepsis when caring for clients in a critical care unit. Which nursing actions follow these principles? Select all that apply. The nurse carries soiled items away from the body. The nurse places soiled bed linen on the floor. The nurse moves soiled equipment away from the body when cleaning it. The nurse opens a window and dusts the room in the direction of the window. The nurse cleans least soiled areas first and then moves to more soiled ones. The nurse pours discarded liquids into a basin then pours them into the drain.
The nurse carries soiled items away from the body. The nurse moves soiled equipment away from the body when cleaning it. The nurse cleans least soiled areas first and then moves to more soiled ones.
A nurse is applying the principles of Standard and Contact Precautions in the care of a hospital client. Which action violates these principles? The nurse performs hand hygiene after touching the client's surroundings. The nurse removes her gown and then removes her gloves. The nurse performs hand hygiene before putting on gloves. The nurse applies nonmedicated hand cream after performing hand hygiene.
The nurse removes her gown and then removes her gloves.
The nurse is preparing to perform handwashing. Place the following steps in the correct order. Use all options. Turn on the faucet and adjust force and temperature of the water. Turn the faucet off with a paper towel. Wet the hand and wrists. Apply soap. Wash the palms and backs of the hands for at least 20 seconds. Pat the hands dry with a paper towel.
Turn on the faucet and adjust force and temperature of the water. Wet the hand and wrists. Apply soap. Wash the palms and backs of the hands for at least 20 seconds. Pat the hands dry with a paper towel. Turn the faucet off with a paper towel.
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? Apply a 1-in (2.5-cm) layer of the ointment to the site using the index finger Use a sterile cotton-tipped applicator to apply the prescription to the site Place sterile 4 × 4 gauze on the wound and secure the dressing with dressing with paper tape Put soiled dressing change supplies in the client's bathroom garbage and double bag
Use a sterile cotton-tipped applicator to apply the prescription to the site
The nurse is providing an in-service educational program for the interprofessional health care team about infection control precautions. What teaching will the nurse include? Select all that apply. Wear personal protective equipment (PPE). Practice hand hygiene. Use standard precautions only for clients with infection. Use equipment repeatedly on clients with similar conditions. Keep client's environment clean.
Wear personal protective equipment (PPE). Practice hand hygiene. Keep client's environment clean.
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? After completing a wound dressing Before direct contact with clients After direct contact with clients When hands are visibly soiled
When hands are visibly soiled
In which situation is an alcohol-based rub an inappropriate option for hand hygiene? When the nurse's hands are visibly soiled When the nurse anticipates contact with the client's skin When the nurse leaves the room of an immunocompromised client When the nurse is caring for a client with an active infection
When the nurse's hands are visibly soiled
Surgical asepsis is defined as: absence of all virulent microorganisms. absence of all microorganisms. slowed growth of microorganisms. use of hand washing, gowning, and gloving.
absence of all microorganisms.
The nurse is reviewing the plan of care for assigned clients. Which client has the highest risk for developing an infection? an older adult client with a history of heart failure a school-age child who is current with immunizations an adolescent who has a right radial fracture a middle-aged adult who takes prescribed medication to control blood pressure
an older adult client with a history of heart failure
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? contact vehicle droplet airborne
contact
The nurse is assisting a client with a history of vancomycin resistant enterococcus (VRE). What precaution should the nurse implement? standard precautions droplet precautions contact precautions airborne precautions
contact precautions
The nurse is admitting a client to the unit who needs frequent airway suctioning. Which precautions will the nurse select for the client? droplet contact airborne respiratory
droplet
The nurse is preparing a client who is in droplet isolation for transport to radiology. What is the appropriate nursing intervention(s)? Select all that apply. facilitating interdepartmental coordination about the transport removing the client's mask for transport placing a clean sheet on the stretcher that the client will be transported upon ensuring that the client has a mask on reminding transporter to utilize droplet precautions
ensuring that the client has a mask on reminding transporter to utilize droplet precautions facilitating interdepartmental coordination about the transport placing a clean sheet on the stretcher that the client will be transported upon
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? gown and gloves gown, gloves, goggles gown, gloves and mask w shield mask
gown and gloves
A client comes to the emergency department reporting becoming very ill after consuming shrimp and lobster. How will the nurse document this condition? contagious disease infectious disease communicable disease noncommunicable disease
noncommunicable disease
The nurse is caring for a client who became very ill after ingesting seafood. How will the nurse document this condition? infectious disease communicable disease noncommunicable disease contagious disease
noncommunicable disease
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 mostimportant thing the nurse can do to prevent the client with HIV from acquiring the upper respiratory infection? wear gloves when touching the client wear a mask and gown in the client's room avoid direct contact with the client perform hand hygiene before and after entering the client's room
perform hand hygiene before and after entering the client's room
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? washes hands for 20 seconds with soap and water picks up the glove at the folded edge with the thumb and forefinger stretches the glove over the hand without touching the unsterile area reaches down to the bed to pick up a sterile drape
reaches down to the bed to pick up a sterile drape
The nurse notices a student preparing to enter the room of a client with pulmonary tuberculosis with only gloves on. What is the appropriate nursing intervention? offer the student a mask do nothing, as the precautions observed are appropriate teach that a gown and shoe coverings must be worn in addition to gloves remind the student that a fitted N95 respirator is required
remind the student that a fitted N95 respirator is required
The nurse has worn a gown and gloves while caring for a client in contact isolation. How will the nurse appropriately remove this personal protective equipment (PPE)? remove gloves, wash hands, remove gown remove gown, wash hands, remove gloves remove gloves, remove gown, wash hands remove gown, remove gloves, wash hands
remove gloves, remove gown, wash hands
A client has sexual intercourse with someone infected with HIV. The vehicle of transmission is: semen. blood. wound drainage. sputum.
semen.
The nurse manager is developing a plan to decrease the transmission of health care associated infections. What would be the best to implement? staff education on utilizing hand hygiene restricting visitors to those older than 12 years of age providing alcohol-based hand sanitizer to all clients having any visitor with a cough or cold wear a mask
staff education on utilizing hand hygiene
Which nursing action demonstrates safe injection practice? recap needles if necessary use sterile single-use disposable syringes for each injection clean injection equipment when dust becomes visible use multiple-dose vials when administering medication to multiple clients
use sterile single-use disposable syringes for each injection
Which care intervention should the nurse anticipate when providing care to a client admitted with a possible diagnosis of tuberculosis (TB)? wearing a particulate respirator for all client care and interaction wearing a face mask when entering and staying at a distance from the client wearing protective eye wear for all client contact placing the client in a regular, private room
wearing a particulate respirator for all client care and interaction