Ch. 24 Asepsis and Infection Control

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) Specimen containers c) Bath blanket d) Indwelling catheter

Indwelling catheter Explanation: Infections are often transmitted to older adult clients through equipment reservoirs (e.g., indwelling urinary catheters, humidifiers, and oxygen equipment) or through incisional sites, such as those for intravenous tubing, parenteral nutrition, or tube feedings. Use of proper aseptic techniques is essential to prevent the introduction of microorganisms. Bath blankets, face shields, and specimen containers are not part of the equipment reservoir that transmits infection easily, because they are disposed of immediately after one-time use.

A nurse prefers to use an alcohol-based hand rub when providing care for patients. In which case is this practice contraindicated? a) The nurse finishes cleaning a patient's table. b) The nurse finishes patient care and hands are not visibly soiled. c) The nurse is caring for a client with a C. difficile infection. d) The nurse performs routine care and is moving to another patient.

The nurse is caring for a client with a C. difficile infection. Explanation: Controversy exists regarding the use of alcohol-based handrubs when C. difficile organisms have been identified. Alcohol does not kill C. difficile spores.

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) When hands are visibly soiled b) After direct contact with clients c) After completing a wound dressing d) Before direct contact with clients

When hands are visibly soiled Explanation: Alcohol-based handrubs can be effective for decontaminating a health care worker's hands before and after direct contact with clients and after completion of a wound dressing, EXCEPT when the health care worker's hands are visibly soiled.

Surgical asepsis is defined as: a) slowed growth of microorganisms. b) absence of all microorganisms. c) use of hand washing, gowning, and gloving. d) absence of all virulent microorganisms.

absence of all microorganisms. Explanation: Surgical asepsis refers to sterile technique and indicates procedures used to eliminate any microorganisms.

Which client would require a negative flow room? a) a 21-year-old man with latent tuberculosis who is postoperative following repair of a femoral fracture b) an 81-year-old man with active tuberculosis and a productive cough c) a 3-year-old with influenza A and a productive cough d) a 4-year-old boy with meningitis

an 81-year-old man with active tuberculosis and a productive cough Explanation: Active tuberculosis always requires a negative flow room.

A client with HIV is the: a) carrier. b) specificity. c) virulence. d) pathogen.

carrier. Explanation: Clients may become infected from people who have active disease, people in the incubation portion of their disease, or people who harbor pathogens but have no symptoms of disease.

An acute medicine unit of a hospital currently has a number of clients who have tested positive for methicillin-resistant Staphylococcus aureus (MRSA). Which measures should the nursing staff prioritize in preventing the spread of MRSA to clients who are currently MRSA-negative? a) reduced length of stay for MRSA-positive clients b) diligent handwashing practices c) prophylactic antibiotic therapy for MRSA-negative clients d) constant use of gloves when on the unit

diligent handwashing practices Explanation: As with all forms of infection, thorough handwashing is the most important infection-control measure. It is inappropriate to reduce clients' length of stay based on their MRSA status, and prophylaxis is not normally used. It is unnecessary to wear gloves at all times on the unit.

A client has sexual intercourse with someone infected with HIV. The vehicle of transmission is: a) blood. b) semen. c) sputum. d) wound drainage.

semen. Explanation: Vehicle transmission involves the transfer of microorganisms by way of vehicles, or contaminated items that transmit pathogens. For example, food can carry Salmonella. In this case, semen can carry human immunodeficiency virus.

Disinfectants are used: a) for preoperative bowel preparations. b) to prepare instruments for surgery. c) to clean rooms between clients. d) to sterilize surgical drapes.

to clean rooms between clients. Explanation: A chemical used on lifeless objects is called a disinfectant.

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

use of one gown per person per shift Explanation: A new gown should be used by the nurse each time the nurse enters the room.

For which clients would the nurse be required to use droplet precautions? Select all that apply. a) a client with SARS b) a client with diphtheria prioritization c) a client with MRSA d) a client with rubella e) a client with mumps f) a client with tuberculosis

• a client with rubella • a client with mumps • a client with diphtheria prioritization Explanation: Droplet precautions would be used for clients with an infection that is spread by large-particle droplets such as rubella, mumps, diphtheria, and the adenovirus infection in infants and young children. For tuberculosis and SARS, airborne precautions would be used. Contact precautions would be the primary method of precautions with MRSA.

When caring for a client with a respiratory infection, the nurse washes her hands frequently and thoroughly. What are the other precautionary steps the nurse should take in order to prevent infection? a) Wear a mask when talking to the client. b) Get monthly immunizations against infections. c) Receive vaccination after every visit. d) Avoid contact with the client.

Wear a mask when talking to the client. Explanation: When caring for a client with a respiratory infection, the nurse washes her hands frequently and thoroughly and wears a mask over her mouth. The nurse need not get monthly immunizations against infections or receive vaccination after every visit. Avoiding contact with the client is also not a good alternative, as the nurse needs to be near the client to care for him.

Which client presents the most significant risk factors for the development of Clostridium difficile infection? a) A client with renal failure who receives hemodialysis three times weekly b) an 81-year-old client who has been receiving multiple antibiotics for the treatment of sepsis c) a 44-year-old client who is paralyzed and whose coccyx ulcer has required a skin graft d) A 30-year-old client who has recently contracted human immunodeficiency virus (HIV) after engaging in high-risk sexual behavior

an 81-year-old client who has been receiving multiple antibiotics for the treatment of sepsis Explanation: Old age and recent, long-term antibiotic therapy are significant risk factors for C. difficile infection. These supersede the risks posed by recent HIV infection, skin grafts, and hemodialysis.

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) Vehicle d) Airborne

Contact Explanation: Direct contact involves body surface-to-body surface contact, causing the physical transfer of organisms between an infected or colonized host and a susceptible host.

An infection-control nurse is discussing needlestick injuries with a group of newly hired nurses. The infection control nurse informs the group that most needlestick injuries result from: a) recapping a needle. b) faulty needles and syringes. c) full needle boxes. d) needles left in the client's linen.

recapping a needle. Explanation: Most needlesticks occur during recapping, so nurses are instructed to never recap needles

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

A commercially packaged surgical item is not considered sterile if past expiration date. Explanation: When preparing the operation theater for a surgical procedure, the nurse should remember that a commercially packaged surgical item is not considered sterile if it has passed its recommended expiration date. When a sterile item touches an item that is not sterile, then the sterile item is contaminated. If a sterile item touches another sterile item, it is not considered contaminated. A partially uncovered sterile package is considered contaminated

Which practice is a correct application of infection control practices? a) A nurse performs hand washing each time the nurse removes a pair of gloves. b) A nurse uses an alcohol-based handrub each time that the nurse's hands are visibly soiled. c) A nurse dons a pair of gloves prior to any client contact. d) A nurse ensures that the nurse rinses the hands thoroughly after the application of an alcohol-based handrub.

A nurse performs hand washing each time the nurse removes a pair of gloves. Explanation: Hand washing should be performed after the removal of a pair of gloves. Gloves are not required for each and every client contact and visibly soiled hands require a wash with soap and water. Alcohol-based handrubs are not followed by a rinse. (less)

The nurse determines that which of the following clients is at greatest risk for a wound infection? a) A client with a urinary catheter b) An elderly client with dry skin c) An infant with intact skin d) A two-day postoperative client

A two-day postoperative client Explanation: The client at greatest risk for a wound infection is the two-day postoperative client, as the surgery disrupted the integrity of the skin, thereby increasing the risk for wound infection. Although elderly clients are at greater risk for infection, this client's skin is dry (versus having an open or surgical wound); thus, this client is at less risk than the postoperative client. An infant with intact skin is not at risk for a wound infection. A client with a urinary catheter is at risk for a urinary tract infection versus a wound infection.

The nurse caring for clients at an outpatient clinic determines that which client is at greatest risk for infection? a) A 12-year-old girl b) An 18-month-old infant c) A 2-year-old toddler d) An 80-year-old woman

An 80-year-old woman Explanation: Age, race, sex, and heredity all influence susceptibility to infection. Neonates and older adults tend to be most vulnerable to infection, so the 80-year-old woman is the client most at risk for infection

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

Before entering the client's room Explanation: The nurse should don the gown before entering the client's room to prevent soiling/contamination of the nurse's clothing with infectious bacteria/viruses and/or the client's blood and body fluids.

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) Use only the correctly gloved hand to perform the sterile procedure while making sure the other hand does not contaminate the sterile field. b) Leave both the thumb and finger in the thumb hole and perform the procedure to the best of the nurse's ability. c) Continue to don the glove, then use the other gloved hand to carefully insert the finger into the proper hole. d) Don a second pair of sterile gloves over the first pair.

Continue to don the glove, then use the other gloved hand to carefully insert the finger into the proper hole. Explanation: It is appropriate to adjust the gloves by touching sterile surface to sterile surface.

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) Use the sphygmomanometer c) Send the sphygmomanometer for sterilization d) Cleanse and disinfect the sphygmomanometer

Cleanse and disinfect the sphygmomanometer Explanation: The nurse should cleanse and disinfect the sphygmomanometer. A sphygmomanometer is another name for a blood pressure cuff. As this equipment is used on the outside of the arm versus entering a sterile body part, there is no need to have the equipment sterilized. It would be inappropriate for the nurse to use the visibly soiled blood pressure cuff or to throw it in the trash.

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) Airborne b) Vehicle c) Contact d) Droplet

Contact Explanation: Contact may be either direct or indirect.

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

Fungi Explanation: Ringworm is caused by a fungal infection. Fungi include yeasts and molds, which cause infections in the skin, mucous membranes, hair, and nails. Rickettsiae are microorganisms that resemble bacteria but cannot survive outside of another living species. They are responsible for Lyme disease. Protozoans are single-celled animals classified according to their ability to move. They do not cause ringworm. Helminths are infectious worms that may or may not be microscopic. They include roundworms, tapeworms, and flukes.

The nurse has completed an intervention with a client. There is no visible soiling on the nurse's hands. Which technique is recommended by the Centers for Disease Control (CDC) for hand hygiene? a) Wash hands with soap and hot water. b) Wash hands with soap and water, followed by an alcohol-based hand rub. c) Decontaminate hands using an alcohol-based hand rub. d) Do not wash hands; apply clean gloves.

Decontaminate hands using an alcohol-based hand rub. Explanation: Alcohol-based hand rubs can be used if hands are not visibly soiled.

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) Proceed with the procedure since it was only touched by the client. b) Discard the sterile field and the supplies and start over. c) Call for help and ask for new supplies. d) Change the sterile field, but reuse the sterile equipment.

Discard the sterile field and the supplies and start over. Explanation: The nurse's next appropriate action would be to discard the sterile field and the supplies and start over. The client touching the end of the sterile field contaminated the field and the items on the field. The nurse cannot reuse the sterile equipment because the items are no longer sterile. The nurse cannot proceed with the procedure since the items have been contaminated. Calling for help and asking for new supplies is not the best answer. The field has been contaminated also.

Upon review of a client's microbiology culture results, the nurse recognizes which organism as indicative of normal flora? a) Shigella in the urinary tract b) Escherichia coli in the intestinal tract c) Shigella in the intestinal tract d) Escherichia coli in the urinary tract

Escherichia coli in the intestinal tract Explanation: Escherichia coli resides in the intestinal tract, is normal flora, and does not cause harm or infection in the client.

A lead nurse is removing personal protective equipment after dressing the infected wounds of a client. Which is the highest priority nursing action? a) Remove the garments that are most contaminated. b) Make contact between two contaminated surfaces. c) Make contact between two clean surfaces. d) Handwashing before leaving the client's room.

Handwashing before leaving the client's room. Explanation: The most important nursing action is to perform a thorough handwashing before leaving the client's room and before touching any other client, personnel, environmental surface, or client care items. Regardless of which garments they wear, nurses follow an orderly sequence for removing them. The procedure involves making contact between two contaminated surfaces or two clean surfaces. Nurses remove the garments that are most contaminated first, preserving the clean uniform underneath.

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) "When you were a child, did you have frequent infections?" c) "Have you ever had an allergic reaction to shellfish or iodine?" d) "Have you had any unusual symptoms after blowing up balloons?"

Have you had any unusual symptoms after blowing up balloons?" Explanation: Awareness of a latex allergy is important for safe home care. Nurses need to ask whether clients have experienced any unusual signs or symptoms when blowing up balloons, using latex condoms, or wearing rubber gloves for dishwashing or cleaning.

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) Consider the outer 3-inch edge of a sterile field to be contaminated. b) Consider the outside of the sterile package to be sterile. c) Hold sterile objects above waist level to prevent inadvertent contamination. d) Open sterile packages so that the first edge of the wrapper is directed toward the nurse.

Hold sterile objects above waist level to prevent inadvertent contamination. Explanation: Holding a sterile object above waist level ensures the object is kept in sight and prevents accidental contamination. The outside of the sterile package and the outer 1 inch of a sterile field are contaminated. Sterile packages should be opened so that the first edge of the wrapper is directed away from the nurse.

To eliminate needlesticks as potential hazards to nurses, the nurse should: a) Immediately deposit uncapped needles into puncture-proof plastic container. b) Place the uncapped needle on a tray and carry it to the medicine room for disposal. c) Slide the needle into the cap and deposit it in a puncture-proof plastic container. d) Stick the uncapped needle into a Styrofoam block and deposit in a plastic container.

Immediately deposit uncapped needles into puncture-proof plastic container. Explanation: All uncapped needles should be placed in puncture-proof plastic units immediately after use.

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) Revising the facility's infection control protocols c) Limiting visitors to family members over the age of 18 d) Incentivizing health care workers to utilize hand hygiene

Incentivizing health care workers to utilize hand hygiene Explanation: Most health care-associated pathogens are transmitted via the contaminated hands of health care workers. Therefore, the most effective strategies for decreasing transmission are those that educate or encourage health care workers to utilize effective hand hygiene

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?

Keep hands lower than elbows to allow water to flow toward fingertips. Explanation: Handwashing, as opposed to hand hygiene with an alcohol-based rub, is required when hands are exposed to body fluids. Jewelry should be removed, if possible, and secured in a safe place, but a plain wedding band may remain in place. Wet the hands and wrist area, and keep hands lower than elbows to allow water to flow toward fingertips and pat hands dry with a paper towel, beginning with the fingers and moving upward toward forearms.

When preparing to use a bottle of sterile saline for a dressing change, the nurse notes that the date it was opened was two days previous. What should the nurse do? a) Continue to utilize the bottle b) Obtain a new bottle of sterile saline c) Switch to sterile water d) Shake the bottle to ensure contents are mixed

Obtain a new bottle of sterile saline Explanation: The nurse should obtain a new bottle of sterile saline, as most solutions are considered sterile for 24 hours after they are opened. Shaking the bottle will not impact its sterility. Switching to sterile water is not indicated

The nurse is completing a sterile dressing change on a confused client. During the procedure, the client reaches down and touches the contents of the open dressing kit. What should the nurse do? a) Wash the client's hands b) Continue changing the dressing c) Open a new sterile dressing kit d) Restrain the client's hands

Open a new sterile dressing kit Explanation: The nurse should obtain a new sterile dressing kit before continuing with the dressing change procedure. Continuing the dressing change without obtaining a new kit would increase the client's risk for infection. The client's hands do not need to be cleansed after touching the contents of the kit, and it would be inappropriate to restrain the client's hands.

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) Place a surgical mask on the client and transport to the CT department at the specified time. b) Notify the CT department in advance so other clients and staff can be removed from the area. c) Request that the examination be done at the bedside. d) Question the need for the examination because the client must remain in Airborne Precautions.

Place a surgical mask on the client and transport to the CT department at the specified time. Explanation: Transport clients in Airborne Precautions out of the room only when necessary and place a surgical mask on the client, if possible.

What is an accurate guideline for the use of PPE? a) Replace gloves if they are visibly soiled. b) Put on PPE after entering the client's room. c) Substitute personal glasses for protective eyewear, if desired. d) When wearing gloves, work from "dirty" areas to "clean" ones.

Replace gloves if they are visibly soiled. Explanation: If gloves become torn or heavily soiled, they should be removed and replaced. PPE should be put on before entering the client's room and glasses should not be substituted for protective eyewear. Work should progress from "clean" areas to "dirty" areas.

After changing the bed linens for a client, the nurse uses an alcohol-based handrub to perform hand antisepsis. What is the proper way to use an alcohol-based handrub? a) Rub the product between the hands for 5 seconds. b) Apply a drop of the handrub, scrub, and rinse with water. c) Distribute the product over the nails and wash with soap. d) Rub the product between the hands until they are dry.

Rub the product between the hands until they are dry. Explanation: When decontaminating with an alcohol-based handrub, the nurse should apply about a nickel- to quarter-sized amount of the product to the palm of one hand, distribute the product to cover all surfaces of the hands and fingers, and rub the product between the hands for 15 to 25 seconds until they are dry. The nurse need not rinse the hands with water after using an alcohol rub

The nurse begins a task and then realizes that personal protective equipment (PPE) is needed. What is the correct action by the nurse? a) Leave PPE in the room b) Complete the task, then obtain PPE c) Stop and obtain appropriate PPE d) Ask a colleague to perform the task

Stop and obtain appropriate PPE Explanation: The nurse should stop the task and obtain the appropriate protective wear. Completing the task without the appropriate equipment is inappropriate, as is asking a colleague to finish the task. Protective equipment should be left outside of the room so that it can be donned prior to entering.

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) Surgical asepsis b) Increased T cells c) Decreased antibiotics d) Increased vitamin C

Surgical asepsis Explanation: Clients are at risk for healthcare-associated infections when the health care staff does not follow safety guidelines. Medical and surgical asepsis are the primary safety interventions for preventing disease in the health care environment.

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

Surgical asepsis technique Explanation: Surgical asepsis technique is the technique followed to insert an indwelling urinary catheter. Surgical asepsis techniques, used regularly in the operating room, labor and delivery areas, and certain diagnostic testing areas, are also used by the nurse at the client's bedside. Procedures that involve the insertion of a urinary catheter, sterile dressing changes, or preparing an injectable medication are examples of surgical asepsis techniques. An object is considered sterile when all microorganisms, including pathogens and spores, have been destroyed. Medical asepsis, or clean technique, involves procedures and practices that reduce the number and transfer of pathogens. Medical asepsis procedures include performing hand hygiene and wearing gloves. Strict reverse isolation is an isolation technique where the client is protected from the nurse, other health care providers, and visitors. A client that has immune system disorders, in which the client might not be able to fight off an organism, would be kept in an environment to minimize exposure to the organism. Droplet precaution is a technique where appropriate personal protective equipment (PPE) is worn so as not to carry the organism via droplet from exposed client to others.

The nurses on a busy surgical ward use hand hygiene when caring for post surgical patients. Which action represents the appropriate use of hand hygiene? a) The nurse uses gloves in place of hand hygiene. b) The nurse uses hand hygiene instead of gloves when in contact with blood. c) The nurse refrains from using hand moisturizer following hand hygiene. d) The nurse keeps fingernails less than ¼ inch long.

The nurse keeps fingernails less than ¼ inch long. Explanation: The nurse needs to keep fingernails less than ¼ inch long. Gloves should never be used in place of hand hygiene. Gloves should always be worn when the nurse is in contact with blood. The nurse could use a hospital sanctioned hand moisturizer after hand hygiene, but this is not the best answer.

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) Urinary catheter b) Endotracheal tube c) Salem sump nasogastric tube d) PICC line

Urinary catheter Explanation: Urinary catheters account for the highest percentage (26%) of hospital-associated infections.

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) Airborne b) Vehicle c) Droplet d) Direct contact

Vehicle Explanation: Vehicle transmission involves the transfer of microorganisms by way of vehicles or contaminated items that transmit pathogens; for example, food can carry Salmonella. Direct contact transmission involves body surface-to-body surface contact causing the physical transfer of organisms between an infected or colonized person and an infected host. Droplet transmission occurs when mucous membranes of the nose, mouth, or conjunctiva are exposed to secretions of an infected person who is coughing, sneezing, or talking. Airborne transmission occurs when fine particles are suspended in the air for a long time or when dust particles contain pathogens.

A nurse who has finished cleansing and dressing the wound of a young client now needs to change the dressings of a client in the burn unit. Which action should the nurse perform, keeping in mind the importance of asepsis and client comfort? a) Avoid washing hands with an antiseptic cleansing agent. b) Avoid using alcohol-based hand sanitizers to protect skin integrity. c) Wash hands thoroughly and then wear sterile gloves. d) Wear gloves made of polyvinyl chloride.

Wash hands thoroughly and then wear sterile gloves. Explanation: To prevent the spread of infection and follow strict asepsis, the nurse should wash hands and wear sterile gloves between contacts with different clients, or before performing any invasive procedure on a client. When entering a high-risk area such as a burn unit, the nurse should use antiseptic cleansing agents, nail files, and antiseptic-impregnated scrub brushes. Alcohol-based hand sanitizers are a better idea, as they are less abrasive and less irritating on skin than washing with soap and water. The nurse should wear latex gloves instead of polyvinyl chloride when examining the client, as latex is more flexible and durable. Latex gloves are preferred when lengthy exposure is anticipated or fine motor skills are required.

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

an incontinent client in a nursing home who has diarrhea Explanation: Standard precautions apply to blood and all body fluids, secretions, and excretions, except sweat. transmission-based precautions are used in addition to standard precautions for clients hospitalized with suspected infection by pathogens that can be transmitted by airborne, droplet, or contact routes, such as is the case in answers A, B, and D.

Which nursing action is a component of medical asepsis? a) handwashing after removing gloves b) drawing blood from a central line c) insertion of an indwelling urinary catheter d) insertion of an intravenous catheter

handwashing after removing gloves Explanation: Medical asepsis (clean technique) involves procedures and practices that reduce the number and transfer of pathogens. Medical asepsis procedures include performing hand hygiene and wearing gloves. Surgical asepsis (sterile technique) includes practices used to render and keep objects and areas free from microorganisms (insertion of urinary or intravenous catheters).

When the client who has been diagnosed with hepatitis B has been hospitalized, the type of isolation the nursing staff should observe is a) contact precautions. b) droplet precautions. c) standard precautions. d) airborne precautions.

standard precautions. Explanation: Standard or universal precautions relate to blood and certain body fluids to protect healthcare workers from clients possibly carrying HIV, hepatitis B virus, or other bloodborne pathogens.

A nurse who is taking the vital signs of a client with acute diarrhea is ordered to attend to another client. What is the highest priority nursing action the nurse must perform before leaving the client's room? a) placing one bag of contaminated items within another b) thorough handwashing c) spraying of disinfectant d) removing personal protective equipment that is most contaminated first

thorough handwashing Explanation: Since the client has an infectious disease, the most important nursing action is to perform thorough handwashing before leaving the client's room and before touching any other client, personnel, environmental surface, or client care item. Spraying a disinfectant before leaving the client's room, or placing one bag of contaminated items in another is not the most important nursing action in this case. Regardless of which garments they wear, nurses follow an orderly sequence for removing them. Nurses remove the personal protective equipment that is most contaminated first to preserve the clean uniform underneath.

Nurses use medical asepsis, or clean technique, in practice to reduce the number and transfer of pathogens. Which of the following are principles of this practice? Select all that apply. a) Use personal grooming habits, such as shampooing hair often, to prevent spreading microorganisms. b) Place soiled bed linen or any other items on the floor, instead of the bed or furniture. c) Carry soiled items close to the body to prevent transfer of pathogens into the environment. d) Clean the least soiled areas first and then move to the more soiled ones. e) Shake out linens and client clothing before placing them back on the bed. f) Move equipment close to the body when brushing, dusting, or scrubbing articles.

• Clean the least soiled areas first and then move to the more soiled ones. • Use personal grooming habits, such as shampooing hair often, to prevent spreading microorganisms. Explanation: Carry soiled items, including linens, equipment, and other used articles, away from the body to prevent them from touching the clothing. Do not place soiled bed linen or any other items on the floor, which is grossly contaminated; it increases contamination of both surfaces. Move equipment away from you when brushing, dusting, or scrubbing articles. Clean the least soiled areas first and then move to the more soiled ones. Use personal grooming habits that help prevent spreading microorganisms; shampoo your hair regularly. Do not shake linens. Dust and lint particles constitute a vehicle by which organisms may be transported from one area to another

A nurse is providing care to several clients. The nurse performs handwashing with soap and water instead of an alcohol-based hand sanitizer for a client infected with which pathogen? Select all that apply. a) Clostridium difficile b) Candida albicans c) E. coli d) Norovirus e) Staphylococcus aureas

• Clostridium difficile • Norovirus Explanation: Alcohol-based products are not effective against Clostridium difficile or Norovirus. Therefore, handwashing with soap and water is required for any contact with a client who has diarrhea. Use of alcohol-based products are appropriate for clients with infections involving Staphylococcus aureas, candida, and E. coli.