Ch. 24 Asepsis and Infection Control - PrepU

The nurse is caring for a client who is to have a sterile dressing change to a wound. A student nurse enters the client's room and notices the nurse preparing the sterile field. After reviewing the image, which response by the student nurse to the nurse is the most accurate understanding of this procedure?

"the way you are doing it helps to minimize contamination of the non-waterproof side"

The nurse is preparing a sterile field for a dressing change. How would the nurse add paper-wrapped sterile items to the sterile field?

Separate the sealed flaps and drop contents onto field.

A nurse is explaining the different procedures used to break the chain of infection to a nursing student. In which link in the chain of infection should a nurse provide special attention to the respiratory and gastrointestinal tracts?

exit route

Which mask should the nurse don when caring for a client with tuberculosis?

filtered respirator

The nurse is caring for a client who became very ill after ingesting seafood. How will the nurse document this condition?

noncommunicable disease

The nurse is caring for an older adult client in a long-term care facility who has been previously alert and oriented. The client has become agitated and disoriented to time and place. The client is afebrile. What action by the nurse may assist with the determination of a causative factor in the client's condition?

obtain a urine specimen, as ordered, because the client may have developed a urinary tract infection

The nurse suspecting that a client has an infected surgical wound should assess for which sign? Select all that apply.

pain, swelling, redness, and exudate

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

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?

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

The nurse is recovering from a mild upper respiratory infection with no fever. The nurse is assigned to care for four clients. What is the appropriate nursing action to prevent clients from getting the infection?

perform meticulous hand hygiene and don a new mask with each client encounter

A nurse has collected the blood, urine, and stool specimens of a client with meningococcal meningitis. Which precaution should the nurse take when transporting the specimens

place the specimens into plastic biohazard bags

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, remove gown, wash hands

Which action is the best example of a nurse donning/removing protective equipment properly?

removing respirator after leaving client's room

The nurse is caring for a client that is suspected of having a latex allergy. What item of personal protective equipment should the nurse use with caution?

surgical masks

The nurse observes a member of the care team removing a gown after assisting a client with hygiene, as seen in image above. What is the nurse's most appropriate action?

teach the colleague to let the gown fall away rather than pulling on the sleeves

The nurse is caring for assigned clients who are all stable. Which client should the nurse see first to minimize the spread of infection?

the client who is 48-hours postsurgical procedure

Which nursing action demonstrates safe injection practice?

use sterile single-use disposable syringes for each injection

The nurse applies an alcohol-based hand rub upon entering the client's room. The client becomes upset stating, "You did not wash your hands!" Which response by the nurse is most appropriate?

"Alcohol-based hand rub provides the greatest reduction in microbial counts on the skin."

The nurse is teaching a community group about transmission of HIV. Which client statement by a community member demonstrates that further teaching is needed?

"I can catch HIV by swimming in pools."

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

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. "all visitors who enter the room must wear special masks." B. "under no circumstances should you touch the client." C. "no visitors are allowed in the room to decrease the spread of disease." D. "everyone who enters the room must wear a gown and gloves."

A. "all visitors who enter the room must wear special masks."

To eliminate needlesticks as potential hazards to nurses, the nurse should: A. immediately deposit uncapped needles into a 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. sticks the uncapped needle into a Styrofoam block and deposit it in a plastic container

A. immediately deposit uncapped needles into a puncture-proof plastic container

The nurse is reviewing the plan of care for assigned clients. Which client has the highest risk for developing an infection? A. an adolescent who has a right radial fracture B. an older adult client with a history of heart failure C. a school-age child who is current with immunizations D. a middle-aged adult who takes prescribed medication to control blood pressure

B. an older adult client with a history of heart failure

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. keep hands lower than elbows to allow water to flow toward fingertips. C. remove all jewelry, including wedding bands, before hand washing. D. pat dry with a paper towel, beginning with the forearms and moving down to fingertips.

B. keep hands lower than elbows to allow water to flow toward fingertips.

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

B. staff education on utilizing hand hygiene

A client is to have an indwelling urinary catheter inserted. Which precaution is followed during this procedure? A. medical asepsis technique B. surgical asepsis technique C. droplet precautions D. strict reverse isolation

B. surgical asepsis technique

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. "until you leave the hospital" B. "for 2 says as you get settled onto the unit" C. "when you sputum culture is negative" D. "only until you begin to feel better"

C. "when you sputum culture is negative"

A lead nurse is removing personal protective equipment after dressing the infected wounds of a client. Which is the priority nursing action? A. make contact between two clean surfaces B. remove the garments that are most contaminated C. hand washing before leaving the client's room D. make contact between two contaminated surfaces

C. hand washing before leaving the client's room

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. A. use standard precautions only for clients with infection B. use equipment repeatedly on clients with similar conditions C. wear PPE D. keep client's environment clean E. practice hand hygiene

C. wear PPE D. keep client's environment clean E. practice hand hygiene

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

D. an 81-year-old man with active tuberculosis and a productive cough

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. prophylactic antibiotic therapy for MRSA-negative clients C. constant use of gloves when on the unit D. diligent hand washing practices

D. diligent hand washing practices

Nurses wear personal protective equipment (PPE) to protect themselves and clients from infectious materials. Which examples accurately represent the proper use of personal protective equipment in a health care agency? Select all that apply.

To remove a gown, nurses should unfasten ties, if at the neck and back, and allow the gown to fall away from shoulders. During some care activities for an individual client, nurses may need to change gloves more than once. Nurses should remove PPE at the doorway or in an anteroom, except for the respirator.

An older adult client has been receiving care in a two-bed room that he has shared with another older, male client for the past several days. Two days ago, the client's roommate developed diarrhea that was characteristic of Clostridium difficile. This morning, the client himself was awakened early by similar diarrhea. The client may have developed which type of infection?

exogenous healthcare-associated

When discontinuing use of a gown in the care of a client in droplet precautions, which method does the nurse use to dispose of this personal protective equipment (PPE)?

fold soiled side to the inside and roll with inner surface exposed

The nurse is preparing discharge instructions for a family member who will be caring for a client with an abdominal incision. Which concept should be the priority in the teaching plan?

hand washing

A student nurse is performing hand washing in the clinical setting. Which observation would require the nursing instructor to intervene?

has manicured nails that are 1-in. (2.5-cm) long

A nurse has put on personal protective equipment (PPE) to perform the dressing change of a client's surgical wound. While the nurse is cleansing the incision, the client begins bleeding and blood hits the nurse's wrist, running down under the cuff of her glove. What is the nurse's best action?

interrupt the dressing change to perform thorough handwashing, and document the exposure according to protocol.

An operating room nurse is caring for a client who will soon undergo an appendectomy. Which handwashing technique is most appropriate for the nurse to use when caring for this client?

perform surgical hand scrub using detergent.

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.

The nurse is caring for a client with a cough and copious secretions. Before providing care, the nurse observes the licensed practical nurse (LPN) standing outside the client's room and donning personal protective equipment as shown above. How should the nurse best interpret the LPN's actions?

the LPN is donning personal protective equipment appropriately.

Which should be documented by the nurse?

the fact that sterile technique was used for a given procedure

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?

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

The nurse performs hand hygiene with soap and water before caring for a client. What is the primary rationale for this action?

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

When the client who has been diagnosed with hepatitis B has been hospitalized, the type of isolation the nursing staff should observe is:

universal precautions

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?

when hands are visibly soiled

The patient has asked the nurse to explain her WBC level of 8,000 cells/mm3. The nurse would identify the level of WBCs as:

within normal limits

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?

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

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?

"wearing an N95 respirator is critical when I care for clients in droplet precautions."

The nurse is providing discharge education for a client with diabetes. Which symptom(s) of foot ulcer infection should the client report to the health care provider? Select all that apply.

-Pain with redness and swelling -Localized heat -Purulent or malodorous drainage

The nurse is caring for several clients assigned single rooms on a medical-surgical unit. In which client(s) can the nurse safely carry out hand hygiene using hand sanitizer instead of washing hands soap and water? Select all that apply.

-The nurse is going from one room to another to introduce self at the start of the shift. -The nurse has entered the client room to adjust settings on the intravenous pump. -The nurse has just completed documentation and is entering another client room

Which factor has contributed to resistant microbial stains? A. use of antibiotics in clients with viral infections B. use of topical antibiotics on skin abrasions C. antibiotic use for bacterial infections D. mutation of common disease-causing viruses

A. use of antibiotics in clients with viral infections

Unbeknownst to him, a nursing student has inhaled droplets containing common cold viruses and is soon to develop a cold himself. Place the following stages of infection in the sequence in which they will occur. Full stage of illness, convalescent period, incubation period, & prodromal stage.

1. incubation period 2. prodromal stage 3. full stage of illness 4. convalescent period

A nurse is caring for a client, age 4 years, who is being treated for osteomyelitis in his left femur. He is on a 28-day course of IV vancomycin to be administered daily at 1300. Today is day 3 of treatment, and the pharmacist asks the nurse to draw a peak vancomycin level. What would be the most appropriate time to draw this blood?

1500

A client on a surgical unit has developed an infection at the site of a diagnostic laparoscopy. This type of infection is best termed as which of the following? A. exogenous B. iatrogenic C. antibiotic resistant D. endogenous

B. iatrogenic

A nurse is taking care of a client with tuberculosis who has developed resistance to the ordered antibiotic. Which type of client is most likely at increased risk for infection? A. adult B. child C. pregnant woman D. older adult

D. older adult

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 HIV

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

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

The nurse is preparing to change a client's sterile dressing. Which action by the nurse would increase the risk for infection?

applying a new dressing with the gloves that were used to remove the old dressing

The nurse is initiating isolation precautions for a client who has chronic Clostridium difficile infection. What should the nurse be sure to include with these precautions?

be sure that there are gloves of various sizes and gowns for use

Which client should the nurse determine to be at the greatest risk for hospital-acquired infection (HAI)?

client with a urinary catheter

The nurse is caring for a client with a draining abscess. Which precautions will the nurse begin?

contact

The nurse is caring for an older adult with a recurrent wound infection. Which precautions will the nurse begin? A. droplet B. airborne C. none D. contact

d. contact

The nurse is inserting a foley catheter for a client. Which nursing action is appropriate if the sterile field is broken during this procedure?

don another pair of sterile gloves.

The nurse needs to place gauze from a wrapped item into the sterile field. Which action does the nurse take?

drop the item from 6 in (15 cm) above the sterile field.

The nurse is caring for a client who requires frequent airway suctioning. Which precautions will the nurse select for the client?

droplet

The nurse is caring for a pediatric client with whooping cough. Which precautions will the nurse begin?

droplet

Upon review of a client's microbiology culture results, the nurse recognizes which organism as indicative of normal flora?

escherichia coli in the intestinal tract

A nurse is caring for a client with ringworm. Which microorganism causes ringworm in a client?

fungi

Which piece of personal protective equipment (PPE) should be removed first?

gloves

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, goggles, gown, respirator

The nurse caring for a client after hip surgery enters the room to take the client's vital signs. Which precaution should the nurse use? Select all that apply.

hand hygiene & non-sterile gloves

The nurse is using aseptic technique to insert an indwelling urinary catheter. Which technique made by the nurse is correct?

keeping sterile field above waist level