Chapter 10 Asepsis

Medical asepsis, or clean technique, includes practices used to render and keep objects and areas free from microorganisms.

False

Personal protective equipment (PPE) is used in healthcare facilities to protect the staff from potentially infected patients.

False

How long should a healthcare worker scrub hands that are not visibly soiled for effective hand hygiene? a) 15 seconds b) 5 minutes c) 1 minute d) 30 seconds

a) 15 seconds

Which of the following most accurately defines an infection? a) A disease resulting from pathogens in or on the body b) An acute or chronic illness resulting from traumatic injury c) An illness resulting from living in an unclean environment d) The result of lack of knowledge about food preparation

a) A disease resulting from pathogens in or on the body

A woman tests positive for the human immunodeficiency virus antibody but has no symptoms. She is considered a carrier. What component of the infection cycle does the woman illustrate? a) A reservoir b) An infectious agent c) A portal of exit d) A portal of entry

a) A reservoir

A nurse is preparing a sterile field and has removed the sterile drape from the outer wrapper. The nurse places the inner drape in the center of the work surface with the outer flap facing in which direction? a) Facing away from the body b) Facing toward the body c) Toward the right side d) Angled to the left side

a) Facing away from the body

The use of alcohol-based hand rubs for hand hygiene in healthcare facilities is approved by the Centers for Disease Control (CDC), but The Joint Commission (TJC) discourages its use. a) False b) True

a) False

An experienced nurse is teaching a student nurse the proper use of hand hygiene. Which of the following is an accurate guideline that should be discussed? a) Hand hygiene must be performed after contact with inanimate objects near the client. b) Hand lotions should not be used after hand hygiene. c) The use of gloves eliminates the need for hand hygiene. d) The use of hand hygiene eliminates the need for gloves.

a) Hand hygiene must be performed after contact with inanimate objects near the client.

A nurse is adding a sterile solution to a sterile field and has just opened the bottle according to manufacturer's directions. What is the next step? a) Hold the bottle outside the edge of the sterile field with the label side facing the palm of the hand and prepare to pour from a height of 4 to 6 inches. b) "Lip" a new or old bottle of solution before pouring it and hold the solution with the label facing out from a height of 4 to 6 inches. c) Hold the bottle inside the 1-inch edges of the sterile field with the label side facing the palm of the hand and pour from a height of 2 to 4 inches. d) Touch the tip of the bottle to the sterile container to start the flow of the solution and pour it into the container directly from the top of the container edge.

a) Hold the bottle outside the edge of the sterile field with the label side facing the palm of the hand and prepare to pour from a height of 4 to 6 inches.

Any microorganism capable of disrupting normal physiologic body processes is a a) Pathogen b) Bacterium c) Fomite d) Virus

a) Pathogen

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

a) Replace gloves if they are visibly soiled.

Which of the following would be appropriate nursing diagnoses related to the use of PPE? Select all that apply. a) Risk for infection b) Deficient knowledge c) Ineffective protection d) Self-care deficit e) Risk for falls

a) Risk for infection b) Deficient knowledge c) Ineffective protection

A nurse at health care facility uses a mask to prevent spread of microorganism by droplet or airborne transmission. What care should the nurse take when using masks? Select all that apply. a) Position the mask so that it covers the mouth b) Avoid touching the mask once it is in place c) Touch only the strings of the mask during removal d) Discard used marks into a regular waste basket e) Change the mask every 20 or 30 minutes

b) Avoid touching the mask once it is in place c) Touch only the strings of the mask during removal e) Change the mask every 20 or 30 minutes

A client suffers from bloody diarrhea after eating contaminated food at a local restaurant. The client has been infected with a(an) a) Protozoa b) Bacteria c) Fungi d) Virus

b) Bacteria

Surgical asepsis is defined as a) Absence of all virulent microorganisms b) Slowed growth of microorganisms c) Absence of all microorganisms d) Use of handwashing, gowning, and gloving

c) Absence of all microorganisms

A nursing student is preparing to return demonstrate the skill of handwashing. Which of the following would indicate that the student needs additional teaching? a) Removes jewelry except for plain wedding band b) Pushes watch to about 4 inches above the wrist c) Adjusts the water temperature to be hot d) Avoids leaning against the wet sink

c) Adjusts the water temperature to be hot

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

c) An 80-year-old woman

What are the recommended cleansing agents for hand hygiene in any setting when the risk of infection is high? a) Liquid or bar hand soap b) Hot water c) Antimicrobial products d) Cold water

c) Antimicrobial products

Which of the following statements about glove use and hand hygiene is true? a) Use of alcohol-based hand rubs is appropriate after using the restroom. b) The use of sterile gloves reduces the need for hand hygiene. c) Artificial fingernails should not be worn by staff involved in direct client care. d) Nonsterile gloves can be decontaminated with alcohol-based hand rub, but must be changed between clients.

c) Artificial fingernails should not be worn by staff involved in direct client care.

A nursing home recently has had a significant number of nosocomial infections. Which of the following measures might be instituted to decrease this trend? a) Mandating antibiotics for all nursing home residents b) Restricting visitors and community activities for residents c) Have written, infection-prevention practices for all employees d) Requiring all employees to have monthly screenings for skin flora

c) Have written, infection-prevention practices for all employees

A nurse follows surgical asepsis techniques for inserting an indwelling urinary catheter in a client. Which of the following is an accurate guideline for using this technique? a) Consider the outside of the sterile package to be sterile. b) Open sterile packages so that the first edge of the wrapper is directed toward you. c) Hold sterile objects above waist level to prevent accidental contamination. d) Consider the outer 3-inch edge of a sterile field to be contaminated.

c) Hold sterile objects above waist level to prevent accidental contamination.

A client comes to the emergency department with major burns over 40% of his body. Although all of the following are true, which one would provide the rationale for a nursing diagnosis of Risk for Infection? a) Age, race, sex, and hereditary factors influence susceptibility to infection. b) Stress may adversely affect normal defense mechanisms. c) Intact skin and mucous membranes protect against microbial invasion. d) White blood cells provide resistance to certain pathogens.

c) Intact skin and mucous membranes protect against microbial invasion.

When pouring a sterile solution, what care should the nurse take to avoid contamination of the solution? a) Open and place the cap of the container inside down on a flat surface b) Wash the inside surface of the cap of the container with water c) Pour and discard a small amount of the solution before each use d) Wipe the mouth of the container with a sterile cloth before and after use

c) Pour and discard a small amount of the solution before each use

The following procedures have been ordered and implemented for a hospitalized client. Which procedure carries the greatest risk for a nosocomial infection? a) Intramuscular injections b) Enema c) Urinary catheterization d) Heat lamp

c) Urinary catheterization

Question: The nurse is preparing to perform handwashing. Arrange the following steps in the correct order.

1. Turn on the faucet and adjust force and temperature of the water. 2. Wet the hand and wrist areas. 3. Apply soap product. 4. Wash the palms and back of the hands for at least 15 seconds. 5. Pat hands dry with a paper towel. 6. Turn the faucet off with a paper towel.

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 of the following actions should the nurse perform, keeping in mind the importance of asepsis and client comfort? a) Wash hands thoroughly and then wear sterile gloves b) Avoid using alcohol-based hand sanitizers to protect skin integrity c) Avoid washing hands with an antiseptic cleansing agent d) Wear gloves made of polyvinyl chloride

a) Wash hands thoroughly and then wear sterile gloves

You have completed an intervention with a patient. There is no visible soiling on your hands. Which of the following techniques is recommended by the Centers for Disease Control (CDC) for hand hygiene? a) Wash hands with soap and water, follow with an alcohol-based hand rub. b) Decontaminate hands using an alcohol-based hand rub. c) Do not wash hands; apply clean gloves. d) Wash hands with soap and hot water.

b) Decontaminate hands using an alcohol-based hand rub

At which link in the chain of infection does the nurse need to provide special attention to the respiratory and gastrointestinal tracts? a) Mode of transmission b) Port of exit c) Port of entry d) Susceptible host

b) Port of exit

A client has an inguinal hernia repair and later develops a methicillin-resistant Staphylococcus aureus infection. What is the most important factor to prevent this infection? a) Increased vitamin C b) Surgical asepsis c) Increased T cells d) Decreased antibiotics

b) Surgical asepsis

The nurse performs hand hygiene with soap and water before caring for a client. What is the primary rationale for this action? a) To sterilize the nurse's hands to prevent infection b) To eliminate disease-producing organisms from the nurse's skin c) To provide effective nursing care d) To prevent the nurse from developing disease

b) To eliminate disease-producing organisms from the nurse's skin

A nurse is educating a rural community group on how to avoid contracting West Nile virus by using approved insect repellant and wearing proper coverings when outdoors. By what means is the pathogen involved in West Nile virus transmitted? a) Airborne route b) Vectors c) Indirect contact d) Direct contact

b) Vectors

A home health nurse is completing a health history for a patient. What is one question that is important to ask to identify a latex allergy for this patient? a) "Have you ever had an allergic reaction to shellfish or iodine?" b) "When you were a child, did you have frequent infections?" c) "Tell me what you use to wash your hands after toileting." d) "Have you had any unusual symptoms after blowing up balloons?

d) "Have you had any unusual symptoms after blowing up balloons?

You have completed an intervention with a patient. There is no visible soiling on your hands. Which of the following techniques is recommended by the Centers for Disease Control (CDC) for hand hygiene? a) Wash hands with soap and water, follow with an alcohol-based hand rub. b) Do not wash hands; apply clean gloves. c) Wash hands with soap and hot water. d) Decontaminate hands using an alcohol-based hand rub.

d) Decontaminate hands using an alcohol-based hand rub.

A nurse changing the linens of a patient bed is exposed to urine and performs hand hygiene. Which of the following is a guideline for performing this skill properly following this patient encounter? a) Remove all jewelry, including wedding bands before handwashing. b) Use an alcohol-based hand rub to decontaminate hands. c) Pat dry with a paper towel, beginning with the forearms and moving down to fingertips. d) Keep hands lower than elbows to allow water to flow toward fingertips.

d) Keep hands lower than elbows to allow water to flow toward fingertips.

A nurse is preparing to add a sterile solution to a sterile container on a sterile field. After opening the container, which of the following would the nurse do with the cap? a) Place it rim down on the corner of the sterile field b) Place it in the biohazard receptacle c) Hold it in the nondominant hand d) Position it with the inside facing up on a flat surface

d) Position it with the inside facing up on a flat surface

A nurse is positioning a sterile drape to extend the working area when performing a urinary catheterization. Which of the following is an appropriate technique for this procedure? a) Touch only the outer two inches of the drape when not wearing sterile gloves. b) Fold the lower edges of the drape over the sterile-gloved hands. c) When reaching over the drape do not allow clothing to touch the drape. d) Use sterile gloves to handle the entire drape surface.

d) Use sterile gloves to handle the entire drape surface.

A nurse is performing a sterile dressing change. If new sterile items or supplies are needed, how can they be added to the sterile field? a) By carefully handling them with clean hands b) By clean hands wearing clean latex gloves c) With clean forceps that touch only the outermost part of the item d) With sterile forceps or hands wearing sterile gloves

d) With sterile forceps or hands wearing sterile gloves