Chapter 23: Asepsis + Infection Control

An African-American client that carries the sickle cell gene is preparing to travel to an area known to have a high incidence of malaria. The client expresses concern about acquiring malaria and asks the nurse about the risk factors. What is the best response by the nurse? "If you are traveling to a country where malaria is prevalent, you should be immunized to avoid disease." "Carrying the sickle cell gene prevents you from acquiring malaria." "You should avoid traveling to countries where malaria is prevalent." "Malaria is not contagious."

"Carrying the sickle cell gene prevents you from acquiring malaria."

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."

Which client would the nurse consider the most infectious? A client who is in the incubation period A client who is in the prodromal stage A client who is in the full stage of illness A client who is in the convalescent period

A client who is in the prodromal stage

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 handrub each time that the nurse's hands are visibly soiled. 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.

The nurse determines that which client is at greatest risk for a wound infection? A two-day postoperative client An older adult client with dry skin An infant with intact skin A client with a urinary catheter

A two-day postoperative client

Which client presents the most significant risk factors for the development of Clostridium difficile infection? 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 Two common factors that increase a persons risk of becoming infected with C difficle are age greater than 65 and current or recent use of antibiotics. In this scenario, 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.

Which client should the nurse determine to be at the greatest risk for hospital-acquired infection (HAI)? Client with a urinary catheter Clint with an intravenous catheter Client with a surgical wound Client with a diabetic foot ulcer

Client with a urinary catheter

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 Escherichia coli in the urinary tract Shigella in the intestinal tract Shigella in the urinary tract

Escherichia coli in the intestinal tract

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 puncture-proof plastic container. Stick the uncapped needle into a Styrofoam block and deposit in a plastic container. Slide the needle into the cap and deposit it in a puncture-proof plastic container.

Immediately deposit uncapped needles into puncture-proof plastic container.

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? a. Use an alcohol-based hand rub to decontaminate hands. b. Remove all jewelry, including wedding bands before hand washing. c. Keep hands lower than elbows to allow water to flow toward fingertips. d. 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.

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.

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

The nurse performs hand hygiene using soap and water before and after providing client care. Which nursing action is performed correctly according to the procedure? The nurse uses soap and cold water to wash hands. The nurse uses about 2 tsp (10 ml) of liquid soap to wash hands. The nurse washes at least 1 in (2.5 cm) above the area of contamination if present. The nurse rinses thoroughly with water flowing away from the fingertips.

The nurse washes at least 1 in (2.5 cm) above the area of contamination if present.

A nurse is caring for a child who is hospitalized for diphtheria. Which guideline would be appropriate when caring for this client? Use a private room with the door closed. Wear PPE when entering the room for all interactions that may involve contact with the client. Place client in private room that has monitored negative air pressure. Use respiratory protection when entering the room of client with known or suspected diphtheria.

Wear PPE when entering the room for all interactions that may involve contact with the client.

A nurse is in charge of care for a client who has MRSA. Which of the following is an accurate guideline for using transmission-based precautions when caring for this client? Place the client in a private room that has monitored negative air pressure. Keep visitors 3 feet (1 m) from the client. Use respiratory protection when entering the room. Wear gloves whenever entering the client's room.

Wear gloves whenever entering the client's room.

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

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. Question the need for the examination because the client must remain in Airborne Precautions. d. Request that the examination be done at the bedside.

a. Place a surgical mask on the client and transport to the CT department at the specified time.

When is hand hygiene with an alcohol-based rub appropriate, as opposed to using handwashing? a. when hands are not visibly soiled b. before eating and after using the restroom c. when hands have been in contact with blood or body fluids d. when hands have been in contact with blood or body fluids, but there is no visible soiling

a. when hands are not visibly soiled

The nurse is caring for an older adult with influenza. Which precautions will the nurse begin? airborne droplet contact none

airborne

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

an 80-year old woman

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

an incontinent client in a nursing home who has diarrhea

The nurse is caring for a client with a draining abscess. Which precautions will the nurse begin? airborne droplet contact none

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? No action is needed. Don another pair of sterile gloves. Complete a sentinel event report. Notify the primary care provider.

don another pair of sterile gloves

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 Endogenous healthcare-associated Iatrogenic Antibiotic-resistant

exogenous healthcare-associated (from something else)

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

fungi

Which personal protective equipment (PPE) should the nurse don to enter the room of a client who is diagnosed with Clostridium difficile? goggles and gloves respirator mask and gown gown and gloves mask and shoe covers

gown and gloves

The nurse is caring for a client who developed pneumonia while hospitalized. How will the nurse document this condition? a. infectious disease b. contagious disease c. community acquired infection d. health care-associated infection (HCAI)

health care-associated infection (HCAI)

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: iatrogenic. endogenous. exogenous. antibiotic resistant.

iatrogenic (from procedure)

The nurse is assessing a client admitted from a long-term facility. Which assessment finding could indicate an increased risk for infection? Select all that apply. elevated blood pressure hyperactive bowel sounds ineffective cough presence of an indwelling urethral catheter 2 cm by 2 cm break in skin on sacrum

ineffective cough presence of an indwelling urethral catheter 2 cm by 2 cm break in skin on sacrum

The nurse is educating a client and caregivers about recurrent infections the client has experienced. What priority iintervention can the nurse include that is a first line of defense? the cell-mediated immune response. early intervention with antibiotics. staying home when sick. intact skin and mucous membranes. low levels of flora.

intact skin and mucous membranes.

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. Sterile gloves Nonsterile gloves Mask Gown Hand hygiene

nonesterile gloves, hand hygiene

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: recapping a needle. needles left in the client's linen. full needle boxes. faulty needles and syringes.

recapping a needle

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 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 Goggles Pillows Gowns

surgical mask (contains latex)

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 the client admitted with a rash who reports recent exposure to measles the client admitted with diarrhea who tested positive for Escherichia coli (E. coli) the client placed in contact isolation who was admitted with a draining abdominal wound

the client who is 8-hours postsurgical procedure (think clean to dirty when seeing stable patients to minimize infection)

The nurse performs hand hygiene with soap and water before caring for a client. What is the primary rationale for this action? to protect the integrity of the nurse's immune system to prevent the nurse from developing disease to eliminate disease-producing organisms from the nurse's skin to sterilize the nurse's hands to prevent infection

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

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

use of antibiotics in clients with viral infections