Infection PrepU Practice

A client has an inguinal hernia repair and later develops a MRSA infection. What is the most important factor to prevent this infection?

Surgical asepsis

The nurse is admitting a client who has been receiving prescribed antibiotics for pneumonia. The client reports experiencing loose, watery stools for the past 4 days. What would be the initial action for the nurse to take?

implementing contact isolation

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 caring for a postpartum mother who delivered her second child yesterday. The mother states that her older child has just been diagnosed with chickenpox. She is concerned that her newborn will develop the disease. What is the best response by the nurse?

"Have you had chickenpox?"

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."

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.

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

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."

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 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."

The nurse is educating a client and caregivers about recurrent infections the client has experienced. What priority intervention can the nurse include that is a first line of defense?

intact skin and mucous membranes

The nurse is caring for an older adult client suspected of having a urinary tract infection. The nurse should assess for what finding specifically associated with the development of this condition in the older adult?

Acute confusion

The nurse is caring for a client with tuberculosis. Which precaution will the nurse select for this client?

Airborne

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 client has tested positive for colonization with a multidrug-resistant organism (MDRO) and has been placed on contact precautions. Which actions should be included in this client's care? Select all that apply.

Arrange for the client to be housed in a single room. Use appropriate PPE.

A nurse is preparing to give a client an initial dose of a penicillin preparation. What should the first action be for the nurse?

Ask the client if there is a history allergy to a penicillin.

The nurse is admitting a client who underwent a hip replacement several weeks ago. The client now has a methicillin-resistant Staphylococcus aureus (MRSA) infection in the nonhealing hip wound. What actions would the nurse implement? Select all that apply.

Assess and document the client's wound. Administer intravenous vancomycin. Assign the client to a private room.

When providing care to a incontinent client with a history of methicillin-resistant Staphylococcus aureus (MRSA), what is the priority goal for the nurse's observable intervention?

Avoiding the introduction of microorganisms to the nurse's uniform

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

Which manifestations would indicate urinary tract infection? Select all that apply.

Chills and fever Urinary frequency Flank pain

A nurse has implemented numerous practices with the goal of reducing the number and transfer of pathogens. Which actions are consistent with this goal? Select all that apply.

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.

Which client should the nurse determine is at greatest risk for vancomycin-resistant enterococci (VRE) infection?

Client receiving chemotherapy (NOT the client on a short course of vancomycin)

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 assessing older adult clients at a community health center. Which client is identified as being at the highest risk for developing an infection?

Client with immobility, incontinence, and dysphagia following a stroke

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.

Clostridium difficile Norovirus

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

Contact

A nurse is providing care to a client diagnosed with impetigo. The nurse would institute which type of infection control?

Contact precautions

The nurse is inserting an indwelling catheter. What steps will the nurse distinguish as priority in preventing an infection?

Create an area for sterile field and opening packages

A nurse assessing an older adult client finds that the client has had four urinary tract infections in the past year. Which physiologic change of aging would the nurse suspect is the cause?

Decreased bladder contractility

When preparing a sterile field, the nurse notes that the bottle of sterile saline was opened 48 hours ago and is half full. What action does the nurse take to ensure that the saline used is sterile?

Discard the bottle and get a new one because the saline has expired.

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.

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.

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

The client is concerned about "catching the flu." What primary information can the nurse teach the client to best prevent the spread of infection?

Hand hygiene

The nurse is caring for a client diagnosed with influenza and acute otitis media. Which is the most effective action the nurse can teach the client's family to prevent the spread of infection?

Hand hygiene

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 implementing the principles of surgical asepsis while inserting a client's indwelling urinary catheter. What action should the nurse perform?

Hold sterile objects above waist level to prevent accidental contamination

A nurse is taking stock of 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?

Indwelling catheter

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.

A nurse is caring for four clients. Which client has the highest risk of infection?

older male with an enlarged prostate

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.

Nonsterile gloves Hand hygiene

A nurse is planning a group teaching session on the topic of urinary tract infection (UTI) prevention. Which point should the nurse include?

Notify the physician if urinary urgency, burning, frequency, or difficulty occurs.

Nurses play a key role in reducing both the spread of disease and adverse outcomes for clients. Which statement accurately describes this process? Select all that apply.

Nurses practice asepsis, which encompasses all activities to prevent infection. Nurses practice medical asepsis, which involves procedures and practices that reduce the number and of pathogens and the transfer of these pathogens. Nurses perform surgical asepsis, which is intended to keep objects and areas free from microorganisms. Nurses use Standard and Transmission-Based Precautions as an important part of preventing infection.

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

A 12-year-old is being hospitalized for pneumonia. The nurse receives the client's culture and sensitivity report on her tracheal aspirate. The client is infected with a strain of Streptococcus pneumoniae, which is particularly prone to cause infections, also referred to as what?

Pathogenic

The nurse uses a small amount of sterile solution from a large, multiuse bottle to moisten gauze in a sterile field. What technique does the nurse use?

Pour the liquid into a sterile container within the sterile field.

Nurses working in bed management are assigning clients from the E.R. to semi-private rooms. Clients with which two diagnoses are appropriate to room together, based on safety and infection control standards?

Reactive airway disease and exacerbation of chronic obstructive pulmonary disorder (COPD)

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

Redness Swelling Pain Exudate

The nurse is caring for a client who has been placed in strict isolation. Which nursing action is appropriate?

Remove fresh fruit from the room

The nurse is exiting the room of a client who has a Clostridium difficile infection. What actions would the nurse perform? Select all that apply.

Remove gloves by securing the first glove inside the second glove. Turn gown inside out and roll the gown into a bundle before discarding. Wash hands with soap and water.

The nurse begins a task and then realizes that personal protective equipment (PPE) is needed. What is the correct action by the nurse?

Stop and obtain appropriate PPE.

The student nurse asks the nursing instructor to explain why stress can increase the risk of infection. The instructor explains:

Stress causes the body to release cortisol, which can increase the risk of infection.

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

Bacterial resistance to antibiotics is an example of:

Survival adaptation

To prevent further urinary tract infections in a preschooler, what measures would you teach her mother?

Teach her to wipe her perineum front to back after voiding.

A client is admitted to the acute care facility for vomiting and diarrhea. An intravenous (IV) catheter is inserted for the delivery of IV fluids. A family member is with the client and observes the nurse enter the room and begin touching the IV site without washing his hands or wearing gloves. Why should the client and family member be concerned with the nurse's actions?

The client will develop a healthcare-associated infection.

A client has a diagnosis of HIV and has been admitted to the hospital with an opportunistic infection that originated with the client's normal flora. Why did this client most likely become ill from his resident microorganisms?

The client's immune system became further weakened

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. *Only the outer 1 in of the sterile package is safe to touch*

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 moves soiled equipment away from the body when cleaning it. The nurse cleans least soiled areas first and then moves to more soiled ones.

The nurse is removing soiled gloves after assisting with a sterile procedure. Which actions follow recommended guidelines for this procedure? Select all that apply.

Use the dominant hand to grasp the opposite glove near cuff end on the outside exposed area. Remove the glove by pulling it off, inverting it as it is pulled, and keeping the contaminated area on the inside. Slide the fingers of the ungloved hand between the remaining glove and the wrist. Discard the gloves in appropriate container, removing additional PPE, if used, and performing hand hygiene.

A nurse is providing care to a client who has Salmonella food poisoning. The nurse understands that this pathogen was transmitted by which mechanism?

Vehicle

The nurse who teaches a client about preventing recurrent urinary tract infections would include which statement?

Void immediately after sexual intercourse.

The nurse is caring for a postoperative client in contact isolation. Which actions should the nurse employ to reduce the spread of disease? Select all that apply.

Wash hands after removing gloves before leaving the client's room. Place used syringes and uncapped needles in a puncture-resistant container after use.

Which nursing actions will be performed to assist in the prevention of health care-associated infections (HCAIs)? Select all that apply.

Wash hands between caring for clients. Recommend vaccinations to clients. Educate clients regarding why antibiotics are not used for viral illnesses.

The charge nurse is completing assignments for staffing on a medical-surgical floor. Which client(s) will the nurse place in contact precautions? Select all that apply.

a client diagnosed with respiratory syncytial virus a client with a new onset of diarrhea a client with a positive wound culture for Methicillin resistant Staphylococcus aureus (MRSA)

For which clients would the nurse be required to use droplet precautions? Select all that apply

a client with rubella a client with mumps a client with diphtheria prioritization

Which of the following most accurately defines an infection?

a disease resulting from pathogens in or on the body

For which client would the use of standard precautions alone be appropriate?

an incontinent client in a nursing home who has diarrhea

Which clients are at a heightened risk for infection? Select all that apply.

client with gastric tube feeding client with an indwelling catheter client with an IV catheter

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

The nurse is collaborating with the healthcare provider of a client who presented with signs and symptoms of an infection. What information should the nurse prioritize so that the healthcare provider can prescribe the proper antibiotic?

culture and sensitivity test results

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 an older adult with streptococcal pneumonia. Which precautions will the nurse begin?

droplet

Personal protective equipment for use with standard precautions includes which items? Select all that apply.

face mask disposable gloves eye protection fluid-repellent gown

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 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

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 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 triaged a number of clients in the emergency department. Which clients would the nurse identify as Risk for Infection? Select all that apply.

the client who has AIDS and is taking antiretroviral medications the client who reports abdominal pain for 1 day and exhibits an elevated white blood cell count the client who has breast cancer, is receiving chemotherapy, and has a low white blood cell (WBC) count the older adult client who is cachetic in appearance

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

Which factor has contributed to resistant microbial strains?

use of antibiotics in clients with viral infections

The nurse has collected data related to the recent occurrence of several health care-associated infections (HCAIs) in the acute care facility. What nursing interventions should be implemented to decrease HHCAIs? Select all that apply.

wash hands before and after client care encourage clients to receive vaccinations cluster clients with similar conditions select appropriate personal protective equipment (PPE) for all isolation clients

The nurse is monitoring a student who is performing surgical hand asepsis. Which student actions indicate the need for further education from the nurse? Select all that apply.

wearing a gold wedding band using at least five strokes for cleansing in each area dropping hands to side when the wash is complete

A nurse is caring for a client with rubella. Which nursing action is an important precaution to be taken when caring for this client?

wearing a mask when working within 3 feet (1 m) of the client

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