Asepsis and Infection Control PT. 2

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

Exudate Swelling Redness Pain

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

Gloves

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

A nurse is preparing a sterile field for the health care provider to perform a biopsy on a client. Which actions follow recommended guidelines for maintaining the sterile field for this procedure?

The nurse considers the outer 1-inch (2.5-cm) edge of the sterile field to be contaminated. The nurse discards a sterile field when a portion of it becomes contaminated. The nurse calls for help when realizing a supply is missing.

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

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!"

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

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."

Which client would the nurse consider the most infectious?

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?

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

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?

Cleanse and disinfect the sphygmomanometer.

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

Client with a urinary catheter

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

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. To remove a gown, nurses should unfasten ties, if at the neck and back, and allow the gown to fall away from shoulders.

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

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

What is the most common client site for development of healthcare-associated infections (HAI)?

Urinary tract

The nurse is reviewing the plan of care for assigned clients. Which client has the highest risk for developing an infection?

an older adult client with a history of heart failure

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

Which clients are at a heightened risk for infection?

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

A client comes to the emergency department reporting becoming very ill after consuming shrimp and lobster. How will the nurse document this condition?

noncommunicable disease

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