ATI Engage Fundamentals: Infection Control and Isolation

Which of these situations require gloves? - Reviewing discharge instruction with a client who had a heart attack - Emptying a client's bedpan - Administering an oral medication to a client who has an MDRO in their urine - Changing a diaper on an infant who has a heart defect - Assisting a client who has a seizure disorder to a bedside chair

- Emptying a client's bedpan - Administering an oral medication to a client who has an MDRO in their urine - Changing a diaper on an infant who has a heart defect

Which of these situations do not require gloves? - Reviewing discharge instruction with a client who had a heart attack - Emptying a client's bedpan - Administering an oral medication to a client who has an MDRO in their urine - Changing a diaper on an infant who has a heart defect - Assisting a client who has a seizure disorder to a bedside chair

- Reviewing discharge instruction with a client who had a heart attack - Assisting a client who has a seizure disorder to a bedside chair

Place the findings in the order in which they occur during the inflammatory response. - Bacteria invade an open wound - Pus develops - Phagocytosis occurs - Histamine, Kinins, and Prostaglandins arrive at the site - Plasma from the blood enters the site

1. Bacteria invade an open wound 2. Histamine, Kinins, and Prostaglandins arrive at the site 3. Plasma from the blood enters the site 4. Phagocytosis occurs 5. Pus develops

Place the steps for removing PPE and performing hand hygiene in the correct order. - Remove mask - Perform hand hygiene - Remove gloves - Remove goggles or face shield

1. Remove gloves 2. Remove goggles or face shield 3. Remove mask 4. Perform hand hygiene

Place the steps in the correct order for removing nonsterile gloves: - Peel glove away from the body turning it inside-out and hold it in the other hand - Use bare fingers to slide under cuff of the glove - Use fingers of opposite hand to grasp the outside of the glove at cuff - Perform hand hygiene - Dispose of gloves in trash receptacle inside client's room - Peel the glove inside out, leaving the first glove inside the second glove

1. Use fingers of opposite hand to grasp the outside of the glove at cuff 2. Peel glove away from the body turning it inside-out and hold it in the other hand 3. Use bare fingers to slide under cuff of the glove 4. Peel the glove inside out, leaving the first glove inside the second glove 5. Dispose of gloves in trash receptacle inside client's room 6. Perform hand hygiene

What PPE should the nurse put on prior to performing care for a client who requires contact precautions?

A nurse caring for a client who requires contact precautions should don PPE (gown and gloves at minimum) prior to entering the room if the nurse expects to come in contact with the client or any contaminated items in the room.

A nurse is assisting with teaching a newly licensed nurse about laboratory tests that can indicate generalized information. The nurse should include which of the following laboratory tests? A. C-reactive protein B. Troponin C. Creatine kinase D. Lactic Acid

A. C-reactive protein

Which of the following factors are examples of reservoirs in the chain of infection? A. Health care workers B. Clients C. Bacteria D. Furniture E. Equipment F. Viruses

A. Health care workers B. Clients D. Furniture E. Equipment

A nurse is setting up a sterile field to perform a dressing change on a client. Which of the following actions should the nurse take? A. Open the first flap on the sterile package away from their body B. Place objects on the sterile field at least 0.5 inches from the edge C. Unwrap both sides of the sterile package at the same time D. Set up the sterile field next to a wall in the client's room

A. Open the first flap on the sterile package away from their body

A nurse is performing a throat culture on a client. Which os the following actions should the nurse take? A. Swab the back of the client's pharyngeal wall B. Place the swab in a clean container after obtaining the culture C. Insert the swab in the culture medium within 1 hour of obtaining the sample D. Don sterile gloves to obtain the culture from the client

A. Swab the back of the client's pharyngeal wall

A nurse is assisting with teaching a newly licensed nurse about airborne infection isolation rooms. Which of the following information should the nurse indicate? A. The door to the AIIR should remain closed B. Clients who are on contact precautions require AIIR C. An AIIR has at least 4 air exchanges each hour D. A mask is not needed to care for clients who are in an AIIR

A. The door to the AIIR should remain closed

A nurse is assisting with implementing an infection control bundle for clients at risk for catheter-associated urinary tract infections. Which of the following interventions should the nurse include in the bundle? A. Try to use alternatives before inserting indwelling urinary catheters B. Use clean technique for insertion of indwelling urinary catheters C. Check clients every 2 days to evaluate the need for indwelling urinary catheters D. Disconnect the system to obtain urine samples from indwelling urinary catheters

A. Try to use alternatives before inserting indwelling urinary catheters

A client suspected of having tuberculosis should have what type of isolation?

Airborne

A nurse is assisting in providing an in-service about infectious agents to a group of nurses. The nurse should include in the teaching that tuberculosis is transmitted by what mode of transmission?

Airborne

A nurse is assisting with teaching a newly licensed nurse about infection control. The nurse should include in the teaching that what types of precautions requires the use of an N95 mask?

Airborne

A nurse enters a room where a client who has a respiratory infection was present for several hours. The nurse inhales small particles that remain in the air and develops an infection. What type of transmission is this?

Airborne transmission

A nurse is washing the hands with antimicrobial soap and water. How long should the nurse rub the hands together?

As long as is needed to sing "Happy Birthday" two times (about 15 to 30 seconds)

A nurse is caring for a client with a large draining foot wound. Which of the following PPE equipment should the nurse don prior to entering the client's room? A. Sterile gloves and mask B. Non-sterile gloves and gown C. Mask and face shield D. Gown and face shield

B. Non-sterile gloves and gown

A nurse is assisting with teaching a newly licensed nurse about needlestick injuries. Which of the following instructions should the nurse include? A. Empty sharps containers when they become full B. Report needlestick injuries to the nursing supervisor C. Engage the safety device on a needle after documenting the medication administration D. Recap needles after medication administration

B. Report needlestick injuries to the nursing supervisor

A nurse is supervising a newly licensed nurse perform hand hygiene. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure? A. Washed their hands for 10 seconds B. Turns off the faucet with a towel C. Uses hot water to wash their hands D. Holds their hands above their elbows while rinsing off the soap

B. Turns off the faucet with a towel

A nurse is caring for a client who is on contact precautions. Which of the following actions should the nurse take? A. Wear an N95 respirator when caring for the client B. Place the client in a private room C. Place a mask on the client when they leave their room D. Place the client in a negative airflow room

B.Place the client in a private room

A nurse is assisting with teaching a newly licensed nurse about hand hygiene for surgical asepsis. Which of the following instructions should the nurse include? A. Use a brush to scrub the surface of the hands B. Rinse antiseptic solution from the hands before it dries C. Apply chlorhexidine and ethanol to the hands D. Leave jewelry on the hands when cleansing them

C. Apply chlorhexidine and ethanol to the hands

A nurse is assisting with teaching a group of nurses on processes that can trigger an inflammatory response in the body. The nurse should include that what is an infectious trigger? A. Burn B. Frostbite C. Bacteria D. Radiation

C. Bacteria

A nurse is assisting with teaching about personal protective equipment with a newly licensed nurse. Which of the following instructions should the nurse include? A. Gowns can be reused on the same client B. Masks should be removed after leaving a clients room C. Gloves should be removed from the inside out D. Eyeglasses can be used in place of goggles

C. Gloves should be removed from the inside out

A client with a draining wound infected with MRSA should have what type of isolation?

Contact

A client with frequent, large diarrheal stools and is incontinent should have what type of isolation?

Contact

A nurse is admitting a client who has vancomycin-resistant enterococcus of the urine. The nurse should place the client on which precautions?

Contact

A nurse is planning to admit a client who has a respiratory syncytial virus. What transmission-based precautions should the nurse plan to implement?

Contact

A nurse is caring for a client who states, "I am feeling so much better. My fever is gone, and I have a good appetite." The nurse should identify the client is likely in what stage of infection?

Convalescence

A nurse is wearing gloves while caring for a client. In which of the following situations should the nurse obtain a new pair of gloves? A. After donning a gown and before collecting vital signs on the client B. After removing food items off the client's tray and before removing soiled linens from the client's bed C. After helping the client stand up and before helping them brush their teeth D. After changing a dressing on the client and before documenting findings on a computer

D. After changing a dressing on the client and before documenting findings on a computer

A nurse is assisting with teaching a newly licensed nurse about surgical asepsis. Which of the following statements should the nurse make? A. You can wear artificial fingernails if they are kept short B. Leave rings on your fingers when performing surgical hand asepsis C. Keep your fingernails less than half an inch in length D. Remove nail polish on your fingernails if it is chipped

D. Remove nail polish on your fingernails if it is chipped

A home health nurse is caring for a client who had a left knee replacement surgery 5 days ago. Which of the following findings should the nurse report to the provider? A. The client can walk with a walker 40 feet B. The client elevates the left leg when sitting and sleeping C. The client's temperature is 98.6 degrees D. The client's left knee is warm to touch and erythematous

D. The client's left knee is warm to touch and erythematous

A client has a draining, infected wound. The drainage touches a cut on a nurse's skin, leading to an infection. What type of transmission is this?

Direct contact transmission

A client diagnosed with adenovirus should have what type of isolation?

Droplet

A client who is sneezing, and is suspected of having seasonal influenza should have what type of isolation?

Droplet

A nurse is assisting with teaching a newly licensed nurse about infectious agents. The nurse should include int he teaching that pertussis is transmitted by what mode of transmission?

Droplet

A nurse is caring for a client who has influenza. The client asked how they acquired the infectious agent. The nurse should inform the client that influenza is transmitted by what mode?

Droplet

A client who has a respiratory infection sneezes without covering the mouth and nose. A person a few feet away becomes infected when large mucus particles land in their mouth. What type of transmission is this?

Droplet transmission

What PPE should a nurse use when transporting a client on droplet precautions to the x-ray department?

Face mask

A nurse is assisting with teaching a newly licensed nurse about removing personal protective equipment. What should the nurse instruct to remove first?

Gloves

What PPE should a nurse use when administering medications to a client on contact precautions?

Gloves and gown

What PPE should a nurse use when performing a wound irrigation where splashing is expected in the facial area?

Gloves, gown, and face shield

A client who coughed on their hand touches a door handler. Another person touches the same door handle and becomes infected with the same pathogen as the client. What type of transmission is this?

Indirect contact transmission

A nurse is caring for a client whose family member asks why nurses cannot wear gel nail polish or have long fingernails. How should the nurse respond to the family member?

Keeping the fingernails short helps to protect clients by preventing the growth of bacteria under the fingernails. Nail polish, if worn, must not be chipped, because this also promotes bacteria growth. Gel nail polish is especially difficult to clean around, even with proper handwashing practices. Even with good hand hygiene, bacteria are not reduced effectively when health care workers wear gel nail polish.

What term describes the clean technique used in healthcare?

Medical asepsis; It reduces the number of micro-organisms on surfaces.

A nurse needs to assign rooms for two new clients needing contact isolation, but only one semi-private room is currently available. One client to being admitted due to diarrhea from Clostridium difficile. The other client has a large draining abdominal wound, but the pathogen has not yet been identified from the culture. Can these two clients be placed in the same room? Why or why not?

No. These two clients both require contact isolation, but for different reasons. It is preferable that clients requiring isolation be assigned a private room. However, if that is not possible, the clients could be placed in the same room, but only if they have the same pathogen. In addition, cohorting clients is a last resort, and the infection control nurse in the facility should be consulted also to assist in the final decision.

How many times can a gown be worn?

Once.

A nurse in a clinic is caring for a client who reports generalized aches and fever for the past 12 hours. The nurse suspects the client has acquired an infection. What stage of infection is the client likely experiencing?

Prodromal

A client who had a hematopoietic stem cell transplant this week should have what type of isolation?

Protective

A nurse is caring for a client who acquired an infection after touching a faucet that an infected person had touched. Which of the links in the chain of infection does the faucet represent?

Reservoir

A nurse is performing hang hygiene after caring for a client who has Clostridium difficile. What hand hygiene method should the nurse use?

Soap and water

A client who needs to have vital signs taken should have what type of isolation?

Standard

A client with a broken bone should have what type of isolation?

Standard

A nurse is caring for a client who has acquired an infection from a visitor. The client is an example of what link in the chain of infection?

Susceptible host

A client who has extremely dry, flaky skin asks why the nursing staff continually applies lotion. How should the nurse respond?

The skin is the largest organ of the body and is the body's primary physical defense. Keeping the skin moisturized helps to keep skin intact, which reduces the risk of infection. The skin performs three major functions, reducing water loss, protecting against abrasion and microbes, and providing a permeable barrier against the environment.