NCLEX-RN REVIEW EXAM - Infection Control

The nurse in the health care clinic is preparing to obtain a throat swab for culture in a client suspected of having a beta-hemolytic streptococcal infection. Which actions are appropriate in collecting this specimen? Select all that apply. 1. Instruct the client to tilt the head back. 2. Swab the tonsillar pillars and the posterior pharynx wall. 3. Tell the client that the test will help to identify microorganisms. 4. Ask the client to open the mouth; then swab the back of the tongue. 5. Place a tongue depressor on the client's tongue before swabbing the throat.

1, 2, 3, 5

The nursing instructor determines that the nursing student understands the purposes of standard and transmission-based precautions if which statements are made? Select all that apply. 1. "They prevent transmission of organisms from client to client." 2. "They prevent transmission of organisms from primary health care providers to clients." 3. "They prevent transmission of organisms from clients to primary health care providers." 4. "They prevent transmission of organisms from hospital visitors to in-hospital clients." 5. "They prevent transmission of organisms from hospital visitors to primary health care providers." 6. "They prevent transmission of organisms from primary health care providers and clients to people outside of the hospital."

1, 2, 3, 6

A client is seen in the health care clinic, and a diagnosis of acute sinusitis is made. The nurse provides home care instructions to the client regarding measures that will promote sinus drainage and comfort. Which statement by the client indicates a need for further instruction? 1. "I need to drink large amounts of fluids." 2. "I need to use a cold mist vaporizer to liquefy secretions." 3. "I need to try to sleep with the head of the bed elevated." 4. "I need to apply heat, such as a wet pack, over the sinuses."

1. "I need to drink large amounts of fluids"

A registered nurse (RN) is providing instructions to an assistive personnel (AP) assigned to give a bed bath to a client who is on contact precautions. The RN instructs the AP to use which protective item when giving the bed bath? 1. A gown and gloves 2. Gloves and goggles 3. A gown and goggles 4. Gloves and shoe protectors

1. A gown and gloves

The ambulatory care nurse is working with a 22-year-old client who has been diagnosed with pelvic inflammatory disease (PID). The nurse incorporates which item in a teaching plan for this client? 1. Avoid frequent douching. 2. Undergarments made of nylon are best. 3. Intrauterine devices are a good birth control method. 4. It is necessary to change sanitary pads only every 8 hours.

1. Avoid frequent douching.

A client with tuberculosis (TB) asks the nurse about precautions to take after discharge to prevent infection of others. The nurse's response to the client's question is based on which correct understanding of TB transmission? 1. The disease is transmitted by droplet nuclei. 2. Clothing and sheets need to be bleached after each use to kill the TB nuclei. 3. Deep pile carpet collects TB bacteria and needs to be removed from the home. 4.The client needs to specifically maintain enteric precautions to prevent transmission.

1. The disease is transmitted by droplet nuclei.

Precautions are used when caring for a client with Clostridium difficile. The nurse is planning on providing morning care for the client and needs to obtain which specific protective equipment for this infection? 1. Gloves and a gown 2. Gloves and a mask 3. Gloves, gown, and a mask 4. Gloves, gown, mask, and a hair covering

1. gloves and a gown

The nurse provides home care instructions to a client with hepatitis B. Which statement made by the client indicates the best understanding of how to prevent transmission of the disease? 1. "It is all right to kiss my partner." 2. "My partner needs to get the vaccine." 3. "I need to be vaccinated as soon as possible." 4. "I never will share towels with anyone else."

2. "My partner needs to get the vaccine."

The community health nurse is providing a teaching session about anthrax to members of the community and asks the participants about the methods of transmission. Which answers by the participants would indicate that teaching was effective? Select all that apply. 1. Bites from ticks or deer flies 2. Inhalation of bacterial spores 3. Through a cut or abrasion in the skin 4. Direct contact with an infected individual 5. Sexual contact with an infected individual6Ingestion of contaminated undercooked meat

2, 3, 6

The community health nurse is providing a teaching session about anthrax to members of the community and asks the participants about the methods of transmission. Which answers by the participants would indicate that teaching was effective? Select all that apply. 1. Bites from ticks or deerflies 2. Inhalation of bacterial spores 3. Through a cut or abrasion in the skin 4. Direct contact with an infected individual 5. Sexual contact with an infected individual 6. Ingestion of contaminated undercooked meat

2, 3, 6

A nursing instructor asks a nursing student about a client admitted with tuberculosis (TB). What comment by the student indicates that there is a need for further teaching? 1. "It is transmitted by the airborne route." 2. "It is a fast-growing infectious disease." 3. "People who have been in constant close contact with the infected person will need to be tested and treated if necessary." 4. "The risk for transmission is reduced after the infectious person has received proper medication therapy for 2 to 3 weeks and clinical improvement occurs."

2. "it is a fast-growing infectious disease."

The nurse prepares to give a bath and change the bed linens of a client with cutaneous Kaposi's sarcoma lesions. The lesions are open and draining a scant amount of serous fluid. Which would the nurse incorporate into the plan during the bathing of this client? 1. Wearing gloves 2. Wearing a gown and gloves 3. Wearing a gown, gloves, and a mask 4. Wearing a gown and gloves to change the bed linens, and gloves only for the bath

2. Wearing a gown and gloves

The nurse teaches the parent of a child diagnosed with bacterial conjunctivitis about measures to prevent transmission of the infection. Which statement by the parent indicates a need for further teaching? 1. "Hands need to be washed frequently." 2. "A clean washcloth can be used to wipe my child's eyes." 3. "It is all right to share towels and washcloths as long as they are bleached after use." 4. "The eye drops must be given as prescribed, and hands need to be washed before and after instillation."

3. "It is all right to share towels and washcloths as long as they are bleached after use."

A man is admitted to the hospital with the diagnosis of urethritis secondary to chlamydial infection. What precaution would the nurse implement for this client? 1. Enteric 2. Contact 3. Standard 4. Reverse isolation

3. Standard

The nurse places a hospitalized client with active tuberculosis in a private, well-ventilated isolation room. In addition, which action would the nurse take before entering the client's room? 1. Wash hands and don a surgical mask. 2. Wash hands and wear a gown and gloves. 3. Wash hands and place a high-efficiency particulate air (HEPA) respirator mask over the nose and mouth. 4. The nurse needs no precautions. The client is instructed to cover the mouth and nose when coughing.

3. Wash hands and place a high-efficiency particulate air (HEPA) respirator mask over the nose and mouth.

A client with pulmonary tuberculosis (TB) is on airborne isolation precautions. Which item(s) is essential for the nurse to wear? 1 Gloves only 2 Fluid shield mask 3 Gown, mask, and gloves 4 High-efficiency particulate air (HEPA) filter mask

4 High-efficiency particulate air (HEPA) filter mask

A client is diagnosed with conjunctivitis, and the nurse provides information to the client about the use of contact lenses. Which statement by the client would indicate the need for further information? 1. "I would not wear my contact lenses." 2. "New contact lenses need to be obtained." 3. "My old contact lenses need to be discarded." 4. "My contact lenses can be worn if they are cleaned properly."

4. "My contact lenses can be worn if they are cleaned properly."

The home health nurse is watching the caregiver change the sternotomy dressing on the postoperative client after teaching the caregiver about the procedure. Which action by the caregiver identifies correct principles of infection control? 1. The caregiver selects a previously opened gauze to cover the sternal wound. 2. The caregiver dons gloves before removal of the old dressing and then applies the new dressing. 3. The caregiver covers own mouth with hand when sneezing and then continues with the dressing change. 4. The caregiver washes hands before removal of the soiled dressing and again before applying the clean dressing.

4. The caregiver washes hands before removal of the soiled dressing and again before applying the clean dressing.

Which interventions are essential to perform when a central venous site is suspected of being infected? Select all that apply. 1. Prepare to administer antibiotics. 2. Notify the primary health care provider (PHCP). 3. Inform the client that blood cultures will need to be obtained. 4. Document the occurrence, the actions taken, and the client's response. 5. Continue to use the central venous catheter until another one is placed.

1, 2, 3, 4

The nurse is caring for a client with newly diagnosed human immunodeficiency virus (HIV). Besides preventing the transmission of the disease, what are the goals of medication therapy? Select all that apply. 1. Decreasing the viral load 2. Delaying disease progression 3. Administering the HIV vaccine 4. Eliminating the use of illegal drugs 5. Maintaining or increasing CD4+ T cell counts 6. Preventing HIV-related symptoms and opportunistic diseases

1, 2, 5, 6

The nurse is caring for a client with meningitis and implements which transmission-based precautions for this client? 1. Private room 2. Personal respiratory protection device 3. Private room with negative airflow pressure 4. Mask worn by staff when the client needs to leave the room

1. Private room

The nurse is caring for a client with meningitis and implements which transmission-based precaution for this client? 1. Private room or cohort client 2. Personal respiratory protection device 3. Private room with negative airflow pressure 4. Mask worn by staff when the client needs to leave the room

1. Private room or cohort client

The nurse is teaching a client with acquired immunodeficiency syndrome (AIDS) how to avoid food-borne illnesses. The nurse would instruct the client that which food can cause a food-borne illness? 1. Raw oysters 2. Bottled water 3. Pasteurized milk 4. Products with sorbitol

1. Raw oysters

The nurse is assisting the assistive personnel (AP) in cleaning a room that was infected with Clostridium difficile. To ensure that all surfaces are evenly disinfected, which cleaning solution would the nurse plan to use? 1. Soap and water 2. Bleach solution 3. Alcohol-based solution 4. Ammonia-based disinfectant

2. Bleach solution

The nurse is conducting a community surveillance study for the purpose of communicable disease control. The nurse knows that performing an active surveillance method of assessment is best for what reason? 1. Always results in clear indicators for interventions 2. Results in detection of a more accurate number of cases 3. Reflects an upward swing if a certain disease is current news 4. Relies solely on the initiative of primary health care providers (PHCPs) to report cases

2. Results in detection of a more accurate number of cases

A 7-year-old child is diagnosed with viral conjunctivitis. Antibiotic eye drops are prescribed for the child. When the parent asks the nurse when the child can return to school, what would the appropriate response be? 1. "The child can return to school immediately." 2. "The child cannot return to school until seen by the pediatrician in 1 week." 3. "The child usually needs to be kept home until the antibiotic eye drops have been administered for 24 hours." 4. "The child needs to be kept home until the antibiotic eye drops have been administered for 72 hours."

3. "The child usually needs to be kept home until the antibiotic eye drops have been administered for 24 hours."

A client with active tuberculosis demonstrates less-than-expected interest in learning about the prescribed medication therapy. The nurse assesses that this client may ultimately need which intervention as a last resort? 1. Directly observed therapy 2. More medication instructions 3. Involvement of the family in teaching 4. Reinforcement by the primary health care provider

1. Directly observed therapy

The nurse participating in a health fair is setting up a booth on prevention of human immunodeficiency virus (HIV) transmission. A poster is planned that will list sexual behaviors in 1 of 2 columns, "safe" and "not safe." Which behavior would the nurse place in the "not safe" column? 1. Abstinence 2. Mutual monogamy 3. Use of latex condoms 4. Use of natural skin condoms

4. Use of natural skin condoms

The nurse is giving a bed bath to a client and discovers that an additional washcloth and towel are needed. Which is the most appropriate action to take to obtain the needed items? 1. Ask the unit secretary to get the needed items. 2. Ask a family member to obtain the needed items. 3. Borrow the client's roommate's washcloth and towel. 4. Wash hands, leave the client's room, and obtain the needed items.

4. Wash hands, leave the client's room, and obtain the needed items.

A client with lung cancer has been receiving a series of medications as part of intravenous antineoplastic therapy. The nurse would implement neutropenic precautions after noting which laboratory result for this client? 1. Ammonia level of 20 mcg/dL (33.3 mcmol/L) 2. Platelet count of 100,000 mm3 (100 × 109/L) 3. International normalized ratio (INR) of 1.2 seconds 4. White blood cell (WBC) count of 2000 mm3 (2 × 109/L)

4. White blood cell (WBC) count of 2000 mm3 (2 × 109/L)

The nurse employed on a medical unit in a hospital receives a telephone call from the admission office and is told that a client with a diagnosis of mycoplasmal pneumonia will be admitted to the unit. The nurse prepares for the admission and obtains the necessary supplies to place the client on which type of transmission-based precautions? 1. Droplet precautions 2. Enteric precautions 3. Contact precautions 4. Protective isolation

1. Droplet precautions

An assistive personnel (AP) is caring for a client who has an indwelling urinary catheter. Which action by the AP would indicate the need for further instruction in the care of the client? 1. Used soap and water to cleanse the perineal area 2. Allowed the drainage tubing to rest under the leg 3. Kept the drainage bag below the level of the bladder 4. Used the drainage tubing port to obtain urine samples

2. Allowed the drainage tubing to rest under leg

The nurse is caring for a client with acute viral hepatitis A who resides in a group home. Which outcome indicates that the most important goal has been achieved? 1. Resumes normal bowel elimination patterns 2. Avoids transmitting the virus to others in the group home 3. Progressively increases activity with planned rest periods 4. Gains at least ½ to 1 lb (0.2 to 0.5 kg) per week until at ideal weight

2. Avoids transmitting the virus to others in the group home

The client seen in the health care clinic has tested positive for gonorrhea. The nurse anticipates that which medication will be prescribed based on this finding? 1. Acyclovir 2. Ceftriaxone 3. Azithromycin 4. Penicillin G benzathine

2. Ceftriaxone

The ambulatory care nurse is seeing a client for a follow-up visit after treatment for toxic shock syndrome (TSS). To assess the client's recovery from TSS, the nurse would ask whether which signs and symptoms have resolved? 1. Low-grade fever, nausea, and vaginal bleeding 2. High fever, abdominal pain, vomiting, and diarrhea 3. Low-grade fever, vomiting, and greenish vaginal discharge 4. High fever, purulent vaginal discharge, and abdominal pain

2. High fever, abdominal pain, vomiting, and diarrhea

The nurse is preparing to give a bed bath to an immobilized client with tuberculosis. The nurse would wear which items when performing this care? 1. Surgical mask and gloves 2. Particulate respirator, gown, and gloves 3. Particulate respirator and protective eyewear 4. Surgical mask, gown, and protective eyewear

2. Particulate respirator, gown, and gloves

A client with tuberculosis (TB), whose status is being monitored in an ambulatory care clinic, asks the nurse when it is permissible to return to work. The nurse replies that the client may resume employment when which occurs? 1. Five sputum cultures are negative. 2. Three sputum cultures are negative. 3. A sputum culture and a chest x-ray are negative. 4. A sputum culture and a tuberculin skin test are negative.

2. Three sputum cultures are negative

A client with tuberculosis whose status is being monitored in an ambulatory care clinic asks the nurse when it is permissible to return to work. What factor would the nurse include when responding to the client? 1. Five blood cultures are negative. 2. Three sputum cultures are negative. 3. A blood culture and a chest x-ray are negative. 4. A sputum culture and a tuberculin skin test are negative.

2. Three sputum cultures are negative

The home care nurse visits a child recently discharged from the hospital with a diagnosis of hepatitis A virus (HAV) infection. The parent asks the nurse when the child can return to school. The nurse would make which response to the mother? 1. "In about 2 months." 2. "When the jaundice disappears." 3. "One week after the onset of jaundice." 4. "At the beginning of the next academic year."

3. "One week after the onset of jaundice."

The nurse is planning to teach a group of adolescents about the use of condoms as part of a risk reduction program for sexually transmitted infections (STIs). The nurse would plan to include which recommendation in the teaching plan? 1. Condoms should not be lubricated. 2. Use condoms whenever the partner seems "risky." 3. Always apply the condom before inserting the penis into the vagina. 4. Natural membrane condoms can be used because they are just as effective as latex.

3. Always apply the condom before inserting the penis into the vagina

The nurse is observing a second nurse perform hemodialysis on a client. The second nurse is drinking coffee and eating a doughnut next to the hemodialysis machine, while talking with the client about the events of his week. What is the nurse's most appropriate action regarding this observation? 1. Offer the client a cup of coffee. 2. Get a cup of coffee and join the conversation. 3. Ask the nurse to refrain from eating and drinking in that area. 4. Appreciate what a wonderful therapeutic relationship this nurse and client have.

3. Ask the nurse to refrain from eating and drinking in that area

The nurse is instructing a postpartum client with endometritis about preventing the spread of infection to the newborn infant. Which statement would the nurse make to the client? 1. Visitors are not allowed to hold the baby. 2. There is no danger of the newborn contracting the disease. 3. Hands needs to be washed thoroughly before holding the infant. 4. The newborn infant will not be allowed in the parent's room at all.

3. Hands needs to be washed thoroughly before holding the infant.

The nurse is providing home care instructions to the parent of a child who has bacterial conjunctivitis. The nurse would provide the parent with which information? 1. The child may attend school if antibiotics have been started. 2. Any unused eye medication would be saved in case a sibling gets the eye infection. 3. The child's towels and washcloths would not be used by other members of the household. 4. Any crusted material needs to be wiped from the eye with a cotton ball soaked in warm water, starting at the outer aspect of the eye and moving toward the inner aspect.

3. The child's towels and washcloths would not be used by other members of the household

The nurse is preparing to insert an intravenous (IV) angiocatheter into a client's inner forearm. Before cannulating the vein, what motion will the nurse implement to cleanse the site? 1. Scrubbing from the wrist toward the elbow 2. Scrubbing from the elbow toward the wrist 3. Using a circular motion from the center outward 4. Using a circular motion inward toward the center

3. Using a circular motion from the center outward

The nurse is preparing to care for a client with acquired immunodeficiency syndrome (AIDS). In planning infection control for this client, the nurse would implement which form of isolation to prevent the spread of the AIDS virus to others? 1. Strict isolation 2. Enteric precautions 3. Contact precautions 4. Blood and body fluid precautions

4. Blood and body fluid precautions

A hospitalized client who has been placed on contact precautions has been prescribed to have a chest radiograph in the radiology department. The nurse would take which action on receipt of this prescription? 1. Transport the client through empty corridors only. 2. Place a mask on the client in preparation for transport. 3. Place a sterile gown on the client in preparation for transport. 4. Question the primary health care provider about whether a portable chest radiograph may be obtained.

4. Questions the primary health care provider about whether a portable chest radiograph may be obtained.

A client has been admitted to the surgical unit after hernia repair surgery. The medical record reports that the client is human immunodeficiency virus (HIV) positive. The nurse would implement which precautions for this client? 1. Contact precautions 2. Droplet precautions 3. Airborne precautions 4. Standard precautions

4. Standard precautions

A client who is admitted for an unrelated medical problem is diagnosed with urethritis caused by chlamydial infection. The assistive personnel (AP) assigned to the client asks the nurse what measures are necessary to prevent contraction of the infection during care. What would the nurse tell the AP? 1. Enteric precautions would be instituted for the client. 2. Gloves and mask need to be used by caregivers in the client's room. 3. Contact isolation need to be initiated because the disease is highly contagious. 4. Standard precautions are sufficient because the disease is transmitted sexually.

4. Standard precautions are sufficient because the disease is transmitted sexually.

A hospitalized client has a diagnosis of pelvic inflammatory disease (PID). The nurse would encourage the client to assume which therapeutic position when in bed? 1. Left side-lying 2. Right side-lying 3. Prone with the head flat 4. Supine in semi-Fowler's

4. Supine in semi-Fowler's

Which action by the parent of an infant with respiratory syncytial virus infection who is receiving ribavirin would indicate a need for further instruction regarding the management of the disease process? 1. Wearing protective garb when visiting the infant 2. Washing the hands before leaving the infant's room 3. Telling a family member who has asthma that they should not visit the infant 4. Telling a family member, who is pregnant, that it is acceptable to visit the infant

4. Telling a family member, who is pregnant, that it is acceptable to visit the infant.