NUR 209 Ch. 23 Asepsis (Fundamentals of Nursing)

A home health nurse is completing a health history for a patient. What is one question that is important to ask to identify a latex allergy for this patient? (page 548)

"Have you had any unusual symptoms after blowing up balloons?

A nurse is preparing an operation theater for a surgical procedure. Which of the following points regarding the principles of surgical asepsis should the nurse keep in mind when preparing sterilized surgical instruments? (page 565)

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

Which practice is a correct application of infection control practices? (page 542)

A nurse performs handwashing each time she removes a pair of gloves

Surgical asepsis is defined as (page 539)

Absence of all microorganisms

When a nurse picks up a client's contaminated tissue without gloves and fails to wash the hands sufficiently, the nurse provides for the client's organisms to be spread by which type of transmission? (page 534)

Contact

The nurse has completed an intervention with a client. There is no visible soiling on the nurse's hands. Which technique is recommended by the Centers for Disease Control (CDC) for hand hygiene? (page 542)

Decontaminate hands using an alcohol-based hand rub

A nurse prefers to use an alcohol-based hand rub when providing care for patients. In which case is this practice contraindicated? (page 534)

Escherichia coli in the intestinal tract

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? (page 544)

Exogenous healthcare-associated

The nurse caring for a client after hip surgery enters the room to take the client's vital signs. Which precaution(s) should the nurse use? (Select ALL that apply.) (page 548)

Hand hygiene Non-sterile gloves

A lead nurse is removing her personal protective equipment after dressing the infected wounds of a client. Which of the following is the highest priority nursing action? (page 542)

Handwashing before leaving the client's room

A nurse follows surgical asepsis techniques for inserting an indwelling urinary catheter in a client. What is an accurate guideline for using this technique? (page 553)

Hold sterile objects above waist level to prevent inadvertent contamination.

A nurse is adding a sterile solution to a sterile field and has just opened the bottle according to manufacturer's directions. What is the next step? (Page 568)

Hold the bottle outside the edge of the sterile field with the label side facing the palm of the hand and prepare to pour from a height of 4 to 6 inches (10 to 15 cm).

The nurse working with the hospital's infection control team is attempting to decrease the transmission of health care-associated pathogens. Which of the following will be most effective? (page 540)

Incentivizing health care workers to utilize hand hygiene

A nurse is taking stock of the 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? (page 535)

Indwelling catheter

A nurse is taking care of a client with tuberculosis who has developed resistance to the ordered antibiotic. Which type of client is most likely at increased risk for infection? (page 536)

Older adult

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 of the following actions by the nurse is appropriate? (page 551)

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

Which of the following is an accurate guideline for the use of PPE? (page 570)

Replace gloves if they are visibly soiled.

A client has an inguinal hernia repair and later develops a methicillin-resistant Staphylococcus aureus (MRSA) infection. What is the most important factor to prevent this infection? (page 540)

Surgical asepsis

A client is to have an indwelling urinary catheter inserted. Which precaution is followed during this procedure? (page 553)

Surgical asepsis technique

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. (page 539)

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 preparing to perform handwashing. Arrange the following steps in the correct order. (page 559)

Turn on the faucet and adjust force and temperature of the water. Wet the hand and wrist areas. Apply soap product. Wash the palms and back of the hands for at least 15 seconds. Pat hands dry with a paper towel. Turn the faucet off with a paper towel.

Which client presents the most significant risk factors for the development of Clostridium difficile infection? (page 543)

an 81-year-old client who has been receiving multiple antibiotics for the treatment of sepsis

Which client would require a negative flow room?

an 81-year-old man with active tuberculosis and a productive cough

For which client would the use of standard precautions alone be appropriate? (page 550)

an incontinent client in a nursing home who has diarrhea

A client with HIV is the: (page 534)

carrier

An acute medicine unit of a hospital currently has a number of clients who have tested positive for methicillin-resistant Staphylococcus aureus (MRSA). Which measures should the nursing staff prioritize in preventing the spread of MRSA to clients who are currently MRSA-negative? (page 545)

diligent handwashing practices

A nurse is explaining the different procedures used to break the chain of infection to a nursing student. In which link in the chain of infection should a nurse provide special attention to the respiratory and gastrointestinal tracts? (page 534)

exit route

Which nursing action is a component of medical asepsis? (page 539)

handwashing after removing gloves

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: (page 552)

recapping a needle.

A client has sexual intercourse with someone infected with HIV. The vehicle of transmission is? (page 535)

semen

Which is not appropriate regarding the use of gowns as PPE?

use of one gown per person per shift

The nurse caring for clients at an outpatient clinic determines that which client is at greatest risk for infection? (page 537)

An 80-year-old woman

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? (page 546)

Cleanse and disinfect the sphygmomanometer

To eliminate needlesticks as potential hazards to nurses, the nurse should: (pages 552)

Immediately deposit uncapped needles into puncture-proof plastic container.

A nurse changing the linens of a patient bed is exposed to urine and performs hand hygiene. Which of the following is a guideline for performing this skill properly following this patient encounter? (page 559)

Keep hands lower than elbows to allow water to flow toward fingertips.

The nurse performs hand hygiene with soap and water before caring for a client. What is the primary rationale for this action? (page 540)

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