nur 304 clinical module PPE

What is the order in donning your PPE prior to performing patient care? a. Hand hygiene, gown, gloves, mask and goggles b. Hand hygiene, mask, gown, gloves and goggles c. Hand hygiene, gown, mask, goggles and gloves d. Hand hygiene, gloves, gown, mask and goggles

c. Hand hygiene, gown, mask, goggles and gloves

What is the final step in doffing your personal protection equipment? a. Removing gloves b. Removing gown c. Removing mask d. Hand hygiene

d. Hand hygiene rationale: Hand hygiene is the final step when doffing or taking off your PPE. Every health care worker should perform hand hygiene before and after taking off PPE.

Select the correct words that are used in abbreviations affiliated with protecting health care workers in a hospital setting. a. Personal Protection Evidence b. Personal Professional Protection c. Professional Protection Equipment d. Personal Protection Equipment

d. Personal Protection Equipment

The nurse is caring for a group of patients. For which patient will the nurse question the form of precautions being used? a. A patient with Clostridium difficile in droplet precautions. b. A patient with tuberculosis in airborne precautions c. A patient with MRSA infection in contact precautions d. A patient with a lung transplant in protective environment precautions

a. A patient with Clostridium difficile in droplet precautions. rationale: C. diff requires Contact Precautions A patient with Clostridium difficile on droplet precautions should be questioned because this patient must be on contact precautions to ensure that the health care provider will wears gloves and a gown when caring for this patient. ****

What type of PPE is required when caring for a patient with tuberculosis? a. N95 respirator b. Surgical mask c. 5100 face mask respirator d. Gas mask respirator

a. N95 respirator rationale: cuz TB is airborne When caring for patients who are diagnosed with tuberculosis, a N95 mask is required because this mask will keep out 95% of the particles dispersed in the air to prevent transmission.

Which type of PPE is used for droplet precautions? a. Surgical mask b. Respirator (N95) c. Gloves d. Gown

a. Surgical mask rationale: Surgical mask is the only recommended PPE for patients who are on droplet precautions. Influenza is one example.

Which type of personal protection equipment are commonly required and used by health care workers in a hospital setting. Select all that apply! Gown Boot covers Mask Goggles/face shield Water resistant disposable Jumpsuit Gloves Disposable stethescope

Gown Mask Goggles/face shield Gloves rationale: Boot covers, water resistant disposable jump suit, and disposable stethoscope are PPE items that are not commonly used or used with a specific population where there's a higher risk of transmitting a pathogen from patient to health care worker or worker to a vulnerable patient.

The nurse is caring for a patient in the hospital. The nurse observes the nursing assistive personnel (NAP) turning off the handle faucet with bare hands. Which professional practice principle supports the need for follow-up with the NAP? a. The nurse is responsible for providing a safe environment for the patient. b. Different scopes of practice allow modification of procedures. c. Allowing the water to run is a waste of resources and money. d. This is a key step in the procedure for washing hands.

a. The nurse is responsible for providing a safe environment for the patient. rationale: The nurse is responsible for providing a safe environment for the patient. The effectiveness of infection control practices depends on conscientiousness and consistency in using effective aseptic technique by all health care providers. After washing hands, turn off a handle faucet with a dry paper towel, and avoid touching the handles with your hands to assist in preventing the transfer of microorganisms. Wet towels and hands allow the transfer of pathogens from faucet to hands. The principles and procedures for washing hands are universal and apply to all members of health care teams. Being resourceful and aware of the cost of health care is important, but taking shortcuts that may endanger an individual's health is not a prudent practice. The nurse is responsible for providing a safe environment to patients and if she observes the nursing assistive personnel (NAP) turning off the handle faucet with bare hands, she should educate this individual.

The nurse is dressed and is preparing to care for a patient in the perioperative area. The nurse has scrubbed hands and has donned a sterile gown and gloves. Which action will indicate a break in sterile technique? a. Touching clean protective eyewear b. Standing with hands above waist area c. Accepting sterile supplies from the surgeon d. Staying with the sterile table once it is open

a. Touching clean protective eyewear rationale: Touching nonsterile (clean) protective eyewear once gowned and gloved with sterile gown and gloves would indicate a break in sterile technique. Sterile objects remain sterile only when touched by another sterile object. Standing with hands folded on the chest is common practice and prevents arms and hands from touching unsterile objects. Accepting sterile supplies from the surgeon who has opened them with the appropriate technique is acceptable. Staying with a sterile table once opened is a common practice to ascertain that no one or nothing has contaminated the table. Once the nurse has put on sterile gloves, she/he should not touch anything that is not sterile. The eye wear is clean and did not state that it was sterile.

The nurse is caring for a patient who becomes nauseated and vomits without warning. The nurse has contaminated hands. Which action is best for the nurse to take next? a. Wash hands with an antimicrobial soap and water. b. Clean hands with wipes from the bedside table. c. Use an alcohol-based waterless hand gel. d. Wipe hands with a dry paper towel.

a. Wash hands with an antimicrobial soap and water. rationale: The Centers for Disease Control and Prevention (CDC) recommends that when hands are visibly soiled, one should wash with a non-antimicrobial soap or with antimicrobial soap. Cleaning hands with wipes or using waterless hand gel does not meet this standard. If hands are not visibly soiled, use an alcohol-based waterless antiseptic agent for routinely decontaminating hands. Wiping hands with a dry paper towel will occur after the nurse has washed both hands. If a health care worker hands are visibly soiled, they must wash hands with an antimicrobial soap and water.

The nurse is admitting a patient with an infectious disease process. Which question will be most appropriate for a nurse to ask about the patient's susceptibility to this infectious process? a. " Do you have a spouse?" b. " Do you have a chronic disease?" c. " Do you have any children living in the home?" d. " Do you have any religious beliefs that will influence your care?"

b. " Do you have a chronic disease?" rationale: Multiple factors influence a patient's susceptibility to infection. Patients with chronic diseases such as diabetes mellitus and multiple sclerosis are also more susceptible to infection because of general debilitation and nutritional impairment. Other factors include age, nutritional status, trauma, and smoking. The other questions are part of an admission assessment process but are not pertinent to the infectious disease process.

The infection control nurse is reviewing data for the medical-surgical unit. The nurse notices an increase in postoperative infections from Aspergillus. Which type of health care-associated infection will the nurse report? a. Vector b. Exogenous c. Endogenous d. Suprainfection

b. Exogenous rationale: An exogenous infection comes from microorganisms found outside the individual such as Salmonella, Clostridium tetani, and Aspergillus. They do not exist as normal floras. A vector transmits microorganisms and is usually a type of insect or organism. Endogenous infection occurs when part of the patient's flora becomes altered and an overgrowth results (e.g., staphylococci, enterococci, yeasts, and streptococci). This often happens when a patient receives broad-spectrum antibiotics that alter the normal floras. A suprainfection develops when broad-spectrum antibiotics eliminate a wide range of normal flora organisms, not just those causing infection.

When doffing your PPE, what is the first item you should remove? a. Mask b. Gloves c. Goggles/face shield d. Gown

b. Gloves rationale: When doffing or taking off your PPE the gloves should be the first item removed and they are considered the most contaminated item in your PPE set.

donning

before = perform hand hygiene then this order: 1. gown 2. mask/respirator 3. goggles/face shield 4. gloves

The patient and the nurse are discussing the vector transmitted Rickettsia rickettsii—Rocky Mountain spotted fever. Which patient statement to the nurse indicates understanding regarding the mode of transmission for this disease? a. "When camping, I will use sunscreen." b. "When camping, I will drink bottled water." c. "When camping, I will wear insect repellent." d. "When camping, I will wash my hands with hand gel."

c. "When camping, I will wear insect repellent." rationale: Rocky Mountain spotted fever occurs in patients who have visited this area and therefore individuals need to protect themselves from insects which carries or transmit this infection to humans. The correct answer is a person should wear insect repellent when camping

The nurse is caring for a patient diagnosed with leukemia and is preparing to provide fluids through a vascular access (IV) device. Which nursing intervention is a priority in this procedure? a. Review the procedure with the patient. b. Position the patient comfortably. c. Maintain surgical aseptic technique. d. Gather available supplies.

c. Maintain surgical aseptic technique. rationale: You maintain surgical aseptic technique at the patient's bedside (e.g., when inserting IV or urinary catheters, suctioning the tracheobronchial airway, and sterile dressing changes) because patients with disease processes of the immune system are at particular risk for infection. These diseases include leukemia, AIDS, lymphoma, and aplastic anemia. These disease processes weaken the defenses against an infectious organism. Reviewing the procedure with the patient, positioning the patient, and gathering the supplies are all important steps in the procedure but are not the priority in the procedure since the patient already has a compromised immune response. The nurse must maintain surgical aseptic technique when putting in an IV to prevent contaminating a very vulnerable patient with a pathogen.

The nurse is caring for a patient in the endoscopy area. The nurse observes the technician performing these tasks. Which observation will require the nurse to intervene? a. Washing hands after removing gloves b. Disinfecting endoscopes in the workroom c. Removing gloves to transfer the endoscope d. Placing the endoscope in a container for transfer

c. Removing gloves to transfer the endoscope rationale: Standard precautions are used to prevent and control the spread of infection. Transferring contaminated equipment without the protection of gloves can assist in the spread of microbes to inanimate objects and to the person doing the transfer; therefore, the nurse must intervene. Utilizing gloves, washing hands, covering contaminated supplies during transfer, and disinfecting equipment in the appropriate way in the appropriate places utilize principles of basic medical asepsis and standard precautions and can break the chain of infection. Once the technician has put on sterile gloves to handle the endoscope he/she can not remove gloves to touch that piece of equipment because it will become contaminated.

The nurse is caring for a patient who has just delivered a neonate. The nurse is checking the patient for excessive vaginal drainage. Which precaution will the nurse use? a. Contact b. Droplet c. Standard d. Protective environment

c. Standard rationale: Standard precautions apply to contact with blood, body fluid, nonintact skin, and mucous membranes of all patients. Contact precautions apply to individuals with infections that can be transmitted by direct or indirect contact. Protective environment precautions apply to individuals who have undergone transplantations and gene therapy. Droplet precautions focus on diseases that are transmitted by large droplets.

A 54 year old female came in the emergency room complaining of a headache, dry cough, and feeling dizzy. She had the following vital signs; temp 100.9, BP 130/88, HR 110, RR 26, and O2 saturation 95%. What type of PPE would you wear when caring for this patient? a. N95 Respirator and gloves b. Gown and gloves c. surgical mask and gloves d. Gloves, gown and mask

c. surgical mask and gloves rationale: When caring for a patient who presents to the emergency room with a dry cough and elevated temperature your standard PPE should include a surgical mask and gloves to protect the health care worker from getting the disease or pathogen or transmitting the pathogen to other patients.

The nurse is providing an educational session for a group of preschool workers. The nurse reminds the group about the most important thing to do to prevent the spread of infection. Which information did the nurse share with the preschool workers? a. Encourage preschool children to eat a nutritious diet. b. Suggest that parents provide a multivitamin to the children. c. Clean the toys every afternoon before putting them away. d. Wash their hands between each interaction with children.

d. Wash their hands between each interaction with children. rationale: The single most important thing that individuals can do to prevent the spread of infection is to wash their hands before and after eating, going to the bathroom, changing a diaper, and wiping a nose and between touching each individual child. It is important for preschool children to have a nutritious diet; a healthy individual can fight infection more effectively. A health care provider, along with the parent, makes decisions about dietary supplements. Cleaning the toys can decrease the number of pathogens but is not the most important thing to do in this scenario. Although all of the choices presented in this question will help prevent the spread of an infection but the most important one that preschool workers must adhere to prevent the spread of infections is washing their hands between each interaction with children.

The nurse is caring for a patient who is at risk for infection. Which action by the nurse indicates correct understanding about standard precautions? a. Teaches the patient about good nutrition. b. Dons gloves when wearing artificial nails. c. Disposes an uncapped needle in the designated container. d. Wears eyewear when emptying the urinary drainage bag

d. Wears eyewear when emptying the urinary drainage bag rationale: Standard precautions include the wearing of eyewear whenever there is a possibility of a splash or splatter, like when emptying the urinary drainage bag. Teaching the patient about good nutrition is positive but does not apply to standard precautions. Standard precautions apply to contact with blood, body fluid (except sweat), nonintact skin, and mucous membranes from all patients. Artificial nails are not worn when using standard precautions. Any needles should be disposed of uncapped, or a mechanical safety device is activated for recapping. A correct statement by the nurse to understanding infection precautions would is that they should wear eye protection when emptying the urinary drainage bag because the urine may splash

N95 respirator

if a patient is in Airborne Precautions

face mask

if a patient is in Droplet Precautions or if you're at risk for splash/splatter into your mucus membranes

clean areas

inside of gloves back of gown gown's ties straps of face shield / goggles straps of mask / respirator

doffing

order: 1. gloves 2. goggles/face shield 3. gown 4. mask/respirator then perform hand hygiene

contaminated areas

outside of gloves front of gown gown's sleeves front of face shield / goggles front of mask / respirator

goggles/face shield

protect eyes from splashes with blood/body fluid

gloves

protect hands from fluids/contaminants need the right size

gown

protects from splashing, body fluids