Prep U Chapter 24: Asepsis and Infection Control

Surgical asepsis is defined as: absence of all microorganisms. absence of all virulent microorganisms. slowed growth of microorganisms. use of hand washing, gowning, and gloving.

absence of all microorganisms.

The nurse is preparing to help mobilize a client with an abdominal wound that is colonized by methicillin-resistant Staphylococcus aureus (MRSA). Which of the shown actions should the nurse perform before assisting the client?

gown and gloves

A nurse follows surgical asepsis techniques for inserting an indwelling urinary catheter in a client. What is an accurate guideline for using this technique? Open sterile packages so that the first edge of the wrapper is directed toward the nurse. Consider the outside of the sterile package to be sterile. Consider the outer 3-in. (8-cm) edge of a sterile field to be contaminated. Hold sterile objects above waist level to prevent inadvertent contamination.

Hold sterile objects above waist level to prevent inadvertent contamination.

A nurse has been exposed to urine while changing the linens of a client's bed. Which guideline is followed for performing hand hygiene after this client encounter? Keep hands lower than elbows to allow water to flow toward fingertips. Use an alcohol-based hand rub to decontaminate the hands. Remove all jewelry, including wedding bands, before hand washing. Pat dry with a paper towel, beginning with the forearms and moving down to fingertips.

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

Following a demonstration to a family member on how to insert a straight catheter, the nurse instructs the family member to remove the gloves by inverting one glove into the other. Which step would the nurse instruct the family member to do next? Use an appropriate lotion that does not interfere with antimicrobial effect of gloves or soaps Wrap all used materials together and discard in biohazard container Don a new pair of gloves to dispose of materials Perform hand hygiene

Perform hand hygiene

The nurse uses a small amount of sterile solution from a large, multiuse bottle to moisten gauze in a sterile field. What technique does the nurse use? Pour the liquid into the palm of a sterile gloved hand for use. Pour the liquid into the cap of the bottle and dip the gauze as needed. Pour the liquid onto gauze on the sterile field until the gauze is moist. Pour the liquid into a sterile container within the sterile field.

Pour the liquid into a sterile container within the sterile field.

An operating room (OR) nurse on the facility's infection control team notices that a coworker in the OR is wearing artificial nails. What is the appropriate action/response by the nurse? Remind coworker of the need to wear gloves Remind coworker that artificial nails increase infections Remind coworker to wash hands for 2 minutes No action is needed at this time

Remind coworker that artificial nails increase infections

What is an accurate guideline for the use of PPE? Substitute personal glasses for protective eyewear, if desired. Replace gloves if they are visibly soiled. When wearing gloves, work from "dirty" areas to "clean" ones. Put on PPE after entering the client's room.

Replace gloves if they are visibly soiled.

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 The client's normal flora proliferated because of a nutritional deficit The resident microorganisms mutated and became virulent The client's normal flora began producing spores

The client's immune system became further weakened

The nurse is teaching a new nurse about preparing a sterile field. Which action made by the new nurse would indicate further teaching is required? The sterile field is set up at waist level. The top flap of the package is opened away from the new nurse's body. Direct visualization of the sterile field is maintained. The new nurse touches 1.5 in. (4 cm) from the outer edges.

The new nurse touches 1.5 in. (4 cm) from the outer edges.

A new perioperative nurse is being educated regarding surgical asepsis. What observations by the preceptor would indicate that there is a need for reinforcement of the principles of asepsis? Select all that apply. The nurse is talking with the scrub nurse over the sterile field. The nurse touches an unsterile object to the instrument tray. The nurse's back is facing the sterile field. The nurse keeps hands above waist level while donning sterile gloves. The nurse disposes of an opened container of sterile saline after half is used.

The nurse's back is facing the sterile field. The nurse touches an unsterile object to the instrument tray. The nurse is talking with the scrub nurse over the sterile field.

The nurse is removing soiled gloves after assisting with a sterile procedure. Which actions follow recommended guidelines for this procedure? Select all that apply. Discard the gloves in appropriate container, removing additional PPE, if used, and performing hand hygiene. Secure the second glove inside the first glove while keeping the contaminated area on the outside. Remove the glove by pulling it off, inverting it as it is pulled, and keeping the contaminated area on the inside. Use the dominant hand to grasp the opposite glove near cuff end on the outside exposed area. Slide the fingers of the ungloved hand between the remaining glove and the wrist. Removing the second glove by pulling the cuff up, inverting it as it is pulled, and keeping the contaminated area on the outside.

Use the dominant hand to grasp the opposite glove near cuff end on the outside exposed area. Remove the glove by pulling it off, inverting it as it is pulled, and keeping the contaminated area on the inside. Slide the fingers of the ungloved hand between the remaining glove and the wrist. Discard the gloves in appropriate container, removing additional PPE, if used, and performing hand hygiene.

The nurse is caring for an older adult with pulmonary tuberculosis. Which precautions will the nurse begin? droplet none contact airborne

airborne

Which are the names of the transmission-based precautions defined by the Centers for Disease Control and Prevention (CDC)? Select all that apply . airborne precautions respiratory precautions droplet precautions microbial precautions body fluid precautions contact precautions

airborne precautions droplet precautions contact precautions

A client suffers from bloody diarrhea after eating contaminated food at a local restaurant. The client has been infected with a(an): fungi. protozoa. virus. bacteria.

bacteria.

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? face shields bath blanket specimen containers indwelling catheter

indwelling catheter

A nurse is working with a 55-year-old woman diagnosed with human immunodeficiency virus (HIV). This nurse has another client that day who has an upper respiratory infection. What is the most important thing the nurse can do to prevent the client with HIV from acquiring the upper respiratory infection? avoid direct contact with the client wear gloves when touching the client wear a mask and gown in the client's room perform hand hygiene before and after entering the client's room

perform hand hygiene before and after entering the client's room

The nurse manager is developing a plan to decrease the transmission of health care associated infections. What would be the best to implement? staff education on utilizing hand hygiene having any visitor with a cough or cold wear a mask restricting visitors to those older than 12 years of age providing alcohol-based hand sanitizer to all clients

staff education on utilizing hand hygiene

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!" Which response by the nurse is mostappropriate? "Alcohol-based hand rub provides the greatest reduction in microbial counts on the skin." "I won't be touching you, so using the alcohol hand rub is the quickest method to perform hand hygiene." "We only wash our hands when they are visibly soiled." "Washing the hands with soap and water is not necessary."

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

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? Any partially uncovered sterile package need not be considered contaminated. When a sterile item touches something that is not sterile, it may not be contaminated. A commercially packaged surgical item is not considered sterile if past expiration date. Sterility may not be preserved even when one sterile item touches another sterile item.

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

The nurse caring for clients at an outpatient clinic determines that which client is at greatest risk for infection? an 80-year-old woman a 12-year-old girl an 18-month-old infant a 2-year-old toddler

an 80-year-old woman

The client is an employee on the medical unit at the local children's hospital. The nurse is an occupational health nurse educating the client on various routes of exposure. The nurse knows that as a hospital employee, the client is most susceptible to infection by what mode of transmission? droplet vehicle airborne contact

contact

The nurse is caring for a college student with meningococcal meningitis. Which precautions will the nurse begin? droplet none airborne contact

droplet

The nurse is caring for a client who developed pneumonia while hospitalized. How will the nurse document this condition? community-acquired infection contagious disease health care-associated infection (HCAI) infectious disease

health care-associated infection (HCAI)

The nurse is caring for a client who is to have a sterile dressing change to a wound. A student nurse enters the client's room and notices the nurse preparing the sterile field. After reviewing the image, which response by the student nurse to the nurse is the most accurate understanding of this procedure? "Using either side of the drape is okay, as long as you do not contaminate the sterile supplies on the field." "It is okay to turn the drape on the other side." "I use my whole hand to touch the non-waterproof surface before placing the sterile equipment on it." "The way you are doing it helps to minimize contamination of the non-waterproof side."

"The way you are doing it helps to minimize contamination of the non-waterproof side."

The nurse is preparing to apply a prescription ointment to the client's wound. After reviewing the image, what is the most important step for the nurse to take? Apply a 1-in (2.5-cm) layer of the ointment to the site using the index finger Use a sterile cotton-tipped applicator to apply the prescription to the site Place sterile 4 × 4 gauze on the wound and secure the dressing with dressing with paper tape Put soiled dressing change supplies in the client's bathroom garbage and double bag

Put soiled dressing change supplies in the client's bathroom garbage and double bag

A pediatric client's caregiver states, "I will never give my child vaccinations." What is the priority nursing response? "Vaccinations prevent disease." "Has your child received any previous vaccinations?" "Transmission of certain diseases is halted with vaccination." "Help me understand your thoughts about vaccinations."

"Help me understand your thoughts about vaccinations.

When preparing a sterile field, the nurse notes that the bottle of sterile saline was opened 48 hours ago and is half full. What action does the nurse take to ensure that the saline used is sterile? Pour the saline into a sterile container on the sterile field by holding it 6 in (15 cm) above the container. Since the bottle has been open, previously used, and unexpired, "lip" it by pouring a small amount into a waste container or waste cup. Use the saline for the procedure and discard the remaining amount because it has been 48 hours since opening. Discard the bottle and get a new one because the saline has expired.

Discard the bottle and get a new one because the saline has expired.

The nurse is caring for an older adult with a recurrent wound infection. Which precautions will the nurse begin? droplet contact none airborne

contact

The nurse manager for a long-term facility notes an increase in infection rates among residents. Which would be the best to implement? Restrict visitors to public places. All new residents are prescribed antibiotics. Review the current infection control protocols. Culture all residents and staff.

Review the current infection control protocols.

The nurse is preparing to perform handwashing. Place the following steps in the correct order. Use all options. 1 Apply soap. 2 Wet the hand and wrists. 3 Turn on the faucet and adjust force and temperature of the water. 4 Turn the faucet off with a paper towel. 5 Wash the palms and backs of the hands for at least 20 seconds. 6 Pat the hands dry with a paper towel.

Turn on the faucet and adjust force and temperature of the water. Wet the hand and wrists. Apply soap. Wash the palms and backs of the hands for at least 20 seconds. Pat the hands dry with a paper towel Turn the faucet off with a paper towel.

A lead nurse is removing personal protective equipment after dressing the infected wounds of a client. Which is the priority nursing action? handwashing before leaving the client's room remove the garments that are most contaminated make contact between two clean surfaces make contact between two contaminated surfaces

handwashing before leaving the client's room

To eliminate needlesticks as potential hazards to nurses, the nurse should: immediately deposit uncapped needles into a puncture-proof plastic container. slide the needle into the cap and deposit it in a puncture-proof plastic container. stick the uncapped needle into a Styrofoam block and deposit it in a plastic container. place the uncapped needle on a tray and carry it to the medicine room for disposal.

immediately deposit uncapped needles into a puncture-proof plastic container.

Nurses working in bed management are assigning clients from the emergency room to semiprivate rooms. Clients with which two diagnoses are appropriate to room together, based on safety and infection control standards? Clostridium difficile and diabetic ketoacidosis Tuberculosis and pneumonia Reactive airway disease and exacerbation of chronic obstructive pulmonary disorder (COPD) Appendectomy and a draining leg ulcer positive for methicillin-resistant Staphylococcus aureus

Reactive airway disease and exacerbation of chronic obstructive pulmonary disorder (COPD)

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 communicable disease infectious disease contagious disease

noncommunicable disease

An older adult client is admitted into the hospital due to pneumonia. Which transmission-based precautions should the nurse initiate? Airborne Contact Standard Droplet

Standard

The nurse planning to insert an indwelling urinary catheter into a client should utilize which technique? Medical asepsis Contact precautions Surgical asepsis Universal precautions

Surgical asepsis

A client is to have an indwelling urinary catheter inserted. Which precaution is followed during this procedure? Strict reverse isolation Medical asepsis technique Droplet precautions Surgical asepsis technique

Surgical asepsis technique

A nurse has finished providing care for a client who is on contact precautions. When removing the protective gown, the nurse should take which action? Perform hand hygiene before removing the gown. Remove the gown immediately after exiting the room. Avoid touching the outer surfaces of the gown. Remove the gown before removing gloves.

Avoid touching the outer surfaces of the gown.

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? Discard the sphygmomanometer in the trash. Cleanse and disinfect the sphygmomanometer. Send the sphygmomanometer for sterilization. Use the sphygmomanometer.

Cleanse and disinfect the sphygmomanometer.

The nurse has completed an intervention with a client. There is no visible soiling on the nurse's hands. Which technique is recommended by infection control practice standards for hand hygiene? Wash hands with soap and water, followed by an alcohol-based hand rub. Decontaminate hands using an alcohol-based hand rub. Do not wash hands; apply clean gloves. Wash hands with soap and hot water.

Decontaminate hands using an alcohol-based hand rub.

Which nursing action carries the greatest likelihood of contributing to the spread of vancomycin-resistant enterococci (VRE)? delivering a meal tray to a VRE-positive client without first donning gloves and a gown Emptying the Foley catheter bag of a client with VRE and then helping the client in the next bed transfer to a chair without washing hands between contact sending a VRE-positive client to the radiology department for a chest X-ray without a face mask removing the staples from a VRE-positive, postoperative client's incision without prior handwashing

Emptying the Foley catheter bag of a client with VRE and then helping the client in the next bed transfer to a chair without washing hands between contact

A nurse is implementing the principles of surgical asepsis while inserting a client's indwelling urinary catheter. Which action should the nurse perform? Open sterile packages so that the first edge of the wrapper is directed toward you. Consider the outside of the sterile package to be partially sterile. Consider the outer 3-in edge of a sterile field to be contaminated. Hold sterile objects above waist level to prevent accidental contamination.

Hold sterile objects above waist level to prevent accidental contamination.

A client has tested positive for methicillin-resistant Staphylococcus aureus after being swabbed on admission to the hospital. Bacterial resistance to antibiotics is an example of: Aerobic activity Spore production Survival adaptation Means of transmission

Survival adaptation

Personal protective equipment (PPE) is used in health care facilities for primarily which reason? To protect staff members from becoming infected by clients To protect both the staff and clients from becoming infected by one another To protect clients from becoming infected by staff members To protect the hospital from legal liability

To protect both the staff and clients from becoming infected by one another

For which client would the use of standard precautions alone be appropriate? a child with chickenpox who is treated in the emergency room a client with diphtheria who needs p.m. care an incontinent client in a nursing home who has diarrhea a client with TB who needs medications administered

an incontinent client in a nursing home who has diarrhea

The nurse is reviewing the plan of care for assigned clients. Which client has the highest risk for developing an infection? a school-age child who is current with immunizations an older adult client with a history of heart failure a middle-aged adult who takes prescribed medication to control blood pressure an adolescent who has a right radial fracture

an older adult client with a history of heart failure

Standard precautions apply to blood; all body fluids, secretions, and excretions; and intact and nonintact skin and mucous membranes. false true

true

The parent of a pediatric client tells the nurse, "I do not believe in vaccinations." What is the appropriate nursing response? "Vaccinations have been shown to contribute to autism." "Vaccines are the only way to halt disease." "Help me understand your perspective about vaccinating." "Why do you not want to vaccinate your child?"

"Help me understand your perspective about vaccinating."

The nurse reminds the visitor of a client with an antibiotic-resistant infection that gloves are necessary. The visitor states, "I need to directly hold my loved one's hand without a barrier." What essential information does the nurse need to explain to the visitor to prevent transmission of the organism? "If you do not wear gloves you will also get the infection." "Your loved-one understands why you have to wear gloves because he or she has been educated about the infection and barrier precautions." "Your loved-one has an antibiotic-resistant infection which means that there are a limited number or no antibiotics available to treat it." "The glove is an important barrier in preventing the transmission of your loved-one's antibiotic-resistant infection to you or other people you come in contact with."

"The glove is an important barrier in preventing the transmission of your loved-one's antibiotic-resistant infection to you or other people you come in contact with."

Several family members are visiting a client with an antibiotic-resistant infection who has been placed on contact precautions. When the nurse teaches the visitors about wearing gloves and gowns, a family member states, "I don't want to wear those. I can't catch anything just by holding my loved one's hand." What is the best response to educate the family about infection transmission? "These barriers help prevent the transmission of infection to you or other people." "I understand; wearing these items is not pleasant but it really isn't optional." "If you don't come into contact with anything with your body, you may wear gloves only, as long as you wash your hands after removing the gloves." "Wearing the gloves and gown prevents sharing additional microorganisms with the client."

"These barriers help prevent the transmission of infection to you or other people."

Which practice is a correct application of infection control practices? A nurse uses an alcohol-based hand rub each time that the nurse's hands are visibly soiled. A nurse rinses hands thoroughly after the application of an alcohol-based hand rub. A nurse dons a pair of gloves prior to any client contact. A nurse performs hand washing each time the nurse removes a pair of gloves.

A nurse performs hand washing each time the nurse removes a pair of gloves.

After meeting with the family to give an update on the surgical client, the nurse shakes their hands before leaving. Which method of hand hygiene is most appropriate following this encounter? Soap and water hand washing technique Alcohol-based hand rub Mixture of soap and alcohol-based hand rub techniques Scrubbing hands with soap, water, and brush

Alcohol-based hand rub

The nurse is caring for a client admitted with tuberculosis (TB). What would be the best action by the nurse? Apply a nonparticulate (N-95) respirator when entering the room. Wear a mask with face shield during invasive procedures. Have the client wear a mask during care. Wear a protective gown and gloves with any direct contact.

Apply a nonparticulate (N-95) respirator when entering the room.

The nurse is setting up a sterile field to perform a catheterization when the client touches the end of the sterile field. What would be the nurse's next appropriate action? Discard the sterile field and the supplies and start over. Change the sterile field, but reuse the sterile equipment. Call for help and ask for new supplies. Proceed with the procedure since it was only touched by the client.

Discard the sterile field and the supplies and start over.

Upon review of a client's microbiology culture results, the nurse recognizes which organism as indicative of normal flora? Shigella in the intestinal tract Shigella in the urinary tract Escherichia coli in the urinary tract Escherichia coli in the intestinal tract

Escherichia coli in the intestinal tract

The nurse must assign a room for a client admitted with endocarditis and methicillin-resistant Staphylococcus aureus (MRSA) in the blood. A client with which diagnosis can share a room with this client? Vancomycin-resistant enterococci and urinary tract infection Coronary artery bypass grafting MRSA in the wound Clostridium difficile and colitis

MRSA in the wound

The nurse is caring for a client with tuberculosis. The prior shift's nurse has placed the client in droplet precautions. Which is the appropriate nursing action? change to standard precautions continue with droplet precautions change to contact precautions change to airborne precautions

change to airborne precautions

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: elevated stable decreased within normal limits

within normal limits