Chapter 22: Infection Control

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?

Contact

The nurse is providing care to a group of clients. What personal protective equipment for use with standard precautions will the nurse include? Select all that apply.

Face mask Disposable gloves Eye protection Fluid-repellent gown

A 34-year-old woman is pregnant with her first child. The nurse notices on her lab results that she is not immune to rubella. When is it most imperative that the client protect herself from a rubella infection?

First trimester

A veteran nurse is working with a new graduate nurse. The graduate nurse states that she was exposed to a client's blood and that she was not wearing any PPE. Which would be considered significant blood exposures by occupational health? Select all that apply.

Hepatitis B Hepatitis C HIV

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?

Indwelling catheter

The nurse is caring for a client who has been hospitalized and placed in airborne precautions for a week. Which nursing intervention is appropriate to provide sensory stimulation?

Move the bed and furnishings to a different place in the room.

A nurse is working with a 55-year-old woman diagnosed with human immunodeficiency virus (HIV). This nurse also has another client today 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?

Perform hand hygiene before and after entering the client's room.

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 action by the nurse is appropriate?

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

The nurse notices a student preparing to enter the room of a client with pulmonary tuberculosis with only gloves on. What is the appropriate nursing intervention

Remind the student that a fitted N95 respirator is required.

A client had her nares and perineum swabbed for pathogens upon admission to the hospital and the results indicate that the client has been colonized with an antibiotic-resistant microorganism. What is an implication of this assessment finding?

The client lacks signs and symptoms of infection but microorganisms are present.

A nurse has sustained a puncture wound on the hand from a scalpel blade that was left on a used procedure tray. What is the first action by the nurse?

Wash the area with soap and water

The nursing student asks the instructor when the immune system is fully mature. The instuctor responds:

adolescence

Since older adults do not always have a fever with an infection, the extended-care facility personnel should observe client for:

agitation.

A nurse is working in a hospital in which a client has been admitted with pulmonary tuberculosis. What type of precautions would this client require?

airborne

The nurse is caring for an older adult with pulmonary tuberculosis. Which precautions will the nurse begin?

airborne

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?

an incontinent client in a nursing home who has diarrhea

What means of transmission do nurses use transmission barriers to protect themselves from? Select all that apply.

blood body substances air droplets

The school nurse is educating a group of teenagers about ways in which human immunodeficiency virus (HIV) can be transmitted. Which methods of infection transmission will the nurse educate the group about? Select all that apply.

contact with blood via sexual contact contact with wound openings cia mucous membranes cia syringes shared between the client and other

A client is on contact precatuions. How frequently must the nurse ensure that care items and bedside equipment for this client are cleaned?

daily

A client is experiencing generalized weakness and body aches. In the progress of infection, the client is in the:

prodromal period.

A college-aged student has influenza. At what stage of the infection is the student most infectious?

prodromal stage

The student nurse asks the nursing instructor to explain why stress can increase the risk of infection. The instructor explains:

stress causes the body to release cortisol, which can increase the risk of infection.

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

true

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

use of one gown per person per shift

What nursing action will the nurse perform to reflect safe injection practices?

using sterile, single use, disposable, syringes for each injection

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:

within normal limits

Which questions asked by the nurse when taking a client's health history would collect data about infection control?

"When did you complete your immunizations?"

The nurse has admitted a client on airborne precautions onto the medical-surgical unit. When the client asks, "When will these airborne precautions be removed?" what is the appropriate nursing response?

"When your sputum culture is negative."

A nurse is reviewing an adult client's chart and sees that the client is overdue for a tetanus booster. How many years must have elapsed for the client to require this shot? Record your answer using a whole number.

10

A nurse has a cold. How long did it take for the cold to incubate before the nurse began to show symptoms?

2 to 4 days

A nurse is caring for a client who is on droplet precautions. How many feet must be maintained between this client and other noninfected clients and visitors? Record your answer using a whole number

3

A nurse provides care for a diverse population of clients on a busy, acute medicine unit. Which client is likely the most susceptible to infection?

A 39-year-old man who has been admitted because his HIV has recently developed into AIDS

Which practice is a correct application of infection control practices?

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

The nurse is initiating isolation precautions for a client who has chronic Clostridium difficile infection. What should the nurse be sure to include with these precautions?

Be sure there are gloves of various sizes and gowns for use.

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.

An 83-year-old resident of an extended-care home has begun displaying uncharacteristic confusion over the past 48 hours and is suspected to have a new infection. However, the nurse has documented that the client's temperature is within normal limits. When performing further assessments of this client, the nurse should understand that:

older adults may present atypical signs and symptoms of infection.

The nurse is caring for a client with a draining abscess. Which precautions will the nurse begin?

contact

The nurse is caring for a client with acute viral conjunctivitis. Which precautions will the nurse begin?

contact

The nurse is caring for an older adult with a recurrent wound infection. Which precautions will the nurse begin?

contact

Which pieces of personal protective equipment should be removed first?

gloves

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

A nurse is in charge of care for a client who has MRSA. Which of the following is an accurate guideline for using transmission-based precautions when caring for this client?

Wear gloves whenever entering the client's room.

The nurse educator is reminding a group of new nurses about precautions. Which statement by a new nurse requires further teaching by the nurse educator?

Wearing an N95 respirator is critical when I care for clients in droplet precautions."

A pregnant woman with a history of genital herpes infection who is near term asks the nurse why she must have a cesarean section when she has not had an outbreak in a "long time". The nurse responds:

"You may have infection in your birth canal that you are unaware of."

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 airborne precautions

A nurse is caring for a client in isolation. Which precaution should the nurse follow when administering medication to a client in isolation?

Discard used intravenous (IV) bags in the room.

The nurse has finished caring for a client on contact precautions. Which nursing action regarding the stethoscope used to auscultate this client's lungs and bowel sounds is appropriate?

Disinfect it with alcohol swabs.

The nurse is caring for a client who became very ill after ingesting seafood. How will the nurse document this condition?

noncommunicable disease

The nurse is aware that an antiviral medication is most effective when given during which phase of the infectious process?

prodromal stage

A 12-year-old is being hospitalized for pneumonia. The nurse receives the client's culture and sensitivity report on her tracheal aspirate. The client is infected with a strain of Streptococcus pneumoniae, which is particularly prone to cause infections, also referred to as what?

Pathogenic

The nurse is caring for a client with tuberculosis who has been placed in airborne precautions. The nurse has not yet been fitted with an N95 respirator. Which nursing action is appropriate?

Use a powered air purifying respirator (PAPR) until fitted for an N95 respirator..

A nurse needs to send the blood and urine specimen of a client with acute diarrhea to the pathology laboratory. Which precaution is the priority when collecting and delivering the specimens to the laboratory?

Use sealed containers in a plastic biohazard bag

A nurse is caring for a client with meningococcal meningitis in a private room located close to the nursing unit of the health care facility. Which infection control measure should the nurse take?

ask housekeeping personnel to clean the client's room last.

The nurse is caring for a client who developed pneumonia while hospitalized. How will the nurse document this condition?

health care-associated infection (HCAI)

The nurse is educating a client and caregivers about recurrent infections the client has experienced. What priority iintervention can the nurse include that is a first line of defense?

intact skin and mucous membranes.

The nurse is receiving a confused client with a draining wound onto the medical-surgical unit. Which room assignment will the nurse make?

into a private room