CHapter 23: Asepsis and Infection Control

Following insertion of a foley catheter, the nurse instructs the unlicensed assistive personnel (UAP) to remove the sterile gloves by inverting one glove into the other. The UAP states, "Why is that important?" Which response by the nurse is most appropriate?

"Inverting the gloves entraps the soiled surface and prevents the spread of microorganisms."

A client who has been diagnosed with a cold is upset that antibiotic therapy was not prescribed. Which nursing response is most appropriate?

"The common cold is a virus and will not respond to antibiotics."

The client presents to the Emergency Department reporting fever, chills, and a productive cough. The chest x-ray shows an area of infiltrate, and the primary care provider prescribes a broad spectrum antibiotic. Which client teaching statement from the nurse is most appropriate regarding the prescribed drug?

"This antibiotic is the best choice since the causative organism is not known."

A home health nurse is completing a health history for a client. What is one question that is important to ask to identify a latex allergy for this client?

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

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

An 80-year-old woman

After the nurse has set up a sterile field for a dressing change, the nurse realizes that an essential item has been forgotten. How should the nurse proceed?

Ask another staff member to bring the forgotten item.

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?

Incentivizing health care workers to utilize hand hygiene

The nurses on a busy surgical ward use hand hygiene when caring for postsurgical patients. Which action represents the appropriate use of hand hygiene?

The nurse keeps fingernails less than ¼ inch long.

Which practice is a correct application of infection control practices?

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

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?

Contact

The nurse is donning a pair of sterile gloves. The nurse correctly dons the first glove, but inadvertently inserts the thumb and index finger into the thumb hole of the second glove. The glove remains intact. Which action is most appropriate?

Continue to don the glove, then use the other gloved hand to carefully insert the finger into the proper hole.

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?

Decontaminate hands using an alcohol-based hand rub.

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.

Which nursing action carries the greatest likelihood of contributing to the spread of vancomycin-resistant enterococci (VRE)?

Emptying the Foley catheter bag of a client with VRE and then helping the client in the next bed transfer to a chair

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.

To eliminate needlesticks as potential hazards to nurses, the nurse should:

Immediately deposit uncapped needles into puncture-proof plastic container.

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

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

The nurse is caring for a client who has been placed in strict isolation. Which nursing action is appropriate?

Remove fresh fruit from the room.

What is an accurate guideline for the use of PPE?

Replace gloves if they are visibly soiled.

The nurse manager for a long-term facility notes an increase in infection rates among residents. Which would be the best to implement?

Review the current infection control protocols.

The nurse is using aseptic technique to insert an indwelling urinary catheter. Which technique made by the nurse is correct?

Sterile field is kept above waist level.

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

Surgical asepsis technique

The nurse performs hand hygiene using soap and water before and after providing client care. Which nursing action is performed correctly according to the procedure?

The nurse washes at least 1 inch above the area of contamination if present.

Personal protective equipment (PPE) is used in health care facilities to protect the staff from potentially infected clients.

True

A nurse is caring for a 55-year-old post-operative client. The client returns to the ICU after surgery intubated and mechanically ventilated with a Salem sump nasogastric tube, a Foley catheter, and a PICC line in place. Based on the nurse's knowledge of the most common hospital-acquired infections, which apparatus is most important to remove first?

Urinary catheter

The nurse conducting a hand hygiene in-service determines that the participants need additional education when they state that the use of an alcohol-based handrub is appropriate in which of the following situations?

When hands are visibly soiled

Surgical asepsis is defined as:

absence of all microorganisms.

The nurse is caring for a client with tuberculosis. Which precautions will the nurse select for this client?

airborne

Which client presents the most significant risk factors for the development of Clostridium difficile infection?

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?

an incontinent client in a nursing home who has diarrhea

The nurse is preparing to change a client's sterile dressing. Which action by the nurse would increase the risk for infection?

describing each step verbally to the client while performing the dressing change

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?

diligent handwashing practices

A nursing student is donning sterile gloves to perform routine tracheostomy care for a client. Which behavior by the student would require immediate intervention from the instructor?

reaches down to the bed to pick up a sterile drape

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:

recapping a needle.

The nurse who is caring for a client in contact isolation is preparing to conduct an assessment. How will the nurse listen to the client's heart?

stethoscope that remains in the client's room

A nurse who is taking the vital signs of a client with acute diarrhea is ordered to attend to another client. What is the priority nursing action the nurse must perform before leaving the client's room?

thorough handwashing

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

use of one gown per person per shift

The nurse is preparing to don sterile gloves for a procedure that requires surgical asepsis. Place the following steps, in the correct order, that the nurse should take when donning sterile gloves. All options must be used.

1. Carefully open the inner package taking care not to touch the inner surface of the package or the gloves. 2. With the thumb and forefinger, grasp the folded cuff of the glove, insert fingers while pulling the glove over thee hand. 3. Place the fingers of the gloved hand inside the cuff of the remaining glove and insert the fingers while stretching it over the hand. 4. Adjust gloves on both hands if necessary, touching only sterile areas with other sterile areas.

The nurse is preparing to perform hand washing. Arrange the steps in the correct order.

1. Turn on the faucet and adjust force and temperature of the water. 2. Wet the hand and wrist areas. 3. Apply soap product. 4. Wash the palms and back of the hands for at least 15 seconds. 5. Pat hands dry with a paper towel. 6. Turn the faucet off with a paper towel.