prep U : Asepsis and Infection Control
A pediatric client's caregiver states, "I will never give my child vaccinations." What is the priority nursing response? "Vaccinations prevent disease." "Help me understand your thoughts about vaccinations." "Has your child received any previous vaccinations?" "Transmission of certain diseases is halted with vaccination."
"Help me understand your thoughts about vaccinations."
A family member with a mild upper respiratory infection comes to visit a client in a long-term care facility. The nurse takes the opportunity to teach the family member about preventing the spread of the cold. What response by the family member indicates that the nurse's teaching was successful? "I will not visit my family member in the first 3 days of my cold." "I will use tissue to cover my nose and mouth while I am visiting and will refrain from touching my family member." "I will obtain a mask from the staff and wash my hands before touching my family member." "If I sneeze or cough, I will make sure to cover my mouth with hand or tissue."
"I will obtain a mask from the staff and wash my hands before touching my family member."
The nurse is speaking to the physician regarding the client's frequent diarrhea episode since starting IV antibiotics. The nurse states "I am concerned that Mr. Clark has developed Clostridium Difficile infection". Which part of the SBAR communication will this statement fall into? S= Situation B= Background A= Assessment R= Recommendation
A= Assessment
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 A 30-year-old client who has recently contracted human immunodeficiency virus (HIV) after engaging in high-risk sexual behavior A 44-year-old client who is paralyzed and whose coccyx ulcer has required a skin graft A client with renal failure who receives hemodialysis three times weekly
An 81-year-old client who has been receiving multiple antibiotics for the treatment of sepsis
Which term describes foreign particles that enter a host and stimulate the body's immune response? Macrophage Phagocyte Antibody Antigen
Antigen
Which client should the nurse determine is at greatest risk for vancomycin-resistant enterococci (VRE) infection? Client receiving chemotherapy Client with a history of eczema Client on a short course of vancomycin Client in the ICU for one day
Client receiving chemotherapy
Upon review of a client's microbiology culture results, the nurse recognizes which organism as indicative of normal flora? Escherichia coli in the intestinal tract Escherichia coli in the urinary tract Shigella in the intestinal tract Shigella in the urinary tract
Escherichia coli in the intestinal tract
A client has sought care because of a knee wound that appears to have become infected. Which process is a component of the cellular stage of inflammation that occurred earlier in his body's response to infection? Migration of leukocytes to the area of the wound Constriction of the small blood vessels near the wound Release of histamine Production of antibodies
Migration of leukocytes to the area of the wound
The nurse prepares for a sterile procedure. Of those listed, what action does the nurse perform first? Put on personal protective equipment, if required. Perform hand hygiene. Check that the packaged kit is dry and unopened. Set up a work area at waist level.
Perform hand hygiene.
What is an accurate guideline for the use of PPE? Put on PPE after entering the client's room. 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.
Replace gloves if they are visibly soiled.
A client is to have an indwelling urinary catheter inserted. Which precaution is followed during this procedure? Surgical asepsis technique Medical asepsis technique Droplet precautions Strict reverse isolation
Surgical asepsis technique
A client suffers from bloody diarrhea after eating contaminated food at a local restaurant. The client has been infected with a(an): bacteria. virus. fungi. protozoa.
bacteria.
After educating students about changes in the immune system and risk for infection as people age, the instructor determines that the education was successful when the students identify: increased humoral immunity response. decreased cellular immunity. increased effectiveness of phagocytosis. decreased susceptibility to infection.
decreased cellular immunity.
The process of phagocytosis involves: secretion of a nonspecific chemical inhibitor. depletion of serotonin in the brain cells. digestion of microbes by white blood cells. breakdown of proteins into amino acids.
digestion of microbes by white blood cells.
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 reduced length of stay for MRSA-positive clients constant use of gloves when on the unit prophylactic antibiotic therapy for MRSA-negative clients
diligent handwashing practices
A nursing student is reviewing the progression of an infection. Place the following in the order in which each would occur during the communicable period.
exposure to the pathogen nonspecific symptoms positive laboratory tests return of appetite
The nurse is getting ready to change the client's wound dressing. Which step best supports infection control? sterile gauze sterile gloves clean environment handwashing
handwashing
A physician performs lumbar puncture and advises the nurse to send the obtained cerebrospinal fluid for Gram stains. The nurse understands that this type of testing is beneficial for which reason? permits selection of antibiotic concentration helps in reducing proliferation of multidrug-resistant organisms narrows the therapeutic range to avoid prolonged use helps to determine prescribed antibiotic therapy
helps to determine prescribed antibiotic therapy
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 bath blanket face shields specimen containers
indwelling catheter
A nurse is explaining the process of infection to a nursing student. Place the process in the most appropriate order.
infectious agent a reservoir an exit route transmission mode entry portal susceptible host
The nurse is caring for a pediatric client who became very ill after being in a day care where a number of other children are sick with the same condition. How will the nurse document this condition? Select all that apply. infectious disease communicable disease noncommunicable disease contagious disease health care-associated infection (HAI)
infectious disease communicable disease contagious disease
The nurse who is caring for a client in contact isolation is preparing to conduct an assessment. Which stethoscope will the nurse choose to auscultate the client's bowel sounds? one that remains in the client's room one that is the nurse's personal stethoscope one that remains directly outside the client's room one that the client has personally purchased for use
one that remains in the client's room
A parent of a 9-year-old child states to the nurse, "I have not noticed any fever yet but my child describes feeling achy and not well." Which phase of the fever does the nurse identify the child may be experiencing? prodromal invasion stationary resolution
prodromal : medical term for early signs or symptoms of an illness or health problem that appear before the major signs or symptoms start
The nurse observes an unlicensed assistive personnel (UAP) collecting a urine specimen from a client with Staphylococcus aureus infection. Which action by the UAP would require the nurse to intervene? removes gloves and walks out of the room asks the client to state name and date of birth applies a mask with face shield performs hand hygiene before donning gloves
removes gloves and walks out of 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? Discard it in the waste can. Do nothing; it can be used again immediately. Disinfect it with alcohol swabs. Sterilize it by placing it in the autoclave.
Disinfect it with alcohol swabs.
Which mask should the nurse don when caring for a client with tuberculosis? Low-efficiency particulate air (LEPA) Filtered respirator Surgical mask No mask is needed
Filtered respirator
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 resident microorganisms mutated and became virulent The client's immune system became further weakened The client's normal flora proliferated because of a nutritional deficit The client's normal flora began producing spores
The client's immune system became further weakened
The nurse is preparing to insert an intravenous catheter into a client. Which infection control procedure will the nurse use to ensure safe client care? Dip the IV catheter into an antiseptic before use. Clean the site with a disinfectant. Use a sterile intravenous catheter. Wear a mask and gown for the procedure.
Use a sterile intravenous catheter.
The nurse is caring for an older adult with pulmonary tuberculosis. Which precautions will the nurse begin? airborne droplet contact none
airborne
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 2-year-old toddler a 12-year-old girl an 18-month-old infant
an 80-year-old woman
Personal protective equipment (PPE) is used in health care facilities to protect the staff from potentially infected clients. true false
true
An older adult client tells the nurse, "I do not understand why I have had so many episodes of infection lately." How should the nurse respond? "It is possible that you are not washing your hands well enough." "As we age, our immune system does not function as well." "You will have to limit who comes to visit since they may be exposing you." "There are a lot of infectious processes around and there is nothing that can be done."
"As we age, our immune system does not function as well."
A client admitted for fever, crackles in the lungs, and cough asks the nurse, "If they do not know what type of bacteria caused my pneumonia, why are they giving me these antibiotics?" What is the appropriate response by the nurse? "We are giving you broad spectrum antibiotics because they are active for many types of bacteria." "You cannot be admitted to the hospital with pneumonia without receiving some sort of antibiotics." "We give antibiotics to treat the virus that are causing your the pneumonia." "The antibiotics we are giving you will boost your immune system and help fight off whatever pathogen is present."
"We are giving you broad spectrum antibiotics because they are active for many types of bacteria."
The nurse determines that which client is at greatest risk for a wound infection? A two-day postoperative client An older adult client with dry skin An infant with intact skin A client with a urinary catheter
A two-day postoperative client
An older adult client is admitted into the hospital due to tuberculosis. In addition to standard precautions, which transmission-based precautions should the nurse initiate? Fomite Airborne Droplet Contact
Airborne
The nurse is caring for a client admitted with tuberculosis (TB). What would be the best action by the nurse? Wear a protective gown and gloves with any direct contact. Apply a nonparticulate (N-95) respirator when entering the room. Have the client wear a mask during care. Wear a mask with face shield during invasive procedures.
Apply a nonparticulate (N-95) respirator when entering the room.
About which public health principle should the nurse educate clients to prevent the spread of West Nile virus? Avoid contact with mosquitoes Use hand sanitizer after touching any public surface Self-quarantine yourself for 2 weeks if you feel ill Use a face mask when in crowds
Avoid contact with mosquitoes
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? Avoid touching the outer surfaces of the gown. Remove the gown before removing gloves. Remove the gown immediately after exiting the room. Perform hand hygiene before removing the gown.
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? Decontaminate hands using an alcohol-based hand rub. Do not wash hands; apply clean gloves. Wash hands with soap and hot water. Wash hands with soap and water, followed by an alcohol-based hand rub.
Decontaminate hands using an alcohol-based hand rub.
A nurse is preparing to obtain a specimen for an anaerobic wound culture. The nurse would obtain the specimen from which area? Edge of the wound Area of active drainage Deep into the cavity Drainage on the dressing
Deep into the cavity
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? Since the bottle has been open, previously used, and unexpired, "lip" it by pouring a small amount into a waste container or waste cup. Discard the bottle and get a new one because the saline has expired. Pour the saline into a sterile container on the sterile field by holding it 6 in (15 cm) above the container. 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.
The nurse is preparing a sterile field for a bedside procedure. During preparation, the client reaches over the field for the water pitcher. What would be the best action by the nurse? Discard the supplies and field and prepare a new sterile field. Educate the client on sterile fields and continue preparing for the procedure. Give the client the water pitcher and continue preparation. Remove the supplies from the field and replace with new supplies.
Discard the supplies and field and prepare a new sterile field.
An experienced nurse is teaching a student nurse about the proper use of hand hygiene. Which guideline should the nurse provide to the student? The use of gloves eliminates the need for hand hygiene. The use of hand hygiene eliminates the need for gloves. Hand hygiene is needed after contact with objects near the client. Hand lotions should not be used after hand hygiene.
Hand hygiene is needed after contact with objects near the client.
A nurse is implementing the principles of surgical asepsis while inserting a client's indwelling urinary catheter. Which action should the nurse perform? Hold sterile objects above waist level to prevent accidental contamination. Consider the outside of the sterile package to be partially sterile. Consider the outer 3-in edge of a sterile field to be contaminated. Open sterile packages so that the first edge of the wrapper is directed toward you.
Hold sterile objects above waist level to prevent accidental contamination.
What is the second line of defense in microbial invasion? Inflammation Infection Disease Disability
Inflammation
A client receiving multi-antibiotic treatment is reporting oral thrush and refuses to eat his meals. Which intervention must the nurse perform next? Inform the physician about this finding. Encourage the client to brush his teeth 3 times a day. Assess for the expiration dates of the antibiotics being administered. Inform the client that the antibiotics will resolve this problem.
Inform the physician about this finding.
The nurse is caring for a client who has active tuberculosis and is under airborne precautions. The health care provider prescribes 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. Notify the CT department in advance so other clients and staff can be removed from the area. Question the need for the examination, because the client must remain under airborne precautions. Request that the examination be done at the bedside.
Place a surgical mask on the client and transport to the CT
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 Reactive airway disease and exacerbation of chronic obstructive pulmonary disorder (COPD) Tuberculosis and pneumonia Appendectomy and a draining leg ulcer positive for methicillin-resistant Staphylococcus aureus
Reactive airway disease and exacerbation of chronic obstructive pulmonary disorder (COPD)
The nurse administered an antipyretic drug to a client with high-grade fever of 101.4°F (38.6°C). Which intervention should the nurse perform next? Reassess temperature after 1 hour and document results in the chart. Encourage the client to ambulate in the room to improve circulation. Ask the client to use his incentive spirometer 5 times. Require the client to drink 8-10 glasses of water to avoid dehydration.
Reassess temperature after 1 hour and document results in the chart.
The nurse planning to insert an indwelling urinary catheter into a client should utilize which technique? Surgical asepsis Medical asepsis Universal precautions Contact precautions
Surgical asepsis
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: Means of transmission Spore production Aerobic activity Survival adaptation
Survival adaptation
A group of nursing students is reviewing the various white blood cells and how they function in infection. The students demonstrate understanding of the information when they identify which cell as important in synthesizing immunoglobulins? Neutrophils Eosinophils T-lymphocytes Monocytes
T-lymphocytes
The student nurse observes another nurse wash her hands in the client's bathroom before exiting the room. This client's stool came back positive (+) for Clostridium Difficile (C diff). Why is this behavior incorrect? Clostridium difficile bacteria is eradicated by the use of hand sanitizer only. The behavior is not a problem as long as the nurse uses gloves in the room. The nurse must make sure that the bathroom has been cleaned recently before washing her hands. The bathroom is highly contaminated with the Clostridium difficile bacteria.
The bathroom is highly contaminated with the Clostridium difficile bacteria.
The nurse is caring for several clients assigned single rooms on a medical-surgical unit. In which client(s) can the nurse safely carry out hand hygiene using hand sanitizer instead of washing hands with soap and water? Select all that apply. The nurse is going from one room to another to introduce themself at the start of the shift. The nurse has entered the client's room to adjust settings on the intravenous pump. The nurse has just completed documentation and is entering another client's room. The nurse is exiting a room after completed indwelling urinary catheter care. The nurse has assisted a client with changing and caring for a new colostomy.
The nurse is going from one room to another to introduce themself at the start of the shift. The nurse has entered the client's room to adjust settings on the intravenous pump. The nurse has just completed documentation and is entering another client's room.
The nurses on a busy surgical ward use hand hygiene when caring for postsurgical patients. Which action represents an appropriate use of hand hygiene? The nurse uses gloves in place of hand hygiene. The nurse keeps fingernails less than 1/4 in (0.63 cm) long. The nurse uses hand hygiene instead of gloves when in contact with blood. The nurse refrains from using hand moisturizer following hand hygiene.
The nurse keeps fingernails less than 1/4 in (0.63 cm) long.
Surgical asepsis is defined as: absence of all virulent microorganisms. absence of all microorganisms. slowed growth of microorganisms. use of hand washing, gowning, and gloving.
absence of all microorganisms.
The nurse is reviewing the plan of care for assigned clients. Which client has the highest risk for developing an infection? an older adult client with a history of heart failure a school-age child who is current with immunizations an adolescent who has a right radial fracture a middle-aged adult who takes prescribed medication to control blood pressure
an older adult client with a history of heart failure
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 contact precautions change to airborne precautions change to standard precautions continue with droplet precautions
change to airborne precautions
The nurse is caring for a client with a surgical wound. Which action by the nurse best reduces the reservoir of infection? changing the soiled dressing wearing clean unsterile gloves when changing the dressing isolating the client's belongings applying a face mask with shield
changing the soiled dressing
The nurse is caring for a 27-year-old client who presents with possible signs of an infected abdominal wound. Which action should the nurse prioritize and initiate after receiving the results of the laboratory test indicating the client has methicillin-resistant Staphylococcus aureus (MRSA) infection? airborne droplet contact reverse isolation TAKE ANOTHER QUIZ
contact
The nurse is caring for an older adult with a recurrent wound infection. Which precautions will the nurse begin? airborne droplet contact none
contact
A client is admitted to the emergency department for multiple lacerations due to a vehicular accident. After wound care, the doctor writes an order for Tdap (Tetanus-diphtheria-pertussis) vaccination. The primary reason for this vaccine is: it is an antiviral vaccine used to eradicate wound infection. it is a vaccine given to booster antibodies towards the tetanus pathogen. it induces humoral immunity in the client's blood. It counteracts the effects of the inflammatory process.
it is a vaccine given to booster antibodies towards the tetanus pathogen.
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? wear gloves when touching the client wear a mask and gown in the client's room avoid direct contact with the client perform hand hygiene before and after entering the client's room
perform hand hygiene before and after entering the client's room
The nurse is adding a sterile solution onto a prepared sterile field. What is the best technique performed by the nurse? pouring the sterile solution from a height of 5 in. (13 cm) touching the tip of the bottle to the sterile container to avoid splashing placing the cap on the table with edges down discarding any unused sterile solution
pouring the sterile solution from a height of 5 in. (13 cm)
Every 2 hours, the nurse turns and repositions the client who is experiencing frequent diarrhea. This action supports, among other things, infection prevention. Which assessment indicates that there is a positive outcome from this nursing care? redness size over sacral area is with minimal increase blanching over elbow area noted skin is dry and intact slight bleeding noted while old dressing is removed
skin is dry and intact
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 belonging to the nurse stethoscope that remains in the client's room stethoscope that hangs outside the client's room stethoscope that has been purchased by the client
stethoscope that remains in the client's room
The most lethal infection in an older adult client is: skin. optic. otic. urinary.
urinary.
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? wear gloves wear face shield wear mask wear goggles
wear gloves
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? "Your loved-one has an antibiotic-resistant infection which means that there are a limited number or no antibiotics available to treat it." "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." "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."
While the nurse is conducting morning rounds, the nurse notices that the client's temperature has gradually increased for the past 3 days. Which assessment(s) should the nurse do next? Select all that apply. Auscultate lung sounds. Check site of wound. Check IV site for infiltration. Review how compliant the client has been with ambulation. Call the laboratory for blood culture test.
Auscultate lung sounds. Check site of wound. Check IV site for infiltration. Review how compliant the client has been with ambulation.
The nurse working with the hospital's infection control team is attempting to decrease the transmission of healthcare-associated pathogens. Which intervention will be most effective? Incentivizing health care workers to utilize hand hygiene Revising the facility's infection control protocols Encouraging visitors to adhere to isolation precautions Limiting visitors to family members over the age of 18
Incentivizing health care workers to utilize hand hygiene
A client with cancer has been receiving chemotherapy for the past few weeks. The nurse is concerned about infection and is reviewing the white blood cell count (WBC) in the chart. Which result supports this concern? WBC of 7,500 mcL WBC of 25,000 mcL WBC of 5,500 mcL WBC of 10,500 mcL
WBC of 25,000 mcL
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 droplet precautions contact precautions respiratory precautions microbial precautions body fluid precautions
airborne precautions droplet precautions contact precautions
