Prep U Ch 24: Asepsis and Infection Control
A client is admitted to the hospital with tuberculosis. Which statement by the nurse explains how to reduce the risk of transmission to others
"All visitors who enter the room must wear special masks."
The nurse is caring for a postpartum mother who delivered her second child yesterday. The mother states that her older child has just been diagnosed with chickenpox. She is concerned that her newborn will develop the disease. What is the best response by the nurse
"Have you had chickenpox?"
A pediatric client's caregiver states, "I will never give my child vaccinations." What is the prioritynursing response
"Help me understand your thoughts about vaccinations." Seeking to understand the caregiver's perspective helps the nurse to collect assessment data and create a therapeutic relationship of trust. The nurse could then collect assessment data regarding past vaccines and provide appropriate teaching.
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
"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 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
"The way you are doing it helps to minimize contamination of the non-waterproof side."
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."
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 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 will assess a client who has a draining abscess. The nurse should perform what action to safely enter the room
*picture shows putting on gloves*
Which nursing actions will be performed to assist in the prevention of health care-associated infections (HCAIs)? Select all that apply
1.Wash hands between caring for clients. 2.Recommend vaccinations to clients. 3.Educate clients regarding why antibiotics are not used for viral illnesses.
In which order should the following steps for putting the first hand into a sterile glove be performed? 1. Carefully open the inner package. Fold open the top flap, then the bottom and sides. 2. Place the inner package on the work surface with the side labeled "cuff end" closest to the body. 3. With the thumb and forefinger of the nondominant hand, grasp the folded cuff of the glove for the dominant hand, touching only the exposed inside of the glove. 4. Keeping the hands above the waistline, lift and hold the glove up and off the inner package with fingers down. 5. Place the sterile glove package on a clean, dry surface at or above your waist. 6. Carefully insert dominant hand palm up into the glove and pull it on. 7. Open the outside wrapper by carefully peeling the top layer back and remove inner package, handling only the outside of it.
5, 7, 2, 1, 3, 4, 6
Which client would the nurse consider the most infectious
A patient who is in the prodromal stage
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."
The nurse caring for clients at an outpatient clinic determines that which client is at greatestrisk for infection
An 80-year-old woman
The nurse is caring for a client admitted with tuberculosis (TB). What would be the best action by the nurse
Apply a non-particulate (N-95) respirator when entering the room.
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.
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.
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
Discard the bottle and get a new one because the saline has expired.
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.
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
Which mask should the nurse don when caring for a client with tuberculosis
Filtered respirator
A nurse is caring for a client with ringworm. Which microorganism causes ringworm in a client
Fungi
Which piece of personal protective equipment (PPE) should be removed first
Gloves
An experienced nurse is teaching a student nurse about the proper use of hand hygiene. Which guideline should the nurse provide to the student
Hand hygiene is needed after contact with objects near the client.
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 older adult woman has been in the hospital for more than 1 week. While assessing her intravenous catheter port, the nurse finds a staph infection, which has developed in the past day or so. This infection is an example of which type of infection
Healthcare-associated infection
To eliminate needlesticks as potential hazards to nurses, the nurse should
Immediately deposit uncapped needles into puncture-proof plastic container.
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
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.
The nurse is asked to check the unit's supply of personal protective equipment (PPE) to see if additional equipment needs to be ordered from central supply. The nurse should assess the level of which type of equipment? Select all that apply
Masks Protective eyewear Gowns Nonsterile gloves
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
Perform hand hygiene
The nurse is caring for a client with a latex sensitivity. Which resource would be mostappropriate for the nurse to access when developing the client's plan of care
Policy for clients with latex sensitivity
What is an accurate guideline for the use of PPE
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
Which should be documented by the nurse
The fact that sterile technique was used for a given procedure
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 keeps fingernails less than 1/4 in (0.63 cm) long.
A nurse is applying the principles of Standard and Contact Precautions in the care of a hospital client. Which action violates these principles
The nurse removes her gown and them removes the gloves
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
Use a sterile cotton-tipped applicator to apply the prescription to the site
The nurse is providing an in-service educational program for the interprofessional health care team about infection control precautions. What teaching will the nurse include? Select all that apply
Wear personal protective equipment (PPE). Practice hand hygiene. Keep client's environment clean.
In which situation is an alcohol-based rub an inappropriate option for hand hygiene
When the nurse's hands are visibly soiled
For which client would the use of standard precautions alone be appropriate
an incontinent client in a nursing home who has diarrhea
A client suffers from bloody diarrhea after eating contaminated food at a local restaurant. The client has been infected with a(an)
bacteria.
A client with HIV is the
carrier.
The nurse is caring for a client with a draining abscess. Which precautions will the nurse begin
contact
The nurse and a colleague have admitted a client who is on contact precautions. The nurse and colleague are removing their personal protective equipment and the nurse sees the colleague perform the pictured action. What is the nurse's most appropriate response
encourage the colleague to remove the glove by grasping the cuff
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 became very ill after ingesting seafood. How will the nurse document this condition
noncommunicable disease
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 a sterile container within the sterile field
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.
A student nurse is attending a clinical rotation in the perioperative department and will be allowed to scrub in to observe. What observation made by the clinical instructor requires intervention before the student is allowed to attend the rotation? Select all that apply
rings on finger artificial nails with intact clear nail polish red nail polish
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 client has an inguinal hernia repair and later develops a methicillin-resistant Staphylococcus aureus (MRSA) infection. What is the most important factor to prevent this infection
surgical asepsis
The nurse is caring for assigned clients who are all stable. Which client should the nurse see firstto minimize the spread of infection
the client who is 48-hours post-surgical procedure
A nurse is caring for a 55-year-old postoperative 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
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 nurse is monitoring a student who is performing surgical hand asepsis. Which student actions indicate the need for further education from the nurse? Select all that apply
wearing a gold wedding band using at least five strokes for cleansing in each area dropping hands to side when the wash is complete
