Safety and Infection Control Plan A quizzes

A client is being treated for influenza A (H1N1). The nurse has provided instructions to the client about how to decrease the risk of transmission to others. Which statement by the client indicates a need for further instruction?

"I should obtain a pneumococcal vaccination each year."

The new nurse is approached by a surveyor from the department of health. The surveyor asks the nurse about the best way to prevent the spread of infection. Which answer by the nurse is correct?

"Wash your hands before and after any client care."

An adolescent with comedonal acne has been prescribed tretinoin gel. Which treatment-specific instructions would be given? Select all that apply. One, some, or all responses may be correct.

Apply the medication at night. Use a scarf to avoid sun exposure on the face. Apply a pea-sized dot of medication on the three main areas of the face and gently rub.

Which action would the nurse take for an older adult client who is agitated, confused, and actively attempting to get out of bed?

Assign the nursing assistant to stay with the client while the nurse calls the health care provider.

An infant with severe developmental dysplasia of the hip has a hip spica cast applied. Which instruction would the nurse give the parents to help prevent a serious complication?

Call the primary health care provider if a foul smell is detected.

Which is the most highly sensitive time within the developing embryo for the risk of malformation related to environmental teratogens?

Cleft palate at 8 weeks' gestation

Which category of isolation would the nurse implement for a client who is positive for Clostridium difficile?

Contact precautions

Which agent would the nurse deduce was used in a terrorist attack in which all victims at the disaster site have breath with an almond odor?

Cyanide

Which intervention would the nurse on a disaster management team consider to be most appropriate to be included in the plan to prevent the spread of pandemic influenza?

Distribute antiviral agents to clients.

Which would the nurse use to monitor for torsades de pointes in a client with schizophrenia being treated with chlorpromazine?

ECG

Which rationale would the nurse provide the parent of an 8-month-old infant for removing small objects from the play environment?

Eight-month-old infants pick up small objects and place them in their mouths.

Which hospital department plays a primary role in disaster preparedness?

Emergency department

Which guidance would the nurse provide to the parent of an 8-year-old child?

Expect an increase in minor injuries.

Which plant, if ingested by a toddler, would necessitate further action by the nurse?

Lily

Which action by the nurse during a fire drill indicates the need for further education on client safety during a fire?

Opens doors for ventilation

The nurse is educating a client on the use of heat and cold for osteoarthritis (OA) pain. Which action by the client indicates the need for additional teaching?

Places ice pack on skin

When a client in the clinic is offered the influenza vaccine and states, "I had the vaccination already last year, so I won't need it now," which response will the nurse give?

"The immunization changes, so you need to get vaccine annually to stay protected."

Which factors contribute to the frequency of iron poisoning in toddlers? Select all that apply. One, some, or all responses may be correct.

- Widespread availability - Resemblance of iron tablets to candy - Lack of parental awareness of the toxicity - Packaging of large quantities in containers Factors related to the frequency of iron poisoning of a toddler include widespread availability, resemblance of iron tablets to candy, lack of parental awareness of the toxicity, and packaging of large quantities in containers. The amount of elemental iron ingested is associated with the toxicity and is not identified as a factor related to the frequency of iron poisoning.

The school nurse is teaching a class about bicycle safety. The nurse determines that a child needs further teaching when the child makes which statement?

"I will always wear a helmet and ride with traffic facing me."

Which parental statement would the nurse recognize as indicating the need for further education about bicycle safety for a school-aged client?

"My child should be able to safely ride after being supervised for a couple of weeks."

Which recommendation would the nurse make to parents when selecting a childcare setting?

"Choose the childcare after you have contacted the state licensing agency." State licensing agencies can help parents identify childcare centers that accept children of specific age-groups. Their records are available to the public and provide reports from the health, safety, and fire departments; periodic evaluations from the licensing agency; complaints filed against the center; and qualification of the center's employees. Choosing a childcare facility based on its location or the fact that it holds a state license does not provide any further information about the facility. Choosing a facility for childcare for which there is a lower child-to-caregiver ratio or what is affordable does not imply the facility is licensed or is compliant with the minimum requirements and safeguards.

Which basic principles of surgical asepsis must the nurse consider when changing the dressing of a child with severe burns? Select all that apply. One, some, or all responses may be correct.

- A paper field must remain dry to be considered sterile. - A 1-inch (2.5 cm) border around a sterile field is considered contaminated. - Sterile objects in contact with clean objects are considered contaminated. Once a sterile paper field becomes wet it allows microorganisms on the surface of the table to contaminate the field. A 1-inch (2.5 cm) border around the outer edge of a sterile field is considered contaminated because the edges touch the table. Once a sterile object comes into contact with any object that is not sterile, it is no longer considered sterile. Sterile objects below the waist are considered contaminated. A fenestrated drape may be considered sterile as long as it has not been contaminated.

To ensure antibody-mediated immunity, which actions would the nurse instruct an older client to implement? Select all that apply. One, some, or all responses may be correct.

- Obtain a shingles vaccination. - Receive a tetanus booster injection. - Obtain the pneumococcal vaccination. - Receive an annual influenza vaccination. Because older adults are less able to make new antibodies in response to the presence of new antigens, they should receive the shingles vaccination. Because older adults may not have sufficient antibodies present to provide protection when they are reexposed to microorganisms they have already generated antibodies against, booster shots are encouraged. The pneumococcal and influenza vaccinations help create antibodies in response to new antigens. Testing for tuberculosis addresses cell-mediated immunity for the older client.

Which action will the nurse complete when preparing a stroke client for cerebral imaging with iodine-based contrast dye?

Ensure a recent creatinine level has been assessed. Cerebral imaging with contrast dye places clients at risk for contrast-induced kidney damage. Assessment of creatinine for kidney function is essential before testing. An iodine allergy is important to note because treatment with antihistamines before imaging may be ordered, but the allergy would not require the imaging to be cancelled. Fluid intake should be increased, not decreased, and documented well before and after imaging because of the potential effect on kidney function. ACE inhibitors and other medications with significant renal implications will be held before and after imaging to protect the kidneys.

The nurse is transferring a client from the bed to the chair. Which action would the nurse take first during the transfer?

Instruct the client to dangle the legs. The nurse would place the client in high-Fowler position, or 80 to 90 degrees, and then assist the client to the side of the bed. Next, the nurse helps the client sit on the edge of the bed and then instructs the client to dangle the legs. The nurse then faces the client and places the chair next to and facing the head of the bed. The semi-Fowler, or 30 to 45 degrees, position is not high enough to get the client in a sitting position.

A client who has syphilis tells the nurse that it must have been contracted from a toilet seat. The nurse knows that this cannot be true because of which property of the causative agent of syphilis?

It is inactivated when exposed to a dry environment. A dry environment inactivates Treponema pallidum, making it incapable of causing disease. The organism is transferred by warm, moist, sexual body contact, which supports growth of the organism. Nothing chelates this organism.

Why should the use of baby powder on an infant be avoided?

Lung irritation The use of baby powder or cornstarch should be avoided on an infant because it is associated with lung irritation. The use of baby powder or cornstarch is not directly associated with skin irritation or with skin or respiratory infections.

Which intervention is the priority for a client who is agitated and has made unprovoked hostile verbal attacks on coworkers?

Maintaining safety

Which are ways used to integrate evidence in the clinical practice setting? Select all that apply. One, some, or all responses may be correct.

New assessment tools Clinical practice guidelines Organization policies and procedures

When laboratory results of a client's bloodwork after chemotherapy indicate bone marrow depression, which activities would the nurse reinforce? Select all that apply. One, some, or all responses may be correct.

Use a soft toothbrush. Read the ingredients in over-the-counter medications before taking them.

Which action would the nurse identify as a potential contributor to staff post-traumatic stress disorder (PTSD) during a mass casualty assessment?

Working continuously without any breaks

Which intervention would the nurse include in the plan of care for a client admitted with herpes zoster? Select all that apply. One, some, or all responses may be correct.

Acyclovir Silvadene Gabapentin Wet compresses Contact isolation

A pregnant woman arrives at the local health department requesting a flu shot. Which action would the nurse perform?

Administer the usual dose of the vaccine.

Which action will the nurse include in the plan for care for a client after a bronchoscopy examination?

Check for the gag reflex.

Applying the emergency severity index (ESI) criteria, which client condition is considered least severe?

Closed extremity trauma Care for a client with closed extremity trauma could be delayed because it is considered less severe when compared with other client conditions and triaged in emergency severity index (ESI-4). This client is given least priority. The client with cardiac arrest is triaged under ESI-1 and should be seen immediately because the condition is more severe. The client with abdominal pain is triaged under ESI-3 and should be seen within 1 hour. The client with multiple trauma should be seen within 1 hour and is triaged under ESI-2.

The nurse recognizes that belly binding is a common cultural practice for the mother of a 9-month-old infant with extrusion of the umbilicus. Which variation of belly binding would the nurse discourage?

Coin in the umbilicus A coin may be dislodged, allowing the infant to put it in his or her mouth, resulting in a safety issue. A diaper fastened tightly around the waist, a binder, or adhesive tape over the umbilicus will not endanger the infant. Cultural beliefs that do not place the infant at risk should not be discouraged.

Which would the nurse assess for in a male child prescribed an androgen?

Decreased height

Which action will the nurse take after noticing condensation in the tubing of humidified oxygen?

Drain the condensation into a water trap.

Which nursing intervention will be priority when caring for a client with status epilepticus?

Establish an airway

To ensure the safety of a client who is receiving a continuous intravenous normal saline infusion, the nurse would change the administration set how often?

Every 72 to 96 hours

Which type of assessment is performed when the nurse uses the mnemonic AMPLE to determine the client's condition after a natural disaster during a secondary emergency assessment survey?

History and head-to-toe assessment History and head-to-toe assessment involves use of the mnemonic AMPLE that includes Allergies, Medication history, Past health history, Last meal, and Events preceding illness or injury to determine the history of the client. Giving comfort measures is an emergency assessment that is used to assess, treat, and reassess for pain and anxiety. Posterior surfaces are inspected to determine bleeding, bruises, and lacerations. Facilitating family presence includes determining the caregiver's desire to be present during invasive procedures.

The nurse educator is presenting to a group of nurses about the use of de-escalatory techniques. Which actions would the nurse include in the presentation? Select all that apply. One, some, or all responses may be correct.

Identify client needs. Determine stressors and triggers. Refrain from arguing with the client.

The nurse is working with an adolescent who reports cutting on a regular basis. The client states, "Life is so hard; it is difficult to handle the stress." Which action made by the client indicates part of the six-step approach to recovery?

Implementing new coping skills The fifth step of the six-step approach to recovery is to replace self-injury with coping skills. Administering antidepressants and encouraging support group attendance are nursing interventions. Refraining from further self-harm is a nursing outcome.

How can the nurse best manage a common side effect of chemotherapy?

Providing meticulous oral hygiene Children undergoing chemotherapy are prone to mucosal cell damage that can produce ulcers throughout the gastrointestinal tract; oral ulcers are a common side effect and can cause extreme discomfort. Increased fluid intake is encouraged to enhance the excretion of uric acid crystals. Chemotherapy acts as an immunosuppressant. Contact precautions protect the care provider; it is the child who needs to be protected. Keeping the hair short will not prevent it from falling out while the child is undergoing chemotherapy.

A child with type 1 diabetes has difficulty measuring the required insulin dose. The child frequently draws up 42 units of insulin instead of the prescribed 24 units. Which is the most appropriate intervention to ensure dosage safety?

Providing the child with a preset syringe that was developed for the visually impaired

Which would the registered nurse say is the priority action of first responders after a community disaster?

Removing the victims from danger First-responders in a disaster include other disaster-trained emergency personnel who had specific search and rescue training. The priority action of first responders is to remove injured and uninjured victims. The nursing staff provides on-site first aid and emergency care. After removing victims from danger, the health care personnel categorize victims using the triage system.

The nurse is planning care for a client with diabetes insipidus (DI). Which intervention made by the nurse requires correction?

Restricting fluids at night

Which nursing interventions are applicable to a client receiving an infusion of magnesium sulfate for severe preeclampsia? Select all that apply. One, some, or all responses may be correct.

Restricting visitors Maintaining a quiet environment

Which are the primary goals of prenatal nursing care? Select all that apply. One, some, or all responses may be correct.

Safe birth for mother and infant Promote health and well-being of mother and infant Satisfaction of mother and family with the birth experience

Offspring of men of advanced paternal age are at an increased risk for which condition?

Schizophrenia

Which action would the nurse do immediately when the nurse finds the respiratory rate is 8 breaths per minute in a client who is on intravenous morphine sulfate?

Stop administering the medication

Which findings noted during assessment would lead the nurse to determine that a client is at an increased risk for infection? Select all that apply. One, some, or all responses may be correct.

Surgical incision Urinary catheter Antibiotic therapy Intravenous access

Which consideration is most important when counseling the family of a child with human immunodeficiency virus (HIV)?

Susceptibility to infection Children with HIV have a dysfunction of the immune system (depressed or ineffective T lymphocytes, B lymphocytes, and immunoglobulins) and are susceptible to opportunistic infections. All children are subject to injury because of their curiosity, inexperience, and lack of judgment. Although inadequate nutrition can be a problem for children with HIV, the prevention of infection is the priority. Although children with HIV are usually small for their age, altered growth and development is not as life threatening as an infection.

Which safety education would the nurse provide to the parent of a 3-month-old infant?

Test the temp of water before bathing. Excessively high temperatures can damage the delicate skin of an infant. Although infants are capable of putting small things in their mouths, a 3-month-old infant is not yet able to crawl and probably will not be placed on the floor. At 3 months of age, infants are not yet able to explore the environment to the point that electric outlets pose a problem. At 3 months of age, infants are still too small and have not yet developed motor capabilities to access hazardous substances.

A newborn is admitted to the nursery with a spiral scalp electrode from an internal monitor in place. How would the nurse remove the electrode?

Twisting the electrode counterclockwise until it is free For the spiral electrode to be removed it must be turned counterclockwise. Quickly jerking the electrode may result in a lacerating injury to the scalp. The electrode is attached by turning it clockwise. It is unnecessary to untwist the wires; the electrode should not be pulled, because this may cause a scalp laceration.

A 2-year-old child with previously diagnosed hemophilia is admitted to the pediatric unit for observation after a motor vehicle collision. The toddler has several bruises but no other apparent injuries. Which is the nurse's specific concern regarding this child?

Undetected injury

Which is the priority nursing action for the nurse caring for a child undergoing chemotherapy to treat leukemia?

Using techniques to minimize risk for infection

A child is admitted to the pediatric unit with a tentative diagnosis of acute glomerulonephritis (AGN). Which would the nurse expect the laboratory report to reveal?

Increased antistreptolysin O (ASO) titer An increased ASO titer indicates the presence of a previous streptococcal infection; levels are highest with AGN, bacterial endocarditis, and scarlet fever. The sedimentation rate is increased in glomerulonephritis; it signifies an inflammatory process. A reduction in serum complement (C3) activity occurs early in the disease process of glomerulonephritis; activity increases as the child improves. The blood urea nitrogen level is increased, not decreased, with glomerulonephritis because of impaired glomerular function, with azotemia occurring as a result.

Which type of unit would be an appropriate placement for a client who was involuntarily admitted for a 48-hour hold due to a suicide attempt and is believed to be an elopement risk?

Locked A client who has been involuntarily admitted due to self-harm should be placed in a locked unit to prevent elopement. An unlocked unit, assisted living, or nursing home would allow the client to leave easily.

A client admitted with urinary retention has an indwelling urinary catheter prescribed. Which action would the nurse implement to prevent the client from developing a urinary tract infection?

Maintain the prescribed hydration

Which areas would the nurse keep in mind when participating in the planning of an organization's emergency preparedness plan? Select all that apply. One, some, or all responses may be correct.

Needs for security Staffing for surge situations Methods of communication Definition of specific nursing roles

When is it not necessary for the nurse to wear gloves while caring for a newborn?

Offering a feeding Standard precautions do not include the use of gloves for feeding. Wearing clean gloves for diaper changes of newborns is standard protocol. Clean gloves should be worn for all admission baths, because the nurse will be exposed to blood and amniotic fluid. Clean gloves should also be worn while the nurse suctions an infant.

According to the Institute of Medicine (IOM) report in 2011 envisioning a transformed health care delivery system report, which transformations in nursing practice would take place? Select all that apply. One, some, or all responses may be correct.

Practice to the full extent of education and training Achieve higher levels of education and training through improved programs Be full partners with other health care providers in redesigning the health care system

Which nursing goal would be priority for an adolescent who has a history of fighting, stealing, vandalizing property, running away from home, and has been suspended from school repeatedly?

Preventing violence

A child with beta-thalassemia (Cooley anemia) is admitted to the ambulatory care unit for a transfusion. Which instruction would the nurse include in the plan of care?

Protect from infections.

Which action would the nurse take when, upon entering a client's room, he or she discovers the client experiencing a seizure on the floor?

Protect the head. Safety is a priority for the client experiencing a seizure. The nurse would protect the head through cradling or using a pad. Movement should not be retrained because that can lead to musculoskeletal injury. An airway should not be placed until the mouth is relaxed because it can chip teeth that can then be aspirated. The body should remain protected where it is while convulsing, not moved.

Which statement by a client who is being discharged with a new prescription for home oxygen therapy indicates the need for further instruction by the nurse?

"I have a new woolen blanket to keep me warm." An open flame or a spark from static electricity (generated by such items as leather-soled shoes; wool, silk, and nylon blankets; or ungrounded electrical appliances) can initiate an explosion and fire in the presence of higher-than-environmental oxygen levels. Grounded electrical equipment helps prevent sparks. When combined with oxygen, heat from lit cigarettes can ignite flammable material. Oxygen is drying; increased fluid intake is advisable.

A new mother asks the nurse administering erythromycin ophthalmic ointment to her newborn why her baby must be subjected to this procedure. Which is the best response by the nurse?

"This antibiotic helps keep babies from contracting eye infections." Erythromycin ophthalmic ointment is used to treat infections cause by Neisseria gonorrhoeae and Chlamydia species, which may be transmitted during birth. It is administered prophylactically. Although it will prevent the newborn from becoming blind if the infant is born with these infections, there is not enough information in the answer to help the mother understand how the ointment prevents blindness. The antibiotic ointment is not administered to protect the newborn from bright lights. Newborns are in fact required by law to receive erythromycin ophthalmic ointment, but simply stating this does not explain why it is administered.

Which nursing interventions are beneficial in the event of fire in the hospital? Select all that apply. One, some, or all responses may be correct.

- Asking ambulatory clients to help push wheelchair clients out of danger - Maintaining injured clients' respiratory status manually until removed from the fire area The nurse would ask ambulatory clients to help push wheelchair clients out of danger. The nurse would maintain the respiratory status of injured clients manually until they can be removed from the fire area. The nurse would close the doors and windows to try to contain the fire. The nurse would move the immobile clients from the fire area in a wheelchair or by stretcher. The nurse would first remove the clients from the fire area and let professional responders put out the fire.

Which actions would be included in the safety plan for a woman in crisis, who is emotionally and physically abused by her husband? Select all that apply. One, some, or all responses may be correct.

- Determining a safe place to go in an emergency - Memorizing the domestic violence hotline number

Which features would the emergency department (ED) nurse use from an automated tracking system for triage during mass casualty incidents (MCIs)? Select all that apply. One, some, or all responses may be correct.

- Priority upon arrival - Interaction with caregivers - Priority per process of care - Priority according to location Automated tracking systems using infrared and radiofrequency technology (RFT) are available in some EDs to track a client's triage priority upon arrival, location, and process of care. The interactions the client has with caregivers can also be tracked; this is an important safety strategy if the client is later found to have contaminants or a disease that could pose a risk to staff members who had close contact and require decontamination or prophylaxis. Clinical manifestations cannot be tracked using this system.

Which items would the nurse instruct community members to include in a personal preparedness bag? Select all that apply. One, some, or all responses may be correct.

Toiletries Cell phone and charger 3-day supply of clothing 3-day supply of nonperishable food items

Which is the most appropriate nursing intervention to prevent further injury in the client who was injured in a tornado and is disoriented?

Asking a family member to remain with the client Asking a family member or significant person who cares for the client to remain with the client will help reduce confusion in the client. It is the most important intervention to prevent injury in the client. Keeping rails up on the stretcher will help prevent injury in the client, but it is not the most appropriate intervention. Keeping the stretcher in the lowest position will prevent injury, but it is not the most appropriate intervention in clients. Maintaining adequate lighting in the room will help prevent injury from a fall, but it is not the most appropriate intervention in case of disoriented or confused clients.

For which reason would an adolescent client be prescribed an adult dose of acetaminophen?

The prescription can be metabolized at the adult dose.

For which reason would the nurse caring for clients who were injured in a tornado call the medical command physician?

To determine resource needs of clients