Safety and Infection Control Practice

6. A patient is diagnosed with Hepatitis A and is incontinent of stool. What type of precautions would be initiated? *A. Contact B. Standard C. Droplet D. Contact and Droplet

A The answer is A. Patients with Hepatitis A are placed in contact precautions IF the patient is diapered or incontinent of stool. Remember Hep A is spread through stool.

7. You'rer providing care to a patient with C. Diff. After removing the appropriate PPE, you would perform hand hygiene by: *A. Using hand sanitizer B. Using soap and water C. Using soap and water only if hands are soiled but can use hand sanitizer D. Using either hand sanitizer or soap and water

B The answer is B. After providing care to patients with C. Diff, Noravirus, or Rotavirus, you must perform hand hygiene by washing the hands with ONLY soap and water. Hand-sanitizer is not sufficent enough in killing the germs in these conditions.

10. Your patient in droplet precautions has family visiting. A family member asks how far they should stand away from the patient while visiting. Your response is:* A. 2 feet or more B. 3 feet or more C. Stand at the doorway D. 6 feet or more

B The answer is B. Patients in droplet precautions should keep a distance of 3 feet or more from visitors or other patients. Remember the respiratory droplets expelled from patients with droplet diseases do not stay suspended in the air (like in airborne disease) and only travel about 3 feet before falling.

9. You're providing an in-service on transmission-based precautions to a group of nursing students. Which statement made by a student warrants re-education about the topic? *A. "I will make sure that any patient who is in droplet precaution wears a surgical mask when being transported. "B. "Patients with airborne diseases such as Meningitis require a special room with negative air pressure. "C. "I will always wear a gown and gloves when entering a room of a patient in contact precautions. "D. "If I provide care to patients with C. Diff, Noravirus, and Rotavirus infections, I will always wash my hands with soap and water, not hand sanitizer."

B The answer is B. This statement is FALSE because Meningitis is not a condition that requires airborne precautions but droplet precautions. However, patients with airborne diseases do require a special room with negative air pressure. However, patients with Meningitis do not.

1. Select ALL the patients that would be placed in droplet precautions:* A. A 5 year old patient with Chicken Pox. B. A 36 year old patient with Pertussis. C. A 25 year old patient with Scarlet Fever. D. A 56 year old patient with Tuberculosis. E. A 69 year old patient with Streptococcal Pharyngitis. F. A 89 year old patient with C. Diff.

B, C, E The answers are B, C, E. Patients with Pertussis (Whooping Cough), Scarlet Fever, and Streptococcal Pharyngitis are to be placed in droplet precautions. Patients with TB are to placed in airborne precautions while a patient with Chicken Pox should be place in both airborne and contact precautions. Patients with C. Diff are to be placed in contact precautions.

Contact precautions have what 5 things?

Private room - the door can be open Gloves Gown- if giving direct care Handwashing Disposable supplies MRSA- GOWN & GLOVES

Droplet precautions

spiderman! sepsis, scarlet fever, streptococcal pharyngitis, parvovirus, pneumonia, pertussis, influenza, diptheria, epiglottitis, rubella, mumps, meningitis, mycoplasma or meningeal pneumonia, adeNovirus (Private room and mask)

A nurse is volunteering in an indigent clinic. She is seeing a patient whom she suspects has active tuberculosis. In this disease process, which of the following body systems serves as both the reservoir and portal of entry for this infection? the respiratory system the hematologic system the gastrointestinal system the integumentary system

the respiratory system Tuberculosis (TB) is a bacterial infection that mainly infects the respiratory system caused by the organism Mycobacterium tuberculosis. It is spread via inhalation of droplets that contain the bacteria that are released during coughing, sneezing, etc. There are two forms of TB: latent and active. Patients are contagious only during an active TB infection, and they usually feel sick during this time. Those with latent infection are not infectious and do not feel ill. The respiratory system is where this organism best grows and reproduces (a reservoir) and how one becomes infected with the organism via inhalation (portal of entry).

A nurse is working with a patient who has a contagious condition. In recalling the chain of infection, the nurse knows that an environment favorable for the growth and reproduction of an infectious agent is referred to as ____. a vector a susceptible host a portal of entry a reservoir

Resevoir The chain of infection has six elements: a pathogen which is an infectious agent a reservoir which is any environment that is favorable for the growth and reproduction of an infectious agent a portal of exit which is a place where an infectious agent gets out of a host a method of transmission which is the way an infectious organism is transferred from a reservoir to a host a portal of entry which is the place where an infectious agent enters a host a susceptible host which is a person who is at risk for infection A vector is an object which can spread an infection via indirect contact. It is one of the three possible methods of transmission.

When evaluating the growth and development of a 6 month-old infant, a nurse expects the infant to be able to perform which of the following actions?

Sit for a moment without support, turn over completely, and reach to be picked up.

During report, the previous nurse emphasized that one of the newly admitted patients is on seizure precautions. The incoming nurse is correct when she performs which of the following actions to the client? 1. Move the client to a room closer to the nurses' station. 2. Maintain the client's bed in the lowest position. 3. Serve the client's food in paper and plastic containers. 4. Ensure that soft limb restraints are applied to upper extremities.

2. Maintain the client's bed in the lowest position. To protect a client with a known or suspected seizure disorder, the bed should be kept in the lowest position, decreasing the chance of injury from falling to the floor during seizure activity.

The nurse cares for a patient with AIDS who has acquired jiroveci pneumonia. Which of the following precautions levels is appropriate for this patient? 1. Contact precautions. 2. Standard precautions. 3. Airborne precautions. 4. Droplet precautions.

2. Standard precautions. Jiroveci pneumonia is an opportunistic infection that only occurs in immunocompromised patients. Anyone with normal immune system function cannot "catch" this infection.

The nurse is correctly implementing the prescribed transmission-based precaution when she does the following: 1. The nurse assigned the child in a semi-private room. 2. The nurse placed a supply of clean masks in the child's room. 3. The nurse sends specimens to the laboratory in a zip-closure biohazard bag. 4. The nurse wipes the thermometer with alcohol every after use.

3. The nurse sends specimens to the laboratory in a zip-closure biohazard bag. The zip-closure prevents contamination of the environment during transportation.

A patient diagnosed with SIADH is ordered by the physician to receive 3% NaCl 500mL at a rate of 60mL/hr. Which of the following actions, if taken by the nurse, is most important in regard to patient safety? 1. Check the patient's name and date of birth before administering the solution. 2. Call the physician and verify the order. 3. Ask another nurse to cosign and check the order before administering the solution. 4. Call the nursing supervisor to question the order.

3. Ask another nurse to cosign and check the order before administering the solution. Hypertonic saline requires two nurses to cosign because it can be dangerous to give this to the wrong patient. Checking the patient's name and date of birth is second in importance.

Which of the following assessments, performed on a patient after a myelogram, is most important in regard to patient safety? 1. Ensure the patient lays flat for two hours after the procedure. 2. Ensure the consent form for the procedure was signed. 3. Perform a neurological assessment. 4. Check the popliteal pulses bilaterally.

3. Perform a neurological assessment. A myelogram is where contrast dye is injected into the spine. Because a needle entered the spinal cord, it is important to check for impaired/altered sensation and neurological malfunction.

4. You're patient is being transported to special procedures for a PICC line placement. The patient is in droplet precautions. What are your nursing actions to ensure proper transport of the patient? *A. Notify the receiving department and place a surgical mask on the patient. B. Place an N95 mask on the patient and notify the receiving department. C. Cancel transport and notify the physician for further orders. D. Notify the receiving department and place goggles, gown, and mask on the patient.

A The answer is A. You should notify the receiving department and place a surgical mask on the patient.

Select the appropriate personal protective equipment (PPE) that will be applied prior to entering the room of a patient with influenza. A. gloves B. mask C. gown D. goggles E. respirator A, B, and C A and C A, B, C, D, and E A, C, and E

A, B, and C influenza is a virus that requires droplet precautions. The PPE used in droplet precautions includes donning gloves, mask, and gown. Respirators are used with airborne precautions such as tuberculosis and varicella. Goggles are used in the event of concern for splashes of bodily fluids or chemicals and not necessary for droplet precautions.

8. Which of the following patients would be in contact precautions? Select-all-that-apply: * A. A 8 year old patient with lice. B. A 85 year old patient with CRE (Klebisella Pneumoniae). C. A 65 year old patient with Noravirus. D. A 75 year old patient with Disseminated Herpes Zoster. E. A 12 year old patient with impetigo. F. A 9 year old with RSV.

A, E all answers are correct

The herpes zoster virus requires a nurse to follow ________ precautions at all times.

Airborne Airborne precautions are added for clients who have illnesses that are transmitted by airborne droplet nuclei, such as chickenpox during the early stage of infection.

2. A patient with Disseminated Herpes Zoster requires routine tracheostomy suction. Select the appropriate PPE you will wear:* A. Surgical mask, goggles, gown B. N95 mask, face shield, gown, gloves C. N95 mask, gown, face shield D. Surgical mask, face shield, gown, gloves

B The answer is B. A patient with Disseminated Herpes Zoster is in airborne AND contact precautions. Therefore, you are required to always wear an N95 mask, gowns, and gloves and to follow standard precautions. In this case (because you are providing trach suction), you will be at risk for splash of mucous or blood on the clothing, skin, and mucous membranes. Therefore, you must wear the required N95 mask ,gown, gloves, AND face shield.

Which of these is the correct order of events a nurse should follow when applying personal protective equipment (PPE)? a. gown, mask, eye protection, handwashing, and gloves b. handwashing, gown, mask, eye protection, and gloves c. handwashing, gloves, gown, eye protection, and mask d. mask, eye protection, handwashing, gloves, and gown

B. handwashing, gown, mask, eye protection, and gloves When applying PPE, the nurse should always follow the order of: handwashing, gown, mask, eye protection, and gloves. This should preferably take place outside of the patient's room. The reverse order is always followed when removing PPE.

A nurse in the emergency room is taking care of a 4-year-old patient who has a suspected case of impetigo. The nurse knows that which of the following precautions is most important to prevent the spread of this infection? airborne precautions contact precautions standard precautions droplet precautions

Contact precaution impetigo is an infectious skin condition that is spread via skin to hand contact or indirect contact of the skin and other surfaces. Contact precautions are, therefore, necessary to limit the spread of this skin infection.

The medical/surgical nurse cares for a middle-aged patient with a wound infected with MRSA (Methicillin-resistant Staphylococcus aureus). Which of the following protective safety items, if worn by the nurse, would be considered appropriate?

Gown and gloves constitute contact precautions.

A hospital has been notified that an alleged inhalation anthrax exposure has occurred at the local post office. Which of the following below is the correct personal protective equipment (PPE) that the response team would wear? 1

N95 This is categorized as Level A protection and is worn when the highest level of respiratory, skin, eye, and mucous membrane protection is required. In this situation of possible inhalation of anthrax, such protection is required.

A nurse inadvertently administers the wrong dose of antibiotic to a patient recovering from surgery. Which of these is the correct course of action for the nurse when documenting this in the patient's medical record? a. The nurse should just document the dosage given in the patient's chart. An incident report is not necessary because it was simply the wrong dosage of a drug that was ordered. b. The nurse should create an incident report and record the facts of the incident in the medical record, but does not have to include an actual copy of the incident report or reference its existence. c. The nurse should create an incident report and include a copy of the report in the patient's medical record. d. The nurse should tell the patient of the incident and ask his or her preference on if an incident report should be created and if one is, it should be included in the patient's medical record.s

b. The nurse should create an incident report and record the facts of the incident in the medical record, but does not have to include an actual copy of the incident report or reference its existence. A nurse who administers the wrong dosage of an ordered drug must create an incident report. Each employment facility will have specific guidelines to follow in doing so. Generally, the facts of the incident should be recorded in the patient's medical record, but an actual copy of the incident report does not have to go into the record and reference as to its existence does not have to be in the record either.

3. A 6 year old female is diagnosed with Varicella. What type of isolation precautions will be initiated for this patient? *A. Droplet B. Airborne C. Airborne and Contact D. Droplet and Contact

c The answer is C. A patient with Varicella (chicken pox) will be in airborne and contact precautions.

5. Select ALL the conditions that warrant airborne precautions: * A. Noravirus B. Hepatitis A C. Measles D. Varicella E. Disseminated Varicella Zoster F. Tuberculosis G. Whooping Cough H. RSV I. Epiglottitis

c,d,e,f, The answers are C, D, E, F. Measles, Varicella (chicken pox), Disseminated Varicella Zoster (shingles), and TB require airborne precautions. NOTE: Varicella and Disseminated Varicella Zoster also require contact precaution as well. Noravirus and RSV are contact precautions. Hepatitis A is contact precautions IF the patient is diapered or incontinent of stool. Whooping cough (Pertussis) and Epiglottitis are droplet precautions.