Ch.28 infection control n iso

Question 1

The nurse and a new nurse in orientation are caring for a patient with pneumonia. Which statement by the new nurse will indicate a correct understanding of this condition?
a. An infectious disease like pneumonia may not pose a risk to others.
b. We need to isolate the patient in a private negative-pressure room.
c. Clinical signs and symptoms are not present in pneumonia.
d. The patient will not be able to return home.

Answer 1

A

Question 2

The patient and the nurse are discussing the vector transmitted Rickettsia rickettsii—Rocky Mountain spotted fever. Which patient statement to the nurse indicates garding the mode of transmission for this disease?
a. When camping, I will use sunscreen.
b. When camping, I will drink bottled water.
c. When camping, I will wear insect repellent.
d. When camping, I will wash my hands with hand gel.

Answer 2

C

Question 3

The nurse is providing an educational session for a group of preschool workers. The nurse
reminds the group about the most important thing to do to prevent the spread of infection.
Which information did the nurse share with the preschool workers?
a. Encourage preschool children to eat a nutritious diet.
b. Suggest that parents provide a multivitamin to the children.
c. Clean the toys every afternoon before putting them away.
d. Wash their hands between each interaction with children.

Answer 3

D

Question 4

The nurse is admitting a patient with an infectious disease process. Which question will be most appropriate for a nurse to ask about the patient’s susceptibility to this infectious process?
a. Do you have a spouse?
b. Do you have a chronic disease?
c. Do you have any children living in the home?
d. Do you have any religious beliefs that will influence your care?

Answer 4

B

Question 5

The patient experienced a surgical procedure, and Betadine was utilized as the surgical prep. Two days postoperatively, the nurse’s assessment indicates that the incision is red and has a small amount of purulent drainage. The patient reports tenderness at the incision site. The patient’s temperature is 100.5F, and the WBC is 10,500/mm3. Which action should the nurse
take first?
a. Plan to change the surgical dressing during the shift.
b. Utilize SBAR to notify the primary health care provider.
c. Reevaluate the temperature and white blood cell count in 4 hours.
d. Check to see what solution was used for skin preparation in surgery

Answer 5

B

Question 6

The nurse is providing an education session to an adult community group about the effects of smoking on infection. Which information is most important for the nurse to include in the educational session?
a. Smoke from tobacco products clings to your clothing and hair.
b. Smoking affects the cilia lining the upper airways in the lungs.
c. Smoking can affect the color of the patient’s fingernails.
d. Smoking tobacco products can be very expensive.

Answer 6

B

Question 7

A female adult patient presents to the clinic with reports of a white discharge and itching in the vaginal area. A nurse is taking a health history. Which question is the priority?
a. ―When was the last time you visited your primary health care provider?‖
b. ―Has this condition affected your eating habits in any way?‖
c. ―What medications are you currently taking?‖
d. ―Are you able to sleep at night?

Answer 7

C

Question 8

The nurse is caring for a school-aged child who has injured the right leg after a bicycle
accident. Which signs and symptoms will the nurse assess for to determine if the child is experiencing a localized inflammatory response?
a. Malaise, anorexia, enlarged lymph nodes, and increased white blood cells
b. Chest pain, shortness of breath, and nausea and vomiting
c. Dizziness and disorientation to time, date, and place
d. Edema, redness, tenderness, and loss of function

Answer 8

D

Question 9

Which interventions utilized by the nurse will indicate the ability to recognize a localized inflammatory response?
a. Vigorous range-of-motion exercises
b. Turn, cough, and deep breathe
c. Orient to date, time, and place
d. Rest, ice, and elevation

Answer 9

D

Question 10

The nurse is caring for a group of medical-surgical patients. Which patient is most at risk for developing an infection?
a. A patient who is in observation for chest pain
b. A patient who has been admitted with dehydration
c. A patient who is recovering from a right total hip surgery
d. A patient who has been admitted for stabilization of heart problems

Answer 10

C

Question 11

The nurse is caring for a patient diagnosed with leukemia and is preparing to provide fluids through a vascular access (IV) device. Which nursing intervention is a priority in this procedure?
a. Review the procedure with the patient.
b. Position the patient comfortably.
c. Maintain surgical aseptic technique.
d. Gather available supplies

Answer 11

C

Question 12

The nurse is caring for an adult patient in the clinic who has been evacuated and is a victim of flooding. The nurse teaches the patient about rest, exercise, and eating properly and how to utilize deep breathing and visualization. What is the primary rationale for the nurse’s actions related to the teaching?
a. Topics taught are standard information taught during health care visits.
b. The patient requested this information to teach the extended family members.
c. Stress for long periods of time can lead to exhaustion and decreased resistance to
infection.
d. These techniques will help the patient manage the pain and loss of personal
belongings

Answer 12

C

Question 13

The nurse is caring for a patient who is susceptible to infection. Which instruction will the nurse include in an educational session to decrease the risk of infection?
a. Teaching the patient about fall prevention
b. Teaching the patient to take a temperature
c. Teaching the patient to select nutritious foods
d. Teaching the patient about the effects of alcohol

Answer 13

C

Question 14

A diabetic patient presents to the clinic for a dressing change. The wound is located on the right foot and has purulent yellow drainage. Which action will the nurse take to prevent the
spread of infection?
a. Position the patient comfortably on the stretcher.
b. Explain the procedure for dressing change to the patient.
c. Review the medication list that the patient brought from home.
d. Don gloves and other appropriate personal protective equipment.

Answer 14

D

Question 15

A patient presents with pneumonia. Which priority intervention should be included in the plan of care for this patient?
a. Observe the patient for decreased activity tolerance.
b. Assume the patient is in pain and treat accordingly.
c. Provide the patient ice chips as requested.
d. Maintain the room temperature at 65F.

Answer 15

A

Question 16

The nurse is caring for a patient in an intensive care unit who needs a bath. Which priority action will the nurse take to decrease the potential for a health care–associated infection?
a. Use local anesthetic on reddened areas.
b. Use nonallergenic tape on dressings.
c. Use a chlorhexidine wash.
d. Use filtered water.

Answer 16

C

Question 17

The infection control nurse is reviewing data for the medical-surgical unit. The nurse notices an increase in postoperative infections from Aspergillus. Which type of health care–associated infection will the nurse report?
a. Vector
b. Exogenous
c. Endogenous
d. Suprainfection

Answer 17

B

Question 18

The patient has contracted a urinary tract infection (UTI) while in the hospital. Which action will most likely increase the risk of a patient contracting a UTI?
a. Reusing the patient’s graduated receptacle to empty the drainage bag
b. Allowing the drainage bag port to touch the graduated receptacle
c. Emptying the urinary drainage bag at least once a shift
d. Irrigating the catheter infrequently

Answer 18

B

Question 19

Which nursing action will most likely increase a patient’s risk for developing a health
care–associated infection?
a. Uses surgical aseptic technique to suction an airway.
b. Uses a clean technique for inserting a urinary catheter.
c. Uses a cleaning stroke from the urinary meatus toward the rectum.
d. Uses a sterile bottled solution more than once within a 24-hour period

Answer 19

B

Question 20

The nurse is caring for a patient in labor and delivery. When near completing an assessment of the patient’s cervix, the electronic infusion device being used on the intravenous (IV) infusion alarms. Which sequence of actions is most appropriate for the nurse to take?
a. Complete the assessment, remove gloves, and silence the alarm.
b. Discontinue the assessment, silence the alarm, and assess the intravenous site.
c. Complete the assessment, remove gloves, wash hands, and assess the intravenous
infusion.
d. Discontinue the assessment, remove gloves, use hand gel, and assess the
intravenous infusion.

Answer 20

C

Question 21

The nurse is dressed and is preparing to care for a patient in the perioperative area. The nurse has scrubbed hands and has donned a sterile gown and gloves. Which action will indicate a break in sterile technique?
a. Touching clean protective eyewear
b. Standing with hands above waist area
c. Accepting sterile supplies from the surgeon
d. Staying with the sterile table once it is open

Answer 21

A

Question 22

22. The nurse is caring for a patient with an incision. Which actions will best indicate an understanding of medical and surgical asepsis for a sterile dressing change?
    a. Donning clean goggles, gown, and gloves to dress the wound
    b. Donning sterile gown and gloves to remove the wound dressing
    c. Utilizing clean gloves to remove the dressing and sterile supplies for the new
    dressing
    d. Utilizing clean gloves to remove the dressing and clean supplies for the new
    dressing

Answer 22

C

Question 23

The nurse is caring for a patient in the endoscopy area. The nurse observes the technician performing these tasks. Which observation will require the nurse to intervene?
a. Washing hands after removing gloves
b. Disinfecting endoscopes in the workroom
c. Removing gloves to transfer the endoscope
d. Placing the endoscope in a container for transfer

Answer 23

C

Question 24

The nurse is caring for a patient who is at risk for infection. Which action by the nurse
indicates correct understanding about standard precautions?
a. Teaches the patient about good nutrition.
b. Dons gloves when wearing artificial nails.
c. Disposes an uncapped needle in the designated container.
d. Wears eyewear when emptying the urinary drainage bag.

Answer 24

D

Question 25

The nurse is caring for a patient who has just delivered a neonate. The nurse is checking the patient for excessive vaginal drainage. Which precaution will the nurse use?
a. Contact
b. Droplet
c. Standard
d. Protective environment

Answer 25

C

Question 26

The nurse is caring for a patient in the hospital. The nurse observes the nursing assistive personnel (NAP) turning off the handle faucet with bare hands. Which professional practice principle supports the need for follow-up with the NAP?
a. The nurse is responsible for providing a safe environment for the patient.
b. Different scopes of practice allow modification of procedures.
c. Allowing the water to run is a waste of resources and money.
d. This is a key step in the procedure for washing hands.

Answer 26

A

Question 27

The nurse is caring for a patient who becomes nauseated and vomits without warning. The nurse has contaminated hands. Which action is best for the nurse to take next?
a. Wash hands with an antimicrobial soap and water.
b. Clean hands with wipes from the bedside table.
c. Use an alcohol-based waterless hand gel.
d. Wipe hands with a dry paper towel.

Answer 27

A

Question 28

The nurse is performing hand hygiene before assisting a health care provider with insertion of a chest tube. While washing hands, the nurse touches the sink. Which action will the nurse take next?
a. Inform the health care provider and recruit another nurse to assist.
b. Rinse and dry hands and begin assisting the health care provider.
c. Extend the handwashing procedure to 5 minutes.
d. Repeat handwashing using antiseptic soap.

Answer 28

D

Question 29

The nurse on the surgical team and the surgeon have completed a surgery. After donning gloves, gathering instruments, and placing in the transport carrier, what is the next step in
handling the instruments used during the procedure?
a. Sending to central sterile for cleaning and sterilization
b. Sending to central sterile for cleaning and disinfection
c. Sending to central sterile for cleaning and boiling
d. Sending to central sterile for cleaning

Answer 29

A

Question 30

The nurse is observing a family member changing a dressing for a patient in the home health environment. Which observation indicates the family member has a correct understanding of
how to manage contaminated dressings?
a. The family member places the used dressings in a plastic bag.
b. The family member saves part of the dressing because it is clean.
c. The family member removes gloves and gathers items for disposal.
d. The family member wraps the used dressing in toilet tissue before placing in trash.

Answer 30

A

Question 31

The nurse is caring for a group of patients. For which patient will the nurse question the form of precautions being used?
a. A patient with Clostridium difficile in droplet precautions
b. A patient with tuberculosis in airborne precautions
c. A patient with MRSA infection in contact precautions
d. A patient with a lung transplant in protective environment precautions

Answer 31

A

Question 32

The home health nurse is teaching a patient and family about hand hygiene in the home. The nurse to emphasize washing hands before and after what form of contact?
a. Shaking hands
b. Performing treatments
c. Opening the refrigerator
d. Working on a computer

Answer 32

B

Question 33

The nurse is caring for a patient on contact precautions. Which action will be most
appropriate to prevent the spread of disease?
a. Place the patient in a room with negative airflow.
b. Wear a gown, gloves, face mask, and goggles for interactions with the patient.
c. Transport the patient safely and quickly when going to the radiology department.
d. Use a dedicated blood pressure cuff that stays in the room and is used for that
patient only

Answer 33

D

Question 34

The surgical mask the perioperative nurse is wearing becomes moist. Which action will the perioperative nurse take next?
a. Apply a new mask.
b. Reapply the mask after it air-dries.
c. Change the mask when relieved by next shift.
d. Do not change the mask if the nurse is comfortable.

Answer 34

A

Question 35

The nurse is caring for a patient who has cultured positive for C. difficile. Which action will the nurse take next?
a. Instruct assistive personnel to use soap and water rather than sanitizer.
b. Wear an N95 respirator when entering the patient room.
c. Place the patient on droplet precautions.
d. Teach the patient cough etiquette.

Answer 35

A

Question 35

The nurse is changing linens for a postoperative patient and feels a prick in the left hand. A nonactivated safe needle is noted in the linens. For which condition is the nurse most at risk?
a. Diphtheria
b. Hepatitis B
c. C. difficile
d. Methicillin-resistant Staphylococcus aureus

Answer 35

B

Question 36

The nurse is caring for a patient who has a bloodborne pathogen. The nurse splashes blood above the glove to intact skin while discontinuing an intravenous (IV) infusion. Which step(s) will the nurse take next?
a. Obtain an alcohol swab, remove the blood with an alcohol swab, and continue
care.
b. Immediately wash the site with soap and running water and seek guidance from the manager.
c. Do nothing; accidentally getting splashed with blood happens frequently and is
part of the job.
d. Delay washing of the site until the nurse is finished providing care to the patient.

Answer 36

B

Question 36

Which process will be required after exposure of a nurse to blood by a cut from a used scalpel in the operative area?
a. Placing the scalpel in a needle safe container
b. Testing the patient and offering treatment to the nurse
c. Removing sterile gloves and disposing of in kick bucket
d. Providing a medical evaluation of the nurse to the manager

Answer 36

B

Question 36

The nurse is caring for a patient who needs a protective environment. The nurse has provided the care needed and is now leaving the room. In which order will the nurse remove the personal protective equipment, beginning with the first step?
1. Remove eyewear/face shield and goggles.
2. Perform hand hygiene, leave room, and close door.
3. Remove gloves.
4. Untie gown, allow gown to fall from shoulders, and do not touch outside of gown; dispose of properly.
5. Remove mask by strings; do not touch outside of mask.
6. Dispose of all contaminated supplies and equipment in designated receptacles.
a. 3, 1, 4, 5, 6, 2
b. 1, 4, 5, 3, 6, 2
c. 1, 4, 5, 3, 2, 6
d. 3, 1, 4, 5, 2, 6

Answer 36

D

Question 37

The nurse manager is evaluating current infection control data for the intensive care unit. The nurse compares past patient data with current data to look for trends. The nurse manager examines the infection chain for possible solutions. In which order will the nurse arrange the items for the infection chain beginning with the first step?
1. A mode of transmission
2. An infectious agent or pathogen
3. A susceptible host
4. A reservoir or source for pathogen growth
5. A portal of entry to a host
6. A portal of exit from the reservoir
a. 3, 2, 4, 1, 5, 6
b. 1, 3, 5, 4, 6, 2
c. 4, 2, 1, 6, 3, 5
d. 2, 4, 6, 1, 5, 3

Answer 37

D

Question 38

The nurse is caring for a patient in protective environment. Which actions will the nurse take? (Select all that apply.)
a. Wear an N95 respirator when entering the patient’s room.
b. Maintain airflow rate greater than 12 air exchanges/hour.
c. Place in special room with negative-pressure airflow.
d. Open drapes during the daytime.
e. Listen to the patient’s interests.
f. Place dried flowers in a plastic vase.

Answer 38

B D E