Infection Control Flashcards
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.”
ANS: A
Infections are infectious and/or communicable. Infectious diseases may not pose a risk for transmission to others, although they are serious for the patient. Pneumonia is not a communicable disease—a disease that is transmitted directly from one individual to the next, so there is no need for isolation. A private negative–air pressure room is used for tuberculosis, not pneumonia. Clinical signs and symptoms are present in pneumonia. Frequently, patients with pneumonia do return home unless there are extenuating circumstances
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?”
ANS: B
Multiple factors influence a patient’s susceptibility to infection. Patients with chronic diseases such as diabetes mellitus and multiple sclerosis are also more susceptible to infection because of general debilitation and nutritional impairment. Other factors include age, nutritional status, trauma, and smoking. The other questions are part of an admission assessment process but are not pertinent to the infectious disease process.
The nurse is caring for a patient 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.
ANS: C
You maintain surgical aseptic technique at the patient’s bedside (e.g., when inserting IV or urinary catheters, suctioning the tracheobronchial airway, and sterile dressing changes) because patients with disease processes of the immune system are at particular risk for infection. These diseases include leukemia, AIDS, lymphoma, and aplastic anemia. These disease processes weaken the defenses against an infectious organism. Reviewing the procedure with the patient, positioning the patient, and gathering the supplies are all important steps in the procedure but are not the priority in the procedure since the patient already has a compromised immune response.
. 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.
ANS: D
Localized infections are most common in the skin or with mucous membrane breakdown. Wear gloves and other personal protective equipment as appropriate when examining or providing treatment to localized infected areas to create a protective barrier. Positioning the patient, explaining the procedure, and reviewing the medication list are all tasks that need to be completed, but they do not prevent the spread of infection.
The nurse is caring for a patient in an intensive care unit who needs a bath. Which priorityaction 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.
ANS: C
The Centers for Disease Control and Prevention (CDC) recommends the use of chlorhexidine (CHG) bathing for patients in intensive care units, patients who are scheduled for surgery, and all patients with invasive central line catheters as part of MRSA reduction efforts. Using local anesthetics, nonallergenic tape, and filtered water does not affect the cause of a health care–associated infection by, for example, decreasing microbial counts like a CHG bath.
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
ANS: B
An exogenous infection comes from microorganisms found outside the individual such as Salmonella, Clostridium tetani, and Aspergillus. They do not exist as normal floras. A vector transmits microorganisms and is usually a type of insect or organism. Endogenous infection occurs when part of the patient’s flora becomes altered and an overgrowth results (e.g., staphylococci, enterococci, yeasts, and streptococci). This often happens when a patient receives broad-spectrum antibiotics that alter the normal floras. A suprainfection develops when broad-spectrum antibiotics eliminate a wide range of normal flora organisms, not just those causing infection.
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.
ANS: B
Allowing the urinary drainage bag port to touch contaminated items (graduated receptacle) may introduce bacteria into the urinary system and contribute to a urinary tract infection. The urinary drainage bag should be emptied at least once a shift. Patients should have their own receptacle for measurement to prevent cross-contamination. Repeated catheter irrigations increase the chance so irrigating infrequently will be beneficial in reducing the risk.
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
ANS: B
Using clean technique (medical asepsis) to insert a urinary catheter would place the patient at risk for a health care–associated infection. Urinary catheters need to be inserted using sterile technique, which is also referred to as surgical asepsis. Surgical aseptic technique (also called sterile technique) should be used when suctioning an airway because it is considered a sterile body cavity. Washing from clean to dirty (urinary meatus toward rectum) is correct for decreasing infection risk. Bottled solutions may be used repeatedly during a 24-hour period; however, special care is needed to ensure that the solution in the bottle remains sterile. After 24 hours, the solution should be discarded.
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.
ANS: C
Completing the assessment while wearing gloves, removing gloves, washing hands after contact with body fluids, and then assessing the intravenous infusion will assist in the prevention and transfer of any potential organisms to this intravenous line. Completing the assessment, removing gloves, and silencing the alarm leaves out the crucial step of decontaminating and washing the hands. Discontinuing the assessment and assessing the IV leaves out removing the gloves and decontamination, as well as completing the assessment for the patient. Discontinuing the assessment, removing gloves, using hand gel, and assessing the IV is incorrect because upon exposure to body fluids, washing hands is appropriate.
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
ANS: A
Touching nonsterile (clean) protective eyewear once gowned and gloved with sterile gown and gloves would indicate a break in sterile technique. Sterile objects remain sterile only when touched by another sterile object. Standing with hands folded on the chest is common practice and prevents arms and hands from touching unsterile objects. Accepting sterile supplies from the surgeon who has opened them with the appropriate technique is acceptable. Staying with a sterile table once opened is a common practice to ascertain that no one or nothing has contaminated the table.
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
ANS: C
Utilize clean gloves (medical asepsis) to remove contaminated dressings and sterile supplies, including gloves and dressings (surgical asepsis–sterile technique) to reapply sterile dressings. Wearing sterile gowns and gloves is not necessary when removing soiled dressings. Donning clean gloves to dress a sterile wound would contaminate the sterile supplies. Utilizing clean supplies for a sterile dressing would not help in decreasing the number of microbes at the incision site.
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
ANS: C
Standard precautions are used to prevent and control the spread of infection. Transferring contaminated equipment without the protection of gloves can assist in the spread of microbes to inanimate objects and to the person doing the transfer; therefore, the nurse must intervene. Utilizing gloves, washing hands, covering contaminated supplies during transfer, and disinfecting equipment in the appropriate way in the appropriate places utilize principles of basic medical asepsis and standard precautions and can break the chain of infection.
. 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
ANS: D
Standard precautions include the wearing of eyewear whenever there is a possibility of a splash or splatter, like when emptying the urinary drainage bag. Teaching the patient about good nutrition is positive but does not apply to standard precautions. Standard precautions apply to contact with blood, body fluid (except sweat), nonintact skin, and mucous membranes from all patients. Artificial nails are not worn when using standard precautions. Any needles should be disposed of uncapped, or a mechanical safety device is activated for recapping.
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
ANS: C
Standard precautions apply to contact with blood, body fluid, nonintact skin, and mucous membranes of all patients. Contact precautions apply to individuals with infections that can be transmitted by direct or indirect contact. Protective environment precautions apply to individuals who have undergone transplantations and gene therapy. Droplet precautions focus on diseases that are transmitted by large droplets.
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.
ANS: A
The nurse is responsible for providing a safe environment for the patient. The effectiveness of infection control practices depends on conscientiousness and consistency in using effective aseptic technique by all health care providers. After washing hands, turn off a handle faucet with a dry paper towel, and avoid touching the handles with your hands to assist in preventing the transfer of microorganisms. Wet towels and hands allow the transfer of pathogens from faucet to hands. The principles and procedures for washing hands are universal and apply to all members of health care teams. Being resourceful and aware of the cost of health care is important, but taking shortcuts that may endanger an individual’s health is not a prudent practice.