Safety & Infections Control

Question 1

Client with ebola vomits 750mL with blood in emesis. Complains headache, Nausea, ecchymoses. What is the first intervention

1. Apply 2L/min nasal canula
2. Infuse NS 500 mL/hr
3. Ondansetron 4mg IV
4. Acetaminophen 650 mg

Answer 1

2. Infuse NS 500 mL/hr

Fluids come first then the antiemetics

Question 2

Cidofovir
Tenofovir
Valaciclovir
Acyclovir
Entecavir
Molnupiravir
Foscarnet

Are which type of medication

Answer 2

Antivirals

Used to treat Flus, HIV, hepatitis

Question 3

Herpes zoster PPE

Answer 3

Gown, N 95 mask, gloves

Airborne & direct contact

Question 4

Which requires most rapid action to prevent spread of infection by triage nurse.

1. 3 yr old paroxysmal cough and sibling has pertussis
2. 5 yr old new pruritic rash and possible chicken pox infection
3. 62 year old MRSA abdominal infection
4. 74 yr old needs TB testing after exposure to TB on international flight

Answer 4

2. 5 yr old new pruritic rash and possible chicken pox infection

Varicella is airborne

Droplet or contact precautions should be done for MRSA & pertussis (Whooping cough)

Client exposed to TB doesn’t present a risk because there are no symptoms if active TB

Question 5

Highest risk of infection

1. Implanted port subclavian vein
2. Midline IV catheter left antecubital fossa
3. Nontunneled central line left internal jugular
4. Peripherally inserted central catherer right upper arm

Answer 5

3. Nontunneled central line left internal jugular

Central lines & Jugular are more prone to infection

PICC Lines & midline catherer lower incidents

Implanted ports lowest infections

Question 6

88 yr old on antibiotics for 10 days tells nurse about watery diarrhea. What action will the nurse take first

1. Notify HCP
2. Obtain stool sample
3. Instruct client about proper handwashing
4. Place on contact precautions

Answer 6

Place on contact precaution

Diarrea after antibiotics could mean C diff. Contact precautions

Infection control polices and PPE use are independent nursing actions

Question 7

Pregant client in first trimestre tells nurse she was recently exposed to Zika while traveling in Southeast Asia. Which action is most important

1. Arrange for zika virus testing
2. Discuss need for multiple fetal ultrasounds during pregnancy
3. Describe possible impact of Zika infection on fetal development
4. Assess for symptoms, rash, joint pain, conjunctivitis, fever

Answer 7

1. Arrange for zika virus testing

Multiple ultrasounds only needed if first is positive for zika.

Question 8

Which client should be seen first

1. 16-mm induration after TB test
2. Low CD4 with HIV
3. H1N1 Swine flu with reports of increased dyspnea
4. Exposed to Zika with rash & joint pain

Answer 8

3. H1N1 Swine flu with reports of increased dyspnea

Due to the increasing dyspnea they will need oxygen quickly

Question 9

Metronidazole aka

Class

Use

SE and Serious Side Effects

Contradictions

Answer 9

Flaggel

Metronidazole

Class: Metronidazole is an antibiotic and antiprotozoal medication.

Gastrointestinal tract, genital tract, skin, and other areas of the body.

Common side effects may include nausea, vomiting, diarrhea, loss of appetite, and metallic taste in the mouth.

Contraindications:

Metronidazole should generally be avoided in the first trimester of pregnancy due to potential teratogenic effects.

Question 10

Acute zika infection, which information is most important to include.

1. Fluids to prevent dehydration
2. Acetaminophen reduce fever and pain
3. Apply Insect repellent to prevent mosquito bites
4. Symptoms include: Rash,fever, red eyes, joint pain

Answer 10

3. Apply Insect repellent to prevent mosquito bites

To stop the spread to others

Question 11

Most effective to reduce catheter associated urinary tract infections

1. Limit use of indwelling catheter in all hospitalized clients
2. Ensure atleast 1500mL fluid intake daily
3. Use urine dipstick testing to screen catherized clients for Asymptomatic bacturia
4. Require use of antimicrobial-impregnated catherers

Answer 11

1. Limit use of indwelling catheter in all hospitalized clients

The other options are also good but CDC says minimal use is best

Don’t dipstick test, why? IDK

Question 12

When should droplet precautions be stopped on a meningococcal meningitis patient?

1. PERRLA
2. Appropriate Antibiotics have been given 24 hrs
3. Cough is productive, clear,non Purulent
4. Temp <100

Answer 12

2. Appropriate Antibiotics have been given 24 hrs

Question 13

While administration of 500 mg Vancomycin via IV clients face becomes Flushed. What action should the nurse take next?

1. Discontinue IV
2. Slow down rate
3. Obtain order for Antihystimine
4. Check clients temp

Answer 13

2. Slow down rate

Redman syndrome is caused by too fast infusion of Vancomycin.

Admin over 60 minutes to avoid vasodilation.

Question 14

Most important to prevent ventilator associated pneumonia SATA

1. HOB >30°
2. Assess clients for readiness for extubation atleast daily
3. Pneumococcal vaccine
4. Kinetic bed to continuously change clients posistion
5. Provide oral care with chlorhexidine solution atleast daily.

Answer 14

1. HOB >30°
2. Assess clients for readiness for extubation atleast daily
3. Provide oral care with chlorhexidine solution atleast daily.

Question 15

Chlorhexidine uses

Answer 15

antiseptic and disinfectant.

It helps reduce the number of germs (bacteria) in your mouth or on your skin.

It can help with: mouth infections, mouth ulcers and gum disease.

Question 16

Best solution to clean arm before insertion of a PICC line

Answer 16

0.5% Chlorhexidine

Question 17

Which order should be questioned for a patient with a PR

1. Warfarin 1.0mg PO
2. Morphine 2 to 4 mg IV
3. Cephalexin 250 mg PO
4. Heparin 900 units/ hr

Answer 17

Warfarin 1.0mg PO

Use of a trailing zero is not appropriate

Can be confused with 10mg

Question 18

Hypertensive crisis & Tachycardia
Which order should be questioned

1. Carvedilol 12.5 mg PO BID daily
2. Hydroclorothiazide 25 mg PO daily
3. Labetalol 20 mg IV over 2 minutes
4. Hydroxyzine 50 mg PO PRN systolic BP >160

Answer 18

4. Hydroxyzine 50 mg PO PRN systolic BP >160

Hydroxyzine is a 1st gen Antihystimine (Anxiety & Pruritus)

Hydralazine is a vasodilatador used for HTN

Question 19

88 yr old no flu vaccine admitted with muscle aches, cough, runny nose for past 24 hours. Which medication is most important for the nurse to admin.

1. Oseltamivir 75 mg PO
2. Guaifenesin 600 mg PO
3. Acetaminophen 650 mg
4. Influenza vaccine 180 mcg

Answer 19

Oseltamivir 75 mg PO

Anti viral med