week 3--book ch 28

Question 1

A patient who has been placed on Contact Precautions for Clostridium difficile (C. difficile) asks you to explain what he should know about this organism. What is the most appropriate information to include in patient teaching? (Select all that apply.)

1. The organism is usually transmitted through the fecal-oral route.
2. Hands should always be cleaned with soap and water versus alcohol-based hand sanitizer.
3. Everyone coming into the room must be wearing a gown and gloves.
4. While the patient is in Contact Precautions, he cannot leave the room.
5. C. difficile dies quickly once outside the body.

Answer 1

1. The organism is usually transmitted through the fecal-oral route.
2. Hands should always be cleaned with soap and water versus alcohol-based hand sanitizer.
3. Everyone coming into the room must be wearing a gown and gloves.

Question 2

A patient is diagnosed with meningitis. Which type of isolation precaution is most appropriate for this patient?

1. Reverse isolation
2. Droplet Precautions
3. Standard Precautions
4. Contact Precautions

Answer 2

2. Droplet Precautions

Question 3

A patient is placed on Airborne Precautions for pulmonary tuberculosis. The nurse notes that the patient seems to be angry, but he knows that this is a normal response to isolation. Which is the best intervention?

1. Provide a dark, quiet room to calm the patient.
2. Reduce the level of precautions to keep the patient from becoming angry.
3. Explain the reasons for isolation procedures and provide meaningful stimulation.
4. Limit family and other caregiver visits to reduce the risk of spreading the infection.

Answer 3

3. Explain the reasons for isolation procedures and provide meaningful stimulation.

Question 4

Which type of personal protective equipment should the nurse wear when caring for a pediatric patient who is placed on Airborne Precautions for confirmed chickenpox/herpes zoster? (Select all that apply.)

1. Disposable gown
2. N95 respirator mask
3. Face shield or goggles
4. Disposable mask
5. Gloves

Answer 4

1. Disposable gown
2. N95 respirator mask
3. Gloves

Question 5

The infection control nurse has asked the staff to work on reducing the number of iatrogenic infections on the unit. Which of the following actions on your part would contribute to reducing health care–acquired infections? (Select all that apply.)

1. Teaching correct handwashing to assigned patients
2. Using correct procedures in starting and caring for an intravenous infusion
3. Providing perineal care to a patient with an indwelling urinary catheter
4. Isolating a patient on antibiotics who has been having loose stool for 24 hours
5. Decreasing a patient’s environmental stimuli to decrease nausea

Answer 5

1. Teaching correct handwashing to assigned patients
2. Using correct procedures in starting and caring for an intravenous infusion
3. Providing perineal care to a patient with an indwelling urinary catheter

Question 6

Which of the following actions by the nurse demonstrate the practice of core principles of surgical asepsis? (Select all that apply.)

1. The front and sides of the sterile gown are considered sterile from the waist up.
2. Keep the sterile field in view at all times.
3. Consider the outer 2.5 cm (1 inch) of the sterile field as contaminated.
4. Only health care personnel within the sterile field must wear personal protective equipment.
5. After cleansing the hands with antiseptic rub, apply clean disposable gloves.

Answer 6

2. Keep the sterile field in view at all times.
3. Consider the outer 2.5 cm (1 inch) of the sterile field as contaminated.

Question 7

Put the following steps for removal of protective barriers after leaving an isolation room in order.

1. Remove and dispose of gloves.
2. Perform hand hygiene.
3. Remove eyewear or goggles.
4. Untie top and then bottom mask strings and remove from face.
5. Untie waist and neck strings of gown. Remove gown, rolling it onto itself without touching the contaminated side.

Answer 7

1. Remove and dispose of gloves.
2. Remove eyewear or goggles.
3. Untie waist and neck strings of gown. Remove gown, rolling it onto itself without touching the contaminated side.
4. Untie top and then bottom mask strings and remove from face.
5. Perform hand hygiene.

Question 8

A patient is diagnosed with a multidrug-resistant organism (MDRO) in his surgical wound and asks the nurse what this means. What is the nurse’s best response? (Select all that apply.)

1. There is more than one organism in the wound that is causing the infection.
2. The antibiotics the patient has received are not strong enough to kill the organism.
3. The patient will need more than one type of antibiotic to kill the organism.
4. The organism has developed a resistance to one or more broad-spectrum antibiotics, indicating that the organism will be hard to treat effectively.
5. There are no longer any antibiotic options available to treat the patient’s infection.

Answer 8

2. The antibiotics the patient has received are not strong enough to kill the organism.
3. The organism has developed a resistance to one or more broad-spectrum antibiotics, indicating that the organism will be hard to treat effectively.

Question 9

Which of these statements are true regarding disinfection and cleaning? (Select all that apply.)

1. Proper cleaning requires mechanical removal of all soil from an object or area.
2. General environmental cleaning is an example of medical asepsis.
3. When cleaning a wound, wipe around the wound edge first and then clean inward toward the center of the wound.
4. Cleaning in a direction from the least to the most contaminated area helps reduce infections.
5. Disinfecting and sterilizing medical devices and equipment involve the same procedures.

Answer 9

1. Proper cleaning requires mechanical removal of all soil from an object or area.
2. General environmental cleaning is an example of medical asepsis.
3. Cleaning in a direction from the least to the most contaminated area helps reduce infections.

Question 10

Patient-to-patient transmission of infection cannot occur if gloves are routinely used.

1. True
2. False

Answer 10

False

Question 11

exogenous infection
vs endogenous infection

Answer 11

exo – microbes outside the indiv.

endo– individuals normal flora becomes altered

Question 12

latrogenic infection

Answer 12

HAI caused by invasive procedure

Question 13

critical items

Answer 13

**sterile
**moist heat
surgical instruments
implants
catheters

Question 14

semi critical items

Answer 14

**contact w/ musocus membranes or non intact skin

-endoscopes
-endotracheal tubes
-respiratory/anesthesia equip

Question 15

Airborne Precautions

Answer 15

*n95 mask
*gown
*gloves
aiir room
private room

Question 16

Droplet Precautions

Answer 16

mask
private room

Question 17

contact precautions

Answer 17

gloves
gown
private room