Deck 41: Nosocomial Infections

Question 1

An individual develops an infection 10 days after release from the hospital. This would be considered a

A) home-acquired infection.
B) community-acquired infection.
C) nosocomial infection.
D) neighborhood-acquired infection.

Answer 1

nosocomial infection.

Question 2

An individual develops an infection 10 hours after admission to a hospital. This would not be considered a

A) home-acquired infection.
B) community-acquired infection.
C) nosocomial infection.
D) neighborhood-acquired infection.

Answer 2

nosocomial infection.

Question 3

Select the factors that play a role in the development of nosocomial infections:
1) Immunocompetent patient
2) Presence of endotracheal tube
3) Antibiotic treatment

A) 1 and 2
B) 2 and 3
C) 1 and 3
D) 1, 2, and 3

Answer 3

2 and 3

Question 4

A premature infant is hospitalized in the neonatal intensive care unit. He sleeps in an incubator, is intubated, and has an intravenous catheter as well as a urinary catheter in place. He is only allowed two visitors for 5 minutes at the top of each hour. How many factors are present that could contribute to the development of a nosocomial infection in this individual?

A) 2
B) 4
C) 6
D) 8

Question 5

The most common type of nosocomial infections include all of the following except

A) catheter-related urinary tract infection.
B) ventilator-associated pneumonia.
C) antibiotic-associated diarrhea.
D) pressure sore-associated skin infections.

Question 6

A 55-year-old female develops a urinary tract infection while in the hospital for back surgery. Which organism(s) would you expect to culture as the causative agent?

A) E. coli
B) Streptococcus pyogenes
C) Enterococcus spp.
D) a and c
E) All of the above

Question 7

Nosocomial infections

A) include any infection present in hospitalized patients.
B) appear two or more days after admission.
C) can appear up to six months after patient discharge.
D) are no longer a major concern for most healthcare facilities.

Question 8

A biofilm is

A) organisms embedded in a protective slime that is attached to a catheter.
B) caused by the host immune response to organisms present on the catheter.
C) the presence of gram-positive cocci on the skin surface.
D) most often seen in catheterized patients on antibiotics.

Question 9

A catheter tip is received in the microbiology laboratory for culture. At 24 hours, the sheep blood agar plate is growing 7 colonies of a gram-positive cocci in chains that are alpha-hemolytic, catalase-negative, bile solubility negative, and esculin/PYR -/-. The next step in the process is

A) report the results as <15 colonies of viridans Streptococcus.
B) no further workup unless requested by the physician.
C) screen the organism for oxacillin and vancomycin resistance.
D) verify when the most recent blood cultures were drawn and their results.

Question 10

The mecA gene of MRSA encodes for resistance to

A) vancomycin.
B) penicillin
C) oxacillin.
D) cephalosporins.

Question 11

Which of the following environmental factors probably plays the greatest role in the incidence of nosocomial infections?

A) Flowers delivered to the patient's room
B) Two patients sharing a room
C) The use of medical devices
D) Nurse-to-patient ratio

Question 12

Which of the following accounts for the largest proportion of nosocomial infections?

A) Urinary tract infections related to catheters
B) Bloodstream infections related to intravascular devices
C) Surgical and wound infections
D) Ventilator-assisted pneumonia
E) Gastrointestinal infections

Question 13

Which of the following are endogenous sources of organisms that can contribute to surgical and wound infections?

A) Gastrointestinal tract
B) Genitourinary tract
C) Hospital environment
D) Personnel
E) a and b
F) c and d

Question 14

Which of the following is most beneficial in limiting the spread of nosocomial infections?

A) Surveillance cultures of patients and personnel
B) Use of standard and contact precautions
C) Limiting the patient's visitors
D) Use of prophylactic antibiotics

Question 15

What is the simplest, most important infection control method in preventing hospital-acquired infections?

A) Wearing a mask
B) Hand washing
C) Wearing a gown and gloves
D) Surveillance cultures

Question 16

A valuable surveillance tool used by microbiologists, infection control team members, physicians, and pharmacists is

A) surveillance cultures.
B) molecular typing.
C) standard and contact precautions.
D) the antibiogram.

Question 17

Which of the following fungi is the most common causative agent of nosocomial infection?

A) Oval, gram-positive yeast cells, germ tube positive
B) Oval, gram-positive yeast cells, germ tube negative, RAT negative
C) Small, oval, gram-positive yeast cells, RAT positive
D) Green, velvety mould colony, aseptate hyphae, double row of phialides covering vesicle

Question 18

A 45-year-old male develops maggots in his surgical wound site. What infection control practices could have prevented this infestation?

A) Standard precautions
B) Maintaining a clean environment
C) No precautions are necessary
D) Hand washing only is necessary

Question 19

You receive a call from a nurse who requests instructions for the collection of a urine specimen from a catheterized patient. You advise him to

A) send urine from the collection bag in a sterile container.
B) use a syringe to draw urine directly from the catheter tubing.
C) remove and insert a new catheter prior to collection.
D) use the sampling port on the catheter tubing.

Question 20

A surgical technician calls the laboratory to ask about good skin preparation to reduce post-operative wound infections. Your suggestions should include
1) preoperative antiseptic or bath.
2) shaving the surgical site with a razor.
3) scrubbing the skin with a bristled brush and isopropyl alcohol/CHG

A) 1 and 2
B) 2 and 3
C) 1 and 3
D) 1, 2, and 3