Deck 34: Infection Prevention and Control

Question 1

Droplet precautions will be instituted for the client admitted to the infectious disease unit with:
1) Streptococcal pharyngitis
2) Herpes simplex
3) Pertussis
4) Measles

Answer 1

1
Droplet precautions are instituted when droplets are larger than 5 micrometers,such as in the case of streptococcal pharyngitis.Contact precautions are instituted for herpes simplex.
Airborne precautions are instituted with pulmonary TB.Airborne precautions are instituted with measles.

Question 2

A client with active tuberculosis is admitted to the medical center.The nurse recognizes that admission of this client to the unit will require the implementation by the staff of:
1) Airborne precautions
2) Droplet precautions
3) Contact precautions
4) Reverse isolation

Answer 2

1
A client with active tuberculosis requires airborne precautions.A client with active tuberculosis does not require droplet precautions,as the droplet nuclei of tuberculosis are smaller than 5 micrometers.Contact precautions are not necessary for the client with active tuberculosis.Reverse isolation is not required for the client with active tuberculosis

Question 3

A nurse is changing the dressing and accidentally drops the packing onto the client's abdomen.The client has a large,deep abdominal incision that is packed with sterile half-inch packing and covered with a dry 4 $\times$ 4 gauze.The nurse should:

A) Add alcohol to the packing and insert it into the incision
B) Throw the packing away,and prepare a new one
C) Pick up the packing with sterile forceps,and gently place it into the incision
D) Rinse the packing with sterile water,and put the packing into the incision with sterile gloves

Answer 3

Throw the packing away,and prepare a new one

Question 4

The nurse is preparing to assist with a sterile procedure in the surgical suite.An appropriate technique that the nurse includes in the surgical scrub is to:
1) Keep the hands below the elbows throughout the scrub
2) Use a brush on the palms and dorsal surface of the hands
3) Maintain the scrub for at least 2 to 5 minutes
4) Wash well around all jewelry

Question 5

Which of the following is an example of a nursing intervention that is implemented to reduce a reservoir of infection for a client?
1) Covering the mouth and nose when sneezing
2) Wearing disposable gloves
3) Isolating client's articles
4) Changing soiled dressings

Question 6

While working with clients in the postoperative period,the nurse is very alert to the results of laboratory tests.Which one of the following results is indicative of an infectious process?
1) Iron 80 g/100 mL
2) Neutrophils 65%
3) White blood cells (WBC)18,000/mm³
4) Erythrocyte sedimentation rate (ESR)15 mm/hr

Question 7

The nurse recognizes the appropriate procedures for sterile asepsis.Of the following,which action is consistent with sterile asepsis?
1) Clean forceps may be used to move items on the sterile field.
2) Sterile fields may be prepared well in advance of the procedures.
3) The first small amount of sterile solution should be poured and discarded .
4) Wrapped sterile packages should be opened starting with the flap closest to the nurse.

Question 8

In preventing and controlling the transmission of infections,the single most important technique is:
1) Hand hygiene
2) The use of disposable gloves
3) The use of isolation precautions
4) Sterilization of equipment

Question 9

Surgical aseptic techniques are employed by a nurse when:
1) Inserting an intravenous catheter
2) Placing soiled linen in moisture-resistant bags
3) Disposing of syringes in puncture-proof containers
4) Washing hands before changing a dressing

Question 10

The nurse is observing the new staff member work with the client.Of the following activities,which one has the greatest possibility of contributing to a nosocomial infection and requires correction?
1) Washing hands before applying a dressing
2) Taping a plastic bag to the bed rail for tissue disposal
3) Placing a Foley catheter bag on the bed when transferring a client
4) Using alcohol to cleanse the skin before starting an intravenous line

Question 11

What is the correct order for a nursing assistant for putting on the protective equipment when caring for a client in isolation?
1) Wash her hands,apply the mask and eyewear,put on the gown,and then apply gloves
2) Apply the mask and eyewear,put on the gown,wash her hands,and then apply gloves
3) Wash her hands,put on the gown,apply the mask and eyewear,and then apply the gloves
4) Put on the gown,apply the mask and eyewear,wash her hands,and then apply gloves

Question 12

A client has requires a mid-abdominal surgical incision which necessitates a sterile dressing.An appropriate intervention for the nurse to implement in maintaining sterile asepsis is to:
1) Put sterile gloves on before opening sterile packages
2) Discard packages that may have been in contact with the area below waist level
3) Place the cap of the sterile solution well within the sterile field
4) Place sterile items on the very edge of the sterile drape

Question 13

A female client has been undergoing diagnostic testing since admission to the medical unit in the hospital.The results of blood testing are sent back to the unit.Upon reviewing the results,the nurse will report which of the following findings to the physician,which is abnormal?
1) Erythrocyte sedimentation rate (ESR)35 mm/hr
2) White blood cell (WBC)count 8000/mm³
3) Neutrophils 65%
4) Iron 75 g/100 mL

Question 14

A nurse must display understanding of the mental implications of a client on isolation precautions when planning care to control the risk of:
1) Denial
2) Aggression
3) Regression
4) Isolation

Question 15

The client has a 6-inch laceration on his right forearm.The arm develops an infection.Which of the following is a sign of an acute inflammatory process?
1) A blanching of the skin
2) A decrease in temperature at the site
3) A decrease in the number of white blood cells
4) A release of histamine trhat adds to the pain response

Question 16

A client has a viral infection.Which of the following is typical of the illness stage of the course of her infection?
1) There are no longer any acute symptoms.
2) An oral temperature reveals a febrile state.
3) The client was first exposed to the infection 2 days ago but has no symptoms.
4) The client "feels sick" but is able to continue her normal activities.

Question 17

Older adult clients may react differently to infectious processes and a nurse suspects that her older adult client may be experiencing hypostatic pneumonia.The nurse must be alert to atypical signs and symptoms,such as:
1) Hypotension
2) Confusion
3) Erythema
4) Chills

Question 18

The parent of a preschool child asks the nurse how chickenpox (varicella zoster)is transmitted.The nurse identifies that the virus is:
1) Carried by a vector organism
2) Carried though the air in droplets after sneezing or coughing
3) Transmitted through person-to-person contact
4) Acquired through contact with contaminated objects

Question 19

The nurse recognizes that special care must be taken in the handling of which of the following to prevent the transmission of hepatitis A?
1) Blood
2) Feces
3) Saliva
4) Vaginal secretions

Question 20

In a small rural hospital they work with a wide variety of clients.Of this afternoon client's admitted,the nurse acknowledges the client with the highest susceptibility to infection is the individual with:
1) Burns
2) Diabetes
3) Pulmonary emphysema
4) Peripheral vascular disease

Question 21

The nurse is providing care for a client who postoperatively has developed an infected incisional wound and is depressed and anorexic.Which of the following nursing interventions has priority?
1) Sterile wound care
2) Frequent small meals
3) Administration of antidepressant medication
4) Educating the client regarding wound care at home

Question 22

The nurse is educating a client diagnosed with type 2 diabetes,who is susceptible to foot wounds,on how to minimize the risk for infection related to poor wound healing by not being a susceptible host.The most appropriate suggestion would be to:
1) Inspect feet and legs daily for skin breakdown
2) See a podiatrist regularly for appropriate foot care
3) Keep blood sugar levels within normal range to maximize the ability to heal
4) Eat well-balanced meals in order to provide the nutrients necessary for healing

Question 23

Which of the following clients is at greatest risk for acquiring a health care-associated (nosocomial)infection?
1) A 32-year-old hospitalized for 2 days for migraine headaches
2) A client with type 1 diabetes who has been experiencing hypoglycemia
3) A trauma victim taken directly from the ED to surgery and then to the postsurgical unit
4) A pregnant 24-year-old diagnosed with both sinusitis and otitis media and prescribed an oral antibiotic

Question 24

An appropriate isolation procedure for the nurse to implement when working with a client who is found to have methicillin-resistant Staphylococcus aureus (MRSA)is to:
1) Leave all linen in the client's room
2) Place specimen containers in plastic bags for transport
3) Wipe the stethoscope off before removing it from the room
4) Remove the mask and goggles first when leaving the client's room

Question 25

A nurse is caring for a client who has colonized methicillin-resistant Staphylococcus aureus (MRSA).Which of the following statements reflects the best understanding of the client's condition?
1) "This client has the bacteria present but it hasn't become infected."
2) "This makes the client's MRSA very infectious and so a danger to others."
3) "Just be sure to follow standard precautions and there won't be a problem."
4) "The client needs to be watched closely for a conversion to active MRSA."

Question 26

Which of the following clients is at greatest risk for acquiring an infection?
1) A 56-year-old with a urinary catheter 2 days after prostatectomy
2) A 27-year-old diagnosed with human immunodeficiency virus (HIV)
3) A 43-year-old who is 3 days post appendectomy and is currently afebrile
4) A 16-year-old with a compound fractured femur as a result of a bike accident

Question 27

A client enters a neighborhood walk-in clinic reporting the symptoms of "a head cold." When the health care provider does not prescribe an antibiotic,the client asks the nurse to explain "why not." The nurse's most appropriate response is:
1) "Antibiotics aren't usually necessary for colds,and they are really very expensive if you don't have insurance."
2) "You know what they say;a cold will go away with medication in 2 weeks;without medication in 14 days."
3) "Your health care provider believes in treating the symptoms since there are so many different strains of the common cold."
4) "Common colds don't usually require an antibiotic,and taking one results in making it harder to treat infections when they do occur."

Question 28

A presurgical client asks the nurse why it seems "so easy to get an infection in the wound" after surgery.The nurse's most appropriate response to this question is:
1) "The contaminated dressing acts as a breeding ground for microorganisms that then infect the wound."
2) "The body's immune system is weakened by the surgery and can't fight off the infection as effectively."
3) "While infections occur,there are many very effective antibiotics available to help minimize the risk of that happening."
4) "The surgical wound provides the microorganisms on the surrounding skin a path to enter deep into the body's tissues."

Question 29

A client is admitted for treatment of various poorly healing,infected leg ulcers.The nurse recognizes that the client's nutritional history is of primary importance since:
1) Nutrition is vital to the client's overall health status
2) The client's food intake will likely be decreased as a result of the illness
3) Wound healing and infection prevention are negatively impacted by poor nutrition
4) The client's habits regarding food intake are directly related to this hospitalization

Question 30

The nurse is caring for a postoperative client with a localized sinus infection.The most appropriate means by which the nurse can minimize the risk of this client developing a systemic infection is to:
1) Adhere strictly to standard precaution techniques
2) Dispense prescribed anti-infective medication as ordered
3) Monitor the client regularly for exacerbation of the sinus infection
4) Review lab work daily to determine the presence of increased white cell count

Question 31

The nurse can best minimize the risk for infection when initiating an intravenous site by:
1) Proper vein site selection
2) Effective topical skin preparation
3) Appropriate site dressing
4) Gloving for the procedure

Question 32

The greatest drawback to the routine use of antibacterial hand soaps and gels is that they:
1) Are expensive
2) Irritate the skin
3) Kill resident flora
4) Encourage resistant bacteria

Question 33

The nurse knows that Staphylococcus aureus found normally on the skin of a client who has had surgery poses a particular risk for that client developing:
1) A cold sore
2) Gastroenteritis
3) A wound infection
4) A urinary tract infection

Question 34

What is the most appropriate answer to the client's question,"What's the difference between antibacterial and antimicrobial hand soaps?"
1) "There is no real difference;use the less expensive."
2) "Antibacterial soaps are more effective at preventing infections."
3) "Antimicrobial soap is better since it won't kill the good bacteria on the skin."
4) "Any soap will do;it's the technique for proper hand washing that is the key."

Question 35

The nurse obtains a new,dry nebulizer when preparing to give an elderly asthmatic client a nebulizer treatment because the risk of infection is increased because:
1) The client's age increases the risk factor for potential infection
2) The client's immune system is compromised as a result of asthma
3) There is a potential presence of Pseudomonas organisms in the reservoir
4) There is a chance for microorganisms to enter the body via the respiratory system

Question 36

A client is told that he is a carrier of the hepatitis B virus.When asked to explain this situation in more detail,the nurse's best response is:
1) "You need to be careful not to pass the virus to other people."
2) "You aren't sick,but you do have the virus within your body."
3) "Be tested often so as to monitor whether the virus becomes active."
4) "While you show no signs of the illness,you can pass the virus to others."

Question 37

A client admitted for an abdominal hysterectomy reports that she has been under a lot of stress since the death of her mother and wonders how that will affect her surgery and recovery.Which of the following nursing interventions reflects the most therapeutic understanding of the relationship stress has on the body and its ability to recover from surgery?
1) Suggest a demonstration of relaxation techniques
2) Arrange for the hospital chaplain to visit the client
3) Offer to call and get an order for an antianxiety medication
4) Share a personal antidote concerning a similarly stressful situation

Question 38

A client admitted for an abdominal hysterectomy reports that she has been under a lot of stress since the death of her mother and wonders how that will affect her surgery and recovery.Which of the following nursing statements reflects the most therapeutic response to the client's question?
1) "Being under stress isn't going to help your recovery;you need to relax and focus on yourself and getting well."
2) "Your mother's death must be very stressful for you but she would want you to concentrate on getting healthy."
3) "Stress does have a negative effect on the body's ability to heal;is there anything I can do to help you minimize the stress you feel?"
4) "Your health care provider can prescribe you some medication to help you cope with the stress;would you like me to mention it?"

Question 39

A client is found to have a bacterial infection of Escherichia coli.The nurse,recognizing the effects of this bacterium,anticipates that the client will demonstrate:
1) Diarrhea
2) Coughing
3) Cold sores around the mouth
4) Discharge from the eyes