Question 1

A nurse caring for a ventilator-dependent patient will incorporate which of the following best practices recommended by the IHI into the care plan, to reduce the incidence of health acquired infections (HAIs)?

Accepted Answer

The Institute for Healthcare Improvement (IHI) developed a VAP bundle based on research and Best Practices. According to the IHI (2012), health care providers can decrease the incidence of VAP by elevating the head of the patient's bed between 30 and 45 degrees, unless contraindicated, daily "sedation vacation" (reducing sedation) and assessing the patient's ability to breathe independently and allow mechanical ventilation to be discontinued as soon as possible, prophylaxis (medication) for preventing peptic ulcer disease (PUD), prophylaxis (medication) for preventing deep vein thrombosis (DVT), daily oral care using chlorhexidine, an antimicrobial oral rinse.

Question 2

The nurse clarifies that the duties of the facility's infection preventionist include: (Select all that apply.)

Accepted Answer

The infection preventionist (IP) follows up on all positive cultures, investigates possible causes of HAIs, and provides ongoing education to staff. Counseling and sanitizing are not directly the responsibility of the IP, although he or she might suggest counseling and supervise sanitizing procedures.

Question 3

The most contagious stage of infection is the ________________ period.

Accepted Answer

The answer of The most contagious stage of infection is...

Question 4

The patient for whom the nurse should observe Contact Precautions in addition to Standard Precautions would be diagnosed with:

Accepted Answer

Contact Precautions are used in addition to Standard Precautions for patients with known or suspected serious illnesses easily transmitted by direct patient contact or by contact with items in the patient's environment. An example of such an illness is respiratory syncytial virus.

Question 5

A patient is hospitalized with suspected disseminated zoster (varicella). The nurse should anticipate that this patient will be placed on:

Accepted Answer

Airborne Precautions are used in addition to Standard Precautions for patients with known or suspected serious illnesses transmitted by airborne droplet nuclei. Examples of such diseases are measles, varicella (including disseminated zoster), and pulmonary tuberculosis.

Question 6

In caring for a patient with active tuberculosis, the nurse should anticipate:

Accepted Answer

When the patient has known or suspected pulmonary tuberculosis, a special particulate filter mask called an N95 mask must be worn.

Question 7

A nurse is instructing a nursing student about principles of aseptic technique. The nurse would recognize the need for further instruction if the nursing student states, "I must:

Accepted Answer

Principles of aseptic technique include avoiding coughing, sneezing, or unnecessary talking near or over a sterile field. They also include avoiding reaching across or above a sterile field with bare hands or arms or with other nonsterile items. The wrapper of a sterile pack must be opened away from the body, the distal flap first, the lateral flaps next, and the proximal flap toward the body last, thus making it unnecessary to reach over the sterile field. When wearing sterile gloves, hands must be kept in sight away from all unsterile objects, and above the waist level.

Question 8

A nurse is caring for a patient who is in isolation. The nurse would correctly do which of the following?

Accepted Answer

General principles regarding isolation include that anything that is brought into the isolation area must not be removed except in proper containers, which are then placed in an outside container labeled "Hazardous Material-Biohazard." They also include never shaking linen when removing it or placing it on the bed, turning faucets on and off using a paper towel to protect the hands, and that floors are considered contaminated; anything dropped on the floor is contaminated and must be discarded or cleaned carefully before reuse.

Question 9

Differences between Airborne and Droplet Precautions include which of the following? (Select all that apply.)

Accepted Answer

The Centers for Disease Control and Prevention (CDC) recommends the use of specialized respirator masks when working with patients on Airborne Precautions and a surgical mask when working within 3 feet of a patient on Droplet Precautions. Both Airborne and Droplet Precautions include the use of a private room; however, a negative pressure room is required for Airborne Precautions. Standard Precautions are to be used with all patients.

Question 10

When picking up the first sterile glove, the nurse will:

Accepted Answer

The first glove is grasped by slipping the thumb in the opening and grasping the cuff with the fingers.

Question 11

A patient had abdominal surgery 3 days ago and now has a temperature of 101.2° F and reports feelings of malaise. The nurse assesses the abdominal incision and observes edema around the incision and some purulent drainage. This patient is in the ____________ stage of infection.

Accepted Answer

The answer of A patient had abdominal surgery 3 days...

Question 12

A patient is hospitalized with pertussis. The nurse should place the patient on what type of precautions?

Accepted Answer

Droplet Precautions are used in addition to Standard Precautions for patients with known or suspected serious illnesses transmitted by large particle droplets. An example of such an illness is pertussis.

Question 13

A nurse is caring for a patient in protective isolation for extreme immunosuppression. Before entering the room, which of the following actions should the nurse take? (Select all that apply.)

Accepted Answer

A gown, mask, and gloves are all that is required; however, the CDC or hospital policies may require full PPE protection.

Question 14

A nurse is instructing one of the facility's unlicensed assistive personnel (UAP) in ways to prevent health care-associated infections. The nurse recognizes that further instruction is warranted when the UAP states, "I will:

Accepted Answer

A person should never cleanse from the rectal area to the urinary meatus because of the risk of introducing infection into the urinary tract.

Question 15

The nurse is instructing one of the facility's unlicensed assistive personnel (UAP) about how to correctly use a sharps container. The nurse recognizes that further instruction is warranted when the UAP states, "I will:

Accepted Answer

No one should ever put fingers inside the opening of the sharps container. The container may be shaken gently to settle the contents and make more room if necessary. Sharps containers should be replaced when they are two thirds full.

Question 16

When the nurse is explaining Tier 2 as developed by the Hospital Infection Control Practices Advisory Committees (HICPAC), the nurse will emphasize that the purpose of Tier 2 is to:

Accepted Answer

Tier 2, or Transmission-Based Precautions, is focused on interrupting the mode of transmission and is always used in combination with Standard Precautions.

Quiz 17: Infection Prevention and Control in the Hospital and Home

A nurse caring for a ventilator-dependent patient will incorporate which of the following best practices recommended by the IHI into the care plan, to reduce the incidence of health acquired infections (HAIs) ?