Question 1

The home health nurse is assessing a new patient.To decrease the risk of infection,which of these questions would be most appropriate to ask? (Select all that apply. )

Accepted Answer

In the home setting,the objective is that the patient and or family will utilize proper infection control techniques.Asking the patient and family about hand hygiene,risk of infection,and signs and symptoms of infection is important in evaluating the patient's knowledge base on infection control strategies.Refrigeration is essential in keeping perishables cold to prevent foodborne illnesses and in allowing storage of enteral feedings or refrigerated medications.Activity assessment is important for evaluation of the overall status of the patient,and knowing who runs errands gives you information on who is helping to meet the needs of the patient,but neither of these are related to decreasing the risk of infection.

Question 2

The nurse is caring for a patient who needs a protective environment.The nurse has provided the care needed and is now leaving the room.Select the correct order for removal of the personal protective equipment and associated tasks.(All answers are used. )
A)Remove eyewear/face shield and goggles.
B)Perform hand hygiene.
C)Remove gloves.
D)Untie gown,allow gown to fall from shoulders,and do not touch outside of gown;dispose of properly.
E)Remove mask by strings;do not touch outside of mask.
F)Dispose of all contaminated supplies and equipment in designated receptacles.
G)Leave room and close the door.

Accepted Answer

The answer of The nurse is caring for a patient...

Question 3

The nurse is caring for a patient in the endoscopy area.The nurse observes the technician performing these tasks.Which of these observations would necessitate intervention by the nurse?

Accepted Answer

Routine practices are used to prevent and control the spread of infection.Transferring contaminated equipment without the protection of gloves can help spread microbes to inanimate objects and to the person doing the transfer.Utilizing gloves,washing hands,covering contaminated supplies during transfer,and disinfecting equipment in the appropriate way in the appropriate places reflect the principles of basic medical asepsis and routine practices and can break the chain of infection.

Question 4

The nurse is performing hand hygiene before assisting a physician with insertion of a chest tube.While washing hands,the nurse touches the sink.What is the next action the nurse should take?

Accepted Answer

The inside of the sink and the counter at the edges of the sink,faucet,and handles are considered contaminated areas.If the hands touch any of these areas during hand hygiene,the nurse should repeat the hand hygiene procedure with antiseptic soap.There is no need to inform the physician or be relieved of this assignment.If the hands are contaminated from touching the sink,drying hands and proceeding with the procedure could possibly contaminate materials,contribute to increased microbial counts during the procedure,and result in infection in the patient.Extending the time for washing the hands (although this is what will happen when the procedure is repeated)is not the focus.The focus is to repeat the whole hand hygiene procedure with antiseptic soap.

Question 5

The nurse is caring for a patient who becomes nauseated and vomits without warning.The nurse has contaminated hands.What is the nurse's best next step?

Accepted Answer

The U.S.Centers for Disease Control and Prevention recommend that when hands are visibly soiled,the health care provider should wash with a plain soap or with antimicrobial soap.Cleaning hands with wipes or using waterless hand gel does not meet this standard.If hands are not visibly soiled,an alcohol-based waterless antiseptic agent should be used for routinely decontaminating hands.The patient may very well need to wash his face and hands,but this is not the best next step.

Question 6

The nurse is preparing to insert a urinary catheter.The nurse is using open gloving to don the sterile gloves.Which steps are included in this process? (Select all that apply. )

Accepted Answer

Sterile objects held below the waist are considered contaminated.Gloving the dominant hand helps improve dexterity.Slipping the fingers underneath the second glove cuff helps protect the gloved fingers.Sterile touching sterile prevents glove contamination.Interlocking fingers ensures a smooth fit over the fingers.To open sterile supplies,the sides of the package are carefully separated and peeled apart;this prevents the sterile contents from accidentally opening and touching contaminated objects.Touching the outside of the glove surface will contaminate the sterile item;only the inside of the glove-the piece that will be against the skin-should be touched.

Question 7

The nurse is caring for a patient whose cultures were positive for Clostridium difficile.Which of the following nursing actions would be appropriate in view of the presence of this organism?

Accepted Answer

C.difficile is a spore-forming organism that can be transmitted through direct and indirect patient contact.Because C.difficile is a spore-forming organism,hand sanitizer is not effective in preventing its transmission.Hands must be washed with soap and water to prevent transmission.This organism is not transmitted via the droplet route;therefore,droplet precautions are not needed.An N95 respirator is used primarily for providing care to patients with airborne illness.All patients should be taught cough etiquette;this action is not one to specific to a patient who has C.difficile infection.

Question 8

The nurse is caring for a patient in the hospital.The nurse observes the unregulated care provider turning off the handle faucet with his hands.What professional practice supports the need for follow-up with the unregulated care provider?

Accepted Answer

The nurse is responsible for providing a safe environment for the patient.The effectiveness of infection control practices depends on conscientiousness and consistency in using effective aseptic technique.It is human nature to forget key procedural steps or to take shortcuts.However,failure to comply with basic procedures places the patient at risk for infection that can impair recovery or lead to death.After washing hands,the health care provider should turn off a handle faucet with a dry paper towel and avoid touching the handles with his or her own hands to assist in preventing the transfer of microorganisms.Wet towels and hands enable the transfer of pathogens from faucet to hands.The principles and procedures for washing hands are universal and apply to all members of health care teams.Being resourceful and aware of the cost of health care is important,but taking shortcuts that may endanger an individual's health is not a prudent practice.

Question 9

The nurse has been caring for a patient in the perioperative area for several hours.The surgical mask the nurse is wearing has become moist.The nurse's best next step is what?

Accepted Answer

A mask should fit snugly around the face and nose.After the mask is worn for several hours,it can become moist.The mask should be changed as soon as possible because moisture encourages the growth of microorganisms.Waiting to change the mask,air-drying it,or wearing it because it is comfortable does not support the principles of infection control.

Question 10

The nurse and the student nurse are caring for two patients on the medical-surgical unit.One patient is on airborne precautions,and the other is on contact precautions.The nurse explains to the student different interventions for care.What should the nurse include in teaching? (Select all that apply. )

Accepted Answer

Washing hands,properly disposing of supplies,applying knowledge of the disease process,and having patients on airborne precautions wear a mask during transfer are all principles to follow when caring for patients in isolation.Multiple differences are evident between these types of isolation,including the type of room used for the patient and what the nurse wears while caring for the patient.It is important to check the working order of a negative-pressure room before admitting a patient to the room,each shift the patient is in the room,and if and when the device sounds an alarm.Even when no patient is in this type of room,regular and routine checks are important to ensure the working order.

Question 11

The home health nurse is teaching a patient and family about hand hygiene in the home.The nurse is sure to emphasize washing hands at what time?

Accepted Answer

Patients should perform hand hygiene before and after treatments and when coming in contact with body fluids.Depending on the patient,holding hands does not necessitate washing of hands before,but washing hands afterwards is good practice,especially before touching eyes,nose,or mouth.Washing hands before and after opening the refrigerator and using the computer is not required,but during cold and flu season,it might be advisable.

Question 12

The nurse is changing linens for a postoperative patient and feels a stick in her hand.A nonactivated safe needle is noted in the linens.In this scenario,the nurse may be at risk for which of the following infections?

Accepted Answer

Bloodborne pathogens such as those associated with hepatitis B and C are most commonly transmitted by contaminated needles.C.difficile is spread by contact with and ingestion of this microbe,and MRSA is spread by contact.Diphtheria is spread by droplets when a person is within 1 m (3 feet)of the patient.

Question 13

The nurse is caring for a patient with an order for routine practices.The nurse includes hand hygiene as part of the plan of care to do which of the following? (Select all that apply. )

Accepted Answer

Hand hygiene is part of routine practices and assists in interrupting the chain of infection.Washing hands can assist in decreasing the incidence of health care-associated infection,protect the nurse from the transfer of microorganisms,decrease the transmission of microbes to other patients,and prevent contamination of clean supplies.Hands are a common vehicle of transmission of bacteria from one place to another.Proper hand hygiene does not decrease the drying effects of soap;in fact,it increases the drying effects of soap.

Question 14

The nurse is caring for a patient for whom contact precautions are ordered.Which of the following actions would be appropriate to prevent the spread of disease?

Accepted Answer

Contact precautions are a type of isolation precaution used for patients with illness that can be transmitted through direct or indirect contact.A patient is placed on contact precautions if a disease is present that can be transmitted through direct or indirect contact.Patients who are on contact precautions should have dedicated equipment wherever possible.This would mean,for example,that one blood pressure cuff and one stethoscope would stay in the room with the patient and would be used for that patient only.A gown and gloves may be required for interactions with a patient who is on contact precautions,but a face mask and goggles are not part of contact precautions.A room with negative airflow is needed for patients placed on airborne precautions;it is not necessary for a patient on contact precautions.When a patient on contact precautions needs to be transported,he or she should wear clean gowns,and wheelchairs or gurneys should be covered with an extra layer of sheets.Anyone who might come in contact with the patient needs to be protected,and equipment must be cleaned with an approved germicide after patient use and before another patient uses the shared equipment.

Question 15

The nurse manager is evaluating current infection control data for the intensive care unit.The nurse compares past patient data with current data to look for trends.The nurse manager examines the chain of infection for possible solutions.Arrange these items in the proper order of the chain of infection.(All answers are used. )
A)A mode of transmission.
B)An infectious agent or pathogen.
C)A susceptible host.
D)A reservoir or source for pathogen growth.
E)A portal of entry to a host.
F)A portal of exit from the reservoir.

Accepted Answer

The answer of The nurse manager is evaluating current infection...

Question 16

The nurse is observing a family member changing a dressing for a patient in the home environment.Which of these observations would indicate that the family member has a correct understanding of how to manage contaminated dressings?

Accepted Answer

Contaminated dressings and other infectious items should be placed in impervious plastic or brown paper bags and then disposed of properly in garbage containers.Gloves should be worn during this process.Parts of the dressing should not be saved,even though they may seem clean,because microbes may be present.

Question 17

The circulating nurse in the perioperative area is observing the surgical technologist while applying a sterile gown and gloves to care for a patient having an appendectomy.Which of the following behaviours indicate to the nurse that the procedure has been done correctly? (Select all that apply. )

Accepted Answer

To maintain sterility,the surgical technologist touches only the inside of the gown that will be against the body.Arms are slipped simultaneously into the gown to prevent contamination.Using the sleeves to cover the hands while gloves are donned maintains the principle of sterile only touching sterile.Extending the fingers fully into both gloves ensures that the surgical technologist has full dexterity while using the sterile gloved hand.The surgical technologist applies the surgical cap,face mask,and eyewear before entering the surgical area and completing the surgical scrub.Reaching behind to tie the back of the gown will contaminate the sterile area of the gown.

Question 18

The nurse is caring for a patient with a nursing diagnosis of Risk for infection.Aware of the need for routine practices,the nurse is careful to do what?

Accepted Answer

Routine practices include the wearing of eyewear whenever there is a possibility of a splash or splatter.Teaching the patient about good nutrition is positive but does not apply to routine practices.The term routine practices applies to all blood and body fluids except sweat,even if blood is not present.It also applies to nonintact skin and mucous membranes.

Question 19

The nurse is caring for a patient who has just given birth.The nurse is checking the patient for excessive vaginal drainage.It is important for the nurse to utilize which type of precautions?

Accepted Answer

Routine practices apply to contact with blood,body fluid,nonintact skin,and mucous membranes of all patients.Contact precautions apply to individuals with colonization of infection such as methicillin-resistant S.aureus (MRSA).Protective precautions apply to individuals who have undergone transplantations.Droplet precautions focus on diseases that are transmitted by large droplets.

Question 20

The nurse is caring for a patient who has a bloodborne pathogen.The nurse splashes blood above the glove onto intact skin while discontinuing an intravenous infusion.The nurse's best next step is which of the following?

Accepted Answer

After getting splashed with blood from a patient who has a known bloodborne pathogen,the nurse must cleanse the site immediately and thoroughly with soap and running water and notify the manager and employee health for guidance on next steps in the process.Removing the blood with an alcohol swab,delaying washing,and doing nothing because the splash was to intact skin could possibly spread the blood within the room and could spread the infection.Contamination should be contained immediately to prevent contact spread.

Quiz 33: Infection Control