Question 1

The nurse is caring for a patient who becomes nauseated and vomits without warning.The nurse has contaminated hands.The nurse's best next step is to
A) Clean hands with wipes from the bedside table.
B) Wash hands with an antimicrobial soap and water.
C) Use an alcohol-based waterless hand gel.
D) Instruct the patient to wash his face and hands.

Accepted Answer

The Centers for Disease Control recommends that when hands are visibly soiled,one should wash with a non-antimicrobial 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,use an alcohol-based waterless antiseptic agent 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 2

The nurse is assessing a new patient admitted to home health.To decrease the risk of infection,which of these questions would be most appropriate to ask?
A) "Will you demonstrate how to wash your hands?"
B) "Do you have a working refrigerator?"
C) "Can you explain the risk for infection in your home?"
D) "What are the signs and symptoms of infection?"
E) "Who runs errands for you?"
F) "Are you able to walk to the mailbox?"

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 washing,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 and in preventing 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 relate to decreasing the risk of infection.

Question 3

The nurse is caring for a patient who has cultured positive for Clostridium difficile.Which of the following nursing actions would be appropriate given this organism?
A) Instruct assistive personnel to use soap and water rather than sanitizer to clean hands.
B) Place the patient on Droplet Precautions.
C) Wear an N95 respirator when entering the patient room.
D) Teach the patient cough etiquette.

Accepted Answer

Clostridium difficile is a spore-forming organism that can be transmitted through direct and indirect patient contact.Because Clostridium 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 patients with airborne illness.All patients should be taught cough etiquette; this action is not one to be take especially because the patient has Clostridium difficile.

Question 4

The nurse is caring for a patient on the medical-surgical unit.The nurse and the physician have completed an invasive procedure.What is the next step in handling the instruments used during the procedure?
A) Don gloves, gather instruments, place in transport carrier, and send to central sterile for cleaning and sterilization.
B) Don gloves, gather instruments, place in transport carrier, and send to central sterile for cleaning and disinfection.
C) Don gloves, gather instruments, place in transport carrier, and send to central sterile for cleaning and boiling.
D) Don gloves, gather instruments, place in transport carrier, and send to central sterile for cleaning.

Accepted Answer

Instruments need to be cleaned and sterilized.Disinfecting,boiling,or cleaning is not utilized on critical items that will be reused on patients in the hospital environment.Items that are used on sterile tissue or in the vascular system present a high risk of infection if they become contaminated with bacteria.

Question 5

The nurse is caring for a patient in the hospital.The nurse observes the nursing assistant turning off the handle faucet with his hands.What professional practice supports the need for follow-up with the nursing assistant?
A) The nurse is responsible for providing a safe environment for the patient.
B) This is a key step in the procedure for washing hands.
C) Allowing the water to run is a waste of resources and money.
D) Different scopes of practice allow modification of procedures.

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,turn off a handle faucet with a dry paper towel and avoid touching the handles with your hands to assist in preventing the transfer of microorganisms.Wet towels and hands allow 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 6

The nurse is caring for a patient who has just delivered a neonate.The nurse is checking the patient for excessive vaginal drainage.It is important for the nurse to utilize _____ Precautions.
A) Contact
B) Protective
C) Droplet
D) Standard

Accepted Answer

Standard Precautions 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 MRSA.Protective Precautions apply to individuals who have undergone transplantations.Droplet Precautions focus on diseases that are transmitted by large droplets.

Question 7

The nurse is caring for a patient in the endoscopy area.The nurse observes the technician performing these tasks.Which of these observations would require the nurse to intervene?
A) Washing hands after removing gloves
B) Placing the endoscope in a container for transfer
C) Removing gloves to transfer the endoscope
D) Disinfecting endoscopes in the workroom

Accepted Answer

Standard Precautions are used to prevent and control the spread of infection.Transferring contaminated equipment without the protection of gloves can assist in the spread of 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 utilize principles of basic medical asepsis and Standard Precautions and can break the chain of infection.

Question 8

The nurse is observing a family member changing a dressing for a patient in the home health environment.Which of these observations would indicate that the family member has a correct understanding of how to manage contaminated dressings?
A) The family member removes gloves and gathers items for disposal.
B) The family member places the used dressings in a plastic bag.
C) The family member saves part of the dressing because it is clean.
D) The family member wraps the used dressing in toilet tissue before placing in the trash.

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 9

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.This scenario would indicate that the nurse may be at risk for
A) Hepatitis B.
B) Clostridium difficile.
C) Methicillin-resistant Staphylococcus aureus.
D) Diphtheria.

Accepted Answer

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

Question 10

The nurse is dressed and is preparing to care for a patient in the perioperative area.The nurse has scrubbed her hands and has donned a sterile gown and gloves.Which action would indicate a break in sterile technique?
A) Touching protective eyewear
B) Standing with hands folded on chest
C) Accepting sterile supplies from the surgeon
D) Staying with the sterile table once it is open

Accepted Answer

Touching nonsterile protective eyewear once gowned and gloved with sterile gown and gloves would indicate a break in sterile technique.Sterile objects remain sterile only when touched by another sterile object.Standing with hands folded on chest is common practice and prevents arms and hands from touching unsterile objects.Accepting sterile supplies from the surgeon who has opened them with the appropriate technique is acceptable.Staying with a sterile table once opened is a common practice to ascertain that no one or nothing has contaminated the table.

Question 11

The nurse is caring for a patient on Contact Precautions.Which of the following actions would be appropriate to prevent the spread of disease?
A) Wear a gown, gloves, face mask, and goggles for interactions with the patient.
B) Use a dedicated blood pressure cuff that stays in the room and is used for that patient only.
C) Place the patient in a room with negative airflow.
D) Transport the patient quickly when going to the radiology department.

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.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 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 12

The nurse is caring for a patient with an incision.Which of the following actions would best indicate an understanding of medical and surgical asepsis?
A) Donning sterile gown and gloves to remove the wound dressing
B) Utilizing clean gloves to remove the dressing and sterile supplies for the new dressing
C) Donning clean goggles, gown, and gloves to dress the wound
D) Utilizing clean gloves to remove the dressing and clean supplies for the new dressing

Accepted Answer

Utilize clean gloves (medical asepsis)to remove contaminated dressings and sterile supplies,including gloves and dressings (surgical asepsis-sterile technique)to reapply sterile dressings.Wearing sterile gowns and gloves is not necessary when removing soiled dressings.Donning clean gloves to dress a sterile wound would contaminate the sterile supplies.Utilizing clean supplies for a sterile dressing would not help in decreasing the number of microbes at the incision site.

Question 13

The nurse is caring for a home health patient.After completing an assessment,the nurse has diagnosed the patient as being at risk for infection.Which of the following orders would the nurse question?
A) Urinary catheter to bedside drainage bag. May change to leg bag during the day.
B) May reuse nebulizer equipment. Clean with mild soap and warm water, and allow to dry.
C) Prepare enough enteral feedings for 12 hours. Rinse feeding bag and tubing daily.
D) Call for temperature greater than 100.5, heart rate greater than 100, and respiratory rate greater than 24.

Accepted Answer

For patients who receive tube feedings in the home,to decrease the risk of bacterial contamination it is important to prepare enough commercially prepared formula for only 8 hours and home-prepared formula for 4 hours.Sometimes the urinary drainage system is disrupted in the home to place the patient on a leg bag system when up and about.Nebulizer equipment is cleaned and reused in the home health environment.Notifying the physician about potential signs and symptoms of infection would be common practice in the home health environment.

Question 14

The nurse is caring for a patient who has a bloodborne pathogen.The nurse splashes blood above the glove to intact skin while discontinuing an intravenous infusion.The nurse's best next step is to
A) Obtain an alcohol swab, remove the blood with an alcohol swab, and continue care.
B) Immediately wash the site with soap and running water, and seek guidance from the manager.
C) Delay washing of the site until the nurse is finished providing care to the patient.
D) Do nothing; accidentally getting splashed with blood happens frequently and is part of the job.

Accepted Answer

After getting splashed with blood from a patient who has a known bloodborne pathogen,it is important to 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.Contain contamination immediately to prevent contact spread.

Question 15

The nurse is caring for a patient with a nursing diagnosis of risk for infection.Aware of the need for Standard Precautions,the nurse is careful to
A) Teach the patient about good nutrition.
B) Wear eyewear when emptying a urinary drainage bag.
C) Avoid contact with intact skin without wearing gloves.
D) Don gloves when wearing artificial nails.

Accepted Answer

Standard Precautions 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 Standard Precautions.The term Standard Precautions 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 16

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 to
A) Change the mask when relieved.
B) Air-dry the mask while at lunch, and reapply.
C) Ask for relief, step out of the surgical area, and apply a new mask.
D) Not change the mask, if the nurse is comfortable.

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 17

What would be required after exposure of a nurse to blood by a cut from a scalpel in the perioperative area?
A) Removing sterile gloves and disposing of in kick bucket
B) Placing the scalpel in a needle safe container
C) Testing the patient and offering treatment to the nurse
D) Providing a medical evaluation of the nurse to the manager

Accepted Answer

Follow-up for risk of infection begins with patient testing.Patients should be tested for HIV and hepatitis B and C.Syphilis may be indicated if the patient is HIV positive.Testing of the nurse is dependent on the results of patient testing; if the patient is positive for one of these infections,the nurse will be started on testing and treatment.Removing sterile gloves and placing sharps in appropriate containers are always part of the perioperative process.A confidential medical evaluation is provided to the nurse.

Question 18

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?
A) Inform the physician and recruit another nurse to assist.
B) Rinse and dry hands, and begin assisting the physician.
C) Repeat handwashing using antiseptic soap,
D) Extend the handwashing procedure to 5 minutes.

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 handwashing,repeat the handwashing procedure utilizing antiseptic soap.There is no need to inform the physician or be relieved of this assignment.If the hands are contaminated when touching the sink,drying hands and proceeding with the procedure could possibly contaminate and contribute to increased microbial counts during the procedure,resulting in infection for 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 utilizing antiseptic soap.

Question 19

The home health nurse is teaching a patient and family about hand hygiene in the home.The nurse is sure to emphasize washing hands before
A) And after shaking hands.
B) And after treatments.
C) Opening the refrigerator.
D) And after using a computer.

Accepted Answer

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

Question 20

The nurse is caring for a patient in Contact Precautions.The nurse includes hand hygiene as part of the plan of care to (Select all that apply).
A) Provide an uninterrupted chain of infection.
B) Decrease the incidence of health care-associated infection.
C) Protect the nurse from transmission of the microbes.
D) Decrease the transmission of microbes to other patients.
E) Prevent contamination of clean supplies.
F) Decrease the drying effects of soap.

Accepted Answer

Handwashing is part of Contact Precautions 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 means 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.

Quiz 76: Infection Prevention and Control

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

The nurse is assessing a new patient admitted to home health.To decrease the risk of infection,which of these questions would be most appropriate to ask?

The nurse is caring for a patient who has cultured positive for Clostridium difficile.Which of the following nursing actions would be appropriate given this organism?

The nurse is caring for a patient on the medical-surgical unit.The nurse and the physician have completed an invasive procedure.What is the next step in handling the instruments used during the procedure?

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

The nurse is caring for a patient who has just delivered a neonate.The nurse is checking the patient for excessive vaginal drainage.It is important for the nurse to utilize _____ Precautions.

The nurse is caring for a patient in the endoscopy area.The nurse observes the technician performing these tasks.Which of these observations would require the nurse to intervene?

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

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.This scenario would indicate that the nurse may be at risk for

The nurse is dressed and is preparing to care for a patient in the perioperative area.The nurse has scrubbed her hands and has donned a sterile gown and gloves.Which action would indicate a break in sterile technique?

The nurse is caring for a patient on Contact Precautions.Which of the following actions would be appropriate to prevent the spread of disease?

The nurse is caring for a patient with an incision.Which of the following actions would best indicate an understanding of medical and surgical asepsis?

The nurse is caring for a home health patient.After completing an assessment,the nurse has diagnosed the patient as being at risk for infection.Which of the following orders would the nurse question?

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

The nurse is caring for a patient with a nursing diagnosis of risk for infection.Aware of the need for Standard Precautions,the nurse is careful to

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 to

What would be required after exposure of a nurse to blood by a cut from a scalpel in the perioperative area?

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?

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

The nurse is caring for a patient in Contact Precautions.The nurse includes hand hygiene as part of the plan of care to (Select all that apply) .