NURSING 306 ASHLAND UNIVERSITY, Infection Prevention and Control (15)

1. What is the most effective way to control transmission of infection?

1. Isolation precautions

2. Identifying the infectious agent

3. Hand hygiene practices

4. Vaccinations

Hand hygiene practices
2. A patient who has been isolated for Clostridium difficile (C. difficile) asks you to explain what he should know about this organism. What is the most appropriate information to include in patient teaching? (Select all that apply.)

1. The organism is usually transmitted through the fecal-oral route.

2. Hands should always be cleaned with soap and water versus alcohol-based hand sanitizer.

3. Everyone coming into the room must be wearing a gown and gloves.

4. While the patient is in contact precautions, he cannot leave the room.

5. C. difficile dies quickly once outside the body.

The organism is usually transmitted through the fecal-oral route.

Hands should always be cleaned with soap and water versus alcohol-based hand sanitizer.

Everyone coming into the room must be wearing a gown and gloves.

3. Your assigned patient has a leg ulcer that has a dressing on it. During your assessment you find that the dressing is saturated with purulent drainage. Which action would be best on your part?

1. Reinforce dressing with a clean, dry dressing and call the health care provider.

2. Remove wet dressing and apply new dressing using sterile procedure.

3. Put on gloves before removing the old dressing; then obtain a wound culture.

4. Remove saturated dressing with gloves, remove gloves, then perform hand hygiene and apply new gloves before putting on a clean dressing.

Remove saturated dressing with gloves, remove gloves, then perform hand hygiene and apply new gloves before putting on a clean dressing.
4. A patient is diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Which type of isolation precaution is most appropriate for this patient?

1. Reverse isolation

2. Droplet precautions

3. Standard precautions

4. Contact precautions

Droplet precautions
5. A family member is providing care to a loved one who has an infected leg wound. What should the nurse instruct the family member to do after providing care and handling contaminated equipment or organic material?

1. Wear gloves before eating or handling food.

2. Place any soiled materials into a bag and double bag it.

3. Have the family member check with the health care provider about need for immunization.

4. Perform hand hygiene after care and/or handling contaminated equipment or material.

Perform hand hygiene after care and/or handling contaminated equipment or material.
6. A patient is isolated for pulmonary tuberculosis. The nurse notes that the patient seems to be angry, but he knows that this is a normal response to isolation. Which is the best intervention?

1. Provide a dark, quiet room to calm the patient.

2. Reduce the level of precautions to keep the patient from becoming angry.

3. Explain the reasons for isolation procedures and provide meaningful stimulation.

4. Limit family and other caregiver visits to reduce the risk of spreading the infection.

Explain the reasons for isolation procedures and provide meaningful stimulation.
7. When should a nurse wear a mask? (Select all that apply.)

1. The patient’s dental hygiene is poor.

2. The nurse is assisting with an aerosolizing respiratory procedure such as suctioning.

3. The patient has acquired immunodeficiency syndrome (AIDS) and a congested cough.

4. The patient is in droplet precautions.

5. The nurse is assisting a health care provider in the insertion of a central line catheter.

The nurse is assisting with an aerosolizing respiratory procedure such as suctioning.

The patient is in droplet precautions.

The nurse is assisting a health care provider in the insertion of a central line catheter.

8. Which type of personal protective equipment are staff required to wear when caring for a pediatric patient who is placed into airborne precautions for confirmed chickenpox/herpes zoster? (Select all that apply.)

1. Disposable gown

2. N 95 respirator mask

3. Face shield or goggles

4. Surgical mask

5. Gloves

Disposable gown
N 95 respirator mask
Gloves
9. The infection control nurse has asked the staff to work on reducing the number of iatrogenic infections on the unit. Which of the following actions on your part would contribute to reducing health care-acquired infections? (Select all that apply.)

1. Teaching correct handwashing to assigned patients

2. Using correct procedures in starting and caring for an intravenous infusion

3. Providing perineal care to a patient with an indwelling urinary catheter

4. Isolating a patient who has just been diagnosed as having tuberculosis

5. Decreasing a patient’s environmental stimuli to decrease nausea

Teaching correct handwashing to assigned patients

Using correct procedures in starting and caring for an intravenous infusion

Providing perineal care to a patient with an indwelling urinary catheter

10. Which of the following actions by the nurse comply with core principles of surgical asepsis? (Select all that apply.)

1. Set up sterile field before patient and other staff come to the operating suite.

2. Keep the sterile field in view at all times.

3. Consider the outer 2.5 cm (1 inch) of the sterile field as contaminated.

4. Only health care personnel within the sterile field must wear personal protective equipment.

5. The sterile gown must be put on before the surgical scrub is performed.

Keep the sterile field in view at all times.
Consider the outer 2.5 cm (1 inch) of the sterile field as contaminated.
11. A patient has an indwelling urinary catheter. Why does an indwelling urinary catheter present a risk for urinary tract infection? (Select all that apply.)

1. It allows migration of organisms into the bladder.

2. The insertion procedure is not done under sterile conditions.

3. It obstructs the normal flushing action of urine flow.

4. It keeps an incontinent patient’s skin dry.

5. The outer surface of the catheter is not considered sterile.

It allows migration of organisms into the bladder.

It obstructs the normal flushing action of urine flow.

12. Put the following steps for removal of protective barriers after leaving an isolation room in order.

1. Remove gloves.

2. Perform hand hygiene.

3. Remove eyewear or goggles.

4. Untie top and then bottom mask strings and remove from face.

5. Untie waist and neck strings of gown. Remove gown, rolling it onto itself without touching the contaminated side.

Remove gloves.

Remove eyewear or goggles.

Untie waist and neck strings of gown. Remove gown, rolling it onto itself without touching the contaminated side.

Untie top and then bottom mask strings and remove from face.

Perform hand hygiene.

13. What does it mean when a patient is diagnosed with a multidrug-resistant organism in his or her surgical wound? (Select all that apply.)

1. There is more than one organism in the wound that is causing the infection.

2. The antibiotics the patient has received are not strong enough to kill the organism.

3. The patient will need more than one type of antibiotic to kill the organism.

4. The organism has developed a resistance to one or more broad-spectrum antibiotics, indicating that the organism will be hard to treat effectively.

5. There are no longer any antibiotic options available to treat the patient’s infection.

The antibiotics the patient has received are not strong enough to kill the organism.

The organism has developed a resistance to one or more broad-spectrum antibiotics, indicating that the organism will be hard to treat effectively.

14. A patient’s surgical wound has become swollen, red, and tender. The nurse notes that the patient has a new fever, purulent wound drainage, and leukocytosis. Which interventions would be appropriate and in what order?

1. Notify the health care provider of the patient’s status.

2. Reassure the patient and recheck the wound later.

3. Support the patient’s fluid and nutritional needs.

4. Use aseptic technique to change the dressing.

Use aseptic technique to change the dressing.

Reassure the patient and recheck the wound later.

Notify the health care provider of the patient’s status.

Support the patient’s fluid and nutritional needs.

15. Which of these statements are true regarding disinfection and cleaning? (Select all that apply.)

1. Proper cleaning requires mechanical removal of all soil from an object or area.

2. General environmental cleaning is an example of medical asepsis.

3. When cleaning a wound, wipe around the wound edge first and then clean inward toward the center of the wound.

4. Cleaning in a direction from the least to the most contaminated area helps reduce infections.

5. Disinfecting and sterilizing medical devices and equipment involve the same procedures.

Proper cleaning requires mechanical removal of all soil from an object or area.

General environmental cleaning is an example of medical asepsis.

Cleaning in a direction from the least to the most contaminated area helps reduce infections.