Deck 21: Coordinating Care for Patients With Multidrug-Resistant Organism Infectious Disorders

Question 1

Which nursing action is appropriate when providing care to a patient who is diagnosed with multidrug-resistant (MDR), methicillin-resistant Staphylococcus aureus?
1)Implementing contact isolation precautions
2)Implementing standard precautions
3)Avoiding alcohol-based hand rubs
4)Wearing a gown that is tied at the neck but not at the waist

Answer 1

1

Question 2

The nurse is teaching a patient about the different routes of transmission. Which patient statement indicates correct understanding of vehicle transmission?
1)"It occurs when I get bit by a tick or other insect."
2)"It occurs when I come in direct contact with a pathogen."
3)"It occurs when I come into contact with pathogens in the air."
4)"It occurs when I ingest food containing a disease-carrying organism."

Answer 2

4

Question 3

The nurse is planning care for several patients in the hospital environment. Which is the greatest risk factor for a patient developing Clostridium difficile?
1)Recent use of antibiotics
2)Recent surgical procedure
3)Current intensive care unit stay
4)Prolonged rehabilitation unit stay

Answer 3

1

Question 4

The nurse is planning care for several patients in the hospital environment. Which is the highest risk factor for a patient developing hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA)?
1)Recent use of antibiotics
2)Recent surgical procedure
3)Current intensive care unit stay
4)Prolonged rehabilitation unit stay

Question 5

Which antibiotic prescription does the nurse correlate as effective in the treatment of the patient with multidrug-resistant (MDR) Clostridium difficile infection who is unable to take vancomycin?
1)Clindamycin
2)Metronidazole
3)Ampicillin-sulbactam
4)Quinupristin-dalfopristin

Question 6

The nurse is conducting an in-service on the spread of infection in the hospital environment. Which statement does the nurse include regarding the most common mode of pathogen transmission?
1)"Contact transmission is the most common mode."
2)"Vehicle transmission is the most common mode."
3)"Airborne transmission is the most common mode."
4)"Vector-borne transmission is the most common mode."

Question 7

The nurse recognizes which finding as the most common clinical manifestation observed in the patient diagnosed with Acinetobacter baumannii infection?
1)Diarrhea
2)Urinary incontinence
3)Hematemesis
4)Ventilator-associated pneumonia

Question 8

In providing an educational program to staff in the intensive care unit, the nurse educator describes which pathogen as the result of decades of use of unnecessary antibiotics and the most prevalent in the United States?
1)Acinetobacter baumannii
2)Clostridium difficile (C diff)
3)Methicillin-resistant Staphylococcus aureus (MRSA)
4)Vancomycin-resistant enterococci (VRE)

Question 9

The nurse is teaching a patient about the different routes of transmission. Which patient statement indicates correct understanding of vector-borne transmission?
1)"It occurs when I get bit by a tick or other insect."
2)"It occurs when I come in direct contact with a pathogen."
3)"It occurs when I come into contact with pathogens in the air."
4)"It occurs when I ingest food containing a disease-carrying organism."

Question 10

Which nursing action is most important to decrease the spread of a multidrug-resistant (MDR) infection when providing patient care?
1)Using protective eye gear if splashes are expected
2)Wearing an isolation gown tied at the neck and waist
3)Performing hand hygiene before leaving the patient's room
4)Removing isolation gowns before leaving the patient's room

Question 11

Which statement by the nursing assistant indicates the need for further teaching regarding infection control measures for patients with Clostridium difficile (C diff)?
1)"Alcohol-based hand sanitizers are most effective for patients with C diff."
2)"It is important that I use soap and water to wash my hands when working with patients with C diff."
3)"I need to rub my hands together to remove the C diff spores."
4)"I need to make sure the family members wash their hands often."

Question 12

The nurse is planning care for several patients. Which is the greatest risk factor for a patient developing community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA)?
1)Recent use of antibiotics
2)Recent surgical procedure
3)Being younger than 2 years of age
4)Being older than 65 years of age

Question 13

The nurse is teaching a patient about the different routes of transmission. Which patient statement indicates correct understanding of contact transmission?
1)"It occurs when I get bit by a tick or other insect."
2)"It occurs when I come in direct contact with a pathogen."
3)"It occurs when I come into contact with pathogens in the air."
4)"It occurs when I ingest food containing a disease-carrying organism."

Question 14

The nurse correlates which diagnostic result as a complication associated with the administration of vancomycin?
1)BUN 28 mg/dL
2)Creatinine 1.0 mg/dL
3)Potassium 3.2 mEq/L
4)Sodium 128 mEq/L

Question 15

The nurse is teaching a patient about the different routes of transmission. Which patient statement indicates correct understanding of airborne transmission?
1)"It occurs when I get bit by a tick or other insect."
2)"It occurs when I come in direct contact with a pathogen."
3)"It occurs when I come into contact with pathogens by breathing."
4)"It occurs when I ingest food containing a disease-carrying organism."

Question 16

Which antibiotic prescription does the nurse correlate as effective in the treatment of the patient diagnosed with multidrug resistant (MDR) methicillin-resistant Staphylococcus aureus (MRSA)?
1)Vancomycin
2)Metronidazole
3)Ampicillin-sulbactam
4)Quinupristin-dalfopristin

Question 17

The nurse is planning care for several patients in the hospital environment. Which is a risk factor for a patient developing Acinetobacter baumannii?
1)Recent use of antibiotics
2)Recent surgical procedure
3)Long-term corticosteroid use
4)Prolonged rehabilitation unit stay

Question 18

Which patient statements indicates to the nurse the need for additional teaching regarding Clostridium difficile?
1)"It is okay for my visitors to use an alcohol-based hand sanitizer."
2)"My healthcare providers must use soap and water when performing hand hygiene."
3)"I need to drink fluids to restore those that are lost because of the diarrhea I am experiencing."
4)"It is important to keep my skin as clean and dry as possible to decrease the risk of breakdown."

Question 19

The infection prevention and control nurse is providing an in-service regarding multidrug-resistant (MDR) infection. The nurse describes which site as the most common site of MDR methicillin-resistant Staphylococcus aureus (MRSA) colonization?
1)Throat
2)Axillae
3)Perineum
4)Anterior nares

Question 20

Which patient requires education from the nurse on decreasing the risk for developing community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA)?
1)A patient with a feeding tube
2)A patient with a weakened immune system
3)A patient who serves overseas in the military
4)A patient who was recently hospitalized for appendicitis

Question 21

Which nursing actions are appropriate when collecting a stool sample to determine if a patient is experiencing a Clostridium difficile infection? Select all that apply.
1)Maintaining the sample on ice for 24 hours
2)Keeping the sample at room temperature
3)Sending the sample to the laboratory immediately
4)Preparing a requisition for a culture and sensitivity
5)Using an alcohol-based hand gel before and after care

Question 22

The nurse monitors for ototoxicity in patients receiving which antibiotics? Select all that apply.
1)Amikacin
2)Clindamycin
3)Metronidazole
4)Plazomicin
5)Vancomycin

Question 23

The nurse correlates which risk factors for development of vancomycin-resistant Enterococci (VRE)? Select all that apply.
1)Prolonged hospital stays
2)Crowded living conditions
3)Cancer diagnosis
4)Transplant patients
5)Limited use of antibiotics

Question 24

Which actions does the nurse include in the plan of care for a patient who is diagnosed with a multidrug-resistant (MDR) pneumonia? Select all that apply.
1)Encourage ambulation.
2)Administer prescribed oxygen.
3)Implement chest physiotherapy.
4)Restrict family visitation to decrease the spread of infection.
5)Educate that alcohol-based hand gels are ineffective.

Question 25

Which is the priority nursing action to decrease the risk of spreading infection among patients diagnosed with multidrug-resistant organism infection?
1)Performing hand hygiene before and after care
2)Donning appropriate personal protective equipment (PPE)
3)Administering prescribed doses of antibiotics as scheduled
4)Monitoring for clinical manifestations of bacterial illnesses

Question 26

In planning care for a patient with carbapenem-resistant Enterobacteriaceae infection, the nurse recognizes the complexity of management for which reasons? Select all that apply.
1)Increased risk in healthy people
2)Increased incidence in older patients
3)Involves organisms that are normal flora
4)Usually spread through airborne transmission
5)May lead to sepsis because of antibiotic resistance

Question 27

The nursing diagnosis "Fluid Volume Deficit related to diarrhea and watery stools secondary to release of toxins in the gastrointestinal tract" is most relevant to the patient with which multidrug-resistant organism?
1)Acinetobacter baumannii
2)Carbapenem-resistant Enterobacteriaceae
3)Clostridium difficile (C diff)
4)Methicillin-resistant Staphylococcus aureus (MRSA)

Question 28

Which clinical manifestations should the nurse anticipate when assessing any patient diagnosed with a multidrug resistant (MDR) infection? Select all that apply.
1)Fever
2)Tachypnea
3)Tachycardia
4)Hypertension
5)Increased urine output

Question 29

Which antibiotic prescription does the nurse correlate as effective in the treatment of a patient diagnosed with multidrug resistant, vancomycin-resistant Enterococci (VRE) infection?
1)Linezolid
2)Metronidazole
3)Imipenem/cilastatin
4)Quinupristin-dalfopristin

Question 30

Which of the following prescriptions for the patient diagnosed with Clostridium difficile (C diff) requires an intervention by the nurse?
1)Antiperistaltic medications
2)Immunoglobulin therapy
3)Probiotics
4)Vancomycin

Question 31

Which assessment data support the nursing diagnosis of Deficient Fluid Volume for a patient diagnosed with Clostridium difficile? Select all that apply.
1)Decreased skin turgor
2)Increased urine output
3)Dry mucous membranes
4)Increased serum creatinine
5)Decreased white blood cells

Question 32

Which antibiotic prescription should the nurse anticipate when providing care to a patient who is diagnosed with multidrug-resistant (MDR) Acinetobacter infection?
1)Vancomycin
2)Metronidazole
3)Imipenem/cilastatin
4)Quinupristin-dalfopristin