Deck 33: Infection Control

Question 1

The nurse is caring for a group of medical-surgical patients.Which patient is most at risk for developing an infection?

A)The patient who is in observation for chest pain.
B)The patient who is recovering from a right total hip arthroplasty.
C)The patient who has been admitted with dehydration.
D)The patient who has been admitted for stabilization of atrial fibrillation.

Answer 1

The patient who is recovering from a right total hip arthroplasty.

Question 2

The patient and the nurse are discussing Rickettsia rickettsii,the cause of Rocky Mountain spotted fever.Which patient statement to the nurse indicates understanding regarding the mode of transmission of this disease?

A)"When I go camping,I will be sure to wear sunscreen."
B)"When I go camping,I will drink bottled water."
C)"When I go camping,I will be sure to wear insect repellent."
D)"When I go camping,I will be sure to use hand gel on my hands."

Answer 2

"When I go camping,I will be sure to wear insect repellent."

Question 3

Which of these interventions would take priority and should be included in a plan of care for a patient who presents with pneumonia?

A)Observe the patient for decreased activity tolerance.
B)Assume that the patient is in pain and treat accordingly.
C)Maintain the ambient temperature at 18.3°C (65°F).
D)Provide the patient ice chips as requested.

Answer 3

Observe the patient for decreased activity tolerance.

Question 4

The nurse is caring for a patient who is susceptible to infection.Which of the following nursing interventions will assist in decreasing the risk of infection?

A)Teaching the patient about fall prevention.
B)Teaching the patient to select nutritious foods.
C)Teaching the patient to measure temperature.
D)Teaching the patient about the effects of alcohol.

Question 5

The nurse is caring for a school-aged child who has injured his leg after a bicycle accident.To determine whether the child is experiencing a localized inflammatory response,the nurse should assess for which of these signs and symptoms?

A)Fever,malaise,anorexia,and nausea and vomiting.
B)Chest pain,shortness of breath,and nausea and vomiting.
C)Dizziness and disorientation to time,date,and place.
D)Edema,redness,tenderness,and loss of function.

Question 6

The nurse is caring for a patient in the labour and delivery area.When an assessment of the patient for dilatation and effacement is nearly completed,the electronic infusion device being used on the IV infusion sounds an alarm.Which of these actions is most appropriate for the nurse to take?

A)Complete the assessment,remove gloves,and silence the alarm.
B)Discontinue the assessment,and assess the intravenous infusion.
C)Complete the assessment,remove gloves,wash hands,and assess the intravenous infusion.
D)Discontinue the assessment,remove gloves,use hand gel,and assess the intravenous infusion.

Question 7

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 using 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.

Question 8

The nurse is inserting a peripherally inserted central catheter (PICC)into the patient.Aware of the potential for health care-associated infection,the nurse is careful to do which of the following?

A)Prepare the skin with 2% chlorhexidine gluconate.
B)Select a catheter of appropriate size for the appropriate vein.
C)Use nonallergenic tape and dressings on the patient.
D)Utilize local anaesthetic on the site as ordered.

Question 9

The nurse is admitting a patient with an infectious disease process.What question would be appropriate for a nurse to ask this patient?

A)"Do you have a chronic disease,and how long have you had it?"
B)"Do you have any children living in the home?"
C)"What is your marital status-single,married,or divorced?"
D)"Do you have any cultural or religious beliefs that will influence your care?"

Question 10

The nurse is caring for an adult patient in the clinic who is a victim of flooding and has been evacuated.The patient presents with signs and symptoms of a urinary tract infection.Along with needed education surrounding this diagnosis,the nurse teaches the patient about rest,exercise,eating properly,and how to utilize deep breathing and visualization.Which of the following explanations would best support these nursing interventions?

A)Urinary tract infections are painful,and these techniques would help with managing the pain.
B)Interventions listed are standard topics taught during health care visits.
C)Stress for long periods of time can lead to exhaustion and decreased resistance to infection.
D)The patient requested this information to teach to extended family at home.

Question 11

A patient with diabetes presents to the clinic for a dressing change.The wound is located on the right foot and has purulent yellow drainage.Which of these interventions would be most appropriate for the nurse to provide?

A)Position the patient comfortably on the stretcher.
B)Explain the procedure for dressing change to the patient.
C)Don gloves and other appropriate personal protective equipment.
D)Review the medication list that the patient brought from home.

Question 12

The infection control nurse is reviewing data for the medical-surgical unit.The nurse notices a spike in postoperative infections on this unit and categorizes this type of health care-associated infection as which infections?

A)Iatrogenic.
B)Exogenous.
C)Endogenous.
D)Nosocomial.

Question 13

The nurse is caring for a patient with leukemia and is preparing to provide fluids through a vascular access device.Which nursing intervention is priority in this procedure?

A)Positioning the patient comfortably.
B)Maintaining aseptic technique.
C)Gathering available supplies.
D)Reviewing the procedure with the patient.

Question 14

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.

Question 15

A woman presents to the clinic with reports of a white discharge and itching in the vaginal area.During the health history,which of these questions should the nurse prioritize?

A)"When was the last time you visited the physician?"
B)"Has this condition affected your eating habits?"
C)"What medications are you currently taking?"
D)"Are you able to sleep at night?"

Question 16

The nurse is providing an educational session for a group of preschool workers.The nurse reminds the group that the most important thing to do to prevent the spread of infection is what?

A)Encourage preschool children to eat a nutritious diet.
B)Encourage parents to provide a multivitamin to the children.
C)Clean the toys every afternoon before putting them away.
D)Perform hand hygiene between each interaction with children.

Question 17

The nurse is providing an education session to an adult community group about the effects of smoking.Which of the following is the most important point to be included in the educational session?

A)Smoke from tobacco products clings to your clothing and hair.
B)Smoking affects the cilia lining the upper airways in the lungs.
C)Smoking tobacco products can be very expensive.
D)Smoking can affect the colour of the patient's fingernails.

Question 18

Which of the following nursing actions would most increase a patient's risk for developing a health care-associated infection?

A)Use of surgical aseptic technique to suction an airway.
B)Placement of a urinary catheter drainage bag below the level of the bladder.
C)Clean technique for inserting a urinary catheter.
D)Use of a sterile bottled solution more than once within a 24-hour period.

Question 19

Which interventions utilized by the nurse would indicate the ability to recognize the inflammatory response?

A)Rest,ice,compression,and elevation.
B)Turn,cough,and deep breathe.
C)Orient to date,time,and place.
D)Passive range-of-motion exercises.

Question 20

The patient underwent a surgical procedure,and povidone-iodine (Betadine)was utilized in the surgical preparation.Two days postoperatively,the nurse's assessment indicates that the incision is red and has a small amount of purulent drainage.The patient reports tenderness at the incision site.The patient's temperature is 38.1°C (100.5°F)and the white blood cell count (WBC)is 10,500/mm³ (10.5 × 10?/L).Which nursing action should the nurse take?

A)Plan to change the surgical dressing during the shift.
B)Check to see what solution was used for skin preparation in surgery.
C)Collect supplies to culture the surgical incision.
D)Communicate the patient's condition to the health care provider.

Question 21

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. )

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?"

Question 22

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.

Question 23

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?

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.

Question 24

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 hand hygiene,using antiseptic soap.
D)Extend the hand hygiene procedure to 5 minutes.

Question 25

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?

A)Cleaning hands with wipes from the bedside table.
B)Washing hands with an antimicrobial soap and water.
C)Using an alcohol-based waterless hand gel.
D)Instructing the patient to wash his face and hands.

Question 26

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. )

A)Lay glove package on clean flat surface above waistline.
B)Remove outer glove package by tearing the package open.
C)Glove the dominant hand of the nurse first.
D)While putting on the first glove,touch only the outside surface of the glove.
E)With gloved dominant hand,slip fingers underneath second glove cuff.
F)After second glove is on,interlock hands.

Question 27

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?

A)Instructing assistive personnel to use soap and water rather than sanitizer to clean hands.
B)Placing the patient on droplet precautions.
C)Wearing an N95 respirator when entering the patient room.
D)Teaching the patient cough etiquette.

Question 28

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?

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.

Question 29

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?

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.

Question 30

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. )

A)Be consistent in nursing interventions;there is only one difference in the precautions.
B)Wash hands before entering and leaving both of the patients' rooms.
C)Dispose of supplies to prevent the spread of microorganisms.
D)Apply the knowledge the nurse has of the disease process to prevent the spread of microorganisms.
E)Patients in airborne precautions wear a mask during transportation to departments.
F)Checking the working order of the negative-pressure room is done on admission and at the time of discharge.

Question 31

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?

A)Before and after shaking hands.
B)Before and after treatments.
C)Before opening the refrigerator.
D)Before and after using a computer.

Question 32

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?

A)Hepatitis B.
B)C.difficile.
C)Methicillin-resistant S aureus (MRSA).
D)Diphtheria.

Question 33

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. )

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.

Question 34

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?

A)Wearing a gown,gloves,face mask,and goggles for interactions with the patient.
B)Using a dedicated blood pressure cuff that stays in the room and is used for that patient only.
C)Placing the patient in a room with negative airflow.
D)Transporting the patient quickly when going to the radiology department.

Question 35

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.

Question 36

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?

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 garbage.

Question 37

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. )

A)Surgical cap and face mask are in place.
B)Surgical technologist ties the back of the gown.
C)Surgical technologist touches only inside of gown.
D)Surgical technologist slips arms into arm holes simultaneously.
E)Surgical technologist uses hands covered by sleeves to open gloves.
F)Fingers are extended fully into both gloves.

Question 38

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?

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.

Question 39

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?

A)Contact precautions.
B)Protective precautions.
C)Droplet precautions.
D)Routine practices.

Question 40

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?

A)To obtain an alcohol swab,remove the blood with an alcohol swab,and continue care.
B)To immediately wash the site with soap and running water,and seek guidance from the manager.
C)To delay washing of the site until the nurse is finished providing care to the patient.
D)To do nothing;accidentally getting splashed with blood happens frequently and is part of the job.