Infection Prevention & Control Ch.28

The nurse provides education for a group of nursing students about the prevention of health care-associated infections (HAIs) and would discus which intervention that is the most effective way to break the chain of infection.

Performing hand hygiene before and after patient care.

Which method is most effective to break the chain of infection

Hand hygiene

Which type of specimen is collected by using a sterile tongue blade?

Stool sample

To avoid contamination during a surgical hand scrub, the nurse recognizes that it is important to keep the hands in which location?

Above the elbows

The nurse would intervene when which handwashing step is performed by another member of the health care team?

Keeping elbows lower than the hands and forearms during washing

Which nursing action is appropriate in surgical hand asepsis?

-Scrubbing the hands for 3 to 5 minutes

Which type of transmission-based precaution requires a gown and gloves?

contact precautions

Which disease requires contact precautions?

Scabies

Which part of a sterile gown is actually considered sterile?

Anterior surface of the sleeves

Boiling water is a common method of disinfection used in the home setting for which type of equipment?

Drainage collection device

Which technique is most effective in preventing and controlling the transmission of an infection?

Performing hand hygiene

Which noncritical item requires surface disinfection?

Stethoscope

Which instrument used by the nurse requires surface disinfection?

Blood pressure cuff

Which infection control practice would the nurse implement for a patient who is hospitalized for treatment of an infection with a multidrug-resistant organism?

Contact Precautions

Which statement is true regarding donning a sterile gown?

-Nurses wear sterile gowns when at a sterile field in the operating room (OR).

Which statement made by the nursing student regarding handwashing with antiseptic soap indicates the need for further learning?

"Hot water removes fewer protective oils than warm water."

Which disease requires the nurse to implement Droplet Precautions?

Group A streptococcus

When creating an education module about closed-gloving, which information would the nurse include?

In the closed-gloving technique, the nurse's hands remain inside the sleeves and do not touch the cuffs.

Which process uses moist heat to sterilize heat-tolerant surgical instruments?

Autoclave

The nurse expects which additional assessment finding in patient who is 10 days post-hysterectomy who reports purulent drainage at the incision site?

Pain

Redness

Tenderness

Nurse recognizes the importance of preventing which specific type of infection when assisting with a bronchoscopy?

Iatrogenic

Which personal protective equipment is the most important for the nurse to wear when entering the room of a patient with mycobacterium tuberculosis infection

n-95 respirator

To reduce transmission of disease, which step would the nurse take when administering medication to a patient with Clostridium difficile infection?

1 Give oral medication using a paper cup.

2 Wash hands with soap and water.

4 Discard safety needles into the sharps container.

5 Wear gloves when administering an injection.

After caring for a patient with diarrhea, which procedure with the nurse employee to clean, visibly soiled hands

Wash with soap and water

When the nurse leaves an isolation room, arrange the steps of personal protective equipment (PPE) removal in order.

1. Remove gloves

2. Remove eyewear.

3. remove gown

4. remove mask

5. perform hand hygiene

To reduce the transmission of infection, arrange the steps for applying personal protective equipment (PPE) in the correct order.

1. Perform hand hygiene

2. Apply gown

3. apply mask

4. put on protective eyewear

5. Put on gloves

Which method would the nurse use for hand hygiene after the nurses ungloved hands come into contact with drainage from a patient's wound

Wash them with soap and water

Which method is effective in reducing the transmission of pathogens to patients in personnel in healthcare settings

Hand hygiene practices

Which nursing action may contaminate the surface of a sterile item

Holding the arm over the sterile field

Which equipment is required for the preparation of a sterile field?

- sterile drape

- Countertop surface

Which equipment is required for surgical hand asepsis

Paper facemask

Protective eyewear

Surgical scrub with sponge

In regards to surgical hand asepsis, which statement describes the rationale for drying the skin, starting at the hands and moving to the elbow?

It allows the drying to occur from the cleanest to the least clean

What is the rationale for removing finger rings when performing hand hygiene

To prevent the harboring of micro organisms

Mycobacterium tuberculosis is spread through which method of transmission

Airborne

Which action by the nurse may cause an infection

Wearing rings on both hands

Which nursing intervention require surgical asepsis

Suctioning the tracheobronchial airway

Place in order the correct steps for removal of protective barriers after leaving an isolation room

1. Remove gloves

2. Remove eyewear.

3. remove gown

4. remove mask

5. perform hand hygiene

Which piece of equipment is considered a noncritical item that should be disinfected?

1. Bedsheet

2. Stethoscope

3. Blood pressure cuff

When preparing a sterile work service, what is the rationale for the nurse opening the outermost flap away from the body, keeping the arm, outstretched, and away from the sterile field

To avoid contamination of the sterile field

A patient who undergoes a bronchoscopy is an increased risk of developing which type of healthcare associated infection (HAI)?

Iatrogenic infection

A positive airflow 12 or more. Eric's changes per hour would be implemented as a barrier protection, for which type of infection or condition?

Allogenic hematopoietic stem cell transplants

Which piece of medical equipment is considered to be a critical item that must be kept sterile?

Urinary catheter

Which action would the nurse take while caring for a patient with an infection that is transmitted by large droplets?

wearing of a surgical mask when within 3 feet of the patient

Arrange the steps chronologically that would be followed by the nurse while performing opening gloving?

1. hand hygiene

2. remove the outer glove package wrapper 3. Grasp the inner package and lay it on a clean surface above waist level

4. open the package and identify the right and left gloves

5. grasp the glove for the dominant hand touching only the inside surface of the cuff.

6. slip the fingers underneath the cuff of the second glove

7. Interlock the fingers of the gloved hands and hold them away from the body above waist level

Which even that occurred during a sterile aseptic procedure indicates potential contamination?

1. The field is lower than the nurse's waist.

2. The package is slightly damp on the bottom.

4. An instrument is out of the nurse's line of sight.

5. The syringe tip touches the nurse's clean glove.

To prepare a sterile field, which action is performed by the nurse in the given image?

Opening of the outermost flap of the sterile kit away from body

Which step is included when the nurse performs surgical hand asepsis?

1. Entering the operating room suite by backing into the room

2. Having a fingernail length of 1/4 inch from fingertip

3. Keeping hands and forearms lower than elbows during washing.

Which information would the nurse evaluate when assessing the infection risk of a patient?

- Daily food intake

- Immunization details

- Recent travel history

- Medication history

Which protection barrier is specified for use with a patient who has chickenpox (varicella)?

- Mask

- N-95 respirator

During surgical hand asepsis, which action increases the nurse's risk of harboring microorganisms?

- Wearing a wristwatch

- Maintaining a natural nail length of 0.5 inch (1.27 cm) long

Which action would the nurse perform to prepare a sterile field for a dressing change?

- Choose a clean, dry work surface above waist level.

- Remove bracelets and rings

- Perform hand hygiene before handling equipment.

- Check the labels and condition of supple packaging and equipment.

Arrange the steps of adding sterile items to the sterile field chronologically.

1. Select a clean, flat, dry work surface.

2. Open the sterile item

3. Carefully peel the wrapper over the nondominant hand

4. Be sure the outer wrapper does not fall onto the sterile field.

5. Dispose of the outer wrapper.

To reduce the spread of infection, which action would the nurse perform when assessing a patient who is 10 days post-hysterectomy and reports pain, itching, and warmth at the incision site?

- Perform hand-hygiene practices.

- Use gloves when assessing the wound.

- Use appropriate, personal protective equipment.

Which question would the nurse ask a patient to assess for the presence of an infection?

- " DO you have a cough that produces sputum"

- " Do you have any pain or burning during urination"?

Which infection control precaution would the nurse take to prevent the spread of influenza?

- Wearing a surgical mask within 3 feet of the patient

- Maintaining proper hand hygiene during the assessment

Which nursing intervention would be appropriate to reduce the risk of transmission of Mycobacterium tuberculosis?

- wearing a N95 respirator and

- Wearing gloves while performing a physical examination of the patient

After educating a nursing student about Standard Precautions, the nurse identifies that which statement made by the student indicates the need for further learning?

" I should wash my hands with antimicrobial soap and water if my hands are not visibly soiled"

Which statement made by the nursing student indicates effective learning regarding sterile procedures?

- "I should inform the patient to avoid touching the sterile supplies and gown."

- "I should administer ordered analgesics half an hour before surgery begins if a patient is in pain."

- "I should inform the patient to avoid sudden movements of any parts of the body covered by sterile drapes."

In which medical unit would the nurse use an N95 respirator?

Medical unit I ( Laryngeal tuberculosis)

The nurse who sustains an accidental needlestick injury is at an increased risk for which condition?

- Hep B

- Hep C

- HIV (Human immunodeficiency virus)

After receiving instructions about pouring a sterile solution during a sterile procedure, which statement made by the nursing student indicates the need for further learning?

- I should quickly pour the contents into the container

- I should make sure that the receptacle for a solution is located far away from the sterile, work surface edge

Which precaution would the nurse follow while performing surgical asepsis?

- Placing objects on the sterile field inside the 1-inch (2.5-cm) border

- Holding sterile objects above waist level

- Discarding objects immediately when stored sterile packages become wet

- Opening sterile packages when a minimum number of people are walking into an area

The nurse observes the process for disinfecting a pair of scissors that contained visible blood and identifies which factor that reduces the efficacy of the disinfectant?

- The blood was not washed off the scissors before application of the disinfectant

- Soap was used to clean the scissors before application of the disinfectant

- The same amount of disinfecting time was used on all handheld instruments, including the scissors

When providing education related to win specimen collection, which procedural step will the nurse include

- White from edges outward to remove old exudate

- Place to clean test tube on a clean paper towel

- After swimming center of the wound site, grasp the collection tube with a paper towel

- Clean the site with sterile water or saline before wound specimen collection

- Use a sterile, cotton-tipped swab or syringe to collect as much drainage as possible

Which patient statement indicates the need for further teaching regarding infection, control, and prevention

I should use povidone iodine wash if there is a risk of MRSA or other resistant bacteria

Which action by the nurse may cause contamination, when pouring a sterile solution from a bottle into a container

removing the sterile, seal, and cap from the bottle in a downward motion

Which statement made by the nursing student indicates the need for further learning regarding caring for patients with infections

- "I only need gloves if there is a risk of splash"

- "I should use a mask while touching a patient's mucous membrane"

Arrange the steps of preparing a sterile field chronologically.

1. Place the sterile kit on a work surface above the waist level

2. Open the outside cover and grasp the outer edge of the tip of the outermost flap

3. Open the outermost flap away from the body

4. Grasp the outer edge of the first side

5. Open the side flap by pulling the side and allow it to lie flat on the table surface

6. Grasp the outer edge of second side flap and outer edge of the last and innermost flap

7. Stand away from the sterile package and pull flap back

Which statement made by the nursing student, indicates a need for further teaching, regarding sterilization and disinfection and cleaning of equipment

- Implants are considered non-critical items and must be disinfected

- Urinary catheters are considered semi-critical items and must be disinfected

The nurse would intervene, when which step is performed by student nurse, when preparing a sterile field

Uses the inner surface of the package (except for the 1.25 cm [1/2 -inch] borer around the edges) as a sterile field to add sterile items

Which nursing action is a measure to reduce reservoirs of infection?

- Changing soiled dressing

- Never raising a urinary drainage bag above the level of the site being drained unless it is clamped off

- Dating bottles when opened and discarding them in24 hrs

Which step is included when the nurse perform surgical hand asepsis

- Entering the operating suite by backing into the room

- Having a finger nail length of 1/4 inch from fingertip

- Keeping hands and forearms lower than elbows during washing

During new hospital employee orientation, which education would the nurse provide regarding hepatitis B vaccination and exposure tot he hepatitis C virus (HCV)?

" After 4 weeks after exposure, an HCV-RNA test is offered to determine whether the employee contracted HCV"

Which nursing intervention is the priority when caring for a patient with Mycoplasma Pneumoniae?

Isolating the patient

To clean artery forceps contaminated with blood, arrange the steps the nurse would take in the appropriate order?

1. Apply protective eyewear.

2. Rinse the artery forceps with cold water.

3.Wash the artery forceps with soap and water.

4. Rinse the artery forceps with warm water.

5. Dry the artery forceps.

After receiving instructions about cleaning instruments before sterilization, which statement made by the nursing student identifies the need for further learning?

" I'll rinse the contaminated objects in hot water"

Arrange the steps involved in cleaning to remove organic and inorganic soil from objects and surfaces in the correct order.

1. Rinse contaminated objects or articles with cold running water to remove organic material.

2. Wash the object with soap and warm water, and rinse again thoroughly.

3. Use a brush to remove dirt or material in grooves or seams.

4. Rinse the object in warm water.

5. Dry the object and prepare it for disinfection or sterilization.

6. Clean and dry the brush, gloves, and sink used to clean the equipment.

Which technique is appropriate for the nurse to use when pouring sterile solution from a bottle into a container?

- Holding the bottle outside the edge of the sterile field

The nurse identifies that which action by the assistive personnel (AP) who is wearing a mask indicates a need for correction?>

Remove a mask before leaving isolation room

Regarding surgical hand asepsis, the nurse would intervene when which action by a nursing student is observed?

Keeping the hands below waist level

The nurse would intervene when a nursing student takes which action when preparing a sterile field?

stands close to the sterile field while opening the last flap

Which statement made by the nursing student indicates effective learning regarding the handling of sterile instruments?

"I will apply sterile gloves to handle sterile forceps."

A plan of care that includes isolation with positive airflow and instructions for the patient to wear a mask when outside of the room would be implemented for which condition?

Allogeneic hematopoietic stem cell transplants

How would the nurse respond to a patient with an infection who states, "I am anxious and feeling depressed that I need to stay in this room with isolation precautions"?

Explain each item used for infection control and isolation procedures.

Which nursing action may allow the transfer of pathogens when performing hand hygiene?

Using wet paper towels to turn off the faucet after washing

regarding home care considerations for patients with infections, which statement made by the nursing student indicates the need for further learning?

" I should ensure that teach-back about sterile asepsis has occurred"

Which statement is true regarding the donning and removing of caps, masks, and eyewear during a medical or surgical procedure?

The nurse should wear eyewear only for procedures that create the risk of body fluids splashing into the eyes.

Which action would the nurse avoid while opening a sterile item on a flat surface?

Grasping 3.5 cm of the border to maneuver the field on the table surface

Regarding health care-associated infections (HAIs), which statement made by the nursing student indicates the need for further learning?

The costs of healthcare-associated (HAIs) infections are reimbursed.

When evaluating the skill of open gloving, the nurse would correct which action by the nursing student?

The student sets the inner package of gloves on a clean, flat surface just below waist level.

an infection of the upper respiratory tract causes lymph node enlargement in which area of the body?

cervical

The nurse would intervene when a nursing student performs which action when using a surgical mask during a sterile surgical procedure?

Removes the masks by touching the outer surface of the mask

Which factor increases the efficacy of disinfectants during the process of disinfection?

Temperature maintained at room temperature

How would the nurse respond when a patient voices resentment about being placed in isolation for pulmonary tuberculosis?

Explain the reasons for isolation procedures

According to the CDC, in which circumstance is it appropriate to decontaminate the hands using an alcohol-based, waterless antiseptic agent?

After removing gloves

Which action by the nurse may cause contamination for a sterile field?

selecting a clean dry work surface below waist level.