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Questions and Answers
Which of the following nursing actions would be appropriate for a patient who has cultured positive for Clostridium difficile?
Which of the following nursing actions would be appropriate for a patient who has cultured positive for Clostridium difficile?
This scenario would indicate that the nurse may be at risk for which of the following after finding a nonactivated safe needle in the linens?
This scenario would indicate that the nurse may be at risk for which of the following after finding a nonactivated safe needle in the linens?
What is the nurse's best next step after splashing blood above the glove to intact skin while discontinuing an intravenous infusion?
What is the nurse's best next step after splashing blood above the glove to intact skin while discontinuing an intravenous infusion?
What is required after exposure of a nurse to blood by a cut from a scalpel in the perioperative area?
What is required after exposure of a nurse to blood by a cut from a scalpel in the perioperative area?
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The nurse is caring for a patient in Contact Precautions. What is the purpose of including hand hygiene in the plan of care?
The nurse is caring for a patient in Contact Precautions. What is the purpose of including hand hygiene in the plan of care?
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To decrease the risk of infection, which questions would be most appropriate to ask a new home health patient?
To decrease the risk of infection, which questions would be most appropriate to ask a new home health patient?
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Which behaviors indicate that the surgical technologist has correctly applied a sterile gown and gloves during an appendectomy?
Which behaviors indicate that the surgical technologist has correctly applied a sterile gown and gloves during an appendectomy?
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Which steps are involved in the open gloving process for inserting a urinary catheter?
Which steps are involved in the open gloving process for inserting a urinary catheter?
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What items are necessary for the nurse to care for a patient with tuberculosis?
What items are necessary for the nurse to care for a patient with tuberculosis?
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What interventions should the nurse include when teaching the student nurse about caring for patients in Airborne and Contact Precautions?
What interventions should the nurse include when teaching the student nurse about caring for patients in Airborne and Contact Precautions?
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Select the correct order for removal of personal protective equipment for a patient needing a protective environment.
Select the correct order for removal of personal protective equipment for a patient needing a protective environment.
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Arrange the following items in the proper order according to the chain of infection.
Arrange the following items in the proper order according to the chain of infection.
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Which of these actions would most likely increase the risk of a patient contracting a urinary tract infection (UTI)? (Select all that apply)
Which of these actions would most likely increase the risk of a patient contracting a urinary tract infection (UTI)? (Select all that apply)
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Which of the following nursing actions would most increase a patient's risk for developing a health care-associated infection? (Select all that apply)
Which of the following nursing actions would most increase a patient's risk for developing a health care-associated infection? (Select all that apply)
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Which of the following statements by the new nurse would indicate an understanding of the nature of pneumonia?
Which of the following statements by the new nurse would indicate an understanding of the nature of pneumonia?
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Which patient statement indicates understanding regarding the mode of transmission of Rocky Mountain spotted fever?
Which patient statement indicates understanding regarding the mode of transmission of Rocky Mountain spotted fever?
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When completing an assessment of a laboring patient, which action is most appropriate for the nurse to take when the intravenous infusion alarms?
When completing an assessment of a laboring patient, which action is most appropriate for the nurse to take when the intravenous infusion alarms?
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Which of the following actions would indicate a break in sterile technique?
Which of the following actions would indicate a break in sterile technique?
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What is the most important action to prevent the spread of infection among preschool workers?
What is the most important action to prevent the spread of infection among preschool workers?
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Which of the following actions demonstrates an understanding of medical and surgical asepsis?
Which of the following actions demonstrates an understanding of medical and surgical asepsis?
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Which question would be appropriate for a nurse to ask a patient with an infectious disease process?
Which question would be appropriate for a nurse to ask a patient with an infectious disease process?
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Which observation would require the nurse to intervene?
Which observation would require the nurse to intervene?
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What nursing action should the nurse take for a patient with a postoperative incision showing signs of infection?
What nursing action should the nurse take for a patient with a postoperative incision showing signs of infection?
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The nurse is caring for a patient with a nursing diagnosis of risk for infection. What precaution should the nurse take?
The nurse is caring for a patient with a nursing diagnosis of risk for infection. What precaution should the nurse take?
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Which point is most important to include in the educational session about the effects of smoking?
Which point is most important to include in the educational session about the effects of smoking?
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When checking for excessive vaginal drainage postpartum, which precautions should the nurse utilize?
When checking for excessive vaginal drainage postpartum, which precautions should the nurse utilize?
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During the health history, which question should the nurse prioritize for a female patient with vaginal discharge?
During the health history, which question should the nurse prioritize for a female patient with vaginal discharge?
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To assess for localized inflammatory response in a child with a leg injury, which signs should the nurse look for?
To assess for localized inflammatory response in a child with a leg injury, which signs should the nurse look for?
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What professional practice supports the need for follow-up with the nursing assistant regarding turning off the faucet with his hands?
What professional practice supports the need for follow-up with the nursing assistant regarding turning off the faucet with his hands?
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After the nurse's hands become contaminated, what is the best next step when caring for a patient who becomes nauseated and vomits?
After the nurse's hands become contaminated, what is the best next step when caring for a patient who becomes nauseated and vomits?
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Which interventions indicate the ability to recognize the inflammatory response?
Which interventions indicate the ability to recognize the inflammatory response?
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The patient most at risk for developing an infection is the patient who:
The patient most at risk for developing an infection is the patient who:
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What is the next action the nurse should take after touching the sink while washing hands?
What is the next action the nurse should take after touching the sink while washing hands?
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Which nursing intervention is priority for a patient with leukemia receiving fluids through a vascular access device?
Which nursing intervention is priority for a patient with leukemia receiving fluids through a vascular access device?
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What is the next step in handling instruments after completing an invasive procedure?
What is the next step in handling instruments after completing an invasive procedure?
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The best explanation to support nursing interventions for a patient with a urinary tract infection is:
The best explanation to support nursing interventions for a patient with a urinary tract infection is:
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Which action indicates correct understanding of managing contaminated dressings?
Which action indicates correct understanding of managing contaminated dressings?
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Which order would the nurse question for a patient in home health at risk for infection?
Which order would the nurse question for a patient in home health at risk for infection?
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Which nursing intervention will assist in decreasing the risk of infection for a susceptible patient?
Which nursing intervention will assist in decreasing the risk of infection for a susceptible patient?
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What is the most appropriate intervention for a diabetic patient with a purulent wound?
What is the most appropriate intervention for a diabetic patient with a purulent wound?
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Before which action should the nurse emphasize hand hygiene in the home?
Before which action should the nurse emphasize hand hygiene in the home?
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Which intervention should take priority for a patient who presents with pneumonia?
Which intervention should take priority for a patient who presents with pneumonia?
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What should the nurse do when the surgical mask has become moist?
What should the nurse do when the surgical mask has become moist?
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Which of the following actions is appropriate to prevent the spread of disease in a patient on Contact Precautions?
Which of the following actions is appropriate to prevent the spread of disease in a patient on Contact Precautions?
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What antiseptic should be used for preparing the skin when inserting a PICC to prevent infection?
What antiseptic should be used for preparing the skin when inserting a PICC to prevent infection?
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What type of health care-associated infection is characterized by a spike in postoperative infections?
What type of health care-associated infection is characterized by a spike in postoperative infections?
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Study Notes
Infection Prevention and Control Key Concepts
- Pneumonia is non-communicable; infectious diseases can be serious without posing transmission risks.
- Negative pressure isolation is not required for pneumonia patients; clinical signs include fever, cough, and fatigue.
Rickettsia Rickettsii
- Rocky Mountain spotted fever is transmitted via tick bites.
- Preventative measures include using insect repellent when camping.
Infection Control in Preschool Settings
- Handwashing is the most effective way to prevent the spread of infection among children.
- Cleaning toys is helpful but secondary to hand hygiene in infection control.
Assessment of Infection Susceptibility
- Chronic diseases increase susceptibility to infections; ask patients about any chronic conditions during assessment.
- Other demographic questions may be relevant but are less critical to infection vulnerability.
Postoperative Infection Indicators
- Redness, purulent drainage, and fever post-surgery suggest infection.
- Utilize SBAR (Situation, Background, Assessment, Recommendation) to communicate patient's status to the physician effectively.
Effects of Smoking
- Smoking disrupts cilia in the lungs, affecting the body's defense against infections.
- Other smoking-related issues include odor retention and potential cost, but these are less critical than the impact on respiratory health.
Vaginal Discharge and Infections
- Antibiotics and contraceptives can alter vaginal flora, increasing the risk of infections like Candida overgrowth.
- Inquire about medications to aid in diagnosis.
Signs of Locally Inflammatory Responses
- Localized inflammation is indicated by edema, redness, tenderness, and loss of function in the affected area.
- Systemic inflammation presents with more generalized symptoms, like fever and malaise.
Recognition of Inflammatory Responses
- Rest, ice, compression, and elevation (RICE) are key interventions for managing inflammation and reducing swelling.
Patients at Risk for Infections
- Patients recovering from surgeries (e.g., total hip arthroplasty) are at a higher risk for infections due to skin breaches and anesthesia effects.
Maintaining Aseptic Technique
- Aseptic techniques are crucial when accessing intravenous lines in immune-compromised patients to prevent infections.
Stress and Infection Resistance
- Chronic stress can deplete the body's defenses, making it crucial to manage stress for enhancing resistance to infections.
Nutritional Considerations for Infection Prevention
- A nutritious diet, especially adequate protein intake, is essential for maintaining the body's defenses against infections.
Management of Diabetic Wounds
- Always wear gloves and personal protective equipment when treating infected wounds to prevent the spread of infection.
Patient Care for Pneumonia
- Monitor for changes in activity tolerance to assess the impact of pneumonia on the patient's health.
Infection Types
- Exogenous infections arise from external organisms; understanding the source of infections (postoperative context) is key to infection control strategies.
Urinary Tract Infection Prevention
- Practices that allow the urinary drainage system to become contaminated increase the risk of UTIs—avoid contact of drainage ports with unsterile items.
Proper Technique in Catheterization
- Inserting urinary catheters requires sterile technique to mitigate the risk of health care-associated infections; clean techniques are inadequate in these scenarios.### Infection Control and Asepsis
- Keeping urinary catheter drainage bags below the bladder reduces the risk of healthcare-associated infections by preventing urine reflux.
- Bottled solutions can be reused within a 24-hour timeframe, but must remain sterile; discard after 24 hours.
Nursing Actions in Labor and Delivery
- In labor and delivery, when alarms sound during a patient assessment, the nurse should complete the assessment, wash hands, and then assess the IV infusion to maintain aseptic technique (Correct Action: C).
Sterile Technique in Perioperative Care
- Touching nonsterile protective eyewear when gowned indicates a breach in sterile technique (Correct Action: A).
- Proper practices include folding arms to avoid contact with unsterile areas and accepting sterile supplies appropriately.
Medical and Surgical Asepsis
- Medical asepsis involves using clean gloves for dressing removal and sterile supplies for re-dressing (Correct Action: B).
- Sterile asepsis requires that sterile items remain uncontaminated throughout the procedure.
Endoscopy Procedures
- Observing a technician removing gloves before transferring an endoscope requires intervention to prevent cross-contamination (Correct Action: C).
Standard Precautions Awareness
- Standard Precautions mandate wearing eyewear when emptying urinary bags to protect against splashes (Correct Action: B).
- They apply to all body fluids and non-intact skin except sweat.
Patient Care Post-Delivery
- Standard Precautions should be employed when checking for excessive vaginal drainage after delivery (Correct Action: D).
- This includes protocols for blood and body fluids, ensuring a safe environment.
Hand Hygiene Practices
- When observing a nursing assistant turning off faucets with bare hands, follow-up is crucial to maintain patient safety (Correct Action: A).
- Proper post-handwashing should involve using paper towels to avoid transferring pathogens.
Handling Contamination
- Immediate handwashing with soap and water is necessary when hands are visibly soiled, such as after patient vomiting (Correct Action: B).
Surgical Procedure Protocol
- If hands touch the sink during handwashing, the nurse should repeat the handwashing with antiseptic soap to prevent contamination (Correct Action: C).
Post-Invasive Procedure Instrument Handling
- Properly gather and transport instruments for sterilization after invasive procedures; gloves must be worn (Correct Action: A).
Home Health Care Dressing Management
- Used dressings should be placed in a plastic bag for safe disposal to prevent contamination (Correct Action: B).
Nutrition and Infection Risk
- In home health, tube feeding preparations should not exceed set time limits to mitigate risk of bacterial contamination (Correct Action: C).
Hand Hygiene Education
- Emphasize the importance of hand hygiene primarily before and after treatments to avoid spreading infection (Correct Action: B).
Surgical Mask Protocol
- A moist surgical mask should be changed promptly to prevent microbial growth and maintain infection control (Correct Action: C).
Contact Precautions Guidelines
- A dedicated blood pressure cuff for patients under Contact Precautions prevents disease transmission (Correct Action: B).
Clostridium Difficile Management
- Soap and water are required for cleanliness after contact with Clostridium difficile to prevent its spread (Correct Action: A).
Post-Needlestick Protocol
- After a needlestick injury, immediate cleansing with soap and reporting to management is necessary for proper assessment and treatment (Correct Action: B).
Blood Exposure Contingencies
- Testing the patient for bloodborne infections is critical after exposure incidents for appropriate follow-up on nursing staff (Correct Action: C).
Contact Precautions and Infection Chain
- Incorporate hand hygiene as an essential component of preventing infection transmission, ensuring an effective break in the chain of infection.### Infection Control Strategies
- Handwashing significantly reduces the incidence of health care-associated infections.
- Protects healthcare workers by limiting the transfer of microorganisms.
- Prevents microbial transmission to other patients and contamination of clean supplies.
- Proper hand hygiene does not mitigate the drying effects of soap; it actually increases this effect.
Patient Assessment in Home Health
- Assessing handwashing techniques and understanding infection risks are crucial to patient safety.
- Knowledge of signs and symptoms of infection helps in early identification and intervention.
- A working refrigerator is vital to prevent foodborne illnesses; however, it is not directly related to infection risk reduction.
- Evaluating the patient's overall activity and support system (like who runs errands) is important for comprehensive care but less relevant to infection prevention.
Surgical Technologist Procedures
- Surgical technologists maintain sterility by only touching the inside of sterile gowns.
- Arms should be inserted into gown sleeves simultaneously to avoid contamination.
- Using the covered hands to open gloves and ensuring fingers reach fully into gloves is critical for maintaining sterility.
- Tying the gown behind the back is a contamination risk.
Urinary Catheterization Technique
- Open gloving requires laying the glove package on a clean, flat surface above waist level.
- The dominant hand must be gloved first to improve dexterity and reduce contamination.
- Only the outside surface of gloves should be touched to maintain sterility, and interlocking hands after gloving helps ensure a proper fit.
Tuberculosis Care Requirements
- Patients with tuberculosis require a private room and negative-pressure airflow to prevent airborne transmission.
- Communication signs for Airborne Precautions must be present; Droplet Precautions are not applicable.
- Personal protective equipment includes an N95 respirator, gloves, gown, and eyewear for safe interaction.
Interventions for Isolation Precautions
- Consistency in nursing interventions is important despite differences in Airborne and Contact Precautions.
- Hand hygiene is essential before and after patient encounters.
- Proper disposal of supplies minimizes the risk of microorganism spread.
- Patients under Airborne Precautions should wear a mask during transportation.
Personal Protective Equipment (PPE) Removal Order
- The order for PPE removal is critical to prevent contamination; gloves are removed first, followed by eyewear, gown, and mask.
- Hand hygiene is performed after equipment removal to ensure cleanliness before exiting the room.
- Contaminated supplies and equipment should be disposed of in designated receptacles.
Chain of Infection Analysis
- Reviewing the chain of infection is essential for identifying and implementing preventive measures in healthcare settings.
- The sequence consists of an infectious agent, a reservoir, a portal of exit, a mode of transmission, a portal of entry, and a susceptible host.
- Understanding this chain helps in strategizing interventions to reduce infection rates in critical care environments.
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