Fundamental Skills - Infection Control

The nurse is changing the central line dressing of a client receiving parenteral nutrition (PN) and notes that the catheter insertion site appears reddened. The nurse should next assess which item? 
1. Client's temperature 
2. Expiration date on the bag 
3. Time of last dressing change 
4. Tightness of tubing connections

A client receiving parenteral nutrition (PN) suddenly develops a fever. The nurse notifies the health care provider (HCP), and the HCP initially prescribes that the solution and tubing be changed. What should the nurse do with the discontinued materials? 
1. Discard them in the unit trash. 
2. Return them to the hospital pharmacy. 
3. Send them to the laboratory for culture. 
4. Save them for return to the manufacturer.

The nurse is caring for a restless client who is beginning nutritional therapy with parenteral nutrition (PN). The nurse should plan to ensure that which action is taken to prevent the client from sustaining injury? 
1. Calculate daily intake and output. 
2. Monitor the temperature once daily. 
3. Secure all connections in the PN system. 
4. Monitor blood glucose levels every 12 hours.

The community health nurse is providing a teaching session about terrorism to members of the community and is discussing information regarding anthrax. The nurse tells those attending that anthrax can be transmitted by which route(s)? Select all that apply. 
1. Bites from ticks or deer flies 
2. Inhalation of bacterial spores 
3. Through a cut or abrasion in the skin 
4. Direct contact with an infected individual 
5. Sexual contact with an infected individual 
6. Ingestion of contaminated undercooked meat

Contact precautions are initiated for a client with a health care–associated (nosocomial) infection caused by methicillin-resistant Staphylococcus aureus. The nurse prepares to provide colostomy care and should obtain which protective items to perform this procedure? 
1. Gloves and gown 
2. Gloves and goggles 
3. Gloves, gown, and shoe protectors 
4. Gloves, gown, goggles, and face shield

The nurse is caring for a client with meningococcal pneumonia and implements which transmission-based precautions for this client? 
1. Private room or cohort client 
2. Personal respiratory protection device 
3. Private room with negative airflow pressure 
4. Mask worn by staff when the client needs to leave the room

The nurse prepares to give a bath and change the bed linens of a client with cutaneous Kaposi's sarcoma lesions. The lesions are open and draining a scant amount of serous fluid. Which would the nurse incorporate into the plan during the bathing of this client? 
1. Wearing gloves 
2. Wearing a gown and gloves 
3. Wearing a gown, gloves, and a mask 
4. Wear a gown and gloves to change the bed linens and gloves only for the bath

The nurse is preparing a group of Cub Scouts for an overnight camping trip and instructs the scouts about the methods to prevent Lyme disease. Which statement by one of the Cub Scouts indicates a need for further instructions? 
1. "I need to bring a hat to wear during the trip." 
2. "I should wear long-sleeved tops and long pants." 
3. "I should not use insect repellents because it will attract the ticks." 
4. "I need to wear closed shoes and socks that can be pulled up over my pants."

A client with tuberculosis whose status is being monitored in an ambulatory care clinic asks the nurse when it is permissible to return to work. What factor should the nurse include when responding to the client? 
1. Five blood cultures are negative. 
2. Three sputum cultures are negative. 
3. A blood culture and a chest x-ray are negative. 
4. A sputum culture and a Mantoux test are negative.

A client with tuberculosis (TB) asks the nurse about precautions to take after discharge to prevent infection of others. The nurse develops a response to the client's question based on which correct understanding of TB transmission? 
1. The disease is transmitted by droplet nuclei. 
2. Deep pile carpet should be removed from the home. 
3. The client should maintain enteric precautions only. 
4. Clothing and sheets should be bleached after each use.

The school nurse prepares a list of home care instructions for the parents of schoolchildren diagnosed with pediculosis capitis. Which instruction should the nurse include in the list? 
1. Soak combs and brushes in warm water. 
2. Use anti-lice sprays on all bedding and furniture. 
3. Take all bedding and linens to the cleaners to be dry cleaned. 
4. Vacuum floors, play areas, and furniture to remove any hairs that might carry live nits.

The nursing instructor is observing a student nurse donning a pair of sterile gloves and preparing a sterile field. Which observations, if made by the instructor, indicate the need for further teaching? 
1. The student puts on the right glove and then the left glove. 
2. The student dons the sterile gloves without washing the hands. 
3. The student uses the inner wrapper of the gloves as a sterile field. 
4. The student touches a glove on the overbed table, removes both gloves, and dons another sterile pair.

Two nurses are leaving the room of a client whose care required them to wear a gown, mask, and gloves. Which action by these nurses could lead to the spread of infection? 
1. Taking off the gloves first before removing the gown 
2. Removing the gown without rolling it from inside out 
3. Washing the hands after the entire procedure has been completed 
4. Removing the gloves and then removing the gown using the neck ties

The nurse teaches the mother of a child diagnosed with bacterial conjunctivitis about measures to prevent transmission of the infection. Which statement by the mother indicates a need for further teaching? 
1. "Hands need to be washed frequently." 
2. "A clean washcloth can be used to wipe my child's eyes." 
3. "It is all right to share towels and washcloths as long as they are bleached after use." 
4. "The eye drops must be given as prescribed, and hands need to be washed before and after instillation."

The nurse is assisting a female client to collect a midstream urine specimen. How should the nurse implement aseptic technique? 
1. Cleansing the meatus with antiseptic pads using upward strokes 
2. Letting go of the labia once this tissue is cleansed, to allow the client to urinate 
3. Making sure that the fingers avoid touching the inside of the collection container 
4. Instructing the client to urinate in the container after the labia have been cleansed

The nurse is giving a bed bath to a client and discovers that an additional washcloth and towel are needed. Which is the most appropriate action to take to obtain the needed items? 
1. Ask the unit secretary to get the needed items. 
2. Ask a family member to obtain the needed items. 
3. Borrow the client's roommate's washcloth and towel. 
4. Wash hands, leave the client's room, and obtain the needed items.

Which infection control method would most effectively prevent hepatitis B? 
1. Immune globulin 
2. Hand washing daily 
3. Proper personal hygiene 
4. Hepatitis B (HBV) vaccine

The nurse provides home care instructions to a client with hepatitis B. Which statement made by the client indicates the best understanding of how to prevent transmission of the disease? 
1. "It is all right to kiss my wife." 
2. "My wife should get the vaccine." 
3. "I should be vaccinated as soon as possible." 
4. "I never will share towels with anyone else."

The nurse is caring for a client with acute viral hepatitis A who resides in a group home. Which outcome indicates that the most important goal has been achieved for this client? 
1. Resumes normal bowel elimination patterns 
2. Avoids transmitting the virus to others in the group home 
3. Progressively increases activity with planned rest periods 
4. Gains at least ½ to 1 pound per week until at ideal weight

The nurse has instructed a client diagnosed with tuberculosis about how to prevent the spread of infection after discharge from the hospital. The nurse determines that the client needs further reinforcement of information if the client makes which statement? 
1. "I should use disposable plates, forks, and knives." 
2. "I should cough into tissues and throw them away carefully." 
3. "It's important to cover my mouth if I laugh, sneeze, or cough." 
4. "It's very important to wash my hands after I touch my mask, tissues, or body fluids."

A client is being discharged to home after 2 weeks with a diagnosis of tuberculosis and is worried about the possibility of infecting family members and others. How should the nurse respond to provide reassurance? 
1. The family does not need therapy, and the client will not be contagious after 1 month of drug therapy. 
2. The family does not need therapy, and the client will not be contagious after 6 consecutive weeks of drug therapy. 
3. The family will be treated prophylactically, and the client will not be contagious after 1 continuous week of drug therapy. 
4. The family will be treated prophylactically, and the client will not be contagious after 2 to 3 consecutive weeks of drug therapy.

A client with active tuberculosis demonstrates less-than-expected interest in learning about the prescribed medication therapy. The nurse assesses that this client may ultimately need which intervention as a last resort? 
1. Directly observed therapy 
2. More medication instructions 
3. Involvement of the family in teaching 
4. Reinforcement by the health care provider

Which action by the parent of an infant with respiratory syncytial virus infection who is receiving ribavirin (Virazole) would indicate a need for further instruction regarding the management of the disease process? 
1. Wearing protective garb when visiting the infant 
2. Washing the hands before leaving the infant's room 
3. Telling a family member who has asthma that he should not visit the infant 
4. Telling the infant's aunt who is pregnant that it is acceptable to visit the infant

A client is seen in the health care clinic, and a diagnosis of acute sinusitis is made. The nurse provides home care instructions to the client regarding measures that will promote sinus drainage and comfort. Which statement by the client indicates a need for further instruction? 
1. "I should drink large amounts of fluids." 
2. "I should use a hot mist vaporizer to liquefy secretions." 
3. "I should try to sleep with the head of the bed elevated." 
4. "I should apply heat, such as a wet pack, over the sinuses."

A client has been receiving a series of medications as part of intravenous antineoplastic therapy. The nurse should implement neutropenic precautions after noting which laboratory result for this client? 
1. Clotting time of 10 minutes 
2. Ammonia level of 20 mcg/dL 
3. Platelet count of 100,000 cells/mm³ 
4. White blood cell (WBC) count of 2000 cells/mm³

An unlicensed assistive personnel (UAP) is caring for a client who has an indwelling urinary catheter. Which action by the UAP would indicate the need for instruction in the care of the client? 
1. Used soap and water to cleanse the perineal area 
2. Allowed the drainage tubing to rest under the leg 
3. Kept the drainage bag below the level of the bladder 
4. Used the drainage tubing port to obtain urine samples

A male client who is admitted for an unrelated medical problem is diagnosed with urethritis caused by chlamydial infection. The unlicensed assistive personnel (UAP) assigned to the client asks the nurse what measures are necessary to prevent contraction of the infection during care. What should the nurse tell the UAP? 
1. Enteric precautions should be instituted for the client. 
2. Gloves and mask should be used by caregivers in the client's room. 
3. Contact isolation should be initiated because the disease is highly contagious. 
4. Standard precautions are quite sufficient because the disease is transmitted sexually.

A client with acute prostatitis has difficulty voiding, which is accompanied by pain. The client asks the nurse, "Can't you just put a catheter in so I won't be in this misery when I try to go?" The nurse's response should be based on what understanding about catheterization? 
1. Will prolong the course of the inflammation 
2. Could result in puncture of the prostate gland because it is so inflamed 
3. Is avoided whenever possible to avoid pushing organisms up into the bladder 
4. Could result in obstruction from rebound edema once the catheter is removed

The nurse is conducting a community surveillance study for the purpose of communicable disease control. The nurse knows that performing an active surveillance method of assessment is best for what reason? 
1. Always results in clear indicators for interventions 
2. Results in detection of a more accurate number of cases 
3. Reflects an upward swing if a certain disease is current news 
4. Relies solely on the initiative of health care providers (HCP) to report cases

A registered nurse (RN) is providing instructions to an unlicensed assistive personnel (UAP) assigned to give a bed bath to a client who is on contact precautions. The RN instructs the UAP to use which protective item when giving the bed bath? 
1. A gown and gloves 
2. Gloves and goggles 
3. A gown and goggles 
4. Gloves and shoe protectors

A nurse is preparing a plan of care for a client with a diagnosis of agranulocytosis who is being admitted to the hospital. The nurse determines that which is the priority when formulating the client's plan of care? 
1. Fatigue 
2. Constipation 
3. Potential for infection 
4. Insufficient knowledge

The nurse in the health care clinic is preparing to obtain a throat swab for culture in a client suspected of having a beta-hemolytic streptococcal infection. Which actions are appropriate in collecting this specimen? Select all that apply. 
1. Instruct the client to tilt the head back. 
2. Swab the tonsillar pillars and the posterior pharynx wall. 
3. Tell the client that the test will help identify microorganisms. 
4. Ask the client to open the mouth; then swab the back of the tongue. 
5. Place a tongue depressor on the client's tongue before swabbing the throat.

A hospitalized client who has been placed on contact precautions has been prescribed to have a chest radiograph in the radiology department. The nurse should plan to take which action on receipt of this prescription? 
1. Transport the client through empty corridors only. 
2. Place a mask on the client in preparation for transport. 
3. Place a sterile gown on the client in preparation for transport. 
4. Question the health care provider about whether a portable chest radiograph may be obtained.

The ambulatory care nurse is working with a 22-year-old female client who has been diagnosed with pelvic inflammatory disease (PID). The nurse incorporates which item in a teaching plan for this client? 
1. Avoid frequent douching. 
2. Undergarments made of nylon are best. 
3. Intrauterine devices are a good birth control method. 
4. It is necessary to change sanitary pads only every 8 hours.

The nurse is planning to teach a group of adolescents about the use of condoms as part of a risk-reduction program for sexually transmitted infections (STIs). The nurse should plan to include which recommendation in the teaching plan? 
1. Condoms should not be lubricated. 
2. Use condoms whenever the partner seems "risky." 
3. Always apply the condom before inserting the penis into the vagina. 
4. Natural membrane condoms can be used because they are just as effective as latex.

The ambulatory care nurse is seeing a client for a follow-up visit after treatment for toxic shock syndrome (TSS). To assess the client's recovery from TSS, the nurse should ask whether which signs and symptoms have resolved? 
1. Low-grade fever, nausea, and vaginal bleeding 
2. High fever, abdominal pain, vomiting, and diarrhea 
3. Low-grade fever, vomiting, and greenish vaginal discharge 
4. High fever, purulent vaginal discharge, and abdominal pain

A female client seen in the ambulatory care clinic has a history of syphilis infection. The nurse assessing the client for reinfection would expect to observe a lesion on the labia that has which characteristic? 
1. Is painless and indurated 
2. Has a cauliflower-like appearance 
3. Is erythematous and papular in appearance 
4. Appears as one or more vesicles that then rupture

The home care nurse visits a child recently discharged from the hospital with a diagnosis of hepatitis A virus (HAV) infection. The mother asks the nurse when the child can return to school. The nurse should make which response to the mother? 
1. "In about 2 months." 
2. "When the jaundice disappears." 
3. "Within 1 week after the onset of jaundice." 
4. "At the beginning of the next academic year."

A hospitalized client has a diagnosis of pelvic inflammatory disease (PID). The nurse should encourage the client to assume which therapeutic position when in bed? 
1. Left side-lying 
2. Right side-lying 
3. Prone with the head flat 
4. Supine in semi-Fowler's

The nurse participating in a health fair is setting up a booth on prevention of human immunodeficiency virus (HIV) transmission. A poster is planned that will list sexual behaviors in one of two columns, "safe" and "not safe." Which behavior should the nurse place in the "not safe" column? 
1. Abstinence 
2. Mutual monogamy 
3. Use of latex condoms 
4. Use of natural skin condoms

A 7-year-old child is diagnosed with viral conjunctivitis. Antibiotic eye drops are prescribed for the child. When the mother asks the nurse when the child can return to school, what should the appropriate response be? 
1. "The child can return to school immediately." 
2. "The child cannot return to school until seen by the health care provider in 1 week." 
3. "The child should be kept home until the antibiotic eye drops have been administered for 24 hours." 
4. "The child should be kept home until the antibiotic eye drops have been administered for 72 hours."

The home health nurse is watching the caregiver change the sternotomy dressing on the postoperative client. Which action by the caregiver identifies correct principles of infection control? 
1. The caregiver selects a previously opened gauze to cover the sternal wound. 
2. The caregiver dons gloves before removal of the old dressing and then applies the new dressing. 
3. The caregiver covers her mouth with her hand when she sneezes and then continues with the dressing change. 
4. The caregiver washes hands before removal of the soiled dressing and again before applying the clean dressing.

A nurse places a hospitalized client with active tuberculosis in a private, well-ventilated isolation room. In addition, which action should the nurse take before entering the client's room? 
1. Wash hands and don a surgical mask. 
2. Wash hands and wear a gown and gloves. 
3. Wash hands and place a high-efficiency particulate air (HEPA) respirator mask over the nose and mouth. 
4. The nurse needs no precautions. The client is instructed to cover his or her mouth and nose when coughing.

A man is admitted to the hospital with the diagnosis of urethritis secondary to chlamydial infection. What precaution should the nurse implement for this client? 
1. Enteric 
2. Contact 
3. Standard 
4. Reverse isolation

The nurse is observing a second nurse perform hemodialysis on a client. The second nurse is drinking coffee and eating a doughnut next to the hemodialysis machine, while talking with the client about the events of his week. What is the nurse'smost appropriate action regarding this observation? 
1. Offer the client a cup of coffee. 
2. Get a cup of coffee and join in on the conversation. 
3. Ask the nurse to refrain from eating and drinking in that area. 
4. Appreciate what a wonderful therapeutic relationship this nurse and client have.

The nurse is preparing to nasotracheally suction a client with acquired immunodeficiency syndrome who has had blood-tinged sputum with previous suctioning. The nurse plans to use which item as part of standard precautions for this client? 
1. Gloves, gown, and mask 
2. Gloves, mask, and protective eyewear 
3. Gown, mask, and protective eyewear 
4. Gloves, gown, and protective eyewear

The nurse is teaching a client with acquired immunodeficiency syndrome (AIDS) how to avoid food-borne illnesses. The nurse should instruct the client that which food can cause a food-borne illness? 
1. Raw oysters 
2. Bottled water 
3. Pasteurized milk 
4. Products with sorbitol

The nurse employed on a medical unit in a hospital receives a telephone call from the admission office and is told that a client with a diagnosis of mycoplasmal pneumonia will be admitted to the unit. The nurse prepares for the admission and obtains the necessary supplies to place the client on which type of transmission-based precautions? 
1. Droplet precautions 
2. Enteric precautions 
3. Contact precautions 
4. Protective precautions

The nurse is working in an illness prevention clinic. An important component of the nurse's practice is to advise high-risk clients to receive an influenza vaccination. Which clients are at high risk for influenza and would benefit from vaccination? Select all that apply. 
1. A 47-year-old mother of a child with cystic fibrosis 
2. A 54-year-old man scheduled for a routine diabetes check 
3. A 43-year-old factory worker with symptoms of influenza 
4. A 35-year-old registered nurse scheduled for an annual pelvic exam 
5. An 87-year-old woman from a nursing home scheduled for a surgical follow-up

The client seen in the health care clinic has tested positive for gonorrhea. The nurse anticipates that which medication will be prescribed based on this finding? 
1. Acyclovir (Zovirax) 
2. Ceftriaxone (Rocephin) 
3. Azithromycin (Zithromax) 
4. Penicillin G benzathine (Bicillin LA)

An adolescent is diagnosed with conjunctivitis, and the nurse provides information to the adolescent about the use of contact lenses. Which statement by the client would indicate the need for further information? 
1. "I should not wear my contact lenses." 
2. "New contact lenses should be obtained." 
3. "My old contact lenses should be discarded." 
4. "My contact lenses can be worn if they are cleaned as directed."

The nursing student is following standard precautions to prevent a hospital-acquired infection in a client. The student understands that which applies to the use of standard precautions? Select all that apply. 
1. Used when working with all clients 
2. Used only when specifically indicated 
3. Does not apply to those who do not have any open wounds 
4. Applies to blood, all body fluids, secretions, and excretions 
5. Is designed to prevent the risk of spreading microorganisms

A client with tuberculosis (TB), whose status is being monitored in an ambulatory care clinic, asks the nurse when it is permissible to return to work. The nurse replies that the client may resume employment when which occurs? 
1. Five sputum cultures are negative. 
2. Three sputum cultures are negative. 
3. A sputum culture and a chest x-ray are negative. 
4. A sputum culture and a tuberculin skin test are negative.

A nurse is admitting a client to the nursing unit who is suspected of having tuberculosis (TB). The nurse should plan to admit the client to a room that has which properties? 
1. Venting to the outside and ultraviolet light 
2. Ultraviolet light and three air exchanges per hour 
3. Ten air exchanges per hour and venting to the outside 
4. Venting to the outside, six air exchanges per hour, and ultraviolet light

A nurse is instructing a postpartum client with endometritis about preventing the spread of infection to the newborn infant. Which statement should the nurse make to the client? 
1. Visitors are not allowed to hold the baby. 
2. There is no danger of the newborn contracting the disease. 
3. Hands should be washed thoroughly before holding the infant. 
4. The newborn infant will not be allowed in the mother's room at all.

A nursing instructor asks a nursing student to describe the route of transmission of tuberculosis (TB). The instructor concludes that the student understands this information if the student states that which is the route of transmission for TB? 
1. Hand to mouth 
2. The airborne route 
3. The fecal-oral route 
4. Blood and body fluids

The home health nurse visits a client with suspected scabies. Which precaution should the nurse institute during the assessment of the client? 
1. Wear gloves only. 
2. Wear a mask and gloves. 
3. Wear a gown and gloves. 
4. Avoid touching the client's home furnishings.

The nurse is caring for a client with a wound infected with methicillin-resistant Staphylococcus aureus (MRSA). The most appropriate infection control precautions for MRSA include which intervention? 
1. A room with positive-pressure airflow 
2. Private room, gown, gloves, and face shield 
3. Private room with negative-pressure airflow 
4. Mask or respiratory protection device and gown

A man has been admitted to the surgical unit after a hernia repair surgery. The medical record reports that the client is human immunodeficiency virus (HIV) positive. The nurse should implement which precautions for this client? 
1. Contact precautions 
2. Droplet precautions 
3. Airborne precautions 
4. Standard precautions

A nurse is providing orientation to a newly graduated nurse. During a discussion of isolation procedures, which statement by the graduate nurse indicates a need for further review of isolation guidelines? 
1. "A client with tuberculosis will be placed on airborne precautions." 
2. "I will wear a mask when working with an isolated client who has a tracheostomy." 
3. "I can reuse a gown if it's not dirty, as long as I hang it up inside the client's room." 
4. "I will remove the gown and gloves and wash my hands before leaving the client's room."

A nurse is preparing an intravenous (IV) set before starting the infusion. After removing the cap from the IV tubing port on the IV bag, the nurse removes the cover from the tubing insertion spike, but then touches the spike with a finger. What should the nurse do next? 
1. Discard the IV tubing and use a new set for the infusion. 
2. Continue on with the procedure and then flush the tubing thoroughly. 
3. Clean the spike with an alcohol swab for 15 seconds and then continue. 
4. Clean the spike and the IV bag tubing port with alcohol and then continue.

A client with pulmonary tuberculosis (TB) is on airborne isolation precautions. Which item(s) is essential for the nurse to wear? 
1. Gloves only 
2. Fluid shield mask 
3. Gown, mask, and gloves 
4. High-efficiency particulate air (HEPA) filter mask

The nurse prepares the client for irrigation of an abdominal wound. After preparation, the nurse would appropriately don which item to perform the procedure?
1. Gloves 
2. Gloves and a gown 
3. Gloves and goggles 
4. Gloves, gown, and goggles

The nurse is preparing to care for a client with acquired immunodeficiency syndrome (AIDS). In planning infection control for this client, the nurse should implement which form of isolation to prevent the spread of the AIDS virus to others? 
1. Strict isolation 
2. Enteric precautions 
3. Contact precautions 
4. Blood and body fluid precautions

A nurse is assigned to care for an infant following a cleft lip repair. The nurse is asked to observe the parent in the procedure for cleaning the lip repair site. The nurse determines that the parent is performing the procedure correctly if the parent uses which solution to clean the site? 
1. Ice water 
2. Sterile water 
3. Half-strength alcohol 
4. Full strength hydrogen peroxide

The nurse is preparing a continuous intravenous (IV) infusion at the medication cart. As the nurse prepares to attach the distal end of the IV tubing to a needleless device, the tubing drops and hits the top of the medication cart. Which is the appropriate action by the nurse? 
1. Change the IV tubing. 
2. Attach a new needleless device. 
3. Wipe the tubing port with Betadine. 
4. Scrub the needleless device with an alcohol swab.

The nurse is caring for a client who is on airborne precautions. The nurse notes that the client is scheduled for magnetic resonance imaging (MRI). Which nursing action is most appropriate in preparing the client for the test? 
1. Place the client in gown, gloves, and mask. 
2. Request that the MRI technicians wear masks. 
3. Place a surgical mask on the client for transport. 
4. Call the radiology department to reschedule the test.