NCCT- infection control
. Which of the following interventions is required by an employer, at no cost to the employee,
following a needlestick exposure? - ANS-Provide a confidential medical evaluation.
Rationale
Counseling, education, and follow-up should be provided by an employer for up to one year
after exposure. Every hospital employee or any healthcare personnel at risk from accidental
exposure to blood should be vaccinated against HBV. There are no preventive vaccines
available yet for HCV and HIV. It is good to note that the risk of a HIV infection following
exposure to blood is very small (0.1-0.5%). The actual risk depends on type of contact and
on the amount of virus in the contaminated material.
A medical assistant completes a blood collection using the evacuated system with a safety
needle. The needle safety device is activated immediately following the collection. The
needle is removed from the tube holder/adapter and discarded in a sharps container. Which
of the following best describes the medical assistant's actions? - ANS-The medical assistant
activated the needle safety device appropriately, but the needle and tube holder/adapter
should not have been separated.
Rationale
There are two actions to evaluate, the timing of activation of the safety device and the
disposal of the needle and adapter (i.e., plastic tube holder). The safety device is designed
to be activated immediately following collection, as the time following collection is the point at
which most needle injuries occur. Once activated, the entire needle/adapter/safety device
must be disposed of in a sharps container to eliminate injury that could occur with needle
handling in any type of separation.
A patient is diagnosed with Hepatitis A. Which of the following is the most likely source of the
infection?
A. exposure from sharing a roommate's razor
B. recent dental implant surgery
C. improper use of a hypodermic needle
D. a hamburger from a local fast food restaurant - ANS-a hamburger from a local fast food
restaurant
Rationale
Hepatitis is generally caused by a viral infection of the liver and can be contracted by the
fecal-oral route, blood, or unprotected sex. Hepatitis A can be contracted via fecal-oral
means (food or water contamination) and infected sexual partners. Hepatitis A infection is
primarily transmitted by the fecal-oral route, by either person-to-person contact or
consumption of contaminated food (like a hamburger in this case) or water. Although viremia
occurs early in infection and can persist for several weeks after onset of symptoms,
bloodborne transmission of Hep A is uncommon. Hepatitis B, C, D & G are contracted by
blood or blood products, including infected needles, razors, etc. (thus these infections are
common among IV drug users). Hepatitis E virus is usually spread by the fecal-oral route.
, While rare in the United States, Hepatitis E is common in many parts of the world. The most
common source of infection of Hep E is fecally contaminated drinking water. Dental surgery
should not put a patient at risk for Hepatitis since gloves should be worn and sterile
technique followed.
A patient suspected of having which of the following respiratory disorders should be placed
in isolation in the medical office? - ANS-Active TB
Rationale
With Active TB, transmission occurs through inhaling bacteria in microscopic droplets -
airborne precautions should be initiated per protocol. COPD refers to a group of lung
diseases that block airflow and make breathing difficult. Emphysema and chronic bronchitis
are the two most common conditions that make up COPD. Asthma is a respiratory condition
marked by spasms in the bronchi of the lungs, causing difficulty in breathing. It usually
results from an allergic reaction or other forms of hypersensitivity. Croup refers to an
infection of the upper airway, generally in children, which obstructs breathing and causes a
characteristic barking cough.
A phlebotomist has been asked to collect a specimen from a patient with respiratory
syncytial virus (RSV). Which of the following transmission-based precautions should be
used? - ANS-contact precautions
Rationale
There are 3 transmission-based precautions: droplet, airborne, and contact. Contact
precautions should be followed in addition to standard precautions when a patient could
transmit their pathogen by direct contact or skin-to-skin. RSV is a virus that can be
transmitted by contact. Airborne precautions are necessary when transmission could occur
through small droplets on the air (i.e. TB). Droplet precautions should be taken when large
droplets (like from a cough or sneeze) could infect the care giver by way of contact with
mucous membranes or the eye (i.e. influenza). In instances where a patient has a highly
infectious or transmittable pathogen, complete isolation precautions must be implemented
(i.e. if infected with the Ebola virus).
A phlebotomist has received a requisition to collect a blood specimen on a patient infected
with diphtheria. The phlebotomist must be sure to follow what precautions? - ANS-standard,
airborne, droplet and contact precautions.
Rationale
Diphtheria is an acute, toxin-mediated disease caused by Corynebacterium diphtheriae.
Transmission is most often person-to-person from the respiratory tract, but transmission may
occur from skin lesions or fomites in touch with discharges from the skin. Thus, both
standard and contact precautions are indicated, in addition to airborne and droplet.
A phlebotomist must follow transmission based precaution for which of the following
patients? - ANS-patient who has rubeola
Rationale
Airborne precautions must be followed for patients with Rubeola (measles) virus exhibiting
maculopapular rash with cough, nasal mucosa secretions, and fever. A patient with a fever
of unknown origin, rheumatic fever, or pneumonia requires standard precautions.
After hand washing, the ECG technician notices the patient has MRSA sores. The next step
to take in order to prevent infection is to - ANS-use universal precautions.
. Which of the following interventions is required by an employer, at no cost to the employee,
following a needlestick exposure? - ANS-Provide a confidential medical evaluation.
Rationale
Counseling, education, and follow-up should be provided by an employer for up to one year
after exposure. Every hospital employee or any healthcare personnel at risk from accidental
exposure to blood should be vaccinated against HBV. There are no preventive vaccines
available yet for HCV and HIV. It is good to note that the risk of a HIV infection following
exposure to blood is very small (0.1-0.5%). The actual risk depends on type of contact and
on the amount of virus in the contaminated material.
A medical assistant completes a blood collection using the evacuated system with a safety
needle. The needle safety device is activated immediately following the collection. The
needle is removed from the tube holder/adapter and discarded in a sharps container. Which
of the following best describes the medical assistant's actions? - ANS-The medical assistant
activated the needle safety device appropriately, but the needle and tube holder/adapter
should not have been separated.
Rationale
There are two actions to evaluate, the timing of activation of the safety device and the
disposal of the needle and adapter (i.e., plastic tube holder). The safety device is designed
to be activated immediately following collection, as the time following collection is the point at
which most needle injuries occur. Once activated, the entire needle/adapter/safety device
must be disposed of in a sharps container to eliminate injury that could occur with needle
handling in any type of separation.
A patient is diagnosed with Hepatitis A. Which of the following is the most likely source of the
infection?
A. exposure from sharing a roommate's razor
B. recent dental implant surgery
C. improper use of a hypodermic needle
D. a hamburger from a local fast food restaurant - ANS-a hamburger from a local fast food
restaurant
Rationale
Hepatitis is generally caused by a viral infection of the liver and can be contracted by the
fecal-oral route, blood, or unprotected sex. Hepatitis A can be contracted via fecal-oral
means (food or water contamination) and infected sexual partners. Hepatitis A infection is
primarily transmitted by the fecal-oral route, by either person-to-person contact or
consumption of contaminated food (like a hamburger in this case) or water. Although viremia
occurs early in infection and can persist for several weeks after onset of symptoms,
bloodborne transmission of Hep A is uncommon. Hepatitis B, C, D & G are contracted by
blood or blood products, including infected needles, razors, etc. (thus these infections are
common among IV drug users). Hepatitis E virus is usually spread by the fecal-oral route.
, While rare in the United States, Hepatitis E is common in many parts of the world. The most
common source of infection of Hep E is fecally contaminated drinking water. Dental surgery
should not put a patient at risk for Hepatitis since gloves should be worn and sterile
technique followed.
A patient suspected of having which of the following respiratory disorders should be placed
in isolation in the medical office? - ANS-Active TB
Rationale
With Active TB, transmission occurs through inhaling bacteria in microscopic droplets -
airborne precautions should be initiated per protocol. COPD refers to a group of lung
diseases that block airflow and make breathing difficult. Emphysema and chronic bronchitis
are the two most common conditions that make up COPD. Asthma is a respiratory condition
marked by spasms in the bronchi of the lungs, causing difficulty in breathing. It usually
results from an allergic reaction or other forms of hypersensitivity. Croup refers to an
infection of the upper airway, generally in children, which obstructs breathing and causes a
characteristic barking cough.
A phlebotomist has been asked to collect a specimen from a patient with respiratory
syncytial virus (RSV). Which of the following transmission-based precautions should be
used? - ANS-contact precautions
Rationale
There are 3 transmission-based precautions: droplet, airborne, and contact. Contact
precautions should be followed in addition to standard precautions when a patient could
transmit their pathogen by direct contact or skin-to-skin. RSV is a virus that can be
transmitted by contact. Airborne precautions are necessary when transmission could occur
through small droplets on the air (i.e. TB). Droplet precautions should be taken when large
droplets (like from a cough or sneeze) could infect the care giver by way of contact with
mucous membranes or the eye (i.e. influenza). In instances where a patient has a highly
infectious or transmittable pathogen, complete isolation precautions must be implemented
(i.e. if infected with the Ebola virus).
A phlebotomist has received a requisition to collect a blood specimen on a patient infected
with diphtheria. The phlebotomist must be sure to follow what precautions? - ANS-standard,
airborne, droplet and contact precautions.
Rationale
Diphtheria is an acute, toxin-mediated disease caused by Corynebacterium diphtheriae.
Transmission is most often person-to-person from the respiratory tract, but transmission may
occur from skin lesions or fomites in touch with discharges from the skin. Thus, both
standard and contact precautions are indicated, in addition to airborne and droplet.
A phlebotomist must follow transmission based precaution for which of the following
patients? - ANS-patient who has rubeola
Rationale
Airborne precautions must be followed for patients with Rubeola (measles) virus exhibiting
maculopapular rash with cough, nasal mucosa secretions, and fever. A patient with a fever
of unknown origin, rheumatic fever, or pneumonia requires standard precautions.
After hand washing, the ECG technician notices the patient has MRSA sores. The next step
to take in order to prevent infection is to - ANS-use universal precautions.
