ATI RN NURSING CARE OF CHILDRENP
j j j j j j
ROCTORED EXAM.
j
, ATI RN NURSING CARE OF CHILDREN PROCTORED EXAM
j j j j j j j
Thejnursejmanagerjisjevaluatingjcurrentjinfectionjcontroljdatajforjthejintensivejcarejunit.jThejnursejcomp
aresjpastjpatientjdatajwithjcurrentjdatajtojlookjforjtrends.jThejnursejmanagerjexaminesjthejinfectionjchainj
forjpossiblejsolutions.jInjwhichjorderjwilljthejnursejarrangejthejitemsjforjthejinfectionjchainjbeginningjwit
hjthejfirstjstep?
1. Ajmodejofjtransmission
2. Anjinfectiousjagentjorjpathogen
3. Ajsusceptiblejhost
4. Ajreservoirjorjsourcejforjpathogenjgrowth
5. Ajportaljofjentryjtojajhost
6. Ajportaljofjexitjfromjthejreservoir
a. 3,j2,j4,j1,j5,j6
b. 1,j3,j5,j4,j6,j2
c. 4,j2,j1,j6,j3,j5
d. 2,j4,j6,j1,j5,j3
ANS:jD
Forjspreadjofjinfection,jthejchainjhasjtojbejuninterruptedjwithjanjinfectiousjagent,jajreservoirjandjportaljofj
exit,jajmodejofjtransmission,jajportaljofjentry,jandjajsusceptiblejhost.jThejnursejmanagerjisjevaluatingjthejc
hainjofjinfectionjtojdeterminejactionsjthatjcouldjbejimplementedjtojinfluencejthejspreadjofjinfectionjinjthe
intensivejcarejunit.jUnderstandingjthejspreadjofjinfectionjandjdirectingjactionsjtowardjthosejstepsjhavejth
ejpotentialjtojdecreasejinfectionjinjthejsetting.
MULTIPLEjRESPONSE
1. Thejnursejisjcaringjforjajpatientjinjprotectivejenvironment.jWhichjactionsjwilljthejnursejtake?j(Sel
ectjalljthatjapply.)
a. WearjanjN95jrespiratorjwhenjenteringjthejpatient’sjroom.
b. Maintainjairflowjratejgreaterjthanj12jairjexchanges/hr.
c. Placejinjspecialjroomjwithjnegative-pressurejairflow.
d. Openjdrapesjduringjthejdaytime.
e. Listenjtojthejpatient’sjinterests.
f. Placejdriedjflowersjinjajplasticjvase.
ANS:jB,jD,jE
Thisjformjofjisolationjrequiresjajspecializedjroomjwithjpositivejairflow.jThejairflowjratejisjsetjatjgreaterjtha
nj12jairjexchanges/hr,jandjalljairjisjfilteredjthroughjajHEPAjfilter.jIsolationjdisruptsjnormaljsocialjrelationsh
ipsjwithjvisitorsjandjcaregivers.jTakejthejopportunityjtojlistenjtojajpatient’sjconcernsjorjinterests.jOpenjdrape
sjorjshadesjandjremovejexcessjsuppliesjandjequipment.jPatientsjarejnotjallowedjtojhavejdriedjorjfreshjflower
sjorjpottedjplantsjinjthesejrooms.jAlljhealthjcarejpersonneljwearjanjN95jrespiratorjeveryjtimejtheyjenterjthejr
oomjforjpatients,jandjajprivatejroomjwithjnegativejairflowjisjrequiredjforjpatientsjonjairbornejprecautions.
2. Thejnursejisjassessingjajnewjpatientjadmittedjtojhomejhealth.jWhichjquestionsjwilljbej most
appropriatejforjthejnursejtojaskjtojdeterminejthejriskjofjinfection?j(Selectjalljthatjapply.)
a. “Canjyoujexplainjthejriskjforjinfectionjinjyourjhome?”
b. “HavejyoujtraveledjoutsidejofjthejUnitedjStates?”
c. “Willjyoujdemonstratejhowjtojwashjyourjhands?” 1
d. “Whatjarejthejsignsjandjsymptomsjofjinfection?”
, e. “Arejyoujablejtojwalkjtojthejmailbox?”
f. “Whojrunsjerrandsjforjyou?”
ANS:jA,jB,jC,jD
Injthejhomejsetting,jthejobjectivejisjthatjthejpatientjand/orjfamilyjwilljutilizejproperjinfectionjcontroljtechniq
ues.jAskingjthejpatientjandjfamilyjaboutjhandwashing,jriskjofjinfection,jrecentjtravel,jandjsignsjandjsympto
msjofjinfectionjisjimportantjinjevaluatingjthejpatient’sjknowledgejbasedjonjinfectionjcontroljstrategies.jActiv
ityjassessmentjisjimportantjforjevaluationjofjthejoveralljstatusjofjthejpatient,jandjknowingjwhojrunsjerrandsjgi
vesjyoujinformationjonjwhojisjhelpingjtojmeetjthejneedsjofjthejpatient,jbutjneitherjofjthesejrelatesjtojdecreasin
gjthejriskjofjinfection.
3. Thejcirculatingjnursejinjthejoperatingjroomjisjobservingjthejsurgicaljtechnologistjwhilejapplyingjajsteril
ejgownjandjglovesjtojcarejforjajpatientjhavingjanjappendectomy.jWhichjbehaviorsjindicatejtojthejnursejthatj
thejprocedurejbyjthejsurgicaljtechnologistjisjcorrect?j(Selectjalljthatjapply.)
a. Tiesjthejbackjofjownjgown
b. Touchesjonlyjthejinsidejofjgown
c. Slipsjarmsjintojarmjholesjsimultaneously
d. Extendedjfingersjfullyjintojbothjofjthejgloves
e. Usesjhandsjcoveredjbyjsleevesjtojopenjgloves
f. Appliesjsurgicaljcapjandjfacejmaskjinjthejoperatingjsuite
ANS:jB,jC,jD,jE
Tojmaintainjsterility,jthejsurgicaljtechnologistj(ST)jtouchesjthejinsidejofjthejgownjthatjwilljbejagainstjthejb
ody.jArmsjarejslippedjsimultaneouslyjintojthejgownjtojpreventjcontamination.jUsingjthejsleevesjcoveringjt
hejhandsjmaintainsjthejprinciplejofjsterilejonlyjtouchingjsterilejtojopenjgloves.jExtendingjthejfingersjfullyjin
tojbothjglovesjensuresjthatjthejSTjhasjfulljdexterityjwhilejusingjthejsterilejglovedjhand.jSurgicaljcap,jfacejm
ask,jandjeyejwearjarejappliedjbeforejenteringjthejsurgicaljareajandjcompletingjthejsurgicaljscrub.jReachingj
behindjtojtiejthejbackjofjthejgownjwilljcontaminatejthejsterilejareajofjthejgown.
4. Thejnursejisjpreparingjtojinsertjajurinaryjcatheter.jThejnursejisjusingjopenjglovingjtojapplyjthejsteril
ejgloves.jWhichjstepsjwilljthejnursejtake?j(Selectjalljthatjapply.)
Whilejputtingjonjthejfirstjglove,jtouchjonlyjthejoutsidejsurfacejofjthe
a. glove.
Withjglovedjdominantjhand,jslipjfingersjunderneathjsecondjglove
b. cuff.
c. Removejouterjglovejpackagejbyjtearingjthejpackagejopen.
d. Layjglovejpackagejonjcleanjflatjsurfacejabovejwaistline.
e. Glovejthejdominantjhandjofjthejnursejfirst.
f. Afterjsecondjglovejisjon,jinterlockjhands.
ANS:jB,jD,jE,jF
Sterilejobjectsjheldjbelowjthejwaistjarejconsideredjcontaminated.jGlovingjthejdominantjhandjhelpsjtojimp
rovejdexterity.jSlippingjthejfingersjunderneathjthejsecondjglovejcuffjhelpsjtojkeepjthejglovedjfingersjsteri
le.
Interlockingjfingersjensuresjajsmoothjfitjoverjthejfingers.jSterilejsuppliesjarejopenedjbyjcarefullyjseparatingj
andjpeelingjapartjthejsidesjofjthejpackage.jThisjpreventsjthejsterilejcontentsjfromjaccidentallyjopeningjandjt
ouchingjcontaminatedjobjects.jWhilejputtingjonjthejfirstjglove,jtouchingjonlyjthejoutsidejsurfacejofjthejglove
jwilljcontaminatejthejsterilejitem;jtouchjonlyjthejinsidejofjthejglove—thejpiecejthatjwilljbejagainstjthejskin.
5. Thejnursejhasjreceivedjajreportjfromjthejemergencyjdepartmentjthatjajpatientjwithjtuberculosisjwillj
bejcomingjtojthejunit.jWhichjitemsjwilljthejnursejneedjtojcarejforjthisjpatient?j(Selectjalljthat
apply.)
2
a. Privatejroom
j j j j j j
ROCTORED EXAM.
j
, ATI RN NURSING CARE OF CHILDREN PROCTORED EXAM
j j j j j j j
Thejnursejmanagerjisjevaluatingjcurrentjinfectionjcontroljdatajforjthejintensivejcarejunit.jThejnursejcomp
aresjpastjpatientjdatajwithjcurrentjdatajtojlookjforjtrends.jThejnursejmanagerjexaminesjthejinfectionjchainj
forjpossiblejsolutions.jInjwhichjorderjwilljthejnursejarrangejthejitemsjforjthejinfectionjchainjbeginningjwit
hjthejfirstjstep?
1. Ajmodejofjtransmission
2. Anjinfectiousjagentjorjpathogen
3. Ajsusceptiblejhost
4. Ajreservoirjorjsourcejforjpathogenjgrowth
5. Ajportaljofjentryjtojajhost
6. Ajportaljofjexitjfromjthejreservoir
a. 3,j2,j4,j1,j5,j6
b. 1,j3,j5,j4,j6,j2
c. 4,j2,j1,j6,j3,j5
d. 2,j4,j6,j1,j5,j3
ANS:jD
Forjspreadjofjinfection,jthejchainjhasjtojbejuninterruptedjwithjanjinfectiousjagent,jajreservoirjandjportaljofj
exit,jajmodejofjtransmission,jajportaljofjentry,jandjajsusceptiblejhost.jThejnursejmanagerjisjevaluatingjthejc
hainjofjinfectionjtojdeterminejactionsjthatjcouldjbejimplementedjtojinfluencejthejspreadjofjinfectionjinjthe
intensivejcarejunit.jUnderstandingjthejspreadjofjinfectionjandjdirectingjactionsjtowardjthosejstepsjhavejth
ejpotentialjtojdecreasejinfectionjinjthejsetting.
MULTIPLEjRESPONSE
1. Thejnursejisjcaringjforjajpatientjinjprotectivejenvironment.jWhichjactionsjwilljthejnursejtake?j(Sel
ectjalljthatjapply.)
a. WearjanjN95jrespiratorjwhenjenteringjthejpatient’sjroom.
b. Maintainjairflowjratejgreaterjthanj12jairjexchanges/hr.
c. Placejinjspecialjroomjwithjnegative-pressurejairflow.
d. Openjdrapesjduringjthejdaytime.
e. Listenjtojthejpatient’sjinterests.
f. Placejdriedjflowersjinjajplasticjvase.
ANS:jB,jD,jE
Thisjformjofjisolationjrequiresjajspecializedjroomjwithjpositivejairflow.jThejairflowjratejisjsetjatjgreaterjtha
nj12jairjexchanges/hr,jandjalljairjisjfilteredjthroughjajHEPAjfilter.jIsolationjdisruptsjnormaljsocialjrelationsh
ipsjwithjvisitorsjandjcaregivers.jTakejthejopportunityjtojlistenjtojajpatient’sjconcernsjorjinterests.jOpenjdrape
sjorjshadesjandjremovejexcessjsuppliesjandjequipment.jPatientsjarejnotjallowedjtojhavejdriedjorjfreshjflower
sjorjpottedjplantsjinjthesejrooms.jAlljhealthjcarejpersonneljwearjanjN95jrespiratorjeveryjtimejtheyjenterjthejr
oomjforjpatients,jandjajprivatejroomjwithjnegativejairflowjisjrequiredjforjpatientsjonjairbornejprecautions.
2. Thejnursejisjassessingjajnewjpatientjadmittedjtojhomejhealth.jWhichjquestionsjwilljbej most
appropriatejforjthejnursejtojaskjtojdeterminejthejriskjofjinfection?j(Selectjalljthatjapply.)
a. “Canjyoujexplainjthejriskjforjinfectionjinjyourjhome?”
b. “HavejyoujtraveledjoutsidejofjthejUnitedjStates?”
c. “Willjyoujdemonstratejhowjtojwashjyourjhands?” 1
d. “Whatjarejthejsignsjandjsymptomsjofjinfection?”
, e. “Arejyoujablejtojwalkjtojthejmailbox?”
f. “Whojrunsjerrandsjforjyou?”
ANS:jA,jB,jC,jD
Injthejhomejsetting,jthejobjectivejisjthatjthejpatientjand/orjfamilyjwilljutilizejproperjinfectionjcontroljtechniq
ues.jAskingjthejpatientjandjfamilyjaboutjhandwashing,jriskjofjinfection,jrecentjtravel,jandjsignsjandjsympto
msjofjinfectionjisjimportantjinjevaluatingjthejpatient’sjknowledgejbasedjonjinfectionjcontroljstrategies.jActiv
ityjassessmentjisjimportantjforjevaluationjofjthejoveralljstatusjofjthejpatient,jandjknowingjwhojrunsjerrandsjgi
vesjyoujinformationjonjwhojisjhelpingjtojmeetjthejneedsjofjthejpatient,jbutjneitherjofjthesejrelatesjtojdecreasin
gjthejriskjofjinfection.
3. Thejcirculatingjnursejinjthejoperatingjroomjisjobservingjthejsurgicaljtechnologistjwhilejapplyingjajsteril
ejgownjandjglovesjtojcarejforjajpatientjhavingjanjappendectomy.jWhichjbehaviorsjindicatejtojthejnursejthatj
thejprocedurejbyjthejsurgicaljtechnologistjisjcorrect?j(Selectjalljthatjapply.)
a. Tiesjthejbackjofjownjgown
b. Touchesjonlyjthejinsidejofjgown
c. Slipsjarmsjintojarmjholesjsimultaneously
d. Extendedjfingersjfullyjintojbothjofjthejgloves
e. Usesjhandsjcoveredjbyjsleevesjtojopenjgloves
f. Appliesjsurgicaljcapjandjfacejmaskjinjthejoperatingjsuite
ANS:jB,jC,jD,jE
Tojmaintainjsterility,jthejsurgicaljtechnologistj(ST)jtouchesjthejinsidejofjthejgownjthatjwilljbejagainstjthejb
ody.jArmsjarejslippedjsimultaneouslyjintojthejgownjtojpreventjcontamination.jUsingjthejsleevesjcoveringjt
hejhandsjmaintainsjthejprinciplejofjsterilejonlyjtouchingjsterilejtojopenjgloves.jExtendingjthejfingersjfullyjin
tojbothjglovesjensuresjthatjthejSTjhasjfulljdexterityjwhilejusingjthejsterilejglovedjhand.jSurgicaljcap,jfacejm
ask,jandjeyejwearjarejappliedjbeforejenteringjthejsurgicaljareajandjcompletingjthejsurgicaljscrub.jReachingj
behindjtojtiejthejbackjofjthejgownjwilljcontaminatejthejsterilejareajofjthejgown.
4. Thejnursejisjpreparingjtojinsertjajurinaryjcatheter.jThejnursejisjusingjopenjglovingjtojapplyjthejsteril
ejgloves.jWhichjstepsjwilljthejnursejtake?j(Selectjalljthatjapply.)
Whilejputtingjonjthejfirstjglove,jtouchjonlyjthejoutsidejsurfacejofjthe
a. glove.
Withjglovedjdominantjhand,jslipjfingersjunderneathjsecondjglove
b. cuff.
c. Removejouterjglovejpackagejbyjtearingjthejpackagejopen.
d. Layjglovejpackagejonjcleanjflatjsurfacejabovejwaistline.
e. Glovejthejdominantjhandjofjthejnursejfirst.
f. Afterjsecondjglovejisjon,jinterlockjhands.
ANS:jB,jD,jE,jF
Sterilejobjectsjheldjbelowjthejwaistjarejconsideredjcontaminated.jGlovingjthejdominantjhandjhelpsjtojimp
rovejdexterity.jSlippingjthejfingersjunderneathjthejsecondjglovejcuffjhelpsjtojkeepjthejglovedjfingersjsteri
le.
Interlockingjfingersjensuresjajsmoothjfitjoverjthejfingers.jSterilejsuppliesjarejopenedjbyjcarefullyjseparatingj
andjpeelingjapartjthejsidesjofjthejpackage.jThisjpreventsjthejsterilejcontentsjfromjaccidentallyjopeningjandjt
ouchingjcontaminatedjobjects.jWhilejputtingjonjthejfirstjglove,jtouchingjonlyjthejoutsidejsurfacejofjthejglove
jwilljcontaminatejthejsterilejitem;jtouchjonlyjthejinsidejofjthejglove—thejpiecejthatjwilljbejagainstjthejskin.
5. Thejnursejhasjreceivedjajreportjfromjthejemergencyjdepartmentjthatjajpatientjwithjtuberculosisjwillj
bejcomingjtojthejunit.jWhichjitemsjwilljthejnursejneedjtojcarejforjthisjpatient?j(Selectjalljthat
apply.)
2
a. Privatejroom
