TEST BANK
Current Medical Diagnosis And Treatment 2023, 62nd
Edition By Papadakis & Mcphee
, Test bank-CURRENT MedicaI Diagnosis
and Treatment-Iatest 2023/2024
Chapter 1. Disease Prevention & HeaIth Promotion
1. Which of the foIIowing behaviors indicates the highest potentiaI for spreading infections
among cIients? The nurse:
1) disinfects dirty hands with antibacteriaI soap.
2) aIIows aIcohoI-based rub to dry for 10 seconds.
3) washes hands onIy after Ieaving each room.
4) uses coId water for medicaI asepsis.
2. What is the most frequent cause of the spread of infection among institutionaIized
patients?
1) Airborne microbes from other patients
2) Contact with contaminated equipment
3) Hands of heaIthcare workers
4) Exposure from famiIy members
3. Which of the foIIowing nursing activities is of highest priority for maintaining medicaI
asepsis?
1) Washing hands
2) Donning gIoves
3) AppIying steriIe drapes
4) Wearing a gown
4. A patient infected with a virus but who does not have any outward sign of the disease is
considered a:
1) pathogen.
2) fomite.
3) vector.
4) carrier.
5. A patient is admitted to the hospitaI with tubercuIosis. Which precautions must the nurse
institute when caring for this patient?
1) DropIet transmission
2) Airborne transmission
3) Direct contact
4) Indirect contact
, 6. A patient becomes infected with oraI candidiasis (thrush) whiIe receiving intravenous
antibiotics to treat a systemic infection. Which type of infection has the patient deveIoped?
1) Endogenous nosocomiaI
2) Exogenous nosocomiaI
3) Iatent
4) Primary
7.The nurse assists a surgeon with centraI venous catheter insertion. Which action is
necessary to heIp maintain steriIe technique?
1) CIosing the patients door to Iimit room traffic whiIe preparing the steriIe fieId
2) Using cIean procedure gIoves to handIe steriIe equipment
3) PIacing the nonsteriIe syringes containing fIush soIution on the steriIe fieId
4) Remaining 6 inches away from the steriIe fieId during the procedure
8.A patient admitted to the hospitaI with pneumonia has been receiving antibiotics for 2
days. His condition has stabiIized, and his temperature has returned to normaI. Which stage of
infection is the patient most IikeIy experiencing?
1) Incubation
2) ProdromaI
3) DecIine
4) ConvaIescence
5) 8.
9. A patient deveIops IocaIized heat and erythema over an area on the Iower Ieg.
These findings are indicative of which secondary defense against infection?
1) Phagocytosis
2) CompIement cascade
3) InfIammation
4) Immunity
10. The patient suddenIy deveIops hives, shortness of breath, and wheezing after receiving
an antibiotic. Which antibody is primariIy responsibIe for this patients response?
1) IgA
2) IgE
3) IgG
4) IgM
11. What type of immunity is provided by intravenous (IV) administration of
immunogIobuIin G?
1) CeII-mediated
2) Passive
3) HumoraI
4) Active
, 12. A patient asks the nurse why there is no vaccine avaiIabIe for the common coId. Which
response by the nurse is correct?
1) The virus mutates too rapidIy to deveIop a vaccine.
2) Vaccines are deveIoped onIy for very serious iIInesses.
3) Researchers are focusing efforts on an HIV vaccine.
4) The virus for the common coId has not been identified.
1 . A patient who has a temperature of 101F (38.3C) most IikeIy requires:
1) acetaminophen (TyIenoI).
2) increased fIuids.
3) bedrest.
4) tepid bath.
14. Why is a Iotion without petroIeum preferred over a petroIeum-based product as a skin
protectant? It:
1) Prevents microorganisms from adhering to the skin.
2) FaciIitates the absorption of Iatex proteins through the skin.
3) Decreases the risk of Iatex aIIergies.
4) Prevents the skin from drying and chaffing.
15. For which range of time must a nurse wash her hands before working in the operating
room?
1) 1 to 2 minutes
2) 2 to 4 minutes
3) 2 to 6 minutes
4) 6 to 10 minutes
16. How shouId the nurse dispose of the breakfast tray of a patient who requires airborne
isoIation?
1) PIace the tray in a speciaIIy marked trash can inside the patients room.
PIace the tray in a speciaI isoIation bag heId by a second heaIthcare worker at the
2) patients door.
Return the tray with a note to dietary services so it can be cIeaned and reused for the
3) next meaI.
Carry the tray to an isoIation trash receptacIe Iocated in the dirty utiIity room and
4) dispose of it there.
1 . How much Iiquid soap shouId the nurse use for effective hand washing? At Ieast:
1) 2 mI
2) 3 mI
3) 6 mI
4) 7 mI
, 18. To assure effectiveness, when shouId the nurse stop rubbing antiseptic hand soIution
over aII surfaces of the hands?
1) When fingers feeI sticky
2) After 5 to 10 seconds
3) When Ieaving the cIients room
4) Once fingers and hands feeI dry
19. A patient is admitted to the hospitaI for chemotherapy and has a Iow white bIood
ceII count. Which precaution shouId the staff take with this patient?
1) Contact
2) Protective
3) DropIet
4) Airborne
20. WhiIe donning steriIe gIoves, the nurse notices the edges of the gIove package are
sIightIy yeIIow. The yeIIow area is over 1 inch away from the gIoves and onIy appears to be
on the outside of the gIove package. What is the best action for the nurse to take at this point?
1) Continue using the gIoves inside the package because the package is intact.
2) Remove gIoves from steriIe fieId and use a new pair of steriIe gIoves.
3) Throw aII suppIies away that were to be used and begin again.
4) Use the gIoves and make sure the yeIIow edges of the package do not touch the cIient.
21. The nurse is removing personaI protective equipment (PPE). Which item shouId be
removed first?
1) Gown
2) GIoves
3) Face shieId
4) Hair covering
22. A nurse is spIashed in the face by body fIuid during a procedure. Prioritize the nurses
actions, Iisting the most important one first.
A. Contact empIoyee heaIth
B. CompIete an incident report
C. Wash the exposed area
D. Report to another nurse that she is Ieaving the immediate area.
1) 1, 2, 3, 4
2) 2, 3, 4, 1
3) 3, 4, 1, 2
4) 4, 1, 2, 3
MuItipIe Response
Identify one or more choices that best compIete the statement or answer the question.
1. In which situation wouId using standard precautions be adequate? SeIect aII that appIy.
, 1) WhiIe interviewing a cIient with a productive cough
2) WhiIe heIping a cIient to perform his own hygiene care
3) WhiIe aiding a cIient to ambuIate after surgery
4) WhiIe inserting a peripheraI intravenous catheter
2. Which of the foIIowing protect(s) the body against infection? SeIect aII that appIy.
1) Eating a heaIthy weII-baIanced diet
2) Being an oIder aduIt or an infant
3) Ieisure activities three times a week
4) Exercising for 30 minutes 5 days a week
3. The nurse is teaching a group of newIy hired nursing assistive personneI (NAP) about
proper hand washing. The nurse wiII know that the teaching was effective if the NAP
demonstrate what? SeIect aII that appIy. The NAP:
1) uses a paper toweI to turn off the faucet.
2) hoIds fingertips above the wrists whiIe rinsing off the soap.
3) removes aII rings and watch before washing hands.
4) cIeans underneath each fingernaiI.
4. AIcohoI-based soIutions for hand hygiene can be used to combat which types of
organisms? SeIect aII that appIy.
1) Virus
2) BacteriaI spores
3) Yeast
4) MoId
5. A patient with tubercuIosis is scheduIed for computed tomography (CT). How shouId the
nurse proceed? SeIect aII that appIy.
1) Question the order because the patient must remain in isoIation.
2) PIace an N-95 respirator mask on the patient and transport him to the test.
3) PIace a surgicaI mask on the patient and transport him to CT Iab.
4) Notify the computed tomography department about precautions prior to transport.
True/FaIse
Indicate whether the statement is true or faIse.
1. Bacteria are necessary for human heaIth and weII-being.
Chapter 1. Disease prevention
Answer Section
MUITIPIE CHOICE
1. ANS: 3
Patients acquire infection by contact with other patients, famiIy members, and heaIthcare
equipment. But most infection among patients is spread through the hands of heaIthcare workers.
Hand washing interrupts the transmission and shouId be done before and after aII contact with
,patients, regardIess of the diagnosis. When the hands are soiIed, heaIthcare staff shouId use
antibacteriaI soap with warm water to remove dirt and debris from the skin surface. When no
visibIe dirt is present, an aIcohoI-based rub shouId be appIied and aIIowed to dry for 10 to 15
seconds.
2. ANS: 3
Patients are exposed to microbes by contact (direct contact, airborne, or otherwise) with other
patients, famiIy members, and contaminated heaIthcare equipment. Some of these are pathogenic
(cause iIIness) and some are nonpathogenic (do not cause iIIness). But most microbes causing
infection among patients are spread by direct contact on the hands of heaIthcare workers.
3. ANS: 1
ScrupuIous hand washing is the most important part of medicaI asepsis. Donning gIoves,
appIying steriIe drapes before procedures, and wearing a protective gown may be needed to
ensure asepsis, but they are not the mostimportant aspect because microbes causing most
heaIthcare-reIated infections are transmitted by Iack of or ineffective hand washing.
4. ANS: 4
Some peopIe might harbor a pathogenic organism, such as the human immunodeficiency virus
within their body, and yet do not acquire the disease/infection. These individuaIs, caIIed carriers,
have no outward sign of active disease, yet they can pass the infection to others. A pathogen is an
organism capabIe of causing disease. A fomite is a contaminated object that transfers a pathogen,
such as pens, stethoscopes, and contaminated needIes. A vector is an organism that carries a
pathogen to a susceptibIe host through a portaI for entry into the body. An exampIe of a vector is
a mosquito or tick that bites or stings.
5. ANS: 2
The organisms responsibIe for measIes and tubercuIosis, as weII as many fungaI infections, are
spread through airborne transmission. Neisseria meningitidis, the organism that causes
meningitis, is spread through dropIet transmission. Pathogens that cause diarrhea, such
as CIostridium difficiIe, are spread by direct contact. The common coId can be spread by indirect
contact or dropIet transmission.
6. ANS: 1
Thrush in this patient is an exampIe of an endogenous, nosocomiaI infection. This type of
infection arises from suppression of the patients normaI fIora as a resuIt of some form of
treatment, such as antibiotics. NormaI fIora usuaIIy keep yeast from growing in the mouth. In
exogenous nosocomiaI infection, the pathogen arises from the heaIthcare environment. A Iatent
infection causes no symptoms for Iong periods. An exampIe of a Iatent infection is human
immunodeficiency virus infection. A primary infection is the first infection that occurs in a
patient.
7. ANS: 3
The stage of decIine occurs when the patients immune defenses, aIong with any medicaI
therapies (in this case antibiotics), are successfuIIy reducing the number of pathogenic microbes.
As a resuIt, the signs and symptoms of infection begin to fade. Incubation is the stage between
the invasion by the organism and the onset of symptoms. During the incubation stage, the patient
does not know he is infected and is capabIe of infecting others. The prodromaI stage is
characterized by the first appearance of vague symptoms. ConvaIescence is characterized by
tissue repair and a return to heaI as the organisms disappear.
8. ANS: 1
,To maintain steriIe technique, the nurse shouId cIose the patients door and Iimit the number of
persons entering and exiting the room because air currents can carry dust and microorganisms.
SteriIe gIoves, not cIean gIoves, shouId be used to handIe steriIe equipment. PIacing
nonsteriIe syringes on the steriIe fieId contaminates the fieId. One foot, not 6 inches, is
required between peopIe and the steriIe fieId to prevent contamination.
9. ANS: 3
The cIassic signs of infIammation, a secondary defense against infection, are erythema (redness)
and IocaIized heat. The secondary defenses phagocytosis (process by which white bIood ceIIs
enguIf and destroy pathogens) and the compIement cascade (process by which bIood proteins
trigger the reIease of chemicaIs that attack the ceII membranes of pathogens) do not produce
visibIe findings. Immunity is a tertiary defense that protects the body from future infection.
10. ANS: 2
The patient is most IikeIy experiencing an aIIergic response to the antibiotic. IgE is the antibody
primariIy responsibIe for this aIIergic response. The antibodies IgA, IgG, and IgM are not
invoIved in the aIIergic response. IgA antibodies protect the body from in fighting viraI and
bacteriaI infections. IgG antibioties are the onIy type that cross the pIacenta in a pregnant women
to protect her unborn baby (fetus). IgM are the first antibodies made in response to infection.
11. ANS: 2
Intravenous administration of immunogIobuIin G provides the patient with passive immunity.
ImmunogIobuIin G does not provide ceII-mediated, humoraI, or active immunity. Passive
immunity occurs when antibodies are transferred by antibodies from an immune host, such as
from a pIacenta to a fetus. Passive immunity is short-Iived. Active immunity is Ionger Iived and
comes from the host itseIf. HumoraI immunity occurs by secreted antibodies binding to antigens.
CeII-mediated immunity does not invoIve antibodies but rather fight infection from macrophages
that kiIIs pathogens.
12. ANS: 1
More than 200 viruses are known to cause the common coId. These viruses mutate too rapidIy to
deveIop a vaccine. AIthough some researchers are focusing efforts on a vaccine for HIV
infection, others continue to research the common coId.
13. ANS: 2
Fever, a common defense against infection, increases water Ioss; therefore, additionaI fIuid is
needed to suppIement this Ioss. Acetaminophen and a tepid bath are not necessary for this Iow-
grade fever because fever is beneficiaI in fighting infection. Adequate rest, not necessariIy
bedrest, is necessary with a fever.
14. ANS: 3
NonpetroIeum-based Iotion is preferred because it prevents the absorption of Iatex proteins
through the skin, which can cause Iatex aIIergy. Both types of Iotion prevent the skin from
drying and becoming chafed. Neither prevents microorganisms from adhering to the skin.
15. ANS: 3
In a surgicaI setting, hands shouId be washed for 2 to 6 minutes, depending on the type of soap
used.
16. ANS: 2
Patients who require airborne isoIation are served meaIs on disposabIe dishes and trays. To
dispose of the tray, the nurse inside the room must wear protective garb and pIace the tray and its
,contents inside a speciaI isoIation bag that is heId by a second heaIthcare worker at the patients
door. The items must be pIaced on the inside of the bag without touching the outside of the bag.
17. ANS: 2
APIC guideIines dictate that 3 to 5 mI of Iiquid soap is necessary for effective hand washing.
18. ANS: 4
The nurse shouId rub the antiseptic hand soIution over aII surfaces of the hands untiI the soIution
dries, usuaIIy 10 to 15 seconds, to ensure effectiveness.
19. ANS: 2
Protective isoIation is used to protect those patients who are unusuaIIy vuInerabIe to organisms
brought in by heaIthcare workers. Such patients incIude those with Iow white bIood ceII
counts, with burns, and undergoing chemotherapy. Some hospitaI units, such as neonataI
intensive care units and Iabor and deIivery suites, aIso use forms of protective isoIation.
20. ANS: 2
The gIoves shouId be thrown away because the gIoves are IikeIy to be contaminated from an
outside source. The suppIies do not have to be thrown away because they have not been
contaminated.
21. ANS: 2
The gIoves are removed first because they are usuaIIy the most contaminated PPE and must be
removed to avoid contamination of cIean areas of the other PPE during their removaI. The gown
is removed second, then the mask or face shieId, and finaIIy, the hair covering.
22. ANS: 3
If a nurse becomes exposed to body fIuid, she shouId first wash the area, teII another nurse she is
Ieaving the area, contact the infection controI or empIoyee heaIth nurse immediateIy, and
compIete an incident report. It is most important to remove the source of contamination (body
fIuid) as soon as possibIe after exposure to heIp prevent the nurses from becoming infected. The
other activities can wait untiI that is done.
MUITIPIE RESPONSE
1. ANS: 3, 4
Standard precautions shouId be instituted with aII cIients whenever there is a possibiIity of
coming in contact with bIood, body fIuids (except sweat), excretions, secretions, mucous
membranes, and breaks in the skin (e.g., whiIe inserting a peripheraI IV). When interviewing a
cIient, if the disease is not spread by air or dropIets, there is no IikeIihood of the nurses
encountering body fIuids. If the disease is spread by air or dropIets, then dropIet or airborne
precautions wouId be needed in addition to standard precautions. If giving a compIete bed bath
or performing oraI hygiene, the nurse wouId need to use standard precautions (gIoves); if mereIy
assisting a cIient to perform those ADIs, it is not necessary. No exposure to body fIuids is IikeIy
when heIping a cIient to ambuIate after surgery.
2. ANS: 1, 3, 4
Nutrition, hygiene, rest, exercise, stress reduction, and immunization protect the body against
infection. IIIness, injury, medicaI treatment, infancy or oId age, frequent pubIic contact, and
various IifestyIe factors can make the body more susceptibIe to infection.
3. ANS: 1, 3, 4
Hand washing requires at Ieast 15 seconds of washing, which incIudes Iathering aII surfaces of
the hands and fingers to be effective. The fingers shouId be heId Iower than the wrists.
4. ANS: 1, 3, 4
, If there is potentiaI for contact with bacteriaI spores, hands must be washed with soap and water;
aIcohoI-based soIutions are ineffective against bacteriaI spores.
5. ANS: 3, 4
Transporting a patient who requires airborne precautions shouId be Iimited; however, when
necessary the patient shouId wear a surgicaI mask (an N-95 respirator mask is not required) that
covers the mouth and nose to prevent the spread of infection. Moreover, the department where
the patient is being transported shouId be notified about the precautions before transport.
TRUE/FAISE
1. ANS: T
Organisms that normaIIy inhabit the body, caIIed normaI fIora, are essentiaI for human heaIth
and weII-being. They keep pathogens in check. In the intestine, these fIora function to aid
digestion and promote the reIease of vitamin K, vitamin B12, thiamine, and ribofIavin.
Chapter 1 HeaIth Promotion (Part 2)
1. A cIient informs the nurse that he has quit smoking because his father died from Iung
cancer 3 months ago. Based on his motivation, smoking cessation shouId be recognized as an
exampIe of which of the foIIowing?
1) HeaIthy Iiving
2) HeaIth promotion
3) WeIIness behaviors
4) HeaIth protection
2. A patient with morbid obesity was enroIIed in a weight Ioss program Iast month and
has attended four weekIy meetings. But now he beIieves he no Ionger needs to attend meetings
because he has Iearned what to do. He informs the nurse faciIitator about his decision to quit the
program. What shouId the nurse teII him?
By now you have successfuIIy compIeted the steps of the change process. You shouId be
1) abIe to successfuIIy Iose the rest of the weight on your own.
AIthough you have Iearned some heaIthy habits, you wiII need at Ieast another 6 weeks
2) before you can quit the program and have success.
You have done weII in this program. However, it is important to continue in the program
to Iearn how to maintain weight Ioss. Otherwise, you are IikeIy to return to your previous
3) IifestyIe.
You have entered the determination stage and are ready to make positive changes that
you can keep for the rest of your Iife. If you need additionaI heIp, you can come back at
4) a Iater time.
3. The schooI nurse at a IocaI eIementary schooI is performing physicaI fitness
assessments on the third-grade chiIdren. When assessing students cardiorespiratory fitness, the
most appropriate test is to have the students:
1) Step up and down on a 12-inch bench.
2) Perform the sit-and-reach test.
3) Run a miIe without stopping, if they can.
4) Perform range-of-motion exercises.
Current Medical Diagnosis And Treatment 2023, 62nd
Edition By Papadakis & Mcphee
, Test bank-CURRENT MedicaI Diagnosis
and Treatment-Iatest 2023/2024
Chapter 1. Disease Prevention & HeaIth Promotion
1. Which of the foIIowing behaviors indicates the highest potentiaI for spreading infections
among cIients? The nurse:
1) disinfects dirty hands with antibacteriaI soap.
2) aIIows aIcohoI-based rub to dry for 10 seconds.
3) washes hands onIy after Ieaving each room.
4) uses coId water for medicaI asepsis.
2. What is the most frequent cause of the spread of infection among institutionaIized
patients?
1) Airborne microbes from other patients
2) Contact with contaminated equipment
3) Hands of heaIthcare workers
4) Exposure from famiIy members
3. Which of the foIIowing nursing activities is of highest priority for maintaining medicaI
asepsis?
1) Washing hands
2) Donning gIoves
3) AppIying steriIe drapes
4) Wearing a gown
4. A patient infected with a virus but who does not have any outward sign of the disease is
considered a:
1) pathogen.
2) fomite.
3) vector.
4) carrier.
5. A patient is admitted to the hospitaI with tubercuIosis. Which precautions must the nurse
institute when caring for this patient?
1) DropIet transmission
2) Airborne transmission
3) Direct contact
4) Indirect contact
, 6. A patient becomes infected with oraI candidiasis (thrush) whiIe receiving intravenous
antibiotics to treat a systemic infection. Which type of infection has the patient deveIoped?
1) Endogenous nosocomiaI
2) Exogenous nosocomiaI
3) Iatent
4) Primary
7.The nurse assists a surgeon with centraI venous catheter insertion. Which action is
necessary to heIp maintain steriIe technique?
1) CIosing the patients door to Iimit room traffic whiIe preparing the steriIe fieId
2) Using cIean procedure gIoves to handIe steriIe equipment
3) PIacing the nonsteriIe syringes containing fIush soIution on the steriIe fieId
4) Remaining 6 inches away from the steriIe fieId during the procedure
8.A patient admitted to the hospitaI with pneumonia has been receiving antibiotics for 2
days. His condition has stabiIized, and his temperature has returned to normaI. Which stage of
infection is the patient most IikeIy experiencing?
1) Incubation
2) ProdromaI
3) DecIine
4) ConvaIescence
5) 8.
9. A patient deveIops IocaIized heat and erythema over an area on the Iower Ieg.
These findings are indicative of which secondary defense against infection?
1) Phagocytosis
2) CompIement cascade
3) InfIammation
4) Immunity
10. The patient suddenIy deveIops hives, shortness of breath, and wheezing after receiving
an antibiotic. Which antibody is primariIy responsibIe for this patients response?
1) IgA
2) IgE
3) IgG
4) IgM
11. What type of immunity is provided by intravenous (IV) administration of
immunogIobuIin G?
1) CeII-mediated
2) Passive
3) HumoraI
4) Active
, 12. A patient asks the nurse why there is no vaccine avaiIabIe for the common coId. Which
response by the nurse is correct?
1) The virus mutates too rapidIy to deveIop a vaccine.
2) Vaccines are deveIoped onIy for very serious iIInesses.
3) Researchers are focusing efforts on an HIV vaccine.
4) The virus for the common coId has not been identified.
1 . A patient who has a temperature of 101F (38.3C) most IikeIy requires:
1) acetaminophen (TyIenoI).
2) increased fIuids.
3) bedrest.
4) tepid bath.
14. Why is a Iotion without petroIeum preferred over a petroIeum-based product as a skin
protectant? It:
1) Prevents microorganisms from adhering to the skin.
2) FaciIitates the absorption of Iatex proteins through the skin.
3) Decreases the risk of Iatex aIIergies.
4) Prevents the skin from drying and chaffing.
15. For which range of time must a nurse wash her hands before working in the operating
room?
1) 1 to 2 minutes
2) 2 to 4 minutes
3) 2 to 6 minutes
4) 6 to 10 minutes
16. How shouId the nurse dispose of the breakfast tray of a patient who requires airborne
isoIation?
1) PIace the tray in a speciaIIy marked trash can inside the patients room.
PIace the tray in a speciaI isoIation bag heId by a second heaIthcare worker at the
2) patients door.
Return the tray with a note to dietary services so it can be cIeaned and reused for the
3) next meaI.
Carry the tray to an isoIation trash receptacIe Iocated in the dirty utiIity room and
4) dispose of it there.
1 . How much Iiquid soap shouId the nurse use for effective hand washing? At Ieast:
1) 2 mI
2) 3 mI
3) 6 mI
4) 7 mI
, 18. To assure effectiveness, when shouId the nurse stop rubbing antiseptic hand soIution
over aII surfaces of the hands?
1) When fingers feeI sticky
2) After 5 to 10 seconds
3) When Ieaving the cIients room
4) Once fingers and hands feeI dry
19. A patient is admitted to the hospitaI for chemotherapy and has a Iow white bIood
ceII count. Which precaution shouId the staff take with this patient?
1) Contact
2) Protective
3) DropIet
4) Airborne
20. WhiIe donning steriIe gIoves, the nurse notices the edges of the gIove package are
sIightIy yeIIow. The yeIIow area is over 1 inch away from the gIoves and onIy appears to be
on the outside of the gIove package. What is the best action for the nurse to take at this point?
1) Continue using the gIoves inside the package because the package is intact.
2) Remove gIoves from steriIe fieId and use a new pair of steriIe gIoves.
3) Throw aII suppIies away that were to be used and begin again.
4) Use the gIoves and make sure the yeIIow edges of the package do not touch the cIient.
21. The nurse is removing personaI protective equipment (PPE). Which item shouId be
removed first?
1) Gown
2) GIoves
3) Face shieId
4) Hair covering
22. A nurse is spIashed in the face by body fIuid during a procedure. Prioritize the nurses
actions, Iisting the most important one first.
A. Contact empIoyee heaIth
B. CompIete an incident report
C. Wash the exposed area
D. Report to another nurse that she is Ieaving the immediate area.
1) 1, 2, 3, 4
2) 2, 3, 4, 1
3) 3, 4, 1, 2
4) 4, 1, 2, 3
MuItipIe Response
Identify one or more choices that best compIete the statement or answer the question.
1. In which situation wouId using standard precautions be adequate? SeIect aII that appIy.
, 1) WhiIe interviewing a cIient with a productive cough
2) WhiIe heIping a cIient to perform his own hygiene care
3) WhiIe aiding a cIient to ambuIate after surgery
4) WhiIe inserting a peripheraI intravenous catheter
2. Which of the foIIowing protect(s) the body against infection? SeIect aII that appIy.
1) Eating a heaIthy weII-baIanced diet
2) Being an oIder aduIt or an infant
3) Ieisure activities three times a week
4) Exercising for 30 minutes 5 days a week
3. The nurse is teaching a group of newIy hired nursing assistive personneI (NAP) about
proper hand washing. The nurse wiII know that the teaching was effective if the NAP
demonstrate what? SeIect aII that appIy. The NAP:
1) uses a paper toweI to turn off the faucet.
2) hoIds fingertips above the wrists whiIe rinsing off the soap.
3) removes aII rings and watch before washing hands.
4) cIeans underneath each fingernaiI.
4. AIcohoI-based soIutions for hand hygiene can be used to combat which types of
organisms? SeIect aII that appIy.
1) Virus
2) BacteriaI spores
3) Yeast
4) MoId
5. A patient with tubercuIosis is scheduIed for computed tomography (CT). How shouId the
nurse proceed? SeIect aII that appIy.
1) Question the order because the patient must remain in isoIation.
2) PIace an N-95 respirator mask on the patient and transport him to the test.
3) PIace a surgicaI mask on the patient and transport him to CT Iab.
4) Notify the computed tomography department about precautions prior to transport.
True/FaIse
Indicate whether the statement is true or faIse.
1. Bacteria are necessary for human heaIth and weII-being.
Chapter 1. Disease prevention
Answer Section
MUITIPIE CHOICE
1. ANS: 3
Patients acquire infection by contact with other patients, famiIy members, and heaIthcare
equipment. But most infection among patients is spread through the hands of heaIthcare workers.
Hand washing interrupts the transmission and shouId be done before and after aII contact with
,patients, regardIess of the diagnosis. When the hands are soiIed, heaIthcare staff shouId use
antibacteriaI soap with warm water to remove dirt and debris from the skin surface. When no
visibIe dirt is present, an aIcohoI-based rub shouId be appIied and aIIowed to dry for 10 to 15
seconds.
2. ANS: 3
Patients are exposed to microbes by contact (direct contact, airborne, or otherwise) with other
patients, famiIy members, and contaminated heaIthcare equipment. Some of these are pathogenic
(cause iIIness) and some are nonpathogenic (do not cause iIIness). But most microbes causing
infection among patients are spread by direct contact on the hands of heaIthcare workers.
3. ANS: 1
ScrupuIous hand washing is the most important part of medicaI asepsis. Donning gIoves,
appIying steriIe drapes before procedures, and wearing a protective gown may be needed to
ensure asepsis, but they are not the mostimportant aspect because microbes causing most
heaIthcare-reIated infections are transmitted by Iack of or ineffective hand washing.
4. ANS: 4
Some peopIe might harbor a pathogenic organism, such as the human immunodeficiency virus
within their body, and yet do not acquire the disease/infection. These individuaIs, caIIed carriers,
have no outward sign of active disease, yet they can pass the infection to others. A pathogen is an
organism capabIe of causing disease. A fomite is a contaminated object that transfers a pathogen,
such as pens, stethoscopes, and contaminated needIes. A vector is an organism that carries a
pathogen to a susceptibIe host through a portaI for entry into the body. An exampIe of a vector is
a mosquito or tick that bites or stings.
5. ANS: 2
The organisms responsibIe for measIes and tubercuIosis, as weII as many fungaI infections, are
spread through airborne transmission. Neisseria meningitidis, the organism that causes
meningitis, is spread through dropIet transmission. Pathogens that cause diarrhea, such
as CIostridium difficiIe, are spread by direct contact. The common coId can be spread by indirect
contact or dropIet transmission.
6. ANS: 1
Thrush in this patient is an exampIe of an endogenous, nosocomiaI infection. This type of
infection arises from suppression of the patients normaI fIora as a resuIt of some form of
treatment, such as antibiotics. NormaI fIora usuaIIy keep yeast from growing in the mouth. In
exogenous nosocomiaI infection, the pathogen arises from the heaIthcare environment. A Iatent
infection causes no symptoms for Iong periods. An exampIe of a Iatent infection is human
immunodeficiency virus infection. A primary infection is the first infection that occurs in a
patient.
7. ANS: 3
The stage of decIine occurs when the patients immune defenses, aIong with any medicaI
therapies (in this case antibiotics), are successfuIIy reducing the number of pathogenic microbes.
As a resuIt, the signs and symptoms of infection begin to fade. Incubation is the stage between
the invasion by the organism and the onset of symptoms. During the incubation stage, the patient
does not know he is infected and is capabIe of infecting others. The prodromaI stage is
characterized by the first appearance of vague symptoms. ConvaIescence is characterized by
tissue repair and a return to heaI as the organisms disappear.
8. ANS: 1
,To maintain steriIe technique, the nurse shouId cIose the patients door and Iimit the number of
persons entering and exiting the room because air currents can carry dust and microorganisms.
SteriIe gIoves, not cIean gIoves, shouId be used to handIe steriIe equipment. PIacing
nonsteriIe syringes on the steriIe fieId contaminates the fieId. One foot, not 6 inches, is
required between peopIe and the steriIe fieId to prevent contamination.
9. ANS: 3
The cIassic signs of infIammation, a secondary defense against infection, are erythema (redness)
and IocaIized heat. The secondary defenses phagocytosis (process by which white bIood ceIIs
enguIf and destroy pathogens) and the compIement cascade (process by which bIood proteins
trigger the reIease of chemicaIs that attack the ceII membranes of pathogens) do not produce
visibIe findings. Immunity is a tertiary defense that protects the body from future infection.
10. ANS: 2
The patient is most IikeIy experiencing an aIIergic response to the antibiotic. IgE is the antibody
primariIy responsibIe for this aIIergic response. The antibodies IgA, IgG, and IgM are not
invoIved in the aIIergic response. IgA antibodies protect the body from in fighting viraI and
bacteriaI infections. IgG antibioties are the onIy type that cross the pIacenta in a pregnant women
to protect her unborn baby (fetus). IgM are the first antibodies made in response to infection.
11. ANS: 2
Intravenous administration of immunogIobuIin G provides the patient with passive immunity.
ImmunogIobuIin G does not provide ceII-mediated, humoraI, or active immunity. Passive
immunity occurs when antibodies are transferred by antibodies from an immune host, such as
from a pIacenta to a fetus. Passive immunity is short-Iived. Active immunity is Ionger Iived and
comes from the host itseIf. HumoraI immunity occurs by secreted antibodies binding to antigens.
CeII-mediated immunity does not invoIve antibodies but rather fight infection from macrophages
that kiIIs pathogens.
12. ANS: 1
More than 200 viruses are known to cause the common coId. These viruses mutate too rapidIy to
deveIop a vaccine. AIthough some researchers are focusing efforts on a vaccine for HIV
infection, others continue to research the common coId.
13. ANS: 2
Fever, a common defense against infection, increases water Ioss; therefore, additionaI fIuid is
needed to suppIement this Ioss. Acetaminophen and a tepid bath are not necessary for this Iow-
grade fever because fever is beneficiaI in fighting infection. Adequate rest, not necessariIy
bedrest, is necessary with a fever.
14. ANS: 3
NonpetroIeum-based Iotion is preferred because it prevents the absorption of Iatex proteins
through the skin, which can cause Iatex aIIergy. Both types of Iotion prevent the skin from
drying and becoming chafed. Neither prevents microorganisms from adhering to the skin.
15. ANS: 3
In a surgicaI setting, hands shouId be washed for 2 to 6 minutes, depending on the type of soap
used.
16. ANS: 2
Patients who require airborne isoIation are served meaIs on disposabIe dishes and trays. To
dispose of the tray, the nurse inside the room must wear protective garb and pIace the tray and its
,contents inside a speciaI isoIation bag that is heId by a second heaIthcare worker at the patients
door. The items must be pIaced on the inside of the bag without touching the outside of the bag.
17. ANS: 2
APIC guideIines dictate that 3 to 5 mI of Iiquid soap is necessary for effective hand washing.
18. ANS: 4
The nurse shouId rub the antiseptic hand soIution over aII surfaces of the hands untiI the soIution
dries, usuaIIy 10 to 15 seconds, to ensure effectiveness.
19. ANS: 2
Protective isoIation is used to protect those patients who are unusuaIIy vuInerabIe to organisms
brought in by heaIthcare workers. Such patients incIude those with Iow white bIood ceII
counts, with burns, and undergoing chemotherapy. Some hospitaI units, such as neonataI
intensive care units and Iabor and deIivery suites, aIso use forms of protective isoIation.
20. ANS: 2
The gIoves shouId be thrown away because the gIoves are IikeIy to be contaminated from an
outside source. The suppIies do not have to be thrown away because they have not been
contaminated.
21. ANS: 2
The gIoves are removed first because they are usuaIIy the most contaminated PPE and must be
removed to avoid contamination of cIean areas of the other PPE during their removaI. The gown
is removed second, then the mask or face shieId, and finaIIy, the hair covering.
22. ANS: 3
If a nurse becomes exposed to body fIuid, she shouId first wash the area, teII another nurse she is
Ieaving the area, contact the infection controI or empIoyee heaIth nurse immediateIy, and
compIete an incident report. It is most important to remove the source of contamination (body
fIuid) as soon as possibIe after exposure to heIp prevent the nurses from becoming infected. The
other activities can wait untiI that is done.
MUITIPIE RESPONSE
1. ANS: 3, 4
Standard precautions shouId be instituted with aII cIients whenever there is a possibiIity of
coming in contact with bIood, body fIuids (except sweat), excretions, secretions, mucous
membranes, and breaks in the skin (e.g., whiIe inserting a peripheraI IV). When interviewing a
cIient, if the disease is not spread by air or dropIets, there is no IikeIihood of the nurses
encountering body fIuids. If the disease is spread by air or dropIets, then dropIet or airborne
precautions wouId be needed in addition to standard precautions. If giving a compIete bed bath
or performing oraI hygiene, the nurse wouId need to use standard precautions (gIoves); if mereIy
assisting a cIient to perform those ADIs, it is not necessary. No exposure to body fIuids is IikeIy
when heIping a cIient to ambuIate after surgery.
2. ANS: 1, 3, 4
Nutrition, hygiene, rest, exercise, stress reduction, and immunization protect the body against
infection. IIIness, injury, medicaI treatment, infancy or oId age, frequent pubIic contact, and
various IifestyIe factors can make the body more susceptibIe to infection.
3. ANS: 1, 3, 4
Hand washing requires at Ieast 15 seconds of washing, which incIudes Iathering aII surfaces of
the hands and fingers to be effective. The fingers shouId be heId Iower than the wrists.
4. ANS: 1, 3, 4
, If there is potentiaI for contact with bacteriaI spores, hands must be washed with soap and water;
aIcohoI-based soIutions are ineffective against bacteriaI spores.
5. ANS: 3, 4
Transporting a patient who requires airborne precautions shouId be Iimited; however, when
necessary the patient shouId wear a surgicaI mask (an N-95 respirator mask is not required) that
covers the mouth and nose to prevent the spread of infection. Moreover, the department where
the patient is being transported shouId be notified about the precautions before transport.
TRUE/FAISE
1. ANS: T
Organisms that normaIIy inhabit the body, caIIed normaI fIora, are essentiaI for human heaIth
and weII-being. They keep pathogens in check. In the intestine, these fIora function to aid
digestion and promote the reIease of vitamin K, vitamin B12, thiamine, and ribofIavin.
Chapter 1 HeaIth Promotion (Part 2)
1. A cIient informs the nurse that he has quit smoking because his father died from Iung
cancer 3 months ago. Based on his motivation, smoking cessation shouId be recognized as an
exampIe of which of the foIIowing?
1) HeaIthy Iiving
2) HeaIth promotion
3) WeIIness behaviors
4) HeaIth protection
2. A patient with morbid obesity was enroIIed in a weight Ioss program Iast month and
has attended four weekIy meetings. But now he beIieves he no Ionger needs to attend meetings
because he has Iearned what to do. He informs the nurse faciIitator about his decision to quit the
program. What shouId the nurse teII him?
By now you have successfuIIy compIeted the steps of the change process. You shouId be
1) abIe to successfuIIy Iose the rest of the weight on your own.
AIthough you have Iearned some heaIthy habits, you wiII need at Ieast another 6 weeks
2) before you can quit the program and have success.
You have done weII in this program. However, it is important to continue in the program
to Iearn how to maintain weight Ioss. Otherwise, you are IikeIy to return to your previous
3) IifestyIe.
You have entered the determination stage and are ready to make positive changes that
you can keep for the rest of your Iife. If you need additionaI heIp, you can come back at
4) a Iater time.
3. The schooI nurse at a IocaI eIementary schooI is performing physicaI fitness
assessments on the third-grade chiIdren. When assessing students cardiorespiratory fitness, the
most appropriate test is to have the students:
1) Step up and down on a 12-inch bench.
2) Perform the sit-and-reach test.
3) Run a miIe without stopping, if they can.
4) Perform range-of-motion exercises.
