NURS 642 TEST 2 UPDATED ACTUAL
Exam Questions and CORRECT Answers
Most common cause of hospital acquired infection? - CORRECT ANSWER - catheter
associated UTI
What should happen if a patient presents with existing foley? - CORRECT ANSWER -
Change the foley, if possible just remove the foley and not replace
How to reduce HAIs - CORRECT ANSWER - use proper hand hygiene recommendations,
follow infection prevention protocols, keep patients in the best possible physical conditions to
help them fight infections, and learn to deal with multi drug resistant organisms, remove lines if
possible.
Systemic signs of infection - CORRECT ANSWER - delirium, lethargy, fever or
hypothermia, tachycardia, hypotension
Anatomic site of infection you take into account what? - CORRECT ANSWER -
proximity to vital structures or joints
Presence of purulence can indicate what? - CORRECT ANSWER - infection
When do symptoms of necrotizing infection occur? - CORRECT ANSWER - late in the
process
Symptoms of necrotizing inection - CORRECT ANSWER - pain disproportionate to
physical findings
violaceous bullae, cutaneous hemorrhage, skin sloughing, skin anesthesia, rapid progression, gas
in tissue
Most effective preventative measure of infection? - CORRECT ANSWER - handwashing
,what percentage of patients acquire a Healthcare associated infection? - CORRECT
ANSWER - 10%
Most common types of HAI infections? - CORRECT ANSWER - UTI from indwelling
catheters or procedures
blood stream infection from catheter or secondary sites
pneumonia of intubated unconscious patient
SSI
MRSA
CDIFF
Preventative measures (aside from handwashing) of HAI? - CORRECT ANSWER - early
removal of invasive devices or lines
limit spectrum of antibiotic coverage and unnecessary duration to prevent multidrug resistance
What are indications for line removal? - CORRECT ANSWER - -purulence at insertion
site
-S.areus, candida, or gram neg rods
-persistent bacteremia (>48hr on abx)
-complications (thromboemboli)
What is empiric antibiotics - CORRECT ANSWER - vanco for MRSA
consider gram neg coverage for immunocompromised/critically ill
treatment if patient presents with UTI symptoms and a foley present - CORRECT
ANSWER - -remove foley
-treat with 7 days abx specific to culture results
-treat for 14 days if fever, back pain, leukocytosis, or suggest pyelonephritis
, SSI (surgical site infection) prevention - CORRECT ANSWER - prophylactic abx IV at
induction of anesthesia or 30-60min prior to skin incision
Treatment for SSI? - CORRECT ANSWER - most common pathogens postop wound
infection are: S.Areus, coagulase-neg staph.
Tx: opening wound, drainage, debriding, culturing, and antibiotics
empiric coverage driven for gram stain for patients with SSI include? - CORRECT
ANSWER - MRSA- vanc
(linezolid if vanc allergy)
s/s, evaluation, and management of cholecystitis: - CORRECT ANSWER - S/s:
RUQ/epigastric pain, fever, nausea, vomiting, murphy sign
eval: blood cultures, RUQ US, amylase, lipase
mgt: admission to hospital, cholecystectomy, antibiotics
presentation of pancreatitis- acute and chronic - CORRECT ANSWER - acute: presents
with gallstone obstruction of pancreatic duct, chronic excessive alcohol, high triglycerides
(>500), hypercalcemia
Chronic presents: multiple overlapping risk factors of alcohol, tobacco, genetics, autoimmune
disease
does a patient with chronic pancreatitis require surgical consult? - CORRECT ANSWER -
no.
eval and mgt of cholelithiasis - CORRECT ANSWER - eval: labs (cbc, fts, pancreatic
enzymes), transabdominal us
mgt: If patient has cholangitis- tx ERCP or percutaneous biliary drainage. May need ERCP or
elective cholecystectomy
Exam Questions and CORRECT Answers
Most common cause of hospital acquired infection? - CORRECT ANSWER - catheter
associated UTI
What should happen if a patient presents with existing foley? - CORRECT ANSWER -
Change the foley, if possible just remove the foley and not replace
How to reduce HAIs - CORRECT ANSWER - use proper hand hygiene recommendations,
follow infection prevention protocols, keep patients in the best possible physical conditions to
help them fight infections, and learn to deal with multi drug resistant organisms, remove lines if
possible.
Systemic signs of infection - CORRECT ANSWER - delirium, lethargy, fever or
hypothermia, tachycardia, hypotension
Anatomic site of infection you take into account what? - CORRECT ANSWER -
proximity to vital structures or joints
Presence of purulence can indicate what? - CORRECT ANSWER - infection
When do symptoms of necrotizing infection occur? - CORRECT ANSWER - late in the
process
Symptoms of necrotizing inection - CORRECT ANSWER - pain disproportionate to
physical findings
violaceous bullae, cutaneous hemorrhage, skin sloughing, skin anesthesia, rapid progression, gas
in tissue
Most effective preventative measure of infection? - CORRECT ANSWER - handwashing
,what percentage of patients acquire a Healthcare associated infection? - CORRECT
ANSWER - 10%
Most common types of HAI infections? - CORRECT ANSWER - UTI from indwelling
catheters or procedures
blood stream infection from catheter or secondary sites
pneumonia of intubated unconscious patient
SSI
MRSA
CDIFF
Preventative measures (aside from handwashing) of HAI? - CORRECT ANSWER - early
removal of invasive devices or lines
limit spectrum of antibiotic coverage and unnecessary duration to prevent multidrug resistance
What are indications for line removal? - CORRECT ANSWER - -purulence at insertion
site
-S.areus, candida, or gram neg rods
-persistent bacteremia (>48hr on abx)
-complications (thromboemboli)
What is empiric antibiotics - CORRECT ANSWER - vanco for MRSA
consider gram neg coverage for immunocompromised/critically ill
treatment if patient presents with UTI symptoms and a foley present - CORRECT
ANSWER - -remove foley
-treat with 7 days abx specific to culture results
-treat for 14 days if fever, back pain, leukocytosis, or suggest pyelonephritis
, SSI (surgical site infection) prevention - CORRECT ANSWER - prophylactic abx IV at
induction of anesthesia or 30-60min prior to skin incision
Treatment for SSI? - CORRECT ANSWER - most common pathogens postop wound
infection are: S.Areus, coagulase-neg staph.
Tx: opening wound, drainage, debriding, culturing, and antibiotics
empiric coverage driven for gram stain for patients with SSI include? - CORRECT
ANSWER - MRSA- vanc
(linezolid if vanc allergy)
s/s, evaluation, and management of cholecystitis: - CORRECT ANSWER - S/s:
RUQ/epigastric pain, fever, nausea, vomiting, murphy sign
eval: blood cultures, RUQ US, amylase, lipase
mgt: admission to hospital, cholecystectomy, antibiotics
presentation of pancreatitis- acute and chronic - CORRECT ANSWER - acute: presents
with gallstone obstruction of pancreatic duct, chronic excessive alcohol, high triglycerides
(>500), hypercalcemia
Chronic presents: multiple overlapping risk factors of alcohol, tobacco, genetics, autoimmune
disease
does a patient with chronic pancreatitis require surgical consult? - CORRECT ANSWER -
no.
eval and mgt of cholelithiasis - CORRECT ANSWER - eval: labs (cbc, fts, pancreatic
enzymes), transabdominal us
mgt: If patient has cholangitis- tx ERCP or percutaneous biliary drainage. May need ERCP or
elective cholecystectomy
