QUESTIONS AND ANSWERS
Which of the following would be considered a hospital acquired infection?
A. a healthcare worker that develops Hepatitis C
B. an 8-year-old patient admitted with chicken pox
C. a patient who contracts a MRSA infection from a venipuncture
D. a 72-year-old patient in the ER with flu-like symptoms
a patient who contracts a MRSA infection from a venipuncture
Rationale: A nosocomial infection is a "hospital-acquired" infection acquired by a patient
who enters the hospital without any symptoms of it and appears to have acquired the
infection during the hospital stay. A female patient who develops a urinary tract infection
after having a urinary catheter inserted is a perfect example. The other patients were
exposed prior to admission or were never admitted, in the case of the healthcare
worker.
Which of the following best describes the proper way to clean up a broken glass
tube?
A. Use a wet towel and wipe over the area so that minute fragments of glass may
be picked up.
B. Place the pieces of glass on a piece of paper and carry the paper to the red
biohazard bag.
C. Use a paper towel to pick up the pieces of glass and place them in a trash can.
D. Use a broom and dust pan to sweep up the glass and fragments and place in a
sharps container.
Use a broom and dust pan to sweep up the glass and fragments and place in a sharps
container.
Rationale: To prevent exposure to potentially infectious materials, a broom and dust pan
should be used to sweep up the glass and fragments and then they should be placed in
, the sharps container (not a bag). This ensures that no one will touch the glass or any of
the materials that were in the ampule. If a paper towel, piece of paper, or wet towel are
used, the risk of coming into direct contact with the glass is increased.
Which of the following is a site preparation solution required for collecting blood
cultures and blood alcohol levels?
A. hydrogen peroxide
B. soap and water
C. isopropyl alcohol
D. povidone-iodine
povidone-iodine
Rationale: 40. Skin antisepsis is the most critical aspect of blood culture collection,
which requires a higher degree of skin antisepsis than 70% isopropyl alcohol
(isopropanol) is able to provide. Iodine, chlorhexidine gluconate (ChloraPrep), and
benzalkonium chloride are acceptable forms of antisepsis for blood culture collection. If
iodine is used, venipuncture site must be cleansed in concentric circles from the center
(inside) to the periphery (outside) using three separate iodine swabs. Cleansing the site
from clean to dirty allows for optimal antiseptic technique since the microbes are moved
away from the venipuncture site. If ChloraPrep and benzalkonium chloride are used, the
venipuncture site must be cleansed using 30-60 second friction scrub. Higher degree of
skin antisepsis ensures that normal flora from the skin will not contaminate blood culture
bottles and thus prevents false positive blood culture results. Antiseptic used to clean
venipuncture site for blood alcohol level collection cannot contain any alcohol.
ChloraPrep contains alcohol. Benzalkonium chloride does not contain alcohol and
would be an appropriate antiseptic to collect both Blood Cultures and Blood Alcohol
level. Iodine comes in two formulations: one is alcohol based and the other is aqueous
(water) based. Tincture of iodine is made by dissolving iodine in alcohol, while
povidone-iodine (PVP or Betadine) is made by dissolving iodine in water. The most
appropriate antiseptic used to collect both Blood Cultures and Blood Alcohol level is
povidone-iodine.