TREATMENT 2023/2024 62ND EDITION BY BY MAXINE and Treatment-latest 2023/2024
PAPADAKIS
Chapter 1. Disease Prevention & Health Promotion
1. Which of the following behaviors indicates the highest potential for spreading infections
among clients? The nurse:
1) disinfects dirty hands with antibacterial soap.
2) allows alcohol-based rub to dry for 10 seconds.
3) washes hands only after leaving each room.
4) uses cold water for medical asepsis.
2. What is the most frequent cause of the spread of infection among institutionalized
patients?
1) Airborne microbes from other patients
2) Contact with contaminated equipment
3) Hands of healthcare workers
4) Exposure from family members
3. Which of the following nursing activities is of highest priority for maintaining medical
asepsis?
1) Washing hands
2) Donning gloves
3) Applying sterile 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 hospital with tuberculosis. Which precautions must the nurse
institute when caring for this patient?
1) Droplet transmission
2) Airborne transmission
3) Direct contact
4) Indirect contact
, 6. A patient becomes infected with oral candidiasis (thrush) while receiving intravenous 12. A patient asks the nurse why there is no vaccine available for the common cold. Which
antibiotics to treat a systemic infection. Which type of infection has the patient developed? response by the nurse is correct?
1) Endogenous nosocomial 1) The virus mutates too rapidly to develop a vaccine.
2) Exogenous nosocomial 2) Vaccines are developed only for very serious illnesses.
3) Latent 3) Researchers are focusing efforts on an HIV vaccine.
4) Primary 4) The virus for the common cold has not been identified.
7.The nurse assists a surgeon with central venous catheter insertion. Which action is 1 . A patient who has a temperature of 101F (38.3C) most likely requires:
necessary to help maintain sterile technique? 1) acetaminophen (Tylenol).
1) Closing the patients door to limit room traffic while preparing the sterile field 2) increased fluids.
2) Using clean procedure gloves to handle sterile equipment 3) bedrest.
3) Placing the nonsterile syringes containing flush solution on the sterile field 4) tepid bath.
4) Remaining 6 inches away from the sterile field during the procedure 14. Why is a lotion without petroleum preferred over a petroleum-based product as a skin
____8.A patient admitted to the hospital with pneumonia has been receiving antibiotics for 2 protectant? It:
days. His condition has stabilized, and his temperature has returned to normal. Which stage of 1) Prevents microorganisms from adhering to the skin.
infection is the patient most likely experiencing?
2) Facilitates the absorption of latex proteins through the skin.
1) Incubation
3) Decreases the risk of latex allergies.
2) Prodromal
4) Prevents the skin from drying and chaffing.
3) Decline
15. For which range of time must a nurse wash her hands before working in the operating
4) Convalescence room?
5) 8.
1) 1 to 2 minutes
9. A patient develops localized heat and erythema over an area on the lower leg. These
findings are indicative of which secondary defense against infection? 2) 2 to 4 minutes
1) Phagocytosis 3) 2 to 6 minutes
2) Complement cascade 4) 6 to 10 minutes
3) Inflammation 16. How should the nurse dispose of the breakfast tray of a patient who requires airborne
isolation?
4) Immunity
1) Place the tray in a specially marked trash can inside the patients room.
10. The patient suddenly develops hives, shortness of breath, and wheezing after receiving
an antibiotic. Which antibody is primarily responsible for this patients response? Place the tray in a special isolation bag held by a second healthcare worker at the
1) IgA 2) patients door.
2) IgE Return the tray with a note to dietary services so it can be cleaned and reused for the
3) next meal.
3) IgG
Carry the tray to an isolation trash receptacle located in the dirty utility room and
4) IgM 4) dispose of it there.
11. What type of immunity is provided by intravenous (IV) administration of 1 . How much liquid soap should the nurse use for effective hand washing? At least:
immunoglobulin G?
1) 2 mL
1) Cell-mediated
2) 3 mL
2) Passive
3) 6 mL
3) Humoral
4) 7 mL
4) Active
, 18. To assure effectiveness, when should the nurse stop rubbing antiseptic hand solution 1) While interviewing a client with a productive cough
over all surfaces of the hands?
2) While helping a client to perform his own hygiene care
1) When fingers feel sticky
3) While aiding a client to ambulate after surgery
2) After 5 to 10 seconds
4) While inserting a peripheral intravenous catheter
3) When leaving the clients room
2. Which of the following protect(s) the body against infection? Select all that apply.
4) Once fingers and hands feel dry 1) Eating a healthy well-balanced diet
19. A patient is admitted to the hospital for chemotherapy and has a low white blood cell
2) Being an older adult or an infant
count. Which precaution should the staff take with this patient?
1) Contact 3) Leisure activities three times a week
2) Protective 4) Exercising for 30 minutes 5 days a week
3. The nurse is teaching a group of newly hired nursing assistive personnel (NAP) about
3) Droplet
proper hand washing. The nurse will know that the teaching was effective if the NAP
4) Airborne demonstrate what? Select all that apply. The NAP:
20. While donning sterile gloves, the nurse notices the edges of the glove package are 1) uses a paper towel to turn off the faucet.
slightly yellow. The yellow area is over 1 inch away from the gloves and only appears to be on
the outside of the glove package. What is the best action for the nurse to take at this point? 2) holds fingertips above the wrists while rinsing off the soap.
1) Continue using the gloves inside the package because the package is intact. 3) removes all rings and watch before washing hands.
2) Remove gloves from sterile field and use a new pair of sterile gloves. 4) cleans underneath each fingernail.
3) Throw all supplies away that were to be used and begin again. 4. Alcohol-based solutions for hand hygiene can be used to combat which types of
organisms? Select all that apply.
4) Use the gloves and make sure the yellow edges of the package do not touch the client.
1) Virus
21. The nurse is removing personal protective equipment (PPE). Which item should be
removed first? 2) Bacterial spores
1) Gown 3) Yeast
2) Gloves 4) Mold
3) Face shield 5. A patient with tuberculosis is scheduled for computed tomography (CT). How should the
nurse proceed? Select all that apply.
4) Hair covering
1) Question the order because the patient must remain in isolation.
22. A nurse is splashed in the face by body fluid during a procedure. Prioritize the nurses
actions, listing the most important one first. 2) Place an N-95 respirator mask on the patient and transport him to the test.
A. Contact employee health 3) Place a surgical mask on the patient and transport him to CT lab.
B. Complete an incident report 4) Notify the computed tomography department about precautions prior to transport.
C. Wash the exposed area
D. Report to another nurse that she is leaving the immediate area. True/False
Indicate whether the statement is true or false.
1) 1, 2, 3, 4 1. Bacteria are necessary for human health and well-being.
2) 2, 3, 4, 1 Chapter 1. Disease prevention
3) 3, 4, 1, 2 Answer Section
MULTIPLE CHOICE
4) 4, 1, 2, 3 1. ANS: 3
Multiple Response Patients acquire infection by contact with other patients, family members, and healthcare
Identify one or more choices that best complete the statement or answer the question. equipment. But most infection among patients is spread through the hands of healthcare workers.
1. In which situation would using standard precautions be adequate? Select all that apply. Hand washing interrupts the transmission and should be done before and after all contact with
, patients, regardless of the diagnosis. When the hands are soiled, healthcare staff should use To maintain sterile technique, the nurse should close the patients door and limit the number of
antibacterial soap with warm water to remove dirt and debris from the skin surface. When no persons entering and exiting the room because air currents can carry dust and microorganisms.
visible dirt is present, an alcohol-based rub should be applied and allowed to dry for 10 to 15 Sterile gloves, not clean gloves, should be used to handle sterile equipment. Placing nonsterile
seconds. syringes on the sterile field contaminates the field. One foot, not 6 inches, is required between
2. ANS: 3 people and the sterile field to prevent contamination.
Patients are exposed to microbes by contact (direct contact, airborne, or otherwise) with other 9. ANS: 3
patients, family members, and contaminated healthcare equipment. Some of these are pathogenic The classic signs of inflammation, a secondary defense against infection, are erythema (redness)
(cause illness) and some are nonpathogenic (do not cause illness). But most microbes causing and localized heat. The secondary defenses phagocytosis (process by which white blood cells
infection among patients are spread by direct contact on the hands of healthcare workers. engulf and destroy pathogens) and the complement cascade (process by which blood proteins
3. ANS: 1 trigger the release of chemicals that attack the cell membranes of pathogens) do not produce
Scrupulous hand washing is the most important part of medical asepsis. Donning gloves, visible findings. Immunity is a tertiary defense that protects the body from future infection.
applying sterile 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 10. ANS: 2
healthcare-related infections are transmitted by lack of or ineffective hand washing. The patient is most likely experiencing an allergic response to the antibiotic. IgE is the antibody
4. ANS: 4 primarily responsible for this allergic response. The antibodies IgA, IgG, and IgM are not
Some people might harbor a pathogenic organism, such as the human immunodeficiency virus involved in the allergic response. IgA antibodies protect the body from in fighting viral and
within their body, and yet do not acquire the disease/infection. These individuals, called carriers, bacterial infections. IgG antibioties are the only type that cross the placenta in a pregnant women
have no outward sign of active disease, yet they can pass the infection to others. A pathogen is an to protect her unborn baby (fetus). IgM are the first antibodies made in response to infection.
organism capable of causing disease. A fomite is a contaminated object that transfers a pathogen, 11. ANS: 2
such as pens, stethoscopes, and contaminated needles. A vector is an organism that carries a Intravenous administration of immunoglobulin G provides the patient with passive immunity.
pathogen to a susceptible host through a portal for entry into the body. An example of a vector is Immunoglobulin G does not provide cell-mediated, humoral, or active immunity. Passive
a mosquito or tick that bites or stings. immunity occurs when antibodies are transferred by antibodies from an immune host, such as
5. ANS: 2 from a placenta to a fetus. Passive immunity is short-lived. Active immunity is longer lived and
The organisms responsible for measles and tuberculosis, as well as many fungal infections, are comes from the host itself. Humoral immunity occurs by secreted antibodies binding to antigens.
spread through airborne transmission. Neisseria meningitidis, the organism that causes Cell-mediated immunity does not involve antibodies but rather fight infection from macrophages
meningitis, is spread through droplet transmission. Pathogens that cause diarrhea, such that kills pathogens.
as Clostridium difficile, are spread by direct contact. The common cold can be spread by indirect 12. ANS: 1
contact or droplet transmission. More than 200 viruses are known to cause the common cold. These viruses mutate too rapidly to
6. ANS: 1 develop a vaccine. Although some researchers are focusing efforts on a vaccine for HIV
Thrush in this patient is an example of an endogenous, nosocomial infection. This type of infection, others continue to research the common cold.
infection arises from suppression of the patients normal flora as a result of some form of
treatment, such as antibiotics. Normal flora usually keep yeast from growing in the mouth. In 13. ANS: 2
exogenous nosocomial infection, the pathogen arises from the healthcare environment. A latent Fever, a common defense against infection, increases water loss; therefore, additional fluid is
infection causes no symptoms for long periods. An example of a latent infection is human needed to supplement this loss. Acetaminophen and a tepid bath are not necessary for this low-
immunodeficiency virus infection. A primary infection is the first infection that occurs in a grade fever because fever is beneficial in fighting infection. Adequate rest, not necessarily
patient. bedrest, is necessary with a fever.
7. ANS: 3 14. ANS: 3
The stage of decline occurs when the patients immune defenses, along with any medical Nonpetroleum-based lotion is preferred because it prevents the absorption of latex proteins
therapies (in this case antibiotics), are successfully reducing the number of pathogenic microbes. through the skin, which can cause latex allergy. Both types of lotion prevent the skin from drying
As a result, the signs and symptoms of infection begin to fade. Incubation is the stage between and becoming chafed. Neither prevents microorganisms from adhering to the skin.
the invasion by the organism and the onset of symptoms. During the incubation stage, the patient 15. ANS: 3
does not know he is infected and is capable of infecting others. The prodromal stage is In a surgical setting, hands should be washed for 2 to 6 minutes, depending on the type of soap
characterized by the first appearance of vague symptoms. Convalescence is characterized by used.
tissue repair and a return to heal as the organisms disappear. 16. ANS: 2
8. ANS: 1 Patients who require airborne isolation are served meals on disposable dishes and trays. To
dispose of the tray, the nurse inside the room must wear protective garb and place the tray and its