Infection control HESI prep questions and answers well illustrated.

Infection control HESI prep questions and answers well illustrated. The nurse is changing the central line dressing of a client receiving parenteral nutrition (PN) and notes that the catheter insertion site appears reddened. The nurse should next assess which item? a) Client's temperature b) Expiration date on the bag c) Time of last dressing change d) Tightness of tubing connections - correct answers.a) Client's temperature Rationale: Redness at the catheter insertion site is a possible indication of infection. The nurse would next assess for other signs of infection. Of the options given, the temperature is the next item to assess. The tightness of tubing connections should be assessed each time the PN is checked; loose connections would result in leakage, not skin redness. The expiration date on the bag is a viable option, but this also should be checked at the time the solution is hung and with each shift change. The time of the last dressing change should be checked with each shift change. A client receiving parenteral nutrition (PN) suddenly develops a fever. The nurse notifies the health care provider (HCP), and the HCP initially prescribes that the solution and tubing be changed. What should the nurse do with the discontinued materials? a) Discard them in the unit trash. b) Return them to the hospital pharmacy. c) Send them to the laboratory for culture. d) Save them for return to the manufacturer. - correct answers.c) Send them to the laboratory for culture. Rationale: When the client who is receiving PN develops a fever, a catheter-related infection should be suspected. The solution and tubing should be changed, and the discontinued materials should be cultured for infectious organisms. The other options are incorrect. Because culture for infectious organisms is necessary, the discontinued materials are not discarded or returned to the pharmacy or manufacturer. The community health nurse is providing a teaching session about terrorism to members of the community and is discussing information regarding anthrax. The nurse tells those attending that anthrax can be transmitted by which route(s)? Select all that apply. 1. Bites from ticks or deer flies 2. Inhalation of bacterial spores 3. Through a cut or abrasion in the skin 4. Direct contact with an infected individual 5. Sexual contact with an infected individual 6. Ingestion of contaminated undercooked meat - correct answers.2. Inhalation of bacterial spores 3. Through a cut or abrasion in the skin 6. Ingestion of contaminated undercooked meat Rationale: Anthrax is caused by Bacillus anthracis and can be contracted through the digestive system or abrasions in the skin, or inhaled through the lungs. It cannot be spread from person to person or from animal to person, and it is not contracted via bites from ticks or deer flies. Contact precautions are initiated for a client with a health care-associated (nosocomial) infection caused by methicillin-resistant Staphylococcus aureus. The nurse prepares to provide colostomy care and should obtain which protective items to perform this procedure? a) Gloves and gown b) Gloves and goggles c) Gloves, gown, and shoe protectors d) Gloves, gown, goggles, and face shield - correct answers.d) Gloves, gown, goggles, and face shield Rationale: Splashes of body secretions can occur when providing colostomy care. Goggles and a face shield are worn to protect the face and mucous membranes of the eyes during interventions that may produce splashes of blood, body fluids, secretions, or excretions. In addition, contact precautions require the use of gloves, and a gown should be worn if direct client contact is anticipated. Shoe protectors are not necessary. The nurse is caring for a client with meningococcal pneumonia and implements which transmission-based precautions for this client? a) Private room or cohort client b) Personal respiratory protection device c) Private room with negative airflow pressure d) Mask worn by staff when the client needs to leave the room - correct answers.a) Private room or cohort client Rationale: Meningococcal pneumonia is transmitted by droplet infection. Precautions for this disease include a private room or cohort client and use of a standard precaution mask. Private negative airflow pressure rooms and personal respiratory protection devices are required for clients with airborne disease such as tuberculosis. When appropriate, a mask must be worn by the client and not the staff when the client leaves the room. The nurse prepares to give a bath and change the bed linens of a client with cutaneous Kaposi's sarcoma lesions. The lesions are open and draining a scant amount of serous fluid. Which would the nurse incorporate into the plan during the bathing of this client? a) Wearing gloves b) Wearing a gown and gloves c) Wearing a gown, gloves, and a mask d) Wear a gown and gloves to change the bed linens and gloves only for the bath - correct answers.b) Wearing a gown and gloves Rationale: Gowns and gloves are required if the nurse anticipates contact with soiled items such as those with wound drainage, or is caring for a client who is incontinent with diarrhea or a client who has an ileostomy or colostomy. Masks are not required unless droplet or airborne precautions are necessary. Regardless of the amount of wound drainage, a gown and gloves must be worn. The nurse is preparing a group of Cub Scouts for an overnight camping trip and instructs the scouts about the methods to prevent Lyme disease. Which statement by one of the Cub Scouts indicates a need for further instructions? a) "I need to bring a hat to wear during the trip." b) "I should wear long-sleeved tops and long pants." c) "I should not use insect repellents because it will attract the ticks." d) "I need to wear closed shoes and socks that can be pulled up over my pants." - correct answers.c) "I should not use insect repellents because it will attract the ticks." Rationale: In the prevention of Lyme disease, individuals need to be instructed to use an insect repellent on the skin and clothes when in an area where ticks are likely to be found. Long-sleeved tops and long pants, closed shoes, and a hat or cap should be worn. If possible, heavily wooded areas or areas with thick underbrush should be avoided. Socks can be pulled up and over the pant legs to prevent ticks from entering under clothing. A client with tuberculosis whose status is being monitored in an ambulatory care clinic asks the nurse when it is permissible to return to work. What factor should the nurse include when responding to the client? a) Five blood cultures are negative. b) Three sputum cultures are negative. c) A blood culture and a chest x-ray are negative. d) A sputum culture and a Mantoux test are negative. - correct answers.b) Three sputum cultures are negative. Rationale: The client with tuberculosis must have sputum cultures performed every 2 to 4 weeks after initiation of antituberculosis drug therapy. The client may return to work when the results of three sputum cultures are negative because the client is considered noninfectious at that point. A client with tuberculosis (TB) asks the nurse about precautions to take after discharge to prevent infection of others. The nurse develops a response to the client's question based on which correct understanding of TB transmission? a) The disease is transmitted by droplet nuclei. b) Deep pile carpet should be removed from the home. c) The client should maintain enteric precautions only. d) Clothing and sheets should be bleached after each use. - correct answers.a) The disease is transmitted by droplet nuclei. Rationale: TB is spread by droplet nuclei or via the airborne route. The disease is not carried on objects such as clothing, eating utensils, linens, or furniture. It is unnecessary to remove carpeting from the home. Bleaching of clothing and linens is unnecessary, although the client and family members should use good hand washing technique. The school nurse prepares a list of home care instructions for the parents of schoolchildren diagnosed with pediculosis capitis. Which instruction should the nurse include in the list? a) Soak combs and brushes in warm water. b) Use anti-lice sprays on all bedding and furniture. c) Take all bedding and linens to the cleaners to be dry cleaned. d) Vacuum floors, play areas, and furniture to remove any hairs that might carry live nits. - correct answers.d) Vacuum floors, play areas, and furniture to remove any hairs that might carry live nits. Rationale: Pediculosis capitis is an infestation of the hair and scalp with lice. Thorough home cleaning is necessary to remove any lice or nits that may fall from the host. Combs and brushes should be soaked in hot water for 10 minutes or a pediculicide for 1 hour. Anti-lice sprays are unnecessary and may be harmful. In addition, they should never be used on a child or on bedding or linens. Bedding and linens should be washed with hot water and dried on a hot setting. Items that cannot be washed should be dry cleaned or sealed in plastic bags in a warm place for 2 weeks. The nursing instructor is observing a student nurse donning a pair of sterile gloves and preparing a sterile field. Which observations, if made by the instructor, indicate the need for further teaching? a) The student puts on the right glove and then the left glove. b) The student dons the sterile gloves without washing the hands. c) The student uses the inner wrapper of the gloves as a sterile field. d) The student touches a glove on the overbed table, removes both gloves, and dons another sterile pair. - correct answers.b) The student dons the sterile gloves without washing the hands.