Chapter 06: Infection Prevention and Control My Nursing Test Banks

Chapter 06: Infection Prevention and Control

MULTIPLE CHOICE

1. The nurse points out that covering the mouth and nose with a tissue for a sneeze will reduce the probability of infection being spread by the _____ route.

a.

droplet

b.

airborne

c.

direct contact

d.

indirect contact

ANS: A

Infection from the droplet route requires the pathogens be expelled in droplets from the host and inhaled by another host.

DIF: Cognitive Level: Application REF: 110 OBJ: 1 (theory)

TOP: Disease-Producing Pathogens KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

2. The nurse is providing infection control teaching to a patient. Additional patient teaching is warranted by which patient statement?

a.

It is important that I get my whooping cough vaccination as directed by my health care provider.

b.

Getting plenty of sleep each night will help my immune system.

c.

I should wash my hands before preparing my food.

d.

It is important that I take my antibiotic until I feel infection free.

ANS: D

The noncompletion of a protocol of prescribed antimicrobial medication can cause a pathogen to become resistant to that particular drug. Vaccinations, adequate rest, and proper hand hygiene are important infection control measures.

DIF: Cognitive Level: Application REF: 113 | Table 6-7, 121

OBJ: 1 (theory) TOP: Infection Control Measures

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

3. When the patient complains, If this viral infection I have right now cant be helped by antibiotics, why am I taking this expensive acyclovir? The nurses best response is, Acyclovir is:

a.

an antiviral drug that kills viruses.

b.

given to many patients with viral infections.

c.

an antiviral drug that prevents your infection from becoming worse.

d.

given to help strengthen your immune system.

ANS: C

The patient currently has a viral infection; acyclovir is an antiviral drug that will decrease the virulence of the infection if started in the early phase of the infection. The drug may not kill the virus and is not given frequently to patients with viruses. Acyclovir will not strengthen the immune system.

DIF: Cognitive Level: Application REF: 102 OBJ: 8 (theory)

TOP: Viruses KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

4. The clinic nurse offers suggestions to a patient who is planning a trip to Mexico that will help prevent a protozoan infection. The most helpful suggestion is:

a.

We will ask the doctor for a prophylactic prescription for an antiviral drug.

b.

Broad-spectrum antibiotics will be most helpful if you contract a protozoan infection.

c.

Be sure to practice good hand hygiene while on your vacation.

d.

It would be best if you drank bottled water while on your trip.

ANS: D

Protozoa frequently live in the water and soil and cause infection by ingestion of the parasite. Water in many foreign countries contains protozoa, so drinking bottled water is the best suggestion.

DIF: Cognitive Level: Application REF: 102 OBJ: 1 (theory)

TOP: Protozoa KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential

5. While assessing an obese resident in a long-term care facility, the nurse finds a red, moist rash under the patients breasts, in the axilla, and in the inguinal fold. Based on this assessment, the nurse reports to the charge nurse that the resident probably has:

a.

a fungal infection.

b.

a bacterial infection.

c.

an allergic reaction.

d.

contact dermatitis.

ANS: A

Fungal infections thrive in warm, moist environments and most frequently affect the skin.

DIF: Cognitive Level: Application REF: 103 OBJ: 1 (theory)

TOP: Fungi KEY: Nursing Process Step: Assessment

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

6. The frustrated patient with a fungal infection complains, Why is the infection taking so long to heal? The nurses most informative response would be that:

a.

fungal infections are essentially incurable.

b.

fungi form spores, which make them difficult to kill.

c.

fungi can be considered natural flora and are protected by the body.

d.

fungi can alter the patients DNA and RNA.

ANS: B

Fungi are capable of forming spores, which makes them resistant to antifungal agents.

DIF: Cognitive Level: Comprehension REF: 103 OBJ: 1 (theory)

TOP: Fungi KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

7. The nurse explains to the patient who is using Prilosec (a proton pump inhibitor) that the drug has reduced the amount of the natural protector _____ in the stomach lining.

a.

lactic acid

b.

lysozyme

c.

cilia

d.

fatty acids

ANS: B

Lysozyme is found in the lining of the stomach and in the stomach acids.

DIF: Cognitive Level: Application REF: 104 OBJ: 2 (theory)

TOP: Chemical Barrier KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

8. The home health nurse advises the patient to treat a fever of 100 F with:

a.

aspirin.

b.

Tylenol.

c.

cool baths.

d.

nothing at all.

ANS: D

Allowing reasonable levels of fever allows the bodys natural defenses to make a hostile environment to the pathogen through heat.

DIF: Cognitive Level: Application REF: 104 OBJ: 3 (theory)

TOP: Fever KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

9. The home health nurse is providing dietary recommendations to keep the immune system healthy. The patient demonstrates understanding by increasing which in the diet?

a.

Proteins

b.

Fluids

c.

Carbohydrates

d.

Unsaturated fats

ANS: A

Protein stores must be kept at an adequate level in order to produce antibodies, thus boosting the immune system. Fluids, carbohydrates, and unsaturated fats will not enhance the immune system.

DIF: Cognitive Level: Application REF: 104 | 107 OBJ: 7 (theory)

TOP: Nutrition KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

10. The nurse is caring for several patients and determines which patient to be at the most risk for developing an infection related to a decreased anti-inflammatory response?

a.

A patient who has been experiencing high levels of stress for the last 3 months

b.

A patient whose glycosylated Hgb level is 6.7%

c.

A patient recently diagnosed with osteoarthritis

d.

A patient scheduled for laparoscopic cholecystectomy in 2 weeks related to gallstones

ANS: A

The presence of increased levels of cortisol resulting from ongoing stress inhibits the anti-inflammatory response, thus making this patient most susceptible to developing an infection. A glycosylated Hgb level of 6.7% is normal; osteoarthritis and gallstones would not significantly increase a patients likelihood of developing an infection.

DIF: Cognitive Level: Application REF: 102 | Box 6-1, 104

OBJ: 1 (theory) TOP: Cortisol KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

11. The home health nurse makes a referral to _____ to supply a home-bound older adult with a daily meal.

a.

a community food bank

b.

the Salvation Army

c.

an agency supplying food stamps

d.

Meals on Wheels

ANS: D

Meals on Wheels provides a large, nutritious meal to home-bound people. A community food bank, the Salvation Army, and food stamps would not adequately assist a home-bound individual.

DIF: Cognitive Level: Application REF: 104 | Elder Care Points

OBJ: 1 (clinical) TOP: Nutrition KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

12. The nurse uses a visual aid to demonstrate how the antibody _____ attaches to the antigen to clear the pathogen from the body.

a.

IgA

b.

IgD

c.

IgG

d.

IgM

ANS: D

Immunoglobulin M (IgM) is the antibody that recognizes the foreign protein and attaches itself to it in order to clear the pathogen from the body.

DIF: Cognitive Level: Comprehension REF: 105 | Table 6-2

OBJ: 2 (theory) TOP: Antibodies KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

13. The nurse explains that exposure to a pathogen stimulates the macrophages to migrate to the area of infection to ingest and destroy the pathogen. This is the process of:

a.

pathogen neutralization.

b.

immune response.

c.

antibody action.

d.

phagocytosis.

ANS: D

Phagocytosis is the process of the ingestion of a pathogen by macrophages.

DIF: Cognitive Level: Comprehension REF: 105 OBJ: 2 (theory)

TOP: Phagocytosis KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

14. When the patient complains of the unsightly swelling of her lip at the site of an infection, the nurse explains that the swelling is part of the inflammatory response and acts as a(n):

a.

store for blood.

b.

compression wall.

c.

antibody reservoir.

d.

producer of leukocytes.

ANS: B

The swelling of the inflammatory response acts as a compression wall to delay the spread of harmful agents to the rest of the body.

DIF: Cognitive Level: Application REF: 107 OBJ: 2 (theory)

TOP: Inflammatory Response KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

15. The nurse is providing infection control teaching to a group of patients. The patient statement that best demonstrates understanding of the teaching provided is:

a.

I should take an antibiotic at the first sign of an infection.

b.

Hand hygiene is one of the most effective ways I can prevent the spread of infection.

c.

Vaccinations only prevent a disease from becoming severe.

d.

If I eat a nutritious diet, it will be difficult for me to get an infection.

ANS: B

Hand hygiene is the most effective single act that can reduce the spread of disease. Antibiotics should not be taken at the first sign of infection, especially if the infection is caused by a virus; vaccinations can also prevent diseases from occurring; a nutritious diet is only one component in the prevention of infection.

DIF: Cognitive Level: Analysis REF: 108-109 OBJ: 2 (theory)

TOP: Hand Hygiene KEY: Nursing Process Step: NA

MSC: NCLEX: Health Promotion and Maintenance

16. The nurse discusses and demonstrates proper hand hygiene to an immunocompromised patient and his wife. The nurse determines additional teaching is necessary when the patient states:

a.

It is okay for my wife to wear artificial nails as long as she performs good handwashing.

b.

I should wash my hands before I eat.

c.

Hand gels work as well as handwashing under most circumstances.

d.

I should use friction and wash my hands for about 20 seconds if I am using soap and water.

ANS: A

Artificial nails harbor microorganisms regardless of good hand hygiene. Washing hands prior to eating is good practice, as well as using friction and washing for 15 to 30 seconds with soap and water. Hand gels are effective in most circumstances except for certain infections such as C. difficile and C. albicans.

DIF: Cognitive Level: Application REF: 108-109 OBJ: 2 (clinical)

TOP: Hand Hygiene KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

17. The nurse explains that a vaccination provides defense against infection via:

a.

innate immunity.

b.

the inflammatory response.

c.

antibody-mediated immunity.

d.

cell-mediated immunity.

ANS: C

Vaccinations produce an antibody-mediated immunity by stimulating the host to develop specific antibodies against specific diseases.

DIF: Cognitive Level: Application REF: 104-105 | 106 | Table 6-3

OBJ: 2 (theory) TOP: Immune Response

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

18. The nurse will use Expanded Precautions when performing care for a patient with:

a.

active tuberculosis (TB).

b.

bacterial pneumonia.

c.

a urinary tract infection caused by E. coli.

d.

a fungal infection of the groin and axilla.

ANS: A

Active TB can be spread by airborne pathogens. Masks and gowns in addition to gloves should be worn while caring for such patients. Standard Precautions would be used for the other patients.

DIF: Cognitive Level: Application REF: 109-110 | Table 6-5

OBJ: 5 (theory) TOP: Expanded Precautions

KEY: Nursing Process Step: Planning

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

19. The nurse caring for a patient with C. difficile should:

a.

use only alcohol-based hand cleanser.

b.

wear a mask.

c.

use eye protection.

d.

notify housekeeping to use appropriate cleaning agents.

ANS: D

Notification of housekeeping to use alcohol-free cleaners is necessary in order to eradicate the pathogen. Soap and water must be used after contact with this organism. A mask and eye protection are not necessary.

DIF: Cognitive Level: Application REF: 114 OBJ: 5 (theory)

TOP: Prevention of Health CareAssociated Infections

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

20. The nurse caring for a patient with general sepsis should notify the charge nurse immediately of the patients:

a.

increased lethargy.

b.

coughing.

c.

elevated blood pressure.

d.

cloudy urine.

ANS: A

Increasing lethargy is an indicator of impending septic shock. Coughing and cloudy urine are not signs of impending septic shock. Decreased rather than increased blood pressure would indicate impending septic shock.

DIF: Cognitive Level: Application REF: 115 OBJ: 1 (theory)

TOP: Septic Shock KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance

21. The nurse who suffers an accidental needle stick following administration of an intramuscular injection to a patient anticipates that facility protocol will suggest immediate treatment with which type of immunotherapy?

a.

IgM

b.

IgD

c.

Ig A

d.

IgG

ANS: D

IgG is frequently given to provide passive immunity until the bodys own immune system can defend itself; therefore, it would most likely be a component of a health care facilitys initial treatment protocol for accidental needle sticks. IgM, IgD, and IgA would not be indicated.

DIF: Cognitive Level: Application REF: 105 | Table 6-2

OBJ: 1 (theory) TOP: Immunoglobulins

KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance

22. Following discharge teaching, the nurse determines that the patient requires additional teaching regarding antibiotic treatment when the patient states:

a.

It is important that I stop taking my medication when I feel completely better.

b.

I should try to take my medication as evenly spaced apart as possible.

c.

If I start feeling worse, I should call my health care provider.

d.

I should not share my medication with anyone.

ANS: A

The antibiotic should be taken until it is completely gone in order to ensure the infection has been adequately treated. Antibiotics are more effective if spaced evenly apart when taken. The patient should continue to improve if therapy is effective, so the health care provider should be notified if symptoms are not improving. Patients should never share any type of prescribed medication.

DIF: Cognitive Level: Application REF: 113 | Table 6-7, 121

OBJ: 8 (theory) TOP: Antimicrobial Therapy

KEY: Nursing Process Step: Evaluation MSC: NCLEX: Health Promotion and Maintenance

MULTIPLE RESPONSE

23. The nurse instructs the nursing assistant in a long-term care facility regarding infection control measures. Which actions by the nursing assistant demonstrate understanding? (Select all that apply.)

a.

Assisting residents with hand hygiene prior to meals

b.

Cleaning incontinent residents as soon as possible

c.

Ensuring residents who require assistance with feeding take prescribed antibiotics during meals

d.

Inspecting residents skin for open areas during bathing

e.

Assisting residents with hand hygiene after participating in group activities

ANS: A, B, D, E

It is important for the nursing assistant to assist residents with hand hygiene prior to meals and after participating in group activities in order to help prevent the spread of infection. Cleaning incontinent residents as soon as possible prevents skin breakdown, which may lead to infection. While bathing residents, the nursing assistant should monitor for signs of skin breakdown and report any areas to the nurse. Nursing assistants are not permitted to administer medications.

DIF: Cognitive Level: Application REF: 121 OBJ: 2 (clinical)

TOP: Infection Control Measures KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance

24. The nurse uses a picture to show the areas of the body that are protected by normal flora. These areas include the: (Select all that apply.)

a.

skin.

b.

bladder.

c.

lower GI tract.

d.

nose and throat.

e.

eye.

ANS: A, C, D, E

The bladder does not have any natural flora for protection.

DIF: Cognitive Level: Comprehension REF: 101 | Table 6-1

OBJ: 2 (theory) TOP: Natural Flora

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

25. The nurse is obtaining a health history on a newly admitted patient. Which information will alert the nurse to an increased risk for this patient developing an infection? (Select all that apply.)

a.

The patient reports having unprotected heterosexual sex in three previous relationships.

b.

The patient is employed as a biochemist in a hospital.

c.

The patients income is considered middle-class level.

d.

The patient reports getting 4 to 5 hours of sleep per night.

e.

The patient is 21% over the suggested normal weight.

ANS: A, D, E

This patients lifestyle habits, insufficient sleep, and being obese increases the chance of developing an infection by the strain placed on the immune system. This patients occupation and income level would not increase the risk for infection.

DIF: Cognitive Level: Application REF: 102 | Box 6-1

OBJ: 1 (theory) TOP: Risk Factors KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

COMPLETION

26. The nurse explains that an infection occurring in the body represents an interrelationship between the __________, __________, and __________.

ANS:

host, agent, environment

host, environment, agent

agent, host, environment

agent, environment, host

environment, host, agent

environment, agent, host

A pathologic agent, upon entering the body, must attach to a host in order to multiply in a supportive environment.

DIF: Cognitive Level: Application REF: 102 | Box 6-1

OBJ: 1 (theory) TOP: Infection Process

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

27. The bacteria that are rod-shaped are classified as _________.

ANS:

bacilli

Bacilli are rod-shaped bacteria.

DIF: Cognitive Level: Knowledge REF: 101 OBJ: 1 (theory)

TOP: Bacteria KEY: Nursing Process Step: NA

MSC: NCLEX: Health Promotion and Maintenance

28. The nurse explains that the four lines of defense the body employs to combat infection are __________, __________, __________, and __________.

ANS:

skin, normal flora, inflammatory response, immune response

skin, normal flora, immune response, inflammatory response

skin, inflammatory response, immune response, normal flora

skin, inflammatory response, normal flora, immune response

skin, immune response, normal flora, inflammatory response

skin, immune response, inflammatory response, normal flora

The body is defended against infection by the skin, normal flora, and inflammatory and immune responses.

DIF: Cognitive Level: Comprehension REF: 103-104 OBJ: 2 (theory)

TOP: Defense Against Infection KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

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