Ch. 26

Question 1

A nurse is teaching a new graduate about the fundamental principles of infection control. Which statement best defines the term asepsis?
a) The process of destroying all microorganisms and their spores.
b) The body’s local response to cellular injury, which includes swelling and redness.
c) Freedom from and prevention of disease-causing contamination.
d) The establishment of a pathogen in a susceptible host.

Answer 1

Answer: c) Freedom from and prevention of disease-causing contamination.
Rationale: The textbook defines asepsis on page 480 as “freedom from and prevention of disease-causing contamination.” Sterilization is the destruction of all microorganisms (a), the inflammatory response involves swelling and redness (b), and infection is the establishment of a pathogen (d).

Question 2

A patient asks the nurse, “What does it mean to have an infection?” Based on the textbook’s definition, the nurse’s best response is that an infection is:
a) The body’s first line of defense against microorganisms.
b) A local response to an injury that causes pain and swelling.
c) The presence of benign microorganisms on the skin.
d) The establishment of a pathogen in a susceptible host.

Answer 2

Answer: d) The establishment of a pathogen in a susceptible host.
Rationale: On page 480, an infection is defined as “the establishment of a pathogen in a susceptible host.” The body’s first line of defense is normal flora (a), a local response to injury is inflammation (b), and benign microorganisms are normal flora (c).

Question 3

A nursing student is explaining the body’s first line of defense against pathogenic microorganisms. The student is correct to identify which of the following?
a) The inflammatory response
b) Normal flora
c) The immune response
d) Cellular immunity

Answer 3

Answer: b) Normal flora
Rationale: The text states on page 480 that normal flora, the group of microorganisms living on the body without causing disease, “constitutes the body’s first line of defense against infection.” Inflammation and the immune response are the second and third lines of defense, respectively.

Question 4

A patient with a localized wound infection exhibits redness, heat, and swelling at the site. The nurse correctly identifies these signs as characteristic of which bodily defense mechanism?
a) Humoral immunity
b) Inflammatory response
c) Normal flora colonization
d) Immune response activation

Answer 4

Answer: b) Inflammatory response
Rationale: The textbook on page 480 defines the inflammatory response as “a local response to cellular injury or infection that includes capillary dilation and leukocyte infiltration,” which produces “redness, heat, pain, and swelling.”

Question 5

When a pathogen bypasses the body’s initial defenses, a more complex reaction is triggered. Which term best describes the body’s attempt to protect itself from foreign substances by recognizing and destroying antigens?
a) Inflammatory response
b) Asepsis
c) Immune response
d) Pathogenesis

Answer 5

Answer: c) Immune response
Rationale: The immune response, as defined on page 481, is “the body’s attempt to protect itself from foreign and harmful substances…initiated by recognition of antigens.”

Question 6

A nurse explains that a vaccine works by introducing a substance that provokes the body to create a specific defense against a future infection. This substance is best known as a(n):
a) Antibody
b) Pathogen
c) Antigen
d) Normal flora

Answer 6

Answer: c) Antigen
Rationale: An antigen is defined on page 481 as “any substance that provokes an adaptive immune response.” Antibodies are produced in response to antigens. A pathogen is the disease-causing organism itself.

Question 7

During an immune response, B lymphocytes produce specific immunoglobulin molecules that recognize and bind to foreign invaders. These molecules are known as:
a) Antigens
b) T-lymphocytes
c) Antibodies
d) Pathogens

Answer 7

Answer: c) Antibodies
Rationale: The textbook defines antibodies on page 481 as “immunoglobulin molecules that recognize foreign invaders” and are produced by B lymphocytes.

Question 8

A patient has recovered from a viral illness and is told their body has developed immunity by producing antibodies. The nurse identifies this specific type of adaptive immunity as:
a) Innate immunity
b) Cellular immunity
c) Humoral immunity
d) Passive immunity

Answer 8

Answer: c) Humoral immunity
Rationale: On page 481, humoral immunity is described as a “defense system that involves WBCs (B lymphocytes) that produce antibodies in response to antigens.” Cellular immunity involves T-lymphocytes attacking cells directly.

Question 9

A patient with a viral infection is relying on their immune system, where T-lymphocytes directly attack the infected cells. This defense mechanism is an example of:
a) Humoral immunity
b) Cellular immunity
c) The inflammatory response
d) The production of antibodies

Answer 9

Answer: b) Cellular immunity
Rationale: Cellular immunity, as defined on page 481, “involves defense by WBCs against any microorganisms that the body does not recognize as its own,” where T-lymphocytes “directly attack cells displaying nonself antigens.”

Question 10

In the chain of infection, what is the correct term for an infectious agent, such as a bacterium or virus, that is capable of causing disease?
a) Reservoir
b) Pathogen
c) Host
d) Vector

Answer 10

Answer: b) Pathogen
Rationale: On page 482, a pathogen is defined as an “infectious agent that causes disease.” A reservoir is the source of infection, a host is where the pathogen lives, and a vector transmits the pathogen.

Question 11

A nurse is caring for four patients with different infections. Which patient’s infectious agent is correctly identified?
a) A patient with the common cold, caused by bacteria.
b) A patient with athlete’s foot, caused by a virus.
c) A patient with a staph infection, caused by bacteria.
d) A patient with a yeast infection, caused by a parasite.

Answer 11

Answer: c) A patient with a staph infection, caused by bacteria.
Rationale: On pages 482-483, bacteria are single-celled organisms like staphylococcus. Viruses, the smallest microorganisms, cause the common cold. Fungi, like molds and yeasts, cause athlete’s foot and yeast infections. Parasites are organisms like protozoa that cause malaria.

Question 12

A nurse is reviewing a microbiology report describing the rapid duplication of E. coli cultured from a urine sample. Which term correctly describes this process of bacterial reproduction?
a) Colonization
b) Infection
c) Replication
d) Transmission

Answer 12

Answer: c) Replication
Rationale: The textbook defines replication on page 482 as the “term used to describe bacterial reproduction or duplication.”

Question 13

A public health nurse is investigating a salmonella outbreak traced back to contaminated chicken. In the chain of infection, the chicken is an example of the:
a) Portal of entry
b) Reservoir
c) Mode of transmission
d) Susceptible host

Answer 13

Answer: b) Reservoir
Rationale: A reservoir (or host/source), as described on page 483, is where microorganisms can survive and find nourishment. This can include animals, humans, or inanimate objects.

Question 14

An individual with a respiratory infection coughs without covering their mouth. In the chain of infection, the cough represents which link?
a) Infectious agent
b) Mode of transmission
c) Portal of exit
d) Portal of entry

Answer 14

Answer: c) Portal of exit
Rationale: The portal of exit is defined on page 483 as “the means by which the pathogen escapes from the reservoir of infection,” such as through a cough or sneeze.

Question 15

A pathogen travels from an infected person to a susceptible individual via contaminated medical equipment. This form of transportation for the pathogen is known as the:
a) Portal of exit
b) Mode of transmission
c) Reservoir
d) Susceptible host

Answer 15

Answer: b) Mode of transmission
Rationale: The mode of transmission, as described on page 483, is the “form of transportation” a microorganism uses to travel from the source to a susceptible host. This includes contact, airborne, vehicle, droplet, and vector-borne routes.

Question 16

The most common mode of transmission for health care-associated infections occurs when a health care worker’s contaminated hands touch a patient. This is an example of which mode of transmission?
a) Airborne
b) Droplet
c) Contact
d) Vector-borne

Answer 16

Answer: c) Contact
Rationale: Contact transmission is defined on page 483 as when “body surfaces touch surfaces of other bodies or objects.” The text specifically notes that in health care, the most common means of transmission is contaminated hands.

Question 17

A nurse is explaining the difference between airborne and droplet precautions to a colleague. Which statement indicates a correct understanding?
a) “Droplet precautions are for smaller microorganisms that travel long distances.”
b) “Airborne particles are smaller and can remain suspended in the air for longer periods.”
c) “Droplet transmission occurs when microorganisms are inhaled from air currents far from the source.”
d) “Tuberculosis requires droplet precautions, while influenza requires airborne precautions.”

Answer 17

Answer: b) “Airborne particles are smaller and can remain suspended in the air for longer periods.”
Rationale: Page 483 explains that the difference between the two is the size of the microorganism. Airborne transmission involves smaller microorganisms that travel longer distances and remain suspended longer (e.g., tuberculosis). Droplet transmission involves larger microorganisms that travel short distances (less than 3 feet) and do not remain suspended (e.g., influenza).

Question 18

A patient is diagnosed with West Nile virus after being bitten by a mosquito. In the chain of infection, the mosquito is an example of a:
a) Vector
b) Reservoir
c) Fomite
d) Host

Answer 18

Answer: a) Vector
Rationale: Page 483 defines vectors as organisms, often invertebrate animals like ticks and mosquitoes, that “carry the pathogens from one host to another.”

Question 19

A patient with a break in their skin develops a wound infection after exposure to a pathogen. For the pathogen, the break in the skin served as which link in the chain of infection?
a) Portal of exit
b) Reservoir
c) Portal of entry
d) Mode of transmission

Answer 19

Answer: c) Portal of entry
Rationale: The portal of entry is defined on page 483 as “the means by which the microorganism enters the susceptible host,” such as through breaks in the skin or mucous membranes.

Question 20

Which of the following individuals best represents a susceptible host?
a) A healthy, well-nourished 30-year-old adult.
b) A 78-year-old patient who recently had surgery and is immunocompromised.
c) A patient who has received all recommended immunizations.
d) A nurse who performs meticulous hand hygiene.

Answer 20

Answer: b) A 78-year-old patient who recently had surgery and is immunocompromised.
Rationale: A susceptible host is “someone exposed to an infectious disease who is likely to contract the disease” (p. 483). Increased susceptibility is associated with extremes in age, recent trauma or surgery, and being immunocompromised.

Question 21

A patient develops pneumonia after being on a ventilator during their hospital stay. This type of infection is best classified as a(n):
a) Community-acquired infection
b) Health care–associated infection (HAI)
c) Antibiotic-resistant infection
d) Systemic infection

Answer 21

Answer: b) Health care–associated infection (HAI)
Rationale: On page 484, HAIs are defined as “infections acquired while the patient is receiving treatment in a health care facility.” The text specifically associates HAIs with the use of medical devices such as ventilators.

Question 22

A nurse is preparing to enter the room of a patient on contact and droplet precautions and dons a gown, gloves, and a mask. These items are collectively known as:
a) Aseptic technique
b) Standard precautions
c) Personal protective equipment (PPE)
d) Medical asepsis tools

Answer 22

Answer: c) Personal protective equipment (PPE)
Rationale: PPE is defined on page 489 as “the equipment that health care personnel use to protect against the spread of infection,” including gloves, masks, gowns, and face shields.

Question 23

A child receives the MMR vaccine to develop immunity against measles, mumps, and rubella. This process is an example of:
a) Natural immunity
b) Immunization
c) The inflammatory response
d) An infectious process

Answer 23

Answer: b) Immunization
Rationale: Immunization is defined on page 493 as “the process by which an individual develops immunity against a specific agent” and is important in preventing the spread of communicable diseases, often through vaccination.

Question 24

Which nursing action is an example of surgical asepsis (sterile technique)?
a) Performing routine handwashing with soap and water.
b) Wearing clean gloves to empty a urinary drainage bag.
c) Wiping down a patient’s overbed table with a disinfectant.
d) Inserting a urinary catheter using a sterile kit and gloves.

Answer 24

Answer: d) Inserting a urinary catheter using a sterile kit and gloves.
Rationale: On page 493, surgical asepsis (sterile technique) is used for invasive procedures like catheterization to prevent introducing microorganisms. The other options are examples of medical asepsis (clean technique), which includes handwashing, using clean gloves, and disinfecting surfaces.

Question 25

A hospital is preparing equipment for patient care. Which statement correctly differentiates disinfection from sterilization? a) Disinfection is used on skin, while sterilization is used on equipment. b) Disinfection destroys most pathogens but not spores, while sterilization destroys all microorganisms, including spores. c) Sterilization uses chemical agents, while disinfection uses physical means like steam. d) Sterilization is a clean technique, while disinfection is a sterile technique.

Answer 25

Answer: b) Disinfection destroys most pathogens but not spores, while sterilization destroys all microorganisms, including spores. Rationale: Page 493 defines disinfection as the removal of pathogenic microorganisms except spores from inanimate objects. Sterilization is defined as a process used to destroy all microorganisms, including their spores.

Question 26

A nursing instructor is teaching about the body's first line of defense against infection. Which of the following, if stated by a student, indicates a correct understanding? a) The inflammatory response b) Normal flora c) The immune response d) Cellular immunity

Answer 26

Answer: b) Normal flora Rationale: The textbook states on page 480 that normal flora constitutes the body's first line of defense against infection by inhibiting pathogenic microorganisms.

Question 27

A patient presents with localized redness, heat, pain, and swelling after an injury. The nurse recognizes these as signs of which defense mechanism? a) Immune response b) Humoral immunity c) Inflammatory response d) Innate immunity

Answer 27

Answer: c) Inflammatory response Rationale: The inflammatory response is defined as a local response to cellular injury that includes capillary dilation and leukocyte infiltration, producing redness, heat, pain, and swelling (p. 480).

Question 28

A patient who recovered from chickenpox as a child is now immune. This long-term immunity is a function of which component of the immune system? a) Innate immunity b) Inflammatory response c) Adaptive immunity d) Normal flora

Answer 28

Answer: c) Adaptive immunity Rationale: The adaptive (acquired) immune system provides long-term, antigen-specific immunity and involves immunologic memory, which prevents or eases later illness upon subsequent exposure (p. 481).

Question 29

Which type of immunity involves T-lymphocytes directly attacking cells that display nonself antigens? a) Humoral immunity b) Passive immunity c) Innate immunity d) Cellular immunity

Answer 29

Answer: d) Cellular immunity Rationale: Cellular immunity involves defense by WBCs, specifically T-lymphocytes, which directly attack microorganisms or infected cells that the body does not recognize as its own (p. 481).

Question 30

A patient receives a tetanus booster shot. This vaccine introduces what substance to provoke an adaptive immune response? a) Antibody b) Antigen c) Pathogen d) T-lymphocyte

Answer 30

Answer: b) Antigen Rationale: An antigen is defined as any substance that provokes an adaptive immune response. Vaccines contain antigens to stimulate the body to create antibodies (p. 481).

Question 31

In the chain of infection, what is the term for an infectious agent that causes disease? a) Host b) Reservoir c) Pathogen d) Vector

Answer 31

Answer: c) Pathogen Rationale: A pathogen is the infectious agent that causes disease, such as a bacterium, virus, fungus, or parasite (p. 482).

Question 32

A patient contracts malaria from a mosquito bite. In this scenario, the mosquito serves as which link in the chain of infection? a) Reservoir b) Portal of exit c) Susceptible host d) Vector

Answer 32

Answer: d) Vector Rationale: Vectors are organisms, such as mosquitoes and ticks, that carry pathogens from one host to another (p. 483).

Question 33

Answer: d) Vector Rationale: Vectors are organisms, such as mosquitoes and ticks, that carry pathogens from one host to another (p. 483).

Answer 33

Answer: b) Portal of exit Rationale: The portal of exit is the means by which a pathogen escapes from the reservoir, such as through a sneeze, cough, or wound drainage (p. 483).

Question 34

A nurse fails to wash their hands between patients and transfers a pathogen from one patient to another. This is an example of which mode of transmission? a) Airborne transmission b) Direct contact c) Droplet transmission d) Indirect contact

Answer 34

Answer: b) Direct contact Rationale: Direct contact involves a physical transfer of microorganisms from an infected individual to a susceptible host. The most common means in healthcare is via contaminated hands (p. 483).

Question 35

Which of the following patients represents the most susceptible host? a) A 25-year-old who is up-to-date on all immunizations. b) A 45-year-old who eats a well-balanced diet and exercises regularly. c) A 75-year-old who recently had hip replacement surgery. d) A 30-year-old who is pregnant and receives regular prenatal care.

Answer 35

Answer: c) A 75-year-old who recently had hip replacement surgery. Rationale: A susceptible host is someone at increased risk of contracting a disease. Factors include extremes in age, recent trauma or surgery, and chronic illness (p. 483).

Question 36

A patient with pulmonary tuberculosis is admitted. Which of the following precautions is the priority for the nurse to implement? a) Contact precautions b) Droplet precautions c) Airborne precautions d) Standard precautions only

Answer 36

Answer: c) Airborne precautions Rationale: Tuberculosis is transmitted via small particles that remain suspended in the air. Airborne precautions, including an N95 respirator and a negative-pressure room, are required (p. 483, Box 26.5).

Question 37

The nurse is caring for a patient with influenza. Which piece of personal protective equipment (PPE) is most essential based on the mode of transmission? a) N95 respirator b) Gown c) Goggles d) Surgical mask

Answer 37

Answer: d) Surgical mask Rationale: Influenza is transmitted via large droplets that travel short distances. Droplet precautions require a surgical mask to protect the mucous membranes of the respiratory tract (p. 483, Box 26.5).

Question 38

A patient is diagnosed with Clostridioides difficile (C. diff). In addition to gown and gloves, which action is critical for infection control? a) Using an alcohol-based hand sanitizer upon exiting the room. b) Washing hands with soap and water. c) Wearing an N95 respirator. d) Placing the patient in a positive-pressure room.

Answer 38

Answer: b) Washing hands with soap and water. Rationale: C. difficile forms spores that are resistant to alcohol-based sanitizers. Handwashing with soap and water is required to physically remove the spores (Box 26.4).

Question 39

A patient develops a urinary tract infection after an indwelling catheter was inserted at the hospital. This type of infection is classified as a(n): a) Community-acquired infection b) Health care-associated infection (HAI) c) Drug-resistant infection d) Localized infection

Answer 39

Answer: b) Health care-associated infection (HAI) Rationale: Health care-associated infections (HAIs) are infections acquired while a patient is receiving treatment in a health care facility. They are often associated with medical devices like urinary catheters (p. 484).

Question 40

A nurse is preparing to enter the room of a patient with methicillin-resistant Staphylococcus aureus (MRSA) in a wound. Which PPE should the nurse don? a) Surgical mask and gloves b) Gown and gloves c) N95 respirator, gown, and gloves d) Goggles and a gown

Answer 40

Answer: b) Gown and gloves Rationale: MRSA requires contact precautions to prevent transmission through direct or indirect contact. This includes wearing a gown and gloves (Box 26.5).

Question 41

Which nursing action is an example of medical asepsis (clean technique)? a) Inserting a sterile urinary catheter. b) Performing hand hygiene with soap and water. c) Preparing a sterile field for a dressing change. d) Donning sterile gloves for a surgical procedure.

Answer 41

Answer: b) Performing hand hygiene with soap and water. Rationale: Medical asepsis (clean technique) includes procedures like handwashing, gowning, and disinfecting to reduce the number of microorganisms. The other options are examples of surgical asepsis (p. 493).

Question 42

While preparing a sterile field, a nurse's sterile glove touches the outer 1-inch border of the drape. What is the nurse's next action? a) Continue with the procedure as planned. b) Remove the sterile gloves and start the entire procedure over. c) Consider the glove contaminated, remove it, and don a new sterile glove. d) Move the items on the sterile field 1 inch further from the border.

Answer 42

Answer: c) Consider the glove contaminated, remove it, and don a new sterile glove. Rationale: The outer 1-inch border of a sterile field is considered contaminated. If a sterile object touches it, that object is now contaminated and must be replaced to maintain surgical asepsis (Box 26.9).

Question 43

A nurse is teaching a student about the principles of surgical asepsis. Which statement by the student indicates a need for further teaching? a) "I must keep my hands above my waist level at all times." b) "If I turn my back on the sterile field, it is still considered sterile." c) "I should open a sterile package away from my body." d) "If a sterile surface becomes wet, it is contaminated."

Answer 43

Answer: b) "If I turn my back on the sterile field, it is still considered sterile." Rationale: A sterile field must always be kept in view. Turning your back on or walking away from a sterile field renders it contaminated (Box 26.9).

Question 44

What is the primary difference between disinfection and sterilization? a) Disinfection is for skin; sterilization is for equipment. b) Disinfection destroys pathogens but not spores; sterilization destroys all microorganisms, including spores. c) Disinfection uses heat; sterilization uses chemicals. d) Sterilization is a clean technique; disinfection is a sterile technique.

Answer 44

Answer: b) Disinfection destroys pathogens but not spores; sterilization destroys all microorganisms, including spores. Rationale: Disinfection removes pathogenic microorganisms except for spores. Sterilization is a process that destroys all microorganisms, including their spores (p. 493).

Question 45

When removing soiled PPE, which item should the nurse remove first? a) Gown b) Mask c) Goggles d) Gloves

Answer 45

Answer: d) Gloves Rationale: Gloves are considered the most contaminated piece of PPE and should be removed first to prevent contaminating other items or the environment during the removal process (Skill 26.3).

Question 46

A nurse is assessing a patient's surgical incision. Which of the following findings are signs of a localized wound infection? (Select all that apply.) a) Redness around the incision b) Purulent drainage c) Wound edges are well-approximated d) Localized warmth and tenderness e) A low-grade fever

Answer 46

Answers: a, b, d, e Rationale: Localized infections cause redness, swelling, warmth, pain, tenderness, and drainage. A systemic response like a fever can also occur (p. 485). Well-approximated edges indicate proper healing, not infection.

Question 47

A nurse is preparing to insert an indwelling urinary catheter. Which of the following actions are consistent with the principles of surgical asepsis? (Select all that apply.) a) Performing hand hygiene before starting the procedure. b) Placing the sterile kit on a clean, dry surface above waist level. c) Reaching over the sterile field to arrange supplies. d) Pouring sterile solution into a container on the sterile field from a height of 10 inches. e) Considering the outer 1-inch border of the sterile drape to be sterile.

Answer 47

Answers: a, b Rationale: Hand hygiene is the first step. A sterile field must be established on a clean, dry surface above the waist. Reaching over the field, pouring from an excessive height (splashing), and assuming the 1-inch border is sterile are all breaks in sterile technique (Box 26.9, Skill 26.4).

Question 48

Which of the following patients are at an increased risk for acquiring a health care-associated infection (HAI)? (Select all that apply.) a) A patient with an indwelling urinary catheter. b) A patient who is immunocompromised due to chemotherapy. c) A patient recovering from surgery. d) A patient admitted for a routine colonoscopy. e) An elderly patient with a chronic respiratory disease.

Answer 48

Answers: a, b, c, e Rationale: Increased susceptibility to HAIs is associated with the use of medical devices (catheters), being immunocompromised, recent trauma or surgery, extremes in age, and chronic illness (p. 483-484). A patient for a routine outpatient procedure is at lower risk.

Question 49

A nurse is educating a family about airborne precautions for a hospitalized patient with measles. What information should be included? (Select all that apply.) a) The patient must be in a private, negative-pressure room. b) Anyone entering the room must wear a fitted N95 respirator. c) The door to the room must be kept closed. d) Visitors should wear a standard surgical mask. e) The pathogen can travel more than 3 feet through the air.

Answer 49

Answers: a, b, c, e Rationale: Airborne precautions require a negative-pressure room, an N95 respirator for all who enter, and a closed door. Airborne microorganisms are small and can travel long distances. A standard surgical mask is insufficient (Box 26.5).

Question 50

A nurse is providing discharge instructions to a family on preventing the spread of infection at home. Which instructions should be included? (Select all that apply.) a) Perform hand hygiene before handling food and after using the restroom. b) Do not share personal care items like toothbrushes or towels. c) Place contaminated dressings in a regular trash can. d) Ensure all family members are up-to-date on immunizations. e) Cover the mouth and nose when coughing or sneezing.

Answer 50

Answers: a, b, d, e Rationale: Hand hygiene, avoiding sharing personal items, immunization, and respiratory etiquette are all key to preventing infection spread at home. Contaminated dressings should be placed in moisture-proof bags before disposal (Box 26.10).

Question 51

Which type of microorganism cannot be treated with antibiotics and reproduces inside the living cells of a host? a) Bacteria b) Fungi c) Parasites d) Viruses

Answer 51

Answer: d) Viruses Rationale: Viruses are the smallest microorganisms that reproduce inside host cells and are not susceptible to antibiotics (p. 482).

Question 52

A patient is placed in protective isolation. What is the primary purpose of this type of isolation? a) To protect staff and visitors from a highly contagious patient. b) To protect a highly susceptible patient from the environment. c) To prevent the spread of drug-resistant organisms. d) To contain pathogens transmitted by large droplets.

Answer 52

Answer: b) To protect a highly susceptible patient from the environment. Rationale: Protective isolation is used for patients who are immunocompromised (e.g., after chemotherapy) to protect them from microorganisms in the environment (Box 26.5).

Question 53

When performing hand hygiene with an alcohol-based sanitizer, how does the nurse know the process is complete? a) When hands have been rubbed together for at least 10 seconds. b) When a lather has been formed. c) When the sanitizer has completely dried. d) After rinsing the hands with water.

Answer 53

Answer: c) When the sanitizer has completely dried. Rationale: The hand sanitizer is not fully effective until it has been rubbed on all surfaces of the hands and has been allowed to dry completely (Skill 26.1).

Question 54

A nurse is preparing to enter the room of a patient with scabies. Which precautions are required? a) Droplet precautions b) Contact precautions c) Airborne precautions d) Standard precautions

Answer 54

Answer: b) Contact precautions Rationale: Scabies is transmitted via direct and indirect contact, requiring contact precautions, including a gown and gloves (Box 26.5).

Question 55

Which laboratory value would most strongly indicate the presence of an acute infection? a) Hemoglobin of 14 g/dL b) White blood cell (WBC) count of 15,000 cells/mm³ c) Platelet count of 250,000/mm³ d) Blood urea nitrogen (BUN) of 15 mg/dL

Answer 55

Answer: b) White blood cell (WBC) count of 15,000 cells/mm³ Rationale: An elevated WBC count (normal is 5,000-10,000 cells/mm³) indicates that the body is mounting an immune response to an infection (p. 487).

Question 56

What is the single most effective method for preventing health care-associated infections? a) Proper use of PPE b) Routine disinfection of surfaces c) Effective hand hygiene d) Administration of prophylactic antibiotics

Answer 56

Answer: c) Effective hand hygiene Rationale: The text explicitly states that handwashing (hand hygiene) is the most effective method for preventing hospital-acquired infections (p. 484, Safe Practice Alert).

Question 57

The process by which an individual develops immunity against a specific agent, often through vaccination, is known as: a) Asepsis b) Colonization c) Immunization d) Inflammation

Answer 57

Answer: c) Immunization Rationale: Immunization is the process by which an individual develops immunity against a specific agent, which is important in preventing the spread of communicable diseases (p. 493).

Question 58

Which action would violate the principles of maintaining a sterile field? a) Keeping sterile items above waist level. b) Pouring sterile liquids slowly to avoid splashing. c) Facing the sterile field at all times. d) Placing a sterile object within the 1-inch border of the field.

Answer 58

Answer: d) Placing a sterile object within the 1-inch border of the field. Rationale: The outer 1-inch edge of a sterile field is considered contaminated. Placing a sterile object in this area contaminates it (Box 26.9).

Question 59

A patient with mumps is admitted to the pediatric unit. The nurse correctly implements which type of transmission-based precautions? a) Contact b) Airborne c) Droplet d) Protective

Answer 59

Answer: c) Droplet Rationale: Mumps is transmitted through large droplets generated when an infected person coughs, sneezes, or talks, requiring droplet precautions (Box 26.5).

Question 60

A nurse sustains a needlestick injury from a used needle. What is the first action the nurse should take? a) Report the incident to the supervisor. b) Wash the area thoroughly with soap and water. c) Request testing of the source patient. d) Complete an injury report.

Answer 60

Answer: b) Wash the area thoroughly with soap and water. Rationale: The immediate priority after a potential exposure is to decontaminate the area by washing it with soap and water to reduce the viral/bacterial load. Reporting and documentation follow immediately after.

Question 61

An elderly patient presents with new-onset confusion. The nurse recognizes that this may be the first indication of which condition? a) Stroke b) Dehydration c) Infection d) Dementia

Answer 61

Answer: c) Infection Rationale: The textbook notes that confusion is a common presentation of infection in the elderly and is often the first sign of conditions like pneumonia or a UTI (p. 486).

Question 62

What is the correct sequence for donning Personal Protective Equipment (PPE)? a) Gown, mask, eyewear, gloves b) Gloves, gown, mask, eyewear c) Mask, gown, gloves, eyewear d) Gown, gloves, mask, eyewear

Answer 62

Answer: a) Gown, mask, eyewear, gloves Rationale: The correct sequence for donning PPE is gown first, then mask, then eyewear, and finally gloves. Gloves are put on last to be pulled over the cuffs of the gown (Skill 26.3).

Question 63

A patient has a draining wound infected with vancomycin-resistant enterococci (VRE). What type of precautions are necessary? a) Standard precautions only b) Airborne precautions c) Droplet precautions d) Contact precautions

Answer 63

Answer: d) Contact precautions Rationale: VRE is a multidrug-resistant organism that requires contact precautions to prevent its spread through direct or indirect contact with the patient or their environment (Box 26.5).

Question 64

The body's defense system that involves B lymphocytes producing antibodies is known as: a) Cellular immunity b) Humoral immunity c) Innate immunity d) Inflammatory response

Answer 64

Answer: b) Humoral immunity Rationale: Humoral immunity is the defense system involving B lymphocytes that produce antibodies in response to circulating antigens (p. 481).

Question 65

When removing a surgical mask, how should the nurse handle it to prevent self-contamination? a) By grasping the front of the mask. b) By touching only the ties or ear loops. c) By folding the mask inward. d) By pulling it down below the chin.

Answer 65

Answer: b) By touching only the ties or ear loops. Rationale: The front of the mask is considered contaminated. The nurse should only handle the ties or ear loops to remove it, pulling it away from the face (Skill 26.3).

Question 66

Which statement best defines a health care-associated infection (HAI)? a) An infection present upon admission to a hospital. b) An infection acquired as a direct result of treatment in a health care facility. c) An infection that is resistant to multiple antibiotics. d) An infection transmitted from a health care worker to their family.

Answer 66

Answer: b) An infection acquired as a direct result of treatment in a health care facility. Rationale: HAIs are defined as infections acquired while the patient is receiving treatment in a health care facility such as a hospital or long-term care facility (p. 484).

Question 67

What is the term for a non-living object, such as a contaminated medical instrument, that transmits a pathogen? a) Vector b) Reservoir c) Fomite d) Host

Answer 67

Answer: c) Fomite Rationale: A fomite is an inanimate object that can become contaminated with infectious agents and serve as a mechanism for transmission. This is a form of indirect contact transmission (p. 483).

Question 68

Which action demonstrates a break in sterile technique during a sterile dressing change? a) Facing the sterile field throughout the procedure. b) Keeping sterile gloved hands above the waist. c) Allowing a sterile saline bottle to touch the sterile field when pouring. d) Opening the sterile dressing package away from the body.

Answer 68

Answer: c) Allowing a sterile saline bottle to touch the sterile field when pouring. Rationale: The outside of the sterile saline bottle is not sterile. Touching it to the sterile field contaminates the field. Liquids should be poured carefully without the container touching the field (Box 26.9).

Question 69

A patient has a systemic infection. Which of the following signs and symptoms would the nurse expect to see? a) Localized redness and swelling at an IV site. b) Fever, chills, and malaise. c) Clear drainage from a surgical wound. d) Pain isolated to one joint.

Answer 69

Answer: b) Fever, chills, and malaise. Rationale: Systemic infections infiltrate the bloodstream and cause systemic signs like fever, chills, and malaise, whereas localized infections cause signs specific to one area of the body (p. 485).

Question 70

A nurse is caring for a patient with pertussis (whooping cough). What is the minimum distance a visitor should maintain from the patient if not wearing a mask? a) 1 foot b) 3 feet c) 6 feet d) 10 feet

Answer 70

Answer: b) 3 feet Rationale: Pertussis is a droplet-transmitted disease. Droplets seldom travel more than 3 feet. Therefore, maintaining a distance of more than 3 feet reduces the risk of transmission (p. 483).

Question 71

What is the purpose of a negative-pressure room for a patient on airborne precautions? a) To keep microorganisms from entering the room from the hallway. b) To prevent microorganisms from flowing out of the room. c) To increase the circulation of fresh air in the room. d) To create a sterile environment for the patient.

Answer 71

Answer: b) To prevent microorganisms from flowing out of the room. Rationale: A negative-pressure room has lower pressure than the adjacent hallway, so air flows into the room, preventing airborne pathogens from escaping into the corridor (Box 26.5).

Question 72

The equipment that health care personnel use to protect against the spread of infection is known as: a) Aseptic supplies b) Sterile kits c) Personal Protective Equipment (PPE) d) Infection control bundles

Answer 72

Answer: c) Personal Protective Equipment (PPE) Rationale: PPE is the equipment used to protect against infection, including gloves, masks, gowns, and goggles (p. 489).

Question 73

A patient with a chronic Foley catheter is at risk for infection primarily because the catheter provides a: a) Reservoir b) Portal of entry c) Mode of transmission d) Susceptible host

Answer 73

Answer: b) Portal of entry Rationale: An indwelling catheter is an invasive device that bypasses the body's natural defenses, providing a direct portal of entry for microorganisms into the normally sterile urinary tract (p. 483).

Question 74

What is the correct action if a nurse is uncertain whether a sterile item is contaminated? a) Ask a colleague for their opinion. b) Use the item quickly to minimize risk. c) Consider the item contaminated and discard it. d) Wipe the item with an antiseptic agent.

Answer 74

Answer: c) Consider the item contaminated and discard it. Rationale: A core principle of surgical asepsis is to consider an object contaminated if there is any doubt about its sterility (Box 26.9).

Question 75

The nurse teaches a female patient to wipe from front to back after urination to prevent UTIs. This health teaching is designed to break which link in the chain of infection? a) Portal of exit b) Reservoir c) Mode of transmission d) Portal of entry

Answer 75

Answer: c) Mode of transmission Rationale: This action prevents the mode of transmission of bacteria (like E. coli) from the gastrointestinal tract (the reservoir) to the urethra (the portal of entry).