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Chapter 07: Asepsis and Infection Control Cooper: Foundations of Nursing, 8th Edition MULTIPLE CHOICE 1. a. b. c. d.

What is true regarding surgical asepsis? It inhibits growth of pathogenic organisms. It is known as a cleaning technique. It includes hand hygiene. It is known as a sterile technique.

ANS: D

Surgical asepsis is known as a sterile technique. DIF: Cognitive Level: Knowledge REF: 118 TOP: Infection KEY: Nursing Process Step: N/A 2.

OBJ: 1 MSC: NCLEX: N/A

What action exemplifies a nurse practicing medical asepsis in performing

daily care? a. b. c.

Lifting a sterile swab from a sterile field Using disposable sterile gowns Washing hands for 5 minutes between patients Keeping bed linens off the floor

d. ANS: D

Keeping the bed linens off the floor is an example of medical asepsis; all other options are examples of surgical asepsis. DIF: Cognitive Level: Comprehension REF: 123 OBJ: 1 | 2 TOP: Infection KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment 3.

What bacteria can lie dormant when conditions for growth are not

favorable? a. b. c. d.

Residue Capsules Spores Flagella

ANS: C

Spore formation occurs when conditions are unfavorable, causing the bacteria to take a dormant form. DIF: Cognitive Level: Comprehension REF: 119 OBJ: 2 | 4 TOP: Bacteria KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment

4. A patient with a respiratory infection reports that he is not yet on an antibiotic. The nurse explains that the health care provider is waiting on the results of the culture and sensitivity. What does this test determine? a. What media the bacteria requires to grow b. How fast the bacteria grow c. Which antibiotics stop bacterial growth d. When the bacteria colonize ANS: C

Sensitivity tests are done to determine which antibiotics will stop growth. DIF: Cognitive Level: Comprehension TOP: Laboratory tests MSC: NCLEX: Physiological Integrity 5. a. b. c. d.

REF: 119 OBJ: 6 KEY: Nursing Process Step: Implementation

What bacterium is responsible for more diseases than any other organism? Staphylococcus Pseudomonas aeruginosa Haemophilus influenzae Streptococcus

ANS: D

The Streptococcus bacterium is responsible for more diseases than any other organism. DIF: Cognitive Level: Knowledge REF: 137 OBJ: 3 TOP: Bacteria KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment 6. What additional complication does a disease caused by a virus have compared to a disease caused by bacteria? a. Multiplies rapidly. b. Returns frequently. c. Is not killed by antibiotics. d. Is unable to be cultured. ANS: C

Antibiotics do not alter the course of a disease caused by a virus. DIF: Cognitive Level: Comprehension REF: 121 TOP: Virus KEY: Nursing Process Step: N/A MSC: NCLEX: Physiological Integrity 7.

OBJ: 3

What should the nurse be diligent in to provide a safe environment for the

patient? a. b. c.

Keeping a light on at night to prevent falls Hand hygiene between patient contacts Regulating the temperature to avoid drafts

d.

Changing the bed linen to diminish microorganisms

ANS: B

One of the most important actions is hand hygiene before caring for another patient. DIF: Cognitive Level: Application REF: 122 OBJ: 5 | 8 | 9 TOP: Safe environment KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment 8. a. b. c. d.

What does the nurse describe when giving an example of a fomite vehicle? Rabid dog Person with AIDS Contaminated stethoscope Infected wound

ANS: C

If a vehicle is an inanimate (nonliving) object, it is called a fomite. DIF: Cognitive Level: Application REF: 123 OBJ: 2 TOP: Infection KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment

The nurse is concerned when a patient admitted with a diagnosis of pneumonia suddenly develops a urinary tract infection (UTI). What type of infection is this UTI considered? a. Viral infection b. Bacterial infection c. Health care–associated infection d. Spore infection 9.

ANS: C

More than 40 million people are admitted to hospitals each year and as many as 10% of them acquire a health care–associated infection while there. Criteria for health care– associated infections require that the infection manifest at least 48 hours after hospitalization or contact with another health agency. DIF: Cognitive Level: Comprehension TOP: Health care–associated infection MSC: NCLEX: Physiological Integrity

REF: 125 OBJ: 2 KEY: Nursing Process Step: Assessment

The nurse prioritizes the care of four patients. Which patient has a systemic infection? a. 14-year-old with acute appendicitis b. 80-year-old with a urinary tract infection c. 40-year-old with AIDS d. 50-year-old with arthritis 10.

ANS: C

AIDS is a systemic viral infection. Acute appendicitis and urinary tract infections are local infections. Arthritis is not an infection. DIF: Cognitive Level: Application TOP: Systemic infection MSC: NCLEX: Physiological Integrity

REF: 124 | 125 OBJ: 6 KEY: Nursing Process Step: Assessment

11. What assessment does the nurse recognize as an inflammatory response in a surgical wound on the leg of a patient? a. A foul drainage is coming from the wound. b. The affected leg is cooler than the other leg. c. There are raised, red, pruritic welts on the leg. d. Rubor and edema appear around the wound. ANS: D

Rubor and edema are two of the cardinal signs of an inflammatory response. Foul drainage suggests infection, the affected leg being cooler than the other leg suggests circulatory disorder, and raised, red, pruritic welts on the leg suggest allergy. DIF: Cognitive Level: Application TOP: Inflammatory response MSC: NCLEX: Physiological Integrity

REF: 125 OBJ: 7 KEY: Nursing Process Step: Assessment

The infection control health care provider plans an in-service on control of health care–associated infections. What should be the focus of this program? a. Observing nurses caring for patients b. Screening patients who are admitted to the hospital c. Educating hospital personnel about aseptic practices d. Discharging infectious patients from the hospital 12.

ANS: C

Duties of the infection control health care provider include staff education on infection control. DIF: Cognitive Level: Application REF: 126 TOP: Infection KEY: Nursing Process Step: Planning MSC: NCLEX: Safe, Effective Care Environment

OBJ: 5 | 13

13. A health care worker is stuck by a needle left on the patient’s bedside table. The staff member appropriately reports the needlestick. What will the indicated treatment be combatting?

a. b. c. d.

Hepatitis B Streptococcal infections Staphylococcal infections Influenza

ANS: A

Workers who have had a needlestick need to complete an injury report and seek treatment in the event of exposure to hepatitis B. DIF: Cognitive Level: Comprehension REF: 126 TOP: Needlesticks KEY: Nursing Process Step: N/A

OBJ: 3 | 5 MSC: NCLEX: N/A

What technique should the nurse use when disposing of linens contaminated with feces? a. Don gown, gloves, and mask b. Wash hands for 5 minutes after disposal c. Don gloves only d. Double-bag the sheets 14.

ANS: C

All health care workers should follow Standard Precautions to prevent infection from pathogens. Standard Precautions for the disposal of ordinary feces require only that the nurse don gloves. DIF: Cognitive Level: Application REF: 131 OBJ: 13 TOP: Standard precautions KEY: Nursing Process Step: Analysis MSC: NCLEX: Safe, Effective Care Environment 15. The nurse is instructing a patient about the most important preventive technique for breaking the chain of infection. What technique is the patient learning about? a. Sterilization b. Standard Precautions c. Hand hygiene d. Medical asepsis ANS: C

Hand hygiene is the most important preventive measure for interrupting the infection process. DIF: Cognitive Level: Comprehension REF: 118 OBJ: 2 | 9 TOP: Infection KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment

A nurse is observing isolation precautions by wearing a mask while performing complex patient care. How often should the nurse change masks? a. 5 to 10 minutes b. 10 to 20 minutes 16.

c. d.

20 to 30 minutes 30 to 40 minutes

ANS: C

The mask should be changed every 20 to 30 minutes. DIF: Cognitive Level: Comprehension REF: 133 OBJ: 8 TOP: Mask KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment 17. A major threat to health care workers is blood-contaminated sharps. What should the nurse use to discard the used syringe? a. Wastebasket b. Sink c. Puncture-proof container d. Disinfecting soap ANS: C

All patient care areas where sharps are used require puncture-proof containers. DIF: Cognitive Level: Comprehension REF: 122 | 136 OBJ: 8 TOP: Sharps KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment 18. The nurse is transporting a patient in respiratory isolation to the radiology department. What intervention should the nurse implement? a. Cover the patient with a sheet. b. Take the patient down the service elevator. c. Apply a mask to the patient. d. Call x-ray to come and get the patient. ANS: C

If a patient requiring respiratory isolation must be transported to another area, the patient must don a mask. DIF: Cognitive Level: Application REF: 133 | 135 OBJ: 5 | 8 TOP: Isolation KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment 19. The patient in isolation may experience psychological or emotional deprivation. What should the nurse do to help minimize these feelings? a. Be cheerful. b. Spend extra time with the patient. c. Protect the patient from additional infection. d. Answer the call light quickly. ANS: B

To minimize feelings of psychological or emotional deprivation, the nurse should spend

extra time with the patient. DIF: Cognitive Level: Application REF: 138 OBJ: 13 TOP: Isolation KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity

The infection control officer is observing hospital staff for appropriate use of aseptic technique. What observation demonstrates the need for more instruction on surgical asepsis? a. Facing the sterile field b. Placing a sterile dressing on a sterile field c. Touching the edges of the sterile field with sterile gloves d. Keeping gloved hands above the waist 20.

ANS: C

The edges of a sterile field are not considered sterile. DIF: Cognitive Level: Application REF: 143 OBJ: 1 TOP: Sterile technique KEY: Nursing Process Step: Evaluation MSC: NCLEX: Safe, Effective Care Environment 21. The nurse is pouring a sterile solution from a bottle. What direction should the label on the bottle be in for appropriate technique? a. Facing outward b. Covered c. Facing downward d. In the palm of the hand ANS: D

The bottle should be held with the label in the palm of the hand. DIF: Cognitive Level: Application REF: 147 OBJ: 11 | 12 TOP: Sterile technique KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment 22. a. b. c. d.

What is a method used to kill all microorganisms, including spores? Disinfecting Using an antiseptic Using chlorine bleach Sterilizing

ANS: D

Sterilization refers to methods used to kill all microorganisms and spores. DIF: Cognitive Level: Knowledge REF: 142 | 143 TOP: Pathogens KEY: Nursing Process Step: N/A 23.

OBJ: 12 MSC: NCLEX: N/A

The nurse accidently spills blood from a specimen container. The first

action the nurse takes is to don gloves. What should the nurse then spray the fluid with? a. Liquid detergent b. 20% bleach solution c. 10% bleach solution d. Warm soapy water ANS: C

Any accidental body fluid spill should be cleaned up as soon as possible. The person cleaning the spill should wear gloves. One cup of bleach diluted with 10 cups of water should be used as a disinfectant to spray over the spill and clean up with paper towels. The paper towels should then be placed in the plastic-lined waste container. DIF: Cognitive Level: Knowledge REF: 153 OBJ: 12 TOP: Body fluids KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment

When assessing a patient for signs of an infection, the nurse recognizes which laboratory result as indicative of an infection? a. Lowered red blood cell count b. Increased white blood cell count c. Lowered white blood cell count d. Increased red blood cell count 24.

ANS: B

Increased white blood cell count may indicate an infection. DIF: Cognitive Level: Application REF: 155 TOP: Lab results KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

OBJ: 3 | 4

What can result from the nurse consistently performing hand hygiene and using sterile supplies when caring for patients in the hospital setting? a. Hospital stay is shortened b. Sense of self-worth is improved c. Risk of infection is reduced d. Nursing care needed is reduced 25.

ANS: C

Hand hygiene is the most important measure for interrupting the infectious process. DIF: Cognitive Level: Comprehension REF: 118 OBJ: 5 TOP: Infection KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment

Recognizing the stages of an infection assists the nurse in identifying the progression of an infection. What is the nonspecific to specific symptom stage of an infection? a. Convalescent 26.

b. c. d.

Illness Prodromal Incubation

ANS: C

The prodromal stage progresses from onset of nonspecific signs and symptoms to more specific signs and symptoms. DIF: Cognitive Level: Knowledge REF: 125 TOP: Infection KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

OBJ: 4 | 6

27. What is the most dependable and practical method to use when sterilizing instruments for the operating room? a. Chemical solution b. Boiling water c. Steam under pressure d. Dry heat ANS: C

Steam under pressure is the most practical and dependable method for destruction of all microorganisms. DIF: Cognitive Level: Comprehension REF: 153 TOP: Sterilization KEY: Nursing Process Step: N/A 28. a. b. c. d.

OBJ: 12 MSC: NCLEX: N/A

What contribution did Joseph Lister introduce to medical practice? Isolation of infected patients Iodine and alcohol use as disinfectants The autoclave Aseptic technique

ANS: D

Joseph Lister contributed to medical practice through the introduction of the aseptic technique. DIF: Cognitive Level: Knowledge TOP: Joseph Lister MSC: NCLEX: N/A

REF: 117 OBJ: 1 KEY: Nursing Process Step: N/A

29. The nurse is providing instruction to an anxious mother of a child with Rocky Mountain spotted fever. When discussing this diagnosis, what information will the nurse relay about this disease? a. It is extremely contagious among humans. b. It is contracted from handling unvaccinated animals. c. It is a hemolytic B Streptococcus infection spread by droplet transmission.

d.

It is a serious disease contracted from the bite of a tick.

ANS: D

Rocky Mountain spotted fever is contracted through the bite of a tick vector. It is not contagious among humans. DIF: Cognitive Level: Comprehension TOP: Vector transmission MSC: NCLEX: Physiological Integrity

REF: 120 OBJ: 2 | 3 KEY: Nursing Process Step: Implementation

30. The emergency department nurse is assessing a puncture wound of the foot. What is the most likely type of infection in this wound? a. Aerobic bacterial infection b. Anaerobic bacterial infection c. Viral infection d. Fungal infection ANS: B

An anaerobic bacterial infection is one that grows in an oxygenated environment. DIF: Cognitive Level: Comprehension TOP: Anaerobic infections MSC: NCLEX: Physiological Integrity

REF: 119 OBJ: 6 KEY: Nursing Process Step: Assessment

31. The nurse is instructing a bioterrorism class regarding anthrax. How can anthrax be transmitted? a. From person to person b. Through microscopic skin punctures c. Through inhalation of the spores d. By exposure to animals that have anthrax ANS: C

Anthrax is contracted by inhaling the spores. DIF: Cognitive Level: Comprehension REF: 119 | 120 OBJ: 3 TOP: Anthrax KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 32. The nurse is providing teaching to elementary students regarding vectors. What example will the nurse provide as an example of a vector? a. Child with measles giving it to his sister b. Tick whose bite causes Lyme disease c. Woman with syphilis infecting her partner d. Dog whose bite causes rabies ANS: B

A vector is a person or animal not sick with the disease harboring an organism that is contagious.

DIF: Cognitive Level: Comprehension REF: 122 OBJ: 3 TOP: Vector KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 33. a. b. c. d.

What type of organism causes malaria? Bacterium Virus Protozoan Fungus

ANS: C

Malaria is caused by the introduction of protozoa from the bite of a mosquito. DIF: Cognitive Level: Knowledge TOP: Protozoan infections MSC: NCLEX: Physiological Integrity

REF: 122 OBJ: 4 KEY: Nursing Process Step: Implementation

34. A nurse is performing an admission assessment on a patient with suspected tuberculosis. What assessment findings by the nurse are consistent with tuberculosis? a. Hemoptysis b. Weight gain c. Night terrors d. Hypothermia ANS: A

Suspicious symptoms consistent with tuberculosis include fatigue, unexplained weight loss, dyspnea, fever, night sweats, and hemoptysis (a cough that can be productive of blood). DIF: Cognitive Level: Comprehension TOP: Tuberculosis MSC: NCLEX: Physiological Integrity

REF: 138 OBJ: 6 KEY: Nursing Process Step: Assessment

A nurse is performing an admission assessment on a patient with suspected tuberculosis. What is the greatest risk of exposure to tuberculosis? a. After a diagnosis is made b. Before a diagnosis is made c. After the patient has begun medication therapy d. After implementation of isolation precautions 35.

ANS: B

The risk of exposure to tuberculosis is greatest before a diagnosis is made and isolation precautions are implemented. DIF: Cognitive Level: Comprehension

REF: 139

OBJ: 8

TOP: Tuberculosis MSC: NCLEX: Physiological Integrity

KEY: Nursing Process Step: Assessment

MULTIPLE RESPONSE 1.

A person can spread a bacterial infection by which actions? (Select all that

apply.) a. b. c. d. e.

Kissing others Sneezing at work Donating blood Coming in contact with blood products Leaving used tissue on the lavatory

ANS: A, B, E

Bacteria can be spread by direct, indirect, or airborne transmission. DIF: Cognitive Level: Comprehension REF: 122 | 155 OBJ: 14 TOP: Bacterial transmission KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 2. a. b. c. d. e.

What are some characteristics of microorganisms? (Select all that apply.) Involved in a life process of their own. Pathogens that cause disease. Nonpathologic organisms that ca...