Description
Clinical Nursing Skills and Techniques 7th Edition Perry Potter Test Bank
ISBN-13: 978-0323052894
ISBN-10: 0323052894
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Perry: Clinical Nursing Skills & Techniques, 7th Edition
Chapter 8: Sterile Technique
Test Bank
MULTIPLE CHOICE
- When the following concepts are compared, which is most important in maintaining a safe environment by following aseptic principles?
| a. | Performing a surgical hand scrub |
| b. | Applying a sterile gown |
| c. | Recognizing the importance of following aseptic principles |
| d. | Applying a mask and protective eyewear |
ANS: C
A nurse in an operating room follows a series of steps toward sterile technique, such as applying a mask, protective eyewear, and a cap; performing a surgical hand scrub; and applying a sterile gown and sterile gloves. In contrast, a nurse who is performing a sterile dressing change at a patient’s bedside or in the home setting may only wash the hands and apply sterile gloves. Regardless of the procedures followed or the setting, the nurse needs to recognize the importance of following strict aseptic principles.
DIF: Cognitive Level: Application REF: Text Reference: Page 189
OBJ: Identify principles of surgical asepsis. TOP: Aseptic Principles
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
- The nurse is preparing to provide wound care for her patient. She realizes that the most effective way to decrease the bacterial count on her hands is to wash her hands:
| a. | Using soap and water only |
| b. | Using a nonalcohol antiseptic alone |
| c. | Using a 50% alcohol-based antiseptic alone |
| d. | Using a 60% to 95% alcohol-based antiseptic alone |
ANS: D
Studies have shown that antiseptics containing 60% to 95% alcohol alone, or 50% to 95% alcohol, when combined with other selected antiseptics (e.g., chlorhexidine), lower bacterial counts on the skin more effectively than do other antiseptics without alcohol.
An alcohol-based hand rub may be used as a preoperative hand scrub after an initial 15-second prewash with plain soap and water.
DIF: Cognitive Level: Synthesis REF: Text Reference: Page 189
OBJ: Identify principles of surgical asepsis. TOP: Antiseptic Hand Wash
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
- The nurse is applying for a job at a local hospital. She wants to look her best for the interview and decides to wear artificial nails. She does this knowing that:
| a. | Artificial nails are appropriate in the ICU setting as long as the nurse washes her hands frequently |
| b. | Artificial nails can lead to fungal growth under the nail |
| c. | Artificial nails can actually lower the bacterial count on the hands because they cover the natural nail |
| d. | Artificial nails are banned only in areas where patients are critically ill |
ANS: B
Numerous reports identify that fungal growth frequently occurs under artificial nails as a result of moisture becoming trapped between the natural nail and the artificial nail.
Because of the risks for infection posed by artificial nail use, health care workers who have direct contact with patients at high risk (e.g., those in intensive care units or operating rooms) should not wear artificial nails. Health care workers who wear artificial nails or nail extenders are more likely to harbor gram-negative pathogens on their fingertips, both before and after hand washing. Many health care institutions have chosen to ban artificial nails and extenders in all clinical areas, with the rationale that all patients are at risk for infection.
DIF: Cognitive Level: Application REF: Text Reference: Page 189
OBJ: Identify principles of surgical asepsis. TOP: Artificial Nails
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
- When removing the mask following an aseptic procedure, the nurse should:
| a. | Remove gloves first |
| b. | Untie top strings of mask first |
| c. | Untie bottom strings last |
| d. | Untie top strings and let mask hang |
ANS: A
Remove gloves first, if worn. This prevents contamination of hair, neck, and facial area by contaminants on gloves.
Untie top strings of mask after untying bottom strings. This prevents the top part of the mask from falling down over the uniform. If the mask falls and touches the uniform, it will be contaminated.
DIF: Cognitive Level: Application REF: Text Reference: Page 191
OBJ: Apply and remove a cap, mask, and eyewear correctly. TOP: Removing the Mask
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
- An appropriate principle of surgical asepsis is that:
| a. | The entirety of a sterile package is sterile once it is opened |
| b. | All of the draped table, top to bottom, is considered sterile |
| c. | An object held below the waist is considered contaminated |
| d. | If the sterile barrier field becomes wet, the dry areas are still sterile |
ANS: C
A sterile object or field out of the range of vision or an object held below a person’s waist is contaminated.
Once a sterile package is opened, a 2.5-cm (1-inch) border around the edges is considered unsterile. Tables draped as part of a sterile field are considered sterile only at table level.
A sterile barrier that has been permeated by punctures, tears, or moisture must be considered contaminated.
DIF: Cognitive Level: Application REF: Text Reference: Page 194
OBJ: Perform the following skills: applying sterile gloves using open glove method, preparing a sterile field, applying a sterile drape correctly. TOP: Sterile Field
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
- A patient requires a sterile dressing change for a mid-abdominal surgical incision. An appropriate intervention for the nurse to implement in maintaining sterile asepsis is to:
| a. | Put sterile gloves on before opening sterile packages |
| b. | Discard items that may have been in contact with the area below waist level |
| c. | Place povidone-iodine bottle well within the sterile field |
| d. | Place sterile items on the very edge of the sterile drape |
ANS: B
A sterile object held below a person’s waist is considered contaminated. To maintain sterile asepsis, discard items that may have been in contact with the area below waist level.
Sterile gloves are not put on before opening sterile packages, as the outside of the package is not sterile. The nurse uses hand hygiene and opens sterile packages while being careful to keep the inner contents sterile. Povidone-iodine and chlorhexidine are not considered sterile solutions and require separate work surfaces for prepping. The edges of a sterile field are considered to be contaminated. Sterile items should be placed in the middle of the sterile field to maintain sterile asepsis.
DIF: Cognitive Level: Application REF: Text Reference: Page 194
OBJ: Perform the following skills: applying sterile gloves using open glove method, preparing a sterile field, applying a sterile drape correctly. TOP: Sterile Field
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
- A patient that the nurse believes may be at risk for a latex allergy is the individual with:
| a. | Food allergies |
| b. | Diabetes |
| c. | Arthritis |
| d. | Hypertension |
ANS: A
Individuals at risk for latex allergy include those with a history of food allergies.
Patients with diabetes, arthritis, and hypertension are not at increased risk for latex allergies.
DIF: Cognitive Level: Application REF: Text Reference: Page 199
OBJ: Identify individuals at risk for latex allergy. TOP: Latex Allergy
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
- An appropriate technique for the nurse to use when performing sterile gloving is to:
| a. | Put the glove on the nondominant hand first |
| b. | Interlock the hands after both gloves are applied |
| c. | Pull the cuffs down on both gloves after gloving |
| d. | Grasp the outside cuff of the other glove with the gloved hand |
ANS: B
After the second glove is on, interlock the hands above waist level. Be sure to touch only sterile sides.
Gloving of dominant hand first improves dexterity. The cuffs usually fall down after application. With gloved dominant hand, slip fingers underneath the second glove’s cuff. The cuff protects gloved fingers. Sterile touching sterile prevents glove contamination.
DIF: Cognitive Level: Application REF: Text Reference: Page 200
OBJ: Perform the following skills: applying sterile gloves using open glove method, preparing a sterile field, applying a sterile drape correctly. TOP: Applying Sterile Gloves
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
- The nurse is preparing to insert a urinary catheter. The package is dry but shows signs of yellowing inside the plastic wrapper, as if the package was wet at one time. The nurse should:
| a. | Use the package since it is dry at present |
| b. | Consider the outer package contaminated, but the inner package sterile |
| c. | Discard the entire package as contaminated |
| d. | Open the package and consider the 1-inch border as contaminated |
ANS: C
A sterile barrier that has been permeated by punctures, tears, or moisture must be considered contaminated. If there is any question or doubt of an item’s sterility, the item is considered to be unsterile.
Once a sterile package is opened, a 2.5-cm (1-inch) border around the edges is considered unsterile.
DIF: Cognitive Level: Application REF: Text Reference: Page 189
OBJ: Explain the importance of organization and caution when using surgical aseptic techniques.
TOP: Principles of Surgical Asepsis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
- A type I hypersensitivity to latex is evident if the nurse assesses:
| a. | Localized swelling |
| b. | Skin redness and itching |
| c. | Runny eyes and nose and cough |
| d. | Tachycardia, hypotension, and wheezing |
ANS: D
Type I allergic reaction is a true latex allergy that can be life-threatening. Reactions vary based on type of latex protein and degree of individual sensitivity, including local and systemic. Symptoms include hives, generalized edema, itching, rash, wheezing, bronchospasm, difficulty breathing, laryngeal edema, diarrhea, nausea, hypotension, tachycardia, and respiratory or cardiac arrest.
Type IV hypersensitivity is a cell-mediated allergic reaction to chemicals used in latex processing. Reaction, including redness, itching, and hives, can be delayed up to 48 hours. Localized swelling, red and itchy or runny eyes and nose, and coughing may develop.
Irritant dermatitis is a nonallergic response characterized by skin redness and itching.
Type IV hypersensitivity is a cell-mediated allergic reaction to chemicals used in latex processing. Reaction, including redness, itching, and hives, can be delayed up to 48 hours.
DIF: Cognitive Level: Comprehension REF: Text Reference: Page 198
OBJ: Identify individuals at risk for latex allergy. TOP: Levels of Latex Reactions
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
MULTIPLE RESPONSE
- Nurses commonly use surgical asepsis in which of the following situations? (Select all that apply.)
| a. | In labor and delivery areas |
| b. | When inserting an intravenous catheter |
| c. | When treating patients with surgical incisions or burns |
| d. | When inserting a urinary catheter |
ANS: A, B, C, D
While nurses commonly practice surgical asepsis in operating rooms, labor and delivery areas, and major diagnostic or special procedure areas, they use surgical aseptic techniques at the patient’s bedside in three primary situations: (1) procedures that require intentional perforation of a patient’s skin (e.g., insertion of intravenous [IV] catheters), (2) when the skin’s integrity is broken as the result of a surgical incision or burns, and (3) during procedures that involve insertion of devices or surgical instruments into normally sterile body cavities (e.g., insertion of a urinary catheter).
DIF: Cognitive Level: Application REF: Text Reference: Page 189
OBJ: Discuss settings where you will use surgical aseptic techniques.
TOP: Surgical Asepsis KEY: Nursing Process Step: Intervention
MSC: NCLEX: Physiological Integrity
- The patient has just had a tracheostomy tube placed and is expectorating copious amounts of sputum that he coughs forcefully from his tracheostomy tube. The patient also is suspected of having methicillin-resistant Staphylococcus aureus (MRSA) in his sputum. The nurse is preparing to suction the patient to clear his airway. Which of the following will the nurse need to wear if following Standard Precautions? (Select all that apply.)
| a. | Mask |
| b. | Goggles |
| c. | Gown |
| d. | Sterile gloves |
ANS: A, B, C, D
Standard Precautions are used for potential contact with blood and all body fluids. The use of Standard Precautions calls for the wearing of masks in combination with eye protection devices such as goggles or glasses with solid side shields whenever splashes, spray, splatter, or droplets of blood or other potentially infectious fluids may occur. These barriers keep the eyes, nose, and mouth free from exposure. Similarly, you wear gowns when there is risk of being splattered with blood or other infectious materials. All health care institutions need to provide to all employees at risk for exposure personal protective equipment and instructions for its use.
DIF: Cognitive Level: Synthesis REF: Text Reference: Page 189
OBJ: Identify principles of surgical asepsis. TOP: Standard Precautions
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
- A sterile field consists of which of the following? (Select all that apply.)
| a. | A sterile tray |
| b. | A work surface draped with a sterile towel |
| c. | A table covered by a large sterile drape |
| d. | A patient’s bedside table |
ANS: A, B, C
A sterile field may consist of a sterile kit or tray, a work surface draped with a sterile towel or wrapper, or a table covered with a large sterile drape. A patient’s bedside table is not sterile but can be a work surface where a sterile field can be applied.
DIF: Cognitive Level: Application REF: Text Reference: Page 193
OBJ: Perform the following skills: applying sterile gloves using open glove method, preparing a sterile field, applying a sterile drape correctly. TOP: Sterile Field
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
COMPLETION
- _____________ is one practice designed to make and maintain objects and areas free from pathogenic microorganisms.
ANS:
Surgical asepsis
Surgical asepsis or aseptic techniques and practices are designed to make and maintain objects and areas free from pathogenic microorganisms.
DIF: Cognitive Level: Comprehension REF: Text Reference: Page 189
OBJ: Describe conditions when you use surgical asepsis. TOP: Surgical Asepsis
KEY: Nursing Process Step: Intervention MSC: NCLEX: Physiological Integrity
- The minimum standard for infection control as established by the Centers for Disease Control and Prevention (CDC) is _______________.
ANS:
Standard Precautions
The Centers for Disease Control and Prevention has established Standard Precautions as the minimum standard for infection control. Standard Precautions are used for potential contact with blood and all body fluids.
DIF: Cognitive Level: Application REF: Text Reference: Page 189
OBJ: Discuss settings where you will use surgical aseptic techniques.
TOP: Standard Precautions KEY: Nursing Process Step: Intervention
MSC: NCLEX: Physiological Integrity
- When performing sterile aseptic procedures, the nurse must create a _____________ in which objects can be handled with a minimal risk of contamination.
ANS:
sterile field
When performing sterile aseptic procedures, the nurse must have a work area in which objects can be handled with minimal risk of contamination. A sterile field serves such a purpose.
DIF: Cognitive Level: Application REF: Text Reference: Page 193
OBJ: Perform the following skills: applying sterile gloves using open glove method, preparing a sterile field, applying a sterile drape correctly. TOP: Sterile Field
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
