Description
Foundations of Basic Nursing 3rd Edition White Duncan Baumle Test Bank
ISBN 13: 9781428317734
ISBN 10: 1428317732
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Chapter 22—Standard Precautions and Isolation
MULTIPLE CHOICE
- Which of these statements about the Guideline for Isolation Precautions in Hospitals revised in 1996 the Centers for Disease Control and Prevention (CDC) is TRUE?
| a. | The recommendations are not subject to legal enforcement. |
| b. | The recommendations are revised every 10 years. |
| c. | The recommendations have been superseded Occupational Safety and Health Administration (OSHA) regulations. |
| d. | The recommendations are subject to individual hospital and health care facility choice as to implementation. |
ANS: A
Standard Precautions are guidelines recommended the CDC to reduce the risk of microorganism transmission from recognized and unrecognized sources of infection in hospitals. Although the CDC recommendations are not subject to legal enforcement, health care facilities must follow regulations issued OSHA; these regulations incorporate the CDC guidelines and thus ensure that Standard Precautions and transmission-based precautions are followed.
PTS: 1 DIF: Application REF: White (2010)
- When a client is admitted to a health care facility, the client will automatically be placed on which type of isolation precautions?
| a. | airborne | c. | none |
| b. | contact | d. | standard |
ANS: D
Standard Precautions apply to blood; all body fluids, secretions, and excretions except sweat, regardless of whether those fluids contain visible blood; nonintact skin; and mucous membranes.
PTS: 1 DIF: Comprehension REF: White (2010)
- A nurse observes a certified nursing assistant (CNA) wearing one pair of gloves when taking vital signs on all assigned clients. What action should the nurse take immediately?
| a. | Ask the CNA to explain the rationale for this in a private conference. |
| b. | Ignore the behavior because the CNA is following agency procedure. |
| c. | Report the CNA to the charge nurse. |
| d. | Teach the CNA the correct procedure, stressing the rationale. |
ANS: D
Components of Standard Precautions include hand washing after touching blood, body fluids, secretions, excretions, and contaminated items, even if gloves were worn, and between tasks and procedures on the same client to prevent cross-contamination of body sites; and applying nonsterile gloves before touching mucous membranes, nonintact skin, blood, body fluids, secretions, excretions, and contaminated items. Gloves must be changed and hand washing done between clients to prevent nosocomial infections.
PTS: 1 DIF: Application REF: White (2010)
- A labor and delivery nurse is assisting a health care provider who will be artificially rupturing a client’s membranes (AROM). What barrier devices must the health care provider wear?
| a. | clean gloves and clean gown |
| b. | face shield and clean gloves |
| c. | face shield, sterile gloves, and clean gown |
| d. | sterile gloves only |
ANS: C
Health care providers must apply nonsterile gloves before touching mucous membranes, nonintact skin, blood, body fluids, secretions, excretions, and contaminated items; and wear a gown during procedures and client care activities with a high probability of generating splashes or sprays of blood, body fluids, secretions, or excretions. Masks, eye protection, and face shields are to be worn when procedures and client care activities may generate splashes or sprays of blood, body fluids, secretions, or excretions.
PTS: 1 DIF: Application REF: White (2010)
- A nurse is providing morning care to a client whose infected wound must be redressed. Which of these actions is correct?
| a. | Don clean gloves and change them between the morning care and dressing change. |
| b. | Don clean gloves, remove them after morning care, wash hands, and apply new gloves for the dressing change. |
| c. | Wash hands and wear one pair of clean gloves for all client’s care. |
| d. | Wear clean gloves for morning care and sterile gloves for the dressing change. |
ANS: B
Barrier precautions refer to the use of personal protective equipment (e.g., gowns, gloves) to minimize risk of exposure to blood and body fluids creating a barrier between the person and the microorganism and preventing transmission of the microorganism. Components of Standard Precautions include hand washing after touching blood, body fluids, secretions, excretions, and contaminated items, even if gloves were worn, and between tasks and procedures on the same client to prevent cross-contamination of body sites; and applying nonsterile gloves before touching mucous membranes, nonintact skin, blood, body fluids, secretions, excretions, and contaminated items.
PTS: 1 DIF: Application REF: White (2010)
- A client who has sustained extensive burns will require what type of isolation precautions?
| a. | barrier | c. | standard |
| b. | reverse | d. | transmission-based |
ANS: B
Reverse precautions are instituted for clients who are known or suspected to have serious illnesses in which contact with additional microorganisms places them at risk for infection.
PTS: 1 DIF: Comprehension REF: White (2010)
- A client with pneumonia has a repeat chest X-ray in the radiology department. The nurse places which of the following on the client for transport?
| a. | a face shield | c. | an N-95 respirator |
| b. | a surgical mask | d. | gloves and a gown |
ANS: B
Droplet precautions are instituted for clients known or suspected to have illnesses spread large particle droplets, such as meningitis, pneumonia, mumps, or influenza. Droplet precautions include placing the client in a private room if possible, or maintenance of at least 3 feet from other clients or visitors; having staff wear masks when within 3 feet of the client; and limiting client transport, with the client wearing a surgical mask.
PTS: 1 DIF: Application REF: White (2010)
- A nurse is caring for a client who has active tuberculosis. What barrier precautions will the nurse wear when in the client’s room?
| a. | a face shield |
| b. | a surgical mask |
| c. | an N-95 respirator |
| d. | mask and eye protection, a gown, and gloves |
ANS: C
Airborne precautions are instituted for clients who are known or suspected to have serious illnesses spread airborne droplet nuclei, such as measles, varicella, and tuberculosis. Airborne precautions include placing the client in a private room; limiting transport of the client to other areas while she or he wears a surgical mask; and employing respiratory protection measures for staff, such as using special respirators.
PTS: 1 DIF: Application REF: White (2010)
- The family of a client who has tuberculosis keeps leaving the isolation room door open. They tell the nurse the client “feels closed in.” The client is in a private room with monitored negative air pressure. Which of these actions should the nurse take immediately?
| a. | Educate the client and the family as to why the door must remain closed. |
| b. | Notify the charge nurse and the client’s physician. |
| c. | Post a “no visitors” sign and ask the family to leave. |
| d. | Spend more time with the client during the shift. |
ANS: A
Airborne precautions are instituted for clients who are known or suspected to have serious illnesses spread airborne droplet nuclei, such as measles, varicella, and tuberculosis. Airborne precautions include placing the client in a private room or a private room with monitored negative air pressure, limiting transport of the client to other areas while she or he wears a surgical mask, and employing respiratory protection measures for staff, such as using special respirators.
PTS: 1 DIF: Application REF: White (2010)
- A client who has a major abscess on the thigh is on isolation precautions in a private room after surgical debridement. The physician changes the dressing each day. What barrier precautions should the nurse wear when providing care to this client?
| a. | an N-95 respirator and gloves |
| b. | eye protection and a face mask |
| c. | gloves and a gown, using antimicrobial-agent hand hygiene after glove removal |
| d. | a gown only |
ANS: C
Contact precautions are instituted for clients who are known or suspected to have serious illnesses easily spread direct contact or contact with fomites, such as wound or skin infections or gastrointestinal or respiratory infections. Contact precautions include placing the client in a private room, if possible; employing staff barrier protection with gloves, gowns, and hand washing; limiting client transport; and using equipment dedicated to that client when possible or, if not possible, cleansing and disinfecting between client uses.
PTS: 1 DIF: Application REF: White (2010)
- When following Standard Precautions while serving a client’s meal tray, which personal protection equipment should be worn?
| a. | gloves only | c. | mask and gloves |
| b. | gown, gloves, mask, and goggles | d. | none |
ANS: D
Standard Precautions apply to blood; all body fluids, secretions, and excretions except sweat, regardless of whether those fluids contain visible blood; nonintact skin; and mucous membranes.
PTS: 1 DIF: Comprehension REF: White (2010)
- When following Standard Precautions, which personal protection equipment should be worn while giving eye care to a client?
| a. | gloves only | c. | mask and gloves |
| b. | gown, gloves, mask, and goggles | d. | none |
ANS: A
Barrier precautions refer to the use of personal protective equipment (e.g., gowns, gloves) to minimize risk of exposure to blood and body fluids creating a barrier between the person and the microorganism and preventing transmission of the microorganism. Nonsterile gloves should be applied before touching mucous membranes, nonintact skin, blood, body fluids, secretions, excretions, and contaminated items.
PTS: 1 DIF: Comprehension REF: White (2010)
- When following Standard Precautions, which personal protection equipment should be worn while attempting to control bleeding?
| a. | gloves only | c. | mask and gloves |
| b. | gown, gloves, mask, and goggles | d. | none |
ANS: B
Barrier precautions refer to the use of personal protective equipment (e.g., gowns, gloves) to minimize risk of exposure to blood and body fluids creating a barrier between the person and the microorganism and preventing transmission of the microorganism. Nonsterile gloves should be applied before touching mucous membranes, nonintact skin, blood, body fluids, secretions, excretions, and contaminated items; a gown should be worn during procedures and client care activities with a high probability of generating splashes or sprays of blood, body fluids, secretions, or excretions. Masks, eye protection, and face shields are to be worn when procedures and client care activities may generate splashes or sprays of blood, body fluids, secretions, or excretions.
PTS: 1 DIF: Application REF: White (2010)
- Which of these approaches should a nurse take when caring for a client placed on isolation precautions?
| a. | Encourage client verbalization of feelings about isolation. |
| b. | Limit visitors to hasten client recovery. |
| c. | Arrange for a psychiatric consult for the client. |
| d. | Split care responsibilities with another nurse to increase client distraction. |
ANS: A
A client placed on isolation precautions may feel isolated from the activities occurring around the client. The nurse should encourage client verbalization of feelings about isolation.
PTS: 1 DIF: Application REF: White (2010)
MULTIPLE RESPONSE
- The nurse’s responsibility in reducing the client’s risk for infection includes which of the following? (Select all that apply.)
| a. | hand hygiene for all who enter the room |
| b. | proper protective equipment |
| c. | not allowing visitors |
| d. | keeping environment clean |
| e. | follow isolation policy |
| f. | limit time spent in client’s room |
ANS: A, B, D, E
The nurse’s responsibility in reducing the client’s risk for infection includes ensuring proper hand hygiene is completed for all who enter the room, keeping the environment clean, and using proper protective equipment such as gowns, masks, and gloves to prevent the spread of infection.
PTS: 1
- When client care equipment is soiled with blood, body fluids, secretions, or excretions, nurses can avoid contaminating their skin, mucous membranes, and clothing doing which of the following? (Select all that apply.)
| a. | requesting new supplies each day |
| b. | careful handling or disposal of the equipment |
| c. | keeping them in the client’s room until discharge to prevent contamination |
| d. | using personal protective equipment |
| e. | using adequate environmental control procedures |
ANS: B, D, E
Barrier precautions refer to the use of personal protective equipment (e.g., gowns, gloves) to minimize risk of exposure to blood and body fluids creating a barrier between the person and the microorganism and preventing transmission of the microorganism. When client care equipment is soiled with blood, body fluids, secretions, or excretions, nurses can avoid contaminating their skin, mucous membranes, and clothing careful handling or disposal of the equipment. The hospital must use adequate environmental control procedures for routine care, cleaning, and disinfection of surfaces such as beds and bedside equipment.
PTS: 1 DIF: Application REF: White (2010)
