Question 1

The nurse is assisting the health care provider insert a chest tube into a client with a hemothorax following a motor vehicle crash.Which would the nurse don in order to assist with this procedure?

Accepted Answer

C,E

Question 2

Which items will the nurse use with all clients to prevent the transmission of potentially infective organisms among the nurse,client,and other individuals?

Accepted Answer

Standard precautions, including hand hygiene and the use of personal protective equipment (PPE), are fundamental practices used to prevent the transmission of infectious agents. Hand hygiene is a critical measure for reducing the spread of pathogens. Standard precautions are a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes. Personal protective equipment (PPE) such as gloves, gowns, masks, and eye protection is used based on the anticipated exposure to prevent skin and mucous membrane exposure when contact with potentially infectious materials is anticipated.

Question 3

The nurse observes the newly hired unlicensed assistive personnel (UAP)performing routine client care.Which behaviors would indicate the UAP understands the use of personal protective equipment?

Accepted Answer

C

Question 4

The nurse is caring for a client with a medical diagnosis of HIV/AIDS admitted to the hospital with Pneumocystis carinii infection.In order to reduce the spread of infection,which is the priority nursing intervention?

Accepted Answer

Teaching respiratory/cough etiquette is the priority nursing intervention to reduce the spread of infection in a client with Pneumocystis carinii infection, as the infection is primarily spread through droplets during coughing or sneezing. While teaching the client self-care, the use of sexual barriers, and standard precautions are also important interventions, they are not the priority in this situation.

Question 5

The nurse is caring for a client with a deep draining abdominal wound.Which factor would require the nurse to wear a mask and goggles when caring for this client?

Accepted Answer

The answer of The nurse is caring for a client...

Question 6

The nurse would don clean disposable gloves in which situation?

Accepted Answer

Donning clean disposable gloves is recommended when providing denture care to prevent the transmission of microorganisms and ensure proper infection control.

Question 7

The nurse is caring for a client who developed an infection after admission to the hospital.Which term would the nurse use when documenting this infection?

Accepted Answer

A nosocomial infection is an infection acquired during hospitalization. It is also known as a health care-associated infection. The term "bacterial infection" is too generic as infections can be viral, fungal, or parasitic as well. "Therapeutic infection" is not a term used to describe infections acquired during hospitalization.

Question 8

The nurse is called into a client's room by the unlicensed assistive personnel (UAP),who informs the nurse that the obstetric client has no pulse or respirations and has profuse vaginal bleeding.Which is the priority action by the nurse?

Accepted Answer

In this situation, the priority is to take immediate action to try and save the client's life. The nurse should assess for pulse and respirations themselves, instruct the UAP to notify the code team while they don personal protective equipment, and begin CPR as soon as possible. Bleeding can be addressed once the client's cardiac and respiratory status have been stabilized. Option A is incorrect as it only instructs the nurse to assess the client, without taking action to notify the code team or begin resuscitation. Option C is also incorrect as it prioritizes assessing for bleeding before initiating potentially life-saving measures. Option D is incorrect as it prioritizes donning personal protective equipment before initiating resuscitation, which could cost critical time.

Question 9

The nurse is working in a day care center for infants with special needs where there recently has been an outbreak of viral conjunctivitis.Which instruction by the nurse to the staff is the best way to stop the spread of this infection?

Accepted Answer

The best way to stop the spread of viral conjunctivitis in a day care center is to practice good hand hygiene, particularly after providing personal care for the children. Requiring children to stay home or isolating them in a separate room may help reduce the spread of the infection, but it is not always practical or effective. Antibiotics are not typically effective for viral infections such as conjunctivitis.

Question 10

Nurses must care for several clients during each shift.Which action by the nurse demonstrates appropriate hand hygiene?

Accepted Answer

Washing hands with soap and water is the most appropriate action for hand hygiene. It is recommended to wash hands before and after client care, especially when coming in contact with bodily fluids, as gloves alone do not provide complete protection. Wiping hands off does not provide adequate cleaning, and using the client's soap can lead to cross-contamination.

Question 11

The nurse would use a Situation,Background,Assessment,and Recommendation (SBAR)process in which situations?

Accepted Answer

The answer of The nurse would use a Situation,Background,Assessment,and Recommendation...

Question 12

The charge nurse is observing a staff nurse caring for a client with extensive burns.Which action by the staff nurse would indicate the need for further teaching regarding infection-control procedures?

Accepted Answer

While it is appropriate to wear gloves and gown when dressing the client's wounds and wearing gloves when bathing the client, wearing gloves alone when teaching a family member how to meet the client's nutritional needs after discharge would not prevent the spread of infection. It is important to emphasize that hand hygiene measures should be taken in all situations where there is a risk of transmission of microorganisms, including when teaching family members.

Question 13

When planning care for a client,the nurse uses which equipment?

Accepted Answer

Personal protective equipment (PPE) is used by nurses to protect themselves and their clients from infection and contamination during care.

Question 14

The nurse,working in an emergency department,is preparing to care for a client admitted with a traumatic amputation of the left hand.Which personal protective equipment would the nurse wear?

Accepted Answer

Gowns, gloves, and masks are all necessary personal protective equipment (PPE) to protect the nurse from blood and other bodily fluids when caring for a client with a traumatic amputation.

Question 15

The nurse observing the unlicensed assistive personnel (UAP)using alcohol-based rubs for hand hygiene would recognize that further teaching is required when the UAP performs which act?

Accepted Answer

Drying hands with a paper towel is not part of the proper technique for using alcohol-based hand rubs. The hands should be allowed to air dry completely after applying the product. Therefore, further teaching is required for the UAP in this regard. Rubbing palm against palm, applying a palmful of product into cupped hands, and interlacing fingers palm to palm are all correct steps in the proper technique for using alcohol-based hand rubs.

Question 16

Which tasks would be appropriate for the nurse to delegate to the unlicensed assistive personnel (UAP)?

Accepted Answer

Tasks that can be delegated to unlicensed assistive personnel (UAP) include those that are routine, do not require nursing judgment, and have predictable outcomes. Taking vital signs, measuring and recording intake and output, postmortem care, and weighing the client are all tasks that fit these criteria. Providing telephone advice, however, requires nursing judgment and assessment skills, and therefore should not be delegated to UAP.

Question 17

The nurse is caring for a client on respiratory isolation and will use which protective equipment?

Accepted Answer

Respiratory isolation requires the use of a mask to protect the healthcare worker from inhaling respiratory secretions from the client, as well as gloves to protect against contact with contaminated surfaces. A gown may be necessary if the client is also on contact isolation.

Question 18

The registered nurse effectively delegates which procedure to the unlicensed assistive personnel (UAP)?

Accepted Answer

Assisting a client to bedside commode is within the scope of practice for UAP and can be safely delegated by the registered nurse. The other options require the expertise and skills of a licensed nurse and cannot be delegated to UAP.

Question 19

The nurse wearing personal protective equipment would take which article off first?

Accepted Answer

Gloves are removed first because they are considered the most contaminated piece of personal protective equipment (PPE), and their removal helps to minimize the risk of contaminating other parts of the PPE or the wearer during the removal process.

Question 20

The nurse is assisting the health care provider with the insertion of a chest tube.Which personal protective equipment would the nurse don?

Accepted Answer

The nurse should wear clean gloves, a gown, and a mask with eye protection to prevent exposure to bodily fluids during the procedure. Sterile gloves are not necessary for the nurse assisting with the procedure.

Quiz 1: Foundational Skills