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Med Surg II Exam 2 21,29,34
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Med Surg II Exam 2 21,29,34Med Surg II Exam 2 21,29,34
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Med Surg II Exam 2 21,29,34The nurse learning about infection discovers that which factor is the best and most important
barrier to infection?
a. Colonization by host bacteria
b. Gastrointestinal secretions
c. Inflammatory processes
d. Skin and mucous membranes - correct answer-ANS: D
A nursing manager is concerned about the number of infections on the hospital unit. What
action by the manager would best help
prevent these infections?
a. Auditing staff members' hand hygiene practices
b. Ensuring clients are placed in appropriate isolation
c. Establishing a policy to remove urinary catheters quickly
d. Teaching staff members about infection control methods - correct answer-ANS: A - All
methods will help prevent infection; however, health care workers' lack of hand hygiene is
the biggest cause of health care-associated infections.
An assistive personnel asks why brushing client s' teeth with a toothbrush in the intensive
care unit is important to infection
control. What response by the registered nurse is best?
a. "It mechanically removes biofilm on teeth."
b. "It's easier to clean all surfaces with a brush."
c. "Oral care is important to all our clients."
d. "Toothbrushes last longer than oral swabs." - correct answer-Biofilms are a complex group
of bacteria that function within a slimy gel on surfaces such as teeth. Mechanical disruption
is the best way to control them.
A client is admitted with possible sepsis. Which action will the nurse perform first?
a. Administer antibiotics.
b. Give an antipyretic.
c. Place the client in isolation.
d. Obtain specified cultures. - correct answer-ANS: D - Prior to administering antibiotics, the
nurse obtains the prescribed cultures. Broad-spectrum antibiotics will be administered until
the culture and sensitivity results are known.
A client is hospitalized and on multiple antibiotics. The client develops frequent diarrhea.
What action by the nurse is most
important?
a. Consult with the primary health care provider about obtaining stool cultures.
b. Delegate frequent perianal care to assistive personnel.
c. Place the client on NPO status until the diarrhea resolves.
d. Request a prescription for an antidiarrheal medication. - correct answer-ANS: A
-Hospitalized clients who have three or more stools a day for 2 or more days are suspected
of having infection with Clostridium difficile.
,A nurse is observing as an assistive personnel (AP) performs hygiene and provides comfort
measures to a client with an infection. What action by the AP requires intervention by the
nurse?
a. Not using gloves while combing the client's hair
b. Rinsing the client's commode pan after use
c. Ordering an oscillating fan for the client
d. Wearing gloves when providing perianal care - correct answer-ANS: C -Fans in client care
areas are discouraged because they can disperse airborne or droplet-borne pathogens.
A client is to receive a fecal microbiota transplantation tomorrow (FMT). What action by the
nurse is best?
a. Administer bowel cleansing as prescribed.
b. Educate the client on immunosuppressive drugs.
c. Inform the client he/she will drink a thick liquid.
d. Place a nasogastric tube to intermittent suction. - correct answer-ANS: A -The usual route
of delivering an FMT is via colonoscopy, so the client would have a bowel cleansing as
prescribed for that procedure.
A nurse manager is preparing an educational session for floor nurses on drug-resistant
organisms. Which statement below indicates
the need to review this information?
a. "Methicillin-resistant Staphylococcus aureus can be hospital- or
community-acquired."
b. "Vancomycin-resistant Enterococcus can live on surfaces and be infectious for
weeks."
c. Carbapenem-resistant Enterobacteriaceae is hard to treat due to enzymes that
break down antibiotics."
d. "If you leave work wearing your scrubs, go directly home and wash them right
away." - correct answer-ANS: D -To help prevent the transmission of an MDRO, wear scrubs
and change clothes before leaving work. Keep work clothes separate from personal clothes.
The nurse caring for clients admitted for infectious diseases understands what information
about emerging global diseases and
bioterrorism?
a. Many infections are or could be spread by international travel.
b. Safer food preparation practices have decreased foodborne illnesses.
c. The majority of Americans have adequate innate immunity to smallpox.
d. Plague produces a mild illness and generally has a low mortality rate. - correct
answer-ANS: A -Increased global travel has resulted in the spread of many emerging
diseases and has the potential to spread diseases caused by bioterrorism.
A client has been placed on Contact Precautions. The client's family is very afraid to visit for
fear of being "contaminated" by the
client. What action by the nurse is best?
a. Explain to them that these precautions are mandated by law.
b. Show the family how to avoid spreading the disease.
c. Reassure the family that they will not get the infection.
, d. Tell the family it is important that they visit the client. - correct answer-ANS: B -Visitors
may be apprehensive about visiting a client in Transmission-Based Precautions.
A nurse is caring for a client who has methicillin-resistant Staphylococcus aureus (MRSA)
infection cultured from the urine. What action by the nurse is most appropriate?
a. Prepare to administer vancomycin.
b. Strictly limit visitors to immediate family only.
c. Wash hands only after taking off gloves after care.
d. Wear a respirator when handling urine output. - correct answer-ANS: A -Vancomycin is
one of a few drugs approved to treat MRSA.
A hospitalized client is placed on Contact Precautions. The client needs to have a computed
tomography (CT) scan. What action by
the nurse is most appropriate?
a. Ensure that the radiology department is aware of the Isolation Precautions.
b. Plan to travel with the client to ensure appropriate precautions are used.
c. No special precautions are needed when this client leaves the unit.
d. Notify the primary health care provider that the client cannot leave the room. - correct
answer-ANS: A - Clients in isolation will leave their rooms only when necessary, such as for
a CT scan that cannot be done portably in the room.
A nurse receives report from the laboratory on a client who was admitted for fever. The
laboratory technician states that the client
has "a shift to the left" on the white blood cell count. What action by the nurse is most
important?
a. Document findings and continue monitoring.
b. Notify the primary health care provider and request antibiotics.
c. Place the client in protective isolation.
d. Tell the client this signifies inflammation. - correct answer-ANS: B -A shift to the left
indicates an increase in immature neutrophils and is often seen in infections, especially
those caused by bacteria.
The nurse caring for clients understands that which factors must be present to transmit
infection? (Select all that apply.)
a. Colonization
b. Host
c. Mode of transmission
d. Portal of entry
e. Reservoir
f. Poor hygiene - correct answer-ANS: B, C, D, E - Factors that must be present in order to
transmit an infection include a host with a portal of entry, a mode of transmission, and a
reservoir.
Which statements are true regarding Standard Precautions? (Select all that apply.)
a. Always wear a gown when performing hygiene on clients.
b. Sneeze into your sleeve or into a tissue that you throw away.
c. Remain 3 feet (1 m) away from any client who has an infection.
d. Use personal protective equipment as needed for client care.
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