Question 1

The nurse is planning care for a client who is taking cyclosporin (Neoral). What would be an appropriate nursing diagnosis for this client?

Accepted Answer

Answer reason: Cyclosporine is an immunosuppressant that decreases T-cell function, increasing susceptibility to infections; thus the priority nursing diagnosis is risk for infection.

Question 2

The nurse is caring for a woman two hours after a vaginal delivery. Documentation indicates that the membranes were ruptured for 36 hours prior to delivery. A PRIORITY nursing diagnoses at this time is?

Accepted Answer

Answer reason: Prolonged rupture of membranes (>24 hours) greatly increases risk of maternal and neonatal infection, making infection the priority diagnosis two hours postpartum.

Question 3

The nurse is responsible for decisions regarding client room assignments. Which one of the following possible roommates would be MOST appropriate for a three-year-old child with minimal change nephrotic syndrome?

Accepted Answer

Answer reason: Children with nephrotic syndrome are immunocompromised due to protein loss and steroid therapy. They must not be placed with infectious or potentially infectious roommates. Hernia repair is non-infectious and the safest option.

Question 4

Which of the following is NOT a risk factor for HIV infection?

Accepted Answer

Answer reason: HIV is transmitted through blood, semen, vaginal/rectal fluids, and breast milk. Kissing does not pose a transmission risk unless blood is present; MSM contact and unprotected vaginal intercourse are established risk exposures.

Question 5

A common type of nosocomial infection is?

Accepted Answer

Answer reason: Urinary tract infections, especially catheter-associated, are the most common healthcare-associated (nosocomial) infections.

Question 6

Which is the most widely used disinfectant for infected material?

Accepted Answer

Answer reason: Sodium hypochlorite (bleach) is inexpensive, broad-spectrum, and commonly used to disinfect contaminated materials and spills; glutaraldehyde is mainly for instrument high-level disinfection, formaldehyde is toxic, and phenolics like Lysol are less widely used.

Question 7

A client is admitted to the outpatient oncology unit for his routine chemotherapy transfusion. The client's current lab report is WBC 2,500 mm3, RBC 5.1 ml/mm3, and calcium 5 mEq/L. Based on these assessments, which of the following should be the priority nursing diagnosis?

Accepted Answer

Answer reason: WBC 2,500/mm3 indicates neutropenia from chemotherapy, making infection risk the immediate priority. RBC is normal and the other diagnoses are not supported by the data.

Question 8

What does asepsis mean?

Accepted Answer

Answer reason: Asepsis refers to the absence of pathogenic microorganisms, i.e., freedom from infection. The other choices are unrelated to infection prevention.

Question 9

Hospital acquired infection is also known as?

Accepted Answer

Answer reason: Hospital-acquired infections are termed nosocomial infections.

Question 10

A 62-year-old male client is being discharged home from the hospital. During his stay, he acquired a nosocomial infection, Clostridium difficile. In preparing a teaching plan for the client and caretaker, which priority point would the nurse include?

Accepted Answer

Answer reason: Clostridioides difficile typically causes watery diarrhea with cramping/abdominal discomfort and flatus. The other options are incorrect: constipation is not expected, high-fiber diet is not appropriate during acute diarrhea, and special cleaning with sporicidal agents is required at home.

Question 11

Which activity would be best in preventing septic shock in the hospitalized client?

Accepted Answer

Answer reason: Strict aseptic technique prevents healthcare-associated infections that can progress to sepsis and septic shock. Normothermia does not prevent infection, blood products address hemorrhage not sepsis prevention, and immobilization may increase complications including infection risk.

Question 12

When preparing a sterile field, which of the following conditions indicates to the nurse that the field is contaminated?

Accepted Answer

Answer reason: Moisture compromises sterility by capillary action; solutions should be poured into a sterile container, not onto the field. A wet field is considered contaminated.

Question 13

The nurse teaches a client’s daughter to perform a dressing change using sterile technique. Which of the following actions by the daughter should indicate to the nurse that the daughter understands prevention of infection?

Accepted Answer

Answer reason: Hand hygiene before gloving is the key step to prevent introducing microorganisms during a sterile dressing change. Opening packages with sterile gloves or using sterile gloves to remove a contaminated old dressing would contaminate the gloves, and standing between the client and sterile field is improper setup.

Question 14

A young adult is being treated for second and third degree burns over 25% of his body and is now ready for discharge. The nurse evaluates his understanding of discharge instructions relating to wound care and is satisfied that he is prepared for home care when he makes which statement?

Accepted Answer

Answer reason: Covering any reopened areas with a sterile dressing and promptly reporting indicates correct infection-prevention and wound-care actions after burns. The Jobst garment should be worn ~23 hours/day, not removed nightly (option 3). Low-grade fever is not expected and should not be self-managed without assessment (option 4). Sponge baths are not specifically required; showers are typically allowed while avoiding soaking (option 1).

Question 15

Mrs. Jones will have to change the dressing on her injured right leg twice a day. The dressing will be a sterile dressing, using 4 X 4s, normal saline irrigant, and abdominal pads. Which statement best indicates that Mrs. Jones understands the importance of maintaining asepsis?

Accepted Answer

Answer reason: Sterile items are considered contaminated if sterility is in doubt; therefore they should not be used. Dropped gauze is not sterile, and touching a nonsterile bottle with sterile gloves contaminates them.

Question 16

Jayson, 1 year old child has a staph skin infection. Her brother has also developed the same infection. Which behavior by the children is most likely to have caused the transmission of the organism?

Accepted Answer

Answer reason: Staphylococcal skin infections are spread primarily through direct skin-to-skin contact and shared bathing water/items. Bathing together provides direct contact and is the most likely transmission route compared with droplets, shared pacifiers, or eating off the same plate.

Question 17

A client has a nursing diagnosis of Risk for infection. What would be the most desirable expected outcome for this client?

Accepted Answer

Answer reason: The best expected outcome directly addresses the diagnosis by stating that the client should remain free of infection.

Question 18

A four year-old child is recovering from chicken pox (varicella). The parents would like to have the child return to day care as soon as possible. In order to ensure that the illness is no longer communicable, the nurse would assess for?

Accepted Answer

Answer reason: Varicella is contagious until all lesions have crusted. Fever, rhinorrhea, or presence of vesicles do not indicate the end of communicability; vesicles mean the child is still contagious.

Question 19

The nurse is talking by telephone with a parent of a four year-old child who has chickenpox. Which of the following is appropriate teaching?

Accepted Answer

Answer reason: Varicella lesions appear in crops so different stages coexist: papules, vesicles, and crusts. Aspirin is avoided due to Reye syndrome risk; topical steroids are not recommended for itch; contagion extends from 1–2 days before rash until all lesions are crusted, not only prior to eruption.

Question 20

A nurse is reinforcing teaching with a client who has HIV and is being discharged to home. Which of the following instructions should the nurse include in the teaching?

Accepted Answer

Answer reason: HIV clients are immunocompromised and should monitor for early signs of infection; daily temperature checks help detect fever promptly. They should avoid changing cat litter (toxoplasmosis risk) and wash dishes in hot water/dishwasher, not warm. Hygiene guidance is to bathe daily with antimicrobial soap, not just a gentle cleanser of limited areas.

Question 21

The nurse is caring for a newborn with a neural tube defect. The BEST covering for the lesion is?

Accepted Answer

Answer reason: For an open neural tube defect (e.g., myelomeningocele), the sac must be kept sterile and moist to prevent drying, rupture, and infection; a moist sterile nonadherent dressing provides protection without sticking.

Question 22

What is the most reliable early indicator of infection in a neutropenic client receiving high-dose chemotherapy?

Accepted Answer

Answer reason: In neutropenic clients the typical inflammatory response is blunted; fever is often the earliest and most reliable sign of infection and requires immediate evaluation.

Question 23

Which method should NOT be used to sterilize sharp instruments?

Accepted Answer

Answer reason: Antiseptic solutions are designed for use on living tissue and do not achieve sterilization of instruments. Sharp instruments should be sterilized by dry heat (hot air oven); antiseptics are inappropriate.

Question 24

A 28-year-old patient presents with painful, grouped vesicles on an erythematous base near the lip margin. The lesions were preceded by tingling and a burning sensation. What is the most likely diagnosis?

Accepted Answer

Answer reason: Painful, grouped vesicles on an erythematous base preceded by a tingling or burning prodrome are classic for reactivation of herpes simplex virus type 1. HSV-1 commonly presents as herpes labialis (“cold sores”), which frequently recur at the lip margin.

Question 25

A 32-year-old patient presents with fever, malaise, and weight loss. Physical examination shows non-tender erythematous macules and papules on the palms and soles along with a new heart murmur. What is the most likely diagnosis?

Accepted Answer

Answer reason: Secondary syphilis often presents with a diffuse, non-tender maculopapular rash that classically involves the palms and soles. Systemic symptoms such as fever, malaise, and weight loss are also characteristic. A heart murmur may reflect coexisting complications or unrelated findings but does not rule out syphilis.

Question 26

The nurse observes infection control practices. Which client situation requires follow-up?

Accepted Answer

Answer reason: Legionnaires’ disease is transmitted via inhalation of aerosolized water droplets, not through direct contact. Standard precautions are sufficient; contact precautions are unnecessary and indicate incorrect isolation practice.

Question 27

A nurse is caring for a hospitalized client with Clostridioides difficile (C. diff) infection. Which action is MOST appropriate to reduce the risk of transmission?

Accepted Answer

Answer reason: C. diff forms spores that survive on surfaces and are resistant to alcohol-based sanitizers. Therefore, strict contact precautions—including gloves and a gown—are required. Alcohol sanitizers alone are ineffective, and airborne precautions are unnecessary.

Question 28

After removing gloves following care of a client with confirmed Clostridioides difficile infection, which hand-hygiene practice should the nurse use?

Accepted Answer

Answer reason: C. diff spores are not reliably destroyed by alcohol-based sanitizer. Mechanical friction with soap and water is required to remove spores from the hands. Failure to do so significantly increases the risk of transmission.

Question 29

A hospitalized client is diagnosed with measles (rubeola). Which infection-control measure is MOST important for the nurse to implement?

Accepted Answer

Answer reason: Measles is a highly contagious airborne virus. Airborne precautions—including a negative-pressure room and N95 respirators—are mandatory to prevent transmission. Droplet or contact precautions alone are insufficient.

Question 30

A nurse is caring for a patient with active pulmonary tuberculosis. Which of the following infection control measures should the nurse implement?

Accepted Answer

Answer reason: Active pulmonary tuberculosis is transmitted via airborne droplets; therefore, a negative-pressure isolation room is the highest-priority intervention to prevent airborne spread.

Question 31

A nurse is reviewing a patient’s health education after treatment for ringworm (tinea corporis). Which instruction is most important to prevent reinfection?

Accepted Answer

Answer reason: Fungi thrive in warm, moist environments. Keeping the area dry is essential to prevent recurrence and transmission.

Question 32

For which condition are alcohol-based hand sanitizers ALONE sufficient for infection control?

Accepted Answer

Answer reason: Mumps spreads via respiratory droplets and is effectively controlled with alcohol-based hand hygiene. C. diff requires soap and water; varicella requires airborne precautions; scabies requires contact precautions.

Question 33

Which infection-control measure is REQUIRED for a patient with varicella (chickenpox)?

Accepted Answer

Answer reason: Varicella spreads via airborne droplet nuclei; therefore, a negative-pressure room and N95 respirator are required for all staff entering the room.

Question 34

Nosocomial infections are also known as-?

Accepted Answer

Answer reason: Nosocomial infections are infections acquired in a healthcare setting, typically appearing 48 hours or more after admission or soon after discharge. They are also termed healthcare- or hospital-acquired infections (HAIs). They can be caused by bacteria, viruses, or fungi, so options limiting them to bacterial or viral only are incorrect.

Question 35

Which of the following body fluids does not transmit HIV?

Accepted Answer

Answer reason: HIV is transmitted through blood, semen, vaginal and rectal fluids, and breast milk. Saliva contains very low levels of virus and has inhibitory enzymes and antibodies, so it is not considered a route of transmission. Casual contact such as kissing does not transmit HIV unless saliva is visibly contaminated with blood. Therefore, among the listed fluids, saliva does not transmit HIV.

Question 36

How can mother-to-child transmission of HIV be prevented?

Accepted Answer

Answer reason: Mother-to-child HIV transmission occurs during pregnancy, delivery, or breastfeeding and is minimized by suppressing maternal viral load with antiretroviral therapy; cesarean delivery is recommended when the viral load is high to further reduce intrapartum transmission. There is no effective HIV vaccine for prevention of perinatal transmission. Breastfeeding can transmit HIV without ART prophylaxis, and early weaning does not reliably prevent transmission and may increase infant morbidity. Therefore, cesarean section with ART is the most evidence-based prevention among the options.

Question 37

The most effective method of sterilization is?

Accepted Answer

Answer reason: Autoclaving uses saturated steam under pressure to achieve temperatures (e.g., 121–134°C) that reliably destroy all microorganisms, including bacterial spores. Boiling and most chemical agents provide disinfection rather than true sterilization and may not eliminate spores or some viruses. Sun drying is not a sterilization method. Therefore, autoclaving is the most effective method for sterilization.

Question 38

Mode of transmission of Typhoid fever is?

Accepted Answer

Answer reason: Typhoid fever, caused by Salmonella enterica serotype Typhi, is transmitted via the fecal-oral route through ingestion of food or water contaminated with feces or urine from infected individuals or chronic carriers. Outbreaks are associated with poor sanitation and unsafe water supplies. It is not spread by airborne routes or vectors, and sexual transmission is not a recognized mode.

Question 39

Which organization leads global efforts to combat HIV/AIDS?

Accepted Answer

Answer reason: The World Health Organization is the directing and coordinating authority for international health within the UN system and leads global health responses, including HIV/AIDS. WHO sets evidence-based norms and guidelines, supports surveillance, and coordinates with countries and partners to scale prevention, testing, and treatment. While UNAIDS spearheads the joint UN program, among the listed options WHO is the primary health authority; IMF, UNDP, and UNESCO do not lead medical control of HIV.

Question 40

Water borne disease is?

Accepted Answer

Answer reason: Typhoid fever is transmitted via the fecal–oral route through ingestion of water or food contaminated with Salmonella Typhi, making it a classic water-borne disease. Malaria is vector-borne through Anopheles mosquitoes, tetanus results from Clostridium tetani spores introduced through wounds (often soil-contaminated), and diabetes is a noninfectious metabolic disorder. Therefore, Typhoid is the only correct option.

Question 41

The umbilical cord should be cut with?

Accepted Answer

Answer reason: Cutting the umbilical cord requires strict aseptic technique to prevent neonatal infection such as omphalitis and sepsis. A sterile disposable blade (or sterile scissors) is the recommended instrument to ensure a clean cut. Plain scissors, a knife, or a safety pin are not sterile and increase infection risk.

Question 42

Needle stick injury except...?

Accepted Answer

Answer reason: Needle-stick injuries transmit bloodborne pathogens. HIV, HBV, and HCV are all well-known bloodborne viruses transmitted through contaminated sharps exposure. Malaria is transmitted through infected Anopheles mosquitoes, not by needle sticks, making it the exception.

Question 43

The best way to prevent the spread of infection is?

Accepted Answer

Answer reason: Hand hygiene is the single most effective measure to prevent transmission of microorganisms between patients and from contaminated surfaces to the patient. It reduces pathogen load on the hands, which are the most common vector for healthcare-associated infections. Gloves and gowns are important for specific exposures, but they do not replace hand hygiene and can become contaminated themselves. Antiseptics are adjunctive, whereas routine and correctly timed hand hygiene interrupts the chain of infection most broadly.

Question 44

Which solution is commonly used to clean wounds?

Accepted Answer

Answer reason: Normal saline (0.9% NaCl) is commonly used for wound cleansing because it is isotonic and nonirritating to tissues, helping remove debris without damaging viable cells. It is widely available, compatible with most wounds, and does not impair healing the way some antiseptics can. Alcohol can be cytotoxic and painful on open tissue, and vinegar is not a standard general wound irrigant. Distilled water may be used in some settings, but normal saline is the most commonly recommended routine cleanser/irrigant.

Question 45

A nurse is teaching a client about hand hygiene. What is the most effective method to prevent infection?

Accepted Answer

Answer reason: Handwashing with soap and water mechanically removes transient microorganisms, dirt, and organic material, making it the most effective routine method for infection prevention in general teaching contexts. Alcohol-based sanitizer is effective when hands are not visibly soiled, but it is less effective against some organisms and does not remove physical debris. Gloves do not replace hand hygiene because contamination can occur during glove removal and through microtears. Lotion can protect skin integrity but does not prevent infection unless proper hand hygiene is performed first.

Question 46

A charge nurse is observing a newly licensed nurse setting up a sterile field for a sterile wound dressing. Which of the following actions by the newly licensed nurse indicates an understanding of maintaining sterility?

Accepted Answer

Answer reason: Sterile items should be added to a sterile field by gently dropping them from a short height (about 6 inches/15 cm or less) to avoid contamination from reaching over the field and to prevent strike-through or bouncing off contaminated surfaces. Dropping gauze from 3 inches is within safe technique and maintains sterility. Opening the first flap toward oneself contaminates the sterile package because the nurse’s arms/clothing cross over the sterile area. A sterile field must be kept at or above waist level and in constant view; below waist level is considered contaminated.

Question 47

Which precaution is most important to prevent infection?

Accepted Answer

Answer reason: Hand hygiene is the single most effective measure to prevent the transmission of microorganisms and reduce healthcare-associated infections. It interrupts contact spread from contaminated hands before and after patient contact, even when gloves are used. Gloves, gowns, and masks are important in specific situations, but they do not replace proper handwashing and can be contaminated during removal.

Question 48

The most important nursing responsibility during tracheostomy suctioning is?

Accepted Answer

Answer reason: Tracheostomy suctioning is an invasive airway procedure that can introduce pathogens directly into the lower respiratory tract, so strict aseptic technique is the priority to prevent infection. Routine saline instillation is not recommended because it can worsen hypoxemia and increase infection risk. Suction should be intermittent and brief (typically no more than about 10–15 seconds per pass) to reduce mucosal trauma and hypoxia, making continuous suctioning and suctioning for >30 seconds unsafe.

Question 49

The term "asepsis" refers to?

Accepted Answer

Answer reason: Asepsis means a state of being free from pathogenic (disease-causing) microorganisms, which is the goal of medical and surgical aseptic techniques. It focuses on preventing contamination and infection transmission. Sterilization is a method used to achieve asepsis but is not synonymous with the definition of asepsis. Presence of infection and use of antibiotics do not define asepsis.

Question 50

The most effective way to prevent hospital-acquired infections is through?

Accepted Answer

Answer reason: Hand hygiene is the single most effective measure to reduce transmission of pathogens and prevent healthcare-associated infections because hands are the primary vector for cross-contamination between patients and surfaces. Proper handwashing or alcohol-based hand rub before and after patient contact interrupts the chain of infection broadly across organisms. Isolation is important for specific transmissible conditions but is not as universally effective as consistent hand hygiene. Routine antibiotic use is inappropriate due to resistance and adverse effects, and early discharge does not address in-hospital transmission risk.

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