Question 1

The hospitalized client has protective precautions (reverse isolation) in place because of severe neutropenia. Which statement by the nurse to the NA is correct regarding the use of protective precautions?

Accepted Answer

Answer reason:  Protective (reverse) isolation is used to protect an immunocompromised/neutropenic client from microorganisms carried by staff and visitors. A surgical mask for anyone entering helps reduce droplet spread of common respiratory pathogens to a client with limited ability to mount an immune response. Negative-pressure rooms are used to protect others from airborne infections (e.g., TB), not to protect a neutropenic client. Gloves are used based on anticipated contact with blood/body fluids or contaminated surfaces and are not the defining universal requirement upon merely entering for protective precautions.

Question 2

The client who is receiving TPN through a subclavian triple-lumen catheter expresses concern to the nurse about bacteria entering the blood through the catheter. The nurse explains that the risk of catheter-related infections can be decreased by taking which action?

Accepted Answer

Answer reason: Reserving a single lumen only for TPN reduces hub access events, medication piggybacks, and disconnections, which are common sources of intraluminal contamination. Routine topical antibiotic ointment or daily antibiotic instillation is not standard practice because it can promote resistance and does not replace strict aseptic technique and line-care bundles. Dressing changes are performed on a schedule (e.g., per policy based on dressing type or if soiled/loose), and unnecessary daily changes can increase manipulation and contamination risk.

Question 3

The client has protective precautions (reverse isolation) in place due to a severely depressed neutrophil count. Which statement by the client demonstrates a good understanding of the precautions?

Accepted Answer

Answer reason:  Protective (reverse) isolation is designed to reduce the client’s exposure to microorganisms when neutrophils are low. The most effective, universally required measure to prevent transmission from staff and visitors is meticulous hand hygiene on entry (and before any contact). Staying “3 feet away” is incomplete because respiratory pathogens can spread via contact and droplets, and ill visitors should generally avoid visiting rather than rely on distance alone. Fresh flowers/soil can harbor bacteria and fungi and are typically restricted for neutropenic clients, and precautions do not directly speed bone marrow recovery—they reduce infection risk while recovery occurs.

Question 4

The nurse is preparing for a dressing change using surgical aseptic technique. Which action by the nurse is correct when setting up the sterile field?

Accepted Answer

Answer reason: Sterile technique requires preventing the sterile field from being contaminated by keeping hands and nonsterile surfaces from crossing over it. Dropping sterile items from about 6 inches (15 cm) above the field minimizes the chance of accidentally touching the sterile field or brushing the item against nonsterile packaging. Donning sterile gloves is performed after opening supplies and setting up the field, not before, to avoid contaminating gloves while handling outer wrappers. The sterile field must remain in constant view and attended; leaving it unattended breaks sterility and requires re-establishing the field.

Question 5

The client with an infected leg wound receives treatment and a prescription for antibiotics during a clinic visit. Which information should the nurse emphasize when completing discharge teaching?

Accepted Answer

Answer reason: Discharge teaching for an infected wound should prioritize recognizing and responding to signs of worsening infection or systemic involvement. Fever with chills suggests the infection may be progressing despite antibiotics and could indicate spreading cellulitis or early sepsis, requiring prompt provider evaluation and possible change in therapy. The other statements are either not universally indicated (repeat tetanus timing depends on immunization status and wound type), potentially unsafe (leaving a dressing untouched for a full week can delay detection of deterioration), or not evidence-based as a standard precaution (avoiding cold medicines briefly after starting antibiotics). Emphasizing when to seek care supports early intervention and reduces complication risk.

Question 6

The new nurse is planning to change a central-line dressing. Which statement by the new nurse to the experienced nurse indicates that further teaching is needed?

Accepted Answer

Answer reason:  Central-line dressing changes require strict aseptic technique to prevent catheter-related bloodstream infection. Clean gloves are appropriate for removing the old dressing, but after removal the nurse must perform hand hygiene and don sterile gloves to clean the site and apply the new dressing. Saying they will use only clean gloves implies a break in sterile technique during the high-risk portion of the procedure. The other statements reflect key infection-control measures (hand hygiene, antiseptic cleansing, and minimizing contamination from the client’s breathing/coughing).

Question 7

The nurse observes the LPN providing care for the client who has contact precautions due to a Clostridium difficile infection. Which action by the LPN requires the nurse’s immediate correction?

Accepted Answer

Answer reason: difficile forms spores that are not reliably killed or removed by alcohol-based hand rubs, so soap-and-water handwashing is required after caring for the client or leaving the room. Immediate correction is needed because ineffective hand hygiene is a high-risk breach that can rapidly transmit spores to other patients and the environment. Gloves and a gown are appropriate for contact precautions, especially with activities likely to soil hands/clothing (e.g., bed bath and linen changes). Visitor instruction to use soap and water on exit aligns with spore precautions and helps limit spread.

Question 8

A client is undergoing a total hip replacement when a screw that is going to be placed into the client is dropped on the floor. The nurse should?

Accepted Answer

Answer reason: A sterile implant that has been dropped is considered contaminated and must not be introduced into a surgical wound due to high risk of deep surgical site infection (including osteomyelitis and prosthetic joint infection). The safest immediate action is to replace it with a sterile item from supply to maintain the sterile field and avoid operative delays. Soaking in disinfectant is inadequate because implants require sterilization, not disinfection, and in-field rapid steam sterilization (“flash”) is not preferred for implants except in true emergencies due to higher contamination risk and process limitations. Waiting to quarantine for biological indicator results is impractical intraoperatively and does not address the urgent need for an immediately sterile implant.

Question 9

The circulating nurse prepares the sterile field in the operating room (OR). Fifteen minutes later, the nurse is informed the surgery is delayed for 20 minutes because the surgeon is working at another hospital. Which is the best action for the nurse to take?

Accepted Answer

Answer reason: Sterility is event-related and requires continuous observation; an unattended sterile field is considered contaminated and cannot be relied upon as sterile. Remaining present allows the circulating nurse to prevent breaks in technique (e.g., accidental touch, splash, or traffic-related contamination) and to intervene immediately if contamination occurs. Covering a sterile field does not guarantee it stays sterile, particularly over time and with ongoing room activity, and can create a false sense of security. Closing/taping doors is inappropriate and does not address the key risk, while tearing down immediately is unnecessary if the field can be continuously maintained and monitored until start time.

Question 10

The nurse knows negative pressure should be used in the operating room (OR)?

Accepted Answer

Answer reason: Operating rooms are typically maintained with positive pressure to keep airborne contaminants from entering the sterile field, reducing surgical site infection risk. Negative pressure is reserved for special situations when the goal is to contain contaminated air within the room, such as performing procedures on a patient requiring airborne isolation. Using negative pressure routinely would increase the chance that nonsterile corridor air flows into the OR. Therefore, it is appropriate only in select circumstances rather than as a universal standard.

Question 11

The nurse at the beginning of the shift is assessing a client. The nurse notes the client has a Foley catheter connected to a collection bag. What are the best routine catheter care actions for the nurse to take while caring for this client?

Accepted Answer

Answer reason: Routine Foley catheter care focuses on reducing catheter-associated UTI risk by maintaining perineal hygiene and promoting adequate urine flow. This choice includes regular cleansing (at least twice daily) plus cleansing after bowel movements, which limits introduction of fecal organisms into the urinary tract. It also encourages adequate oral fluids to support urinary dilution and flow, decreasing stasis that promotes bacterial growth. A common trap is selecting a single correct action (hygiene only or spigot technique only); best practice is a bundled approach that addresses both infection prevention and urinary flow maintenance.

Question 12

A child enrolled in a private preparatory school has been diagnosed with scarlet fever. Several parents have called the school and voiced concern over the risk of their children becoming infected. The parents are requesting that the infected child be isolated for one month. It is most appropriate for the nurse to tell the parents that respiratory isolation of an infected child is necessary?

Accepted Answer

Answer reason: Group A streptococcal infections are primarily transmitted via respiratory droplets, and effective antibiotic therapy rapidly decreases contagiousness. After appropriate antibiotics are started, infectivity typically drops substantially within about 24 hours, making prolonged isolation unnecessary. Isolation until rash resolution is not a reliable marker of contagiousness because the rash can persist after transmissibility has ended. Waiting for completion of the entire antibiotic course is unnecessarily restrictive and not required for infection-control purposes in this setting.

Question 13

A child with leukemia has been exposed to chickenpox. The mother calls the doctor's office and asks the nurse if the child needs to have anything done. What is the most appropriate response by the nurse?

Accepted Answer

Answer reason: Immunocompromised children (e.g., leukemia) are at high risk for severe, disseminated varicella after exposure, so postexposure prophylaxis is indicated to prevent or blunt infection. Passive immunization with VZIG is most effective when administered as soon as possible after exposure, and standard exam guidance emphasizes a limited window (commonly cited as within 72 hours). Starting acyclovir immediately at the time of exposure is not the preferred first-line prophylaxis in this setting compared with VZIG. Waiting until signs of disease appear forfeits the opportunity to prevent severe complications in a high-risk patient.

Question 14

The charge nurse is instructing a new graduate nurse on the procedure of obtaining a wound culture for a client with a suspected infection. The nurse determines that teaching has been effective when the graduate nurse states?

Accepted Answer

Answer reason:  The key principle in wound culturing is to obtain a specimen that reflects organisms in viable wound tissue while minimizing contamination from surrounding skin flora. Sampling the wound bed (after appropriate cleansing per protocol) captures the most clinically relevant microorganisms rather than surface contaminants. Collecting from the crusty outer area would increase contamination and may mislead therapy. Using one swab across multiple sites mixes flora and prevents accurate source identification, while vigorous irrigation before collection can dilute organisms and reduce yield.

Question 15

Following morning shift report, the nurse identifies care needs for four clients. Which client should be the nurse’s priority?

Accepted Answer

Answer reason: An ANC of 98/mm3 indicates profound immunosuppression, requiring prompt initiation of neutropenic precautions to reduce the chance of rapid deterioration from sepsis. The other needs are time-sensitive but do not pose the same immediate safety threat: antiemetic timing and keeping an oncology appointment can be addressed after implementing isolation, and tube feeding for stomatitis is important but is not as urgent as preventing infection in a profoundly neutropenic client. Prioritization here follows the safety-first and risk-of-complications framework.

Question 16

The nurse is providing information to the client diagnosed with genital herpes- Which is the priority information that the nurse should provide to the client?

Accepted Answer

Answer reason: Genital herpes can be transmitted via asymptomatic viral shedding, so absence of lesions does not eliminate infectious risk. This is the highest-priority teaching because it directly impacts immediate prevention behaviors (e.g., consistent barrier use, disclosure, and considering suppressive antivirals) and reduces spread to partners. The other statements are educational but do not address the key safety concept that transmission can occur even when symptoms are not present. Emphasizing asymptomatic transmission supports safer sexual practices and partner protection.

Question 17

The postpartum client is being discharged to home with a streptococcal puerperal infection. The client is taking antibiotics but asks the nurse what precautions she should take at home to prevent spreading the infection to her husband, newborn, and toddler. Which is the best response by the nurse?

Accepted Answer

Answer reason:  Hand hygiene is the most effective, evidence-based measure to prevent transmission of infectious organisms in the home. Streptococcal puerperal infection involves organisms that can be spread via contact with contaminated hands after perineal care or toileting, making targeted handwashing a high-yield intervention. Antibiotic therapy reduces bacterial load but does not immediately eliminate contagiousness or prevent contact transmission if hygiene is poor. Routine masking is not the primary precaution for this scenario, and requiring the husband to provide all child care is unnecessary and not a practical standard infection-control recommendation.

Question 18

The adolescent client with acute vomiting and diarrhea is diagnosed at the clinic with a norovirus infection. Which instruction should the nurse include when teaching the client?

Accepted Answer

Answer reason:  Norovirus is primarily transmitted via the fecal–oral route and can continue to be shed in stool after symptoms resolve, so prevention teaching must emphasize ongoing hygiene. Strict handwashing with soap and water is the most reliable way to reduce transmission in household and community settings because alcohol-based sanitizers are less effective against norovirus. Advising return to normal activities based only on symptom improvement is unsafe because contagiousness can persist and outbreaks are common. Respiratory droplet spread is not the primary route, so masking is not the key preventive instruction compared with hand hygiene and environmental sanitation.

Question 19

The clinic nurse is teaching the parent of the 3-year- old with rubella. Which information should the nurse provide?

Accepted Answer

Answer reason: " Rubella teaching prioritizes infection-control timing and high-risk exposure counseling based on the known contagious window. Infectivity begins about a week before rash onset and continues for several days after, so families must understand that spread can occur before the child looks ill and that many infections are mild or subclinical. Serious sequelae are uncommon in young children, so emphasizing rare complications is appropriate. Statements that exposure is not a concern during pregnancy or that there are no fetal risks are unsafe because congenital infection can cause significant teratogenic harm.

Question 20

A grandmother calls the pediatric children’s clinic to find out whether her 3-year-old grandson can get shingles from her. Which response by the nurse would be most appropriate?

Accepted Answer

Answer reason: Herpes zoster results from reactivation of varicella-zoster virus in someone who has previously had varicella infection, so it is not typically “caught” as shingles from another person. A person with active zoster lesions can transmit varicella-zoster virus via direct contact with vesicle fluid to a susceptible child. That exposure would most classically cause primary varicella (chickenpox), not shingles, in the non-immune contact. Therefore the safest, most accurate counseling focuses on infection transmission risk and the likely outcome for a susceptible 3-year-old.

Question 21

The nurse is using contact precautions for the client with Clostridium difficile. While the nurse transfers the client from the bed to the commode, the client has loose stool that falls on the floor. After positioning the client on the commode, how should the nurse proceed to cleanse the floor?

Accepted Answer

Answer reason: Difficile forms spores that are not reliably killed by routine detergents or alcohol-based products, so environmental decontamination requires a sporicidal agent. Removing visible stool first reduces organic load so the disinfectant can contact the surface effectively. A dilute bleach (sodium hypochlorite) solution is the standard sporicidal disinfectant used for C. difficile contamination of surfaces. Soap and water alone is insufficient for spores, and alcohol-based hand rub is not an appropriate surface disinfectant and is ineffective against spores.

Question 22

Following morning shift report the nurse plans to assess clients who had surgery two days ago. Which client should the nurse assess first?

Accepted Answer

Answer reason: 30-year-old who had a splenectomy and has an oral temperature of 102.2°F (39°C) A high fever on postoperative day 2 is a red flag for a potentially serious infection requiring rapid assessment and escalation. Asplenic clients are at increased risk for overwhelming infection from encapsulated organisms, so a temperature of 39°C represents the most time-sensitive threat among the choices. The mildly elevated WBC after surgery can be a normal stress response and is less urgent without other findings. The recent opioid dose and a platelet count of 100 K/mm3 warrant monitoring, but neither suggests an immediately life-threatening complication as strongly as high fever in an asplenic postoperative client.

Question 23

The nurse prepares to insert an indwelling urinary catheter in a client who is disoriented to time, place, and person and cannot follow directions or commands. Which intervention is most important when inserting the urinary catheter?

Accepted Answer

Answer reason: This client cannot reliably follow directions, increasing the likelihood of contaminating the sterile field, so the nurse must prioritize strict maintenance of sterility to prevent CAUTI. Explaining the procedure is appropriate, but comprehension is limited by disorientation and it does not reduce infection risk as directly as sterile technique. Proper kit placement and disposal of soiled swabs are supportive infection-control measures, but they are secondary to maintaining the sterile field throughout insertion.

Question 24

Which of the following patients is at highest risk for a postoperative infection?

Accepted Answer

Answer reason: Postoperative infection risk increases with impaired host defenses and with procedures involving implanted foreign material. Advanced age is associated with reduced immune function and slower tissue healing, and diabetes further increases risk through hyperglycemia-related neutrophil dysfunction and poorer perfusion. Hip replacement also introduces a prosthetic joint, where bacterial adherence and biofilm formation make infections more likely and harder to eradicate. While IV drug use and traumatic wounds can raise infection risk, the combination of advanced age, diabetes, and prosthetic implantation is the strongest overall predictor among these choices.

Question 25

The nurse is caring for a child in the emergency department (ED) who sustained a bite from a rabid animal. The nurse should take which initial action?

Accepted Answer

Answer reason: This action is a nursing measure that can be initiated promptly in the ED without waiting for orders, making it the appropriate first step. Detailed assessment, antibiotics, and notification are important, but they do not reduce viral load as quickly as irrigation/cleansing does. Rabies is nearly universally fatal once symptomatic, so early local wound care is prioritized alongside arranging postexposure prophylaxis.

Question 26

The home care nurse visits a client diagnosed with acquired immune deficiency syndrome (AIDS). The nurse instructs the client's caregiver about how to prevent infection. Which is the most important instruction the nurse will give to the caregiver?

Accepted Answer

Answer reason: " Hand hygiene is the single most effective measure to reduce transmission of infectious organisms in home and healthcare settings. A caregiver’s hands are the most common vector for moving pathogens between surfaces, the client, and themselves, which is especially dangerous for an immunocompromised person with AIDS. Frequent handwashing before and after client contact, food handling, toileting, and handling body fluids directly targets the highest-risk pathway for infection. Other measures like covering coughs are helpful but narrower in scope, while separate dishes and removing pets are not routinely necessary when standard hygiene and basic precautions are followed.

Question 27

The charge nurse notes there are four patients in isolation on the unit but only three nurses. Patients with which diagnoses should be assigned to the same nurse?

Accepted Answer

Answer reason: Both influenza and RSV are managed with droplet precautions (and often contact precautions for RSV, especially with copious secretions), making combined assignment the safest among the choices. Tuberculosis requires airborne precautions, so pairing it with influenza would risk incorrect PPE/room requirements and exposure. Neutropenia requires protective (reverse) precautions and should not be paired with infectious isolation cases like meningitis or C. difficile due to the high risk of harm to the immunocompromised patient.

Question 28

Which laboratory finding should the nurse assess further on a client 24 hours after delivery?

Accepted Answer

Answer reason: " Postpartum perineal care prioritizes infection prevention and protection of episiotomy/laceration repairs. Wiping back and forth over stitches increases contamination risk from the anal area and can disrupt healing tissue, increasing pain, bleeding, and infection risk. Proper technique is gentle cleansing/patting and always front-to-back to reduce introduction of fecal flora. The other statements support safety (assist with ambulation due to orthostatic hypotension risk) and hygiene teaching that decreases urinary/perineal infection risk.

Question 29

Several patients are being admitted to the medical unit of the hospital. Which diagnosis should be placed in negative pressure room for airborne isolation?

Accepted Answer

Answer reason: Airborne isolation with a negative-pressure room is indicated when pulmonary tuberculosis is suspected because infectious droplet nuclei can remain suspended and travel on airflow. Hemoptysis plus an abnormal chest x-ray and a pending TB test represent a high-risk presentation that warrants immediate airborne precautions until TB is ruled out. Influenza requires droplet (and often contact) precautions rather than airborne isolation, and bacterial pneumonias like Klebsiella are managed with standard precautions plus droplet/contact as indicated by symptoms. Lung carcinoma alone is not infectious and does not require isolation.

Question 30

A new mother asks why she has to open a new bottle of formula for each feeding. What is the nurse's best response?

Accepted Answer

Answer reason: " Preventing contamination is the key principle in safe infant feeding because prepared formula can quickly support bacterial growth once exposed to the environment and an infant’s saliva. Keeping or reusing an opened/partially used bottle increases the risk of pathogen proliferation and subsequent gastrointestinal illness in the newborn. This option directly explains the infection-control rationale in a way that addresses the mother’s “why” and links the practice to safety. In contrast, “turn sour” is nonspecific and doesn’t emphasize the clinically important hazard of bacterial contamination. The other options focus on nutrition or tracking intake rather than the primary safety concern.

Question 31

The nurse in the pediatric unit is preparing to admit a client with pertussis. The nurse should assign the client to a?

Accepted Answer

Answer reason: When a private room is not required or available, cohorting patients with the same confirmed infection is an acceptable infection-control strategy. Airborne precautions and negative-pressure-related measures are reserved for true airborne pathogens and are not indicated for pertussis. Sharing a room with a patient who has RSV risks cross-infection with a different respiratory virus and is unsafe.

Question 32

What is the maximum length of time a nurse should allow an IV bag of solution to infuse?

Accepted Answer

Answer reason: For most continuous crystalloids (non-lipid, non-blood) in a closed system, the standard upper limit is to complete/replace the bag within 24 hours using aseptic technique and facility policy. Allowing a single container to hang longer increases microbial growth potential at the access points and in the fluid pathway. Shorter limits may apply to specific products (e.g., parenteral nutrition or lipids), but for a routine IV solution bag the best general maximum is 24 hours.

Question 33

A client is admitted to the hospital for the treatment of active tuberculosis (TB). The nurse teaches the client about TB. Which of the following statements by the client indicates to the nurse that further teaching is necessary?

Accepted Answer

Answer reason: g., improvement on effective therapy, negative sputum smears/cultures, and clinical response), not a fixed number of weeks. Many clients can discontinue airborne precautions after adequate treatment and documented noninfectious status, which may occur before 6 weeks depending on results and clinical course. Stating a mandatory 6-week isolation reflects misunderstanding of infection-control criteria. In contrast, cough etiquette is appropriate, and a prior TB infection commonly results in a persistently positive tuberculin skin test even after treatment.

Question 34

The nurse is teaching a client about adequate hand hygiene. What component of hand washing should the nurse include that is most important for removing microorganisms?

Accepted Answer

Answer reason: Rubbing all hand surfaces (including between fingers, backs of hands, thumbs, and under nails) loosens organisms so they can be lifted and rinsed away. Soap mainly emulsifies oils and helps suspend dirt, but without vigorous rubbing organisms remain on the skin. Water alone does not remove microbes effectively, and while adequate duration supports effectiveness, it works through allowing sufficient rubbing rather than replacing it.

Question 35

The nurse is planning a staff educational conference about indwelling urinary catheters. Which of the following information should the nurse include?

Accepted Answer

Answer reason: Routine perineal hygiene with soap and water is recommended to reduce bacterial colonization and CAUTI risk without causing mucosal irritation. Catheter care is typically a clean procedure (hand hygiene and clean gloves), with sterile technique reserved for insertion and specific sterile procedures. Urine specimens should be obtained from the sampling port using aseptic technique, not from the drainage bag due to contamination risk. Catheter irrigation is not done routinely for poor outflow and, when ordered, should use prescribed sterile solution and technique because unnecessary irrigation increases infection risk and may traumatize the bladder.

Question 36

Which of the following is the most important purpose of handwashing?

Accepted Answer

Answer reason: This option directly targets transmission of pathogens from hands to patients, surfaces, or equipment, which is the primary safety goal. “Dirty hands” is a vague description and does not explicitly address microbial spread, including organisms not visible to the eye. Promoting circulation and providing comfort may be incidental effects but do not address the central infection-prevention purpose.

Question 37

What should be done in order to prevent contaminating of the environment in bed making?

Accepted Answer

Answer reason: Shaking or fanning contaminated sheets can release skin scales, dust, and pathogens into the air and onto nearby surfaces, increasing environmental contamination and transmission risk. Keeping linens handled gently and close to the body, and bagging them promptly, reduces spread in the room. Stripping all linens at once and handling multiple items together can increase contamination and is not the key prevention step compared with avoiding agitation.

Question 38

A nurse observes a colleague failing to perform hand hygiene before entering multiple client rooms and administering medications. What is the most appropriate action by the nurse?

Accepted Answer

Answer reason: Failure to perform hand hygiene is a serious infection-control breach that creates immediate risk for cross-contamination between clients. The nurse’s priority is client safety and adherence to facility policy/chain of command for unsafe practice, which requires prompt escalation when another staff member’s actions endanger patients. Reporting enables timely intervention, education, and monitoring to prevent harm and reduce healthcare-associated infections. Confronting in a client room risks violating professionalism and confidentiality, and documenting in the patient record or delaying action does not directly stop or address the unsafe practice.

Question 39

Which question is appropriate to ask a client with West Nile virus disease?

Accepted Answer

Answer reason:  West Nile virus is primarily a vector-borne infection transmitted to humans via mosquito bites, so assessing insect-bite exposure directly targets the most likely route of acquisition. This question helps confirm a plausible exposure history and supports focused patient teaching on bite prevention and community risk. Asking about deer ticks is more consistent with tick-borne illnesses (e.g., Lyme disease), making it a common but incorrect distractor. Questions about being in the woods/forest are nonspecific and do not identify the key transmission mechanism needed for accurate risk assessment.

Question 40

The infection control nurse is rounding on the unit. Each client is assessed in regards to the risk for development of a hospital-acquired infection (HAI). Which finding requires intervention by the infection control nurse?

Accepted Answer

Answer reason: Dressing changes should be performed using sterile gloves and sterile supplies after appropriate hand hygiene, because the insertion site and catheter tract provide direct access for pathogens. Using only clean (nonsterile) gloves breaks sterile technique and increases contamination risk, making this the finding that warrants immediate correction. In contrast, an IV catheter dwelling 72 hours is not automatically a breach of infection control policy in many current guidelines if the site is clinically indicated and monitored, and MRSA contact precautions do not require special trash placement beyond proper containment.

Question 41

What is the key advantage of using mobile disinfection robots equipped with multi-modal sensors and machine learning algorithms for targeted pathogen detection and treatment?

Accepted Answer

Answer reason: Mobile disinfection robots can deliver more standardized, repeatable coverage than manual cleaning alone, which supports consistent treatment of high-risk areas. By automating portions of disinfection, they can also decrease staff contact with contaminated surfaces and aerosols, lowering occupational exposure risk. Multi-modal sensing plus machine learning allows navigation and adjustment to changing layouts/obstacles and contamination patterns, improving performance in real-world settings. Because each listed benefit is a recognized advantage of such systems, the combined option is the best answer.

Question 42

The infection control team is rounding clients on a med-surg unit. The goal of this rounding is to identify patients at high risk for nosocomial infections. Which of the following patients would be at the highest risk of developing a nosocomial infection?

Accepted Answer

Answer reason: Loss of the skin barrier and exposure of moist tissue create a major portal of entry for bacteria, making extensive burns one of the highest-risk conditions for hospital-acquired infection. Intubation adds a second high-risk factor by bypassing normal airway defenses and increasing risk for ventilator-associated pneumonia, especially with sedation and reduced cough/clearance. In contrast, type 2 diabetes increases infection risk but typically less than the combined risks of large open wounds plus an artificial airway. A stable ambulatory GERD history and an uncomplicated post-appendectomy patient on oral opioids generally have substantially lower nosocomial infection risk.

Question 43

You have an assignment of four patients who are all in isolation – one contact, one contact and droplet, one droplet, and one airborne. Which of the following will assist you in caring for these patients throughout the day?

Accepted Answer

Answer reason: The key principle is to minimize room entries/exits and prevent contamination while maintaining required isolation precautions. Organizing care and bringing needed supplies reduces repeated donning/doffing cycles, lowers exposure opportunities, and supports adherence to contact/droplet/airborne workflows. Carrying extra gloves in pockets risks contaminating clean supplies and undermines aseptic technique. Reusing a gown between rooms violates standard transmission-based precautions and increases cross-transmission risk, while adding another RN is unnecessary and may increase exposure without improving infection control.

Question 44

A patient has a central line in his right subclavian for the simultaneous infusion of multiple medications. During your assessment, his arm is not red, swollen, or hot to the touch. There is a moderate amount of dried blood noted under the central line dressing. What should the nurse do next?

Accepted Answer

Answer reason: Central venous catheter dressings must be clean, dry, and intact to reduce central line–associated bloodstream infection risk and allow ongoing site assessment. A dressing with visible blood underneath is no longer considered “clean/dry,” even if erythema, warmth, or swelling are absent, so it warrants a dressing change per facility protocol. Dressing changes for central lines are a nursing responsibility performed with sterile technique (and often CHG/transparent dressing per policy), not something to defer until a scheduled date. Simply documenting and leaving it in place increases infection risk and could obscure early bleeding or insertion-site issues.

Question 45

A nurse is monitoring a patient recovering from abdominal surgery. The nurse notices redness, swelling, and purulent drainage at the surgical wound site. Which of the following types of wound drainage is the nurse observing?

Accepted Answer

Answer reason: The accompanying wound findings of redness and swelling are classic local inflammatory signs that commonly occur with a surgical site infection. In contrast, serous drainage is clear and watery, and sanguineous drainage is primarily blood, typically seen in fresh wounds or early postoperative bleeding. Serosanguineous drainage is thin and pink-tinged, reflecting a mixture of serum and small amounts of blood rather than pus.

Question 46

A client arrives at the emergency department after exposure to an unknown liquid at work. A new graduate nurse is assigned to the client. Which statement by the new nurse would require further education by the preceptor?

Accepted Answer

Answer reason: Unknown chemical exposure does not automatically require contact isolation. Priority actions include decontamination and assessment. Isolation is reserved for confirmed or suspected infectious transmission risks.

Question 47

The charge nurse is assigning staff to care for the client with disseminated herpes zoster. Which staff member should the charge nurse exclude from being assigned?

Accepted Answer

Answer reason: Disseminated herpes zoster can transmit varicella (chickenpox) via airborne and contact routes. Staff caring for these clients must have confirmed immunity. A nurse with unknown immunity status is at risk and should not be assigned. Option A is acceptable because prior infection confers immunity (pregnancy alone is not a contraindication if immune). Option C is vaccinated and immune. Option D has received zoster vaccine, indicating prior varicella immunity.

Question 48

The clinic nurse is preparing to assess the 14-year-old client who has impetigo on the hands and neck. In reviewing the client’s history, the nurse would expect which predisposing factors to be associated with bacterial skin infections?

Accepted Answer

Answer reason: Bacterial skin infections are more likely in conditions that impair skin integrity or immune function. Eczema disrupts the skin barrier, diabetes mellitus impairs immune response and wound healing, and obesity can contribute to skin folds and moisture retention, all increasing infection risk.

Question 49

A preschool teacher has just found out she is pregnant. She asks the school nurse if there is any communicable disease that requires isolating an infected child from pregnant women. What is the most appropriate response by the nurse?

Accepted Answer

Answer reason: Rubella infection during pregnancy, especially in the first trimester, can lead to severe fetal complications known as congenital rubella syndrome, including deafness, cardiac defects, and developmental delays. Therefore, pregnant women must avoid exposure to individuals infected with rubella. The other diseases listed do not pose the same level of teratogenic risk to the fetus.

Question 50

The nurse cares for a client with a methicillin-resistant Staphylococcus aureus infection. The client is on contact precautions. The facility uses a bar code medication administration system. Which is the best nursing action when administering this client’s medications?

Accepted Answer

Answer reason: Barcode medication administration is designed to prevent identification and medication-selection errors by verifying the right patient and right medication at the point of care. Bedside scanning ensures the medication being given matches the active order and the specific patient’s identifier in real time, which is especially important when workflow changes are tempting under isolation precautions. Printing extra ID bands or scanning empty packages creates workarounds that defeat system safety checks and increase risk of wrong-patient or wrong-medication errors. Infection-control barriers should be managed with proper PPE and equipment cleaning, not by bypassing required verification steps.

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