Chapter 23: Care of Patients with Infection

Chapter 23: Care of Patients with Infection

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nursing instructor explaining infection tells students that which factor is the best and most important barrier to infection?
   1. Colonization by host bacteria
   2. Gastrointestinal secretions
   3. Inflammatory processes
   4. Skin and mucous membranes

ANS:   D

The skin and mucous membranes are the most important barrier against infection. The other options are also barriers, but are considered secondary to skin and mucous membranes.

DIF:     Understanding/Comprehension         REF:    400                   KEY: Infection| physiology              MSC:                                                  Integrated Process: Teaching/Learning NOT:             Client Needs Category: Physiological Integrity: Physiological Adaptation

2. 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?
   1. Auditing staff members’ hand hygiene practices
   2. Ensuring clients are placed in appropriate isolation
   3. Establishing a policy to remove urinary catheters quickly
   4. Teaching staff members about infection control methods

ANS:   A

All methods will help prevent infection; however, health care workers’ lack of hand hygiene is the biggest cause of healthcare-associated infections. The manager can start with a hand hygiene audit to see if this is a contributing cause.

DIF:     Applying/Application                         REF:    401                   KEY: Infection control| infection| hand hygiene                                                               MSC:             Integrated Process: Nursing Process: Assessment                                       NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control

3. A student nurse asks why brushing clients’ teeth with a toothbrush in the intensive care unit is important to infection control. What response by the registered nurse is best?
   1. “It mechanically removes biofilm on teeth.”
   2. “It’s easier to clean all surfaces with a brush.”
   3. “Oral care is important to all our clients.”
   4. “Toothbrushes last longer than oral swabs.”

ANS:   A

Biofilms are a complex group of bacteria that function within a slimy gel on surfaces such as teeth. Mechanical disruption (i.e., toothbrushing with friction) is the best way to control them. The other answers are not accurate.

DIF:            Understanding/Comprehension         REF:    405                   KEY: Infection| infection control| oral care                                                                  MSC: Integrated Process: Teaching/Learning                               NOT:                                                 Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control

4. A client is admitted with possible sepsis. Which action should the nurse perform first?
   1. Administer antibiotics.
   2. Give an antipyretic.
   3. Place the client in isolation.
   4. Obtain specified cultures.

ANS:           D

Prior to administering antibiotics, the nurse obtains the ordered cultures. Broad-spectrum antibiotics will be administered until the culture and sensitivity results are known. Antipyretics are given if the client is uncomfortable; fever is a defense mechanism. Giving antipyretics does not take priority over obtaining cultures. The client may or may not need isolation.

DIF:            Applying/Application                         REF:    408

KEY:          Infection| antibiotics| cultures

MSC:          Integrated Process: Nursing Process: Implementation           NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care

5. A client is hospitalized and on multiple antibiotics. The client develops frequent diarrhea. What action by the nurse is most important?
   1. Consult with the provider about obtaining stool cultures.
   2. Delegate frequent perianal care to unlicensed assistive personnel.
   3. Place the client on NPO status until the diarrhea resolves.
   4. Request a prescription for an anti-diarrheal medication.

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. The nurse should inform the practitioner and request stool cultures. Frequent perianal care is important and can be delegated but is not the priority. The client does not necessarily need to be NPO; if the client is NPO, the nurse ensures he or she is getting appropriate IV fluids to prevent dehydration. Anti-diarrheal medication may or may not be appropriate, and the diarrhea serves as the portal of exit for the infection.

DIF:            Applying/Application                         REF:    412

KEY:          Infection| cultures| communication

MSC:          Integrated Process: Communication and Documentation  NOT:     Client Needs Category: Physiological Integrity: Reduction of Risk Potential