Chapter 14: Infection Prevention and Control

Chapter 14: Infection Prevention and Control

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse has had a nasal culture performed and has been found to be MRSA positive. Because the nurse has not been ill from the bacteria, the nurse’s nasal cavity can best be described as a:

ANS:   B

A place in which microorganisms survive, multiply, and wait to transfer to a susceptible host is called a reservoir. Common reservoirs are humans and animals (hosts), insects, food, water, and organic matter on inanimate surfaces (fomites). Frequent reservoirs for health care–acquired infections (HAIs) include health care workers (especially their hands), patients’ body excretions and secretions, equipment, and the health care environment. A susceptible host is one who will get an infection. Susceptibility to an infection depends on the individual’s degree of resistance to pathogens. The fact that the nurse has not become ill indicates that he or she is not very susceptible. Portal of entry describes how the organism entered the body. Although the MRSA may have used the nasal cavity as the portal of entry, it now resides there so the nasal cavity is now the reservoir. Mode of transmission refers to how the organism is passed from one person to another. This can be from touch, sneezing, coughing, and so on. The nasal cavity is a place, not a mode of transmission.

PTS:    1                      DIF:    Cognitive Level: Remembering (Knowledge)

REF:    240 | 241         OBJ:    Describe characteristics of each link of the infection chain.

TOP:    Nursing Process: Assessment            MSC:   NCLEX: Safety and Infection Control

2. The nursing assistive personnel (NAP) is working on a busy pediatric unit in a hospital. She has a cut on her hand that has not been kept covered. It hurts her to wash her hands or sanitize them, so she has been providing patient care without performing hand hygiene. Several of the patients on the pediatric unit have suffered hospital-associated infections of rotavirus. This was thought to be a result of the NAP’s lack of hand hygiene. This type of disease transmission can best be described as:

ANS:   C

Hands of health care workers often transmit microorganisms. This mode of transmission is called direct transmission. Indirect transmission occurs when microorganisms are transferred to health care workers’ hands from contaminated items that are part of patient care, such as a blood pressure cuff or a bedside table. Natural active immunity results from having a certain disease, such as measles, and mounting an immune response that usually lasts a lifetime. Natural passive immunity is the acquisition of an antibody by one person from another, such as a baby born with its mother’s antibodies. The baby acquires these antibodies through the placenta during the last months of pregnancy. This type of immunity is of short duration, usually lasting only a few weeks to months.

PTS:    1                      DIF:    Cognitive Level: Remembering (Knowledge)

REF:    241 | 242         OBJ:    Identify the body’s normal defenses against infection.

TOP:    Nursing Process: Assessment            MSC:   NCLEX: Safety and Infection Control

3. The nurse is working for a postsurgical unit. He is caring for four postsurgical patients, all of whom have been in the hospital for 3 days or more. Which of the following patients should he be most concerned about regarding a health care–associated infection?

ANS:   D

By assessing existing signs and symptoms (e.g., the condition of a wound, the presence of fever), you will determine whether a patient’s clinical condition indicates the onset or extension of a systemic infection. The patient with an elevated temperature such as 101.3° F and a feeling of malaise is demonstrating signs of infection. When assessing laboratory data, consider the age of the patient. For example, in an older adult, bacterial growth in urine without clinical symptoms does not always indicate the presence of a urinary tract infection. Normal white blood cell count is 5000 to 10,000/mm³, so a patient with that level would not be showing a sign of infection unless he or she were already immunosuppressed. Redness at the incision site is a sign of inflammation, and the body’s inflammatory response is a protective reaction that neutralizes pathogens and repairs body cells.

PTS:    1                      DIF:    Cognitive Level: Analyzing (Analysis)

REF:    243 | 245 | 246

OBJ:    Assess patients at risk for acquiring an infection.

TOP:    Nursing Process: Evaluation              MSC:   NCLEX: Safety and Infection Control

4. A patient with a history of poor nutrition and chronic illness is admitted to the medical unit. The nurse caring for this patient is preparing to provide the patient with a bed bath and recalls that normal body flora:

ANS:   D

Normal flora usually does not cause disease, but instead help to maintain health. The number and variety of flora maintain a sensitive balance with other microorganisms to prevent infection. The body’s normal flora is made up of a large numbers of microorganisms residing on the surface and deep layers of the skin, in the saliva and oral mucosa, and in the intestinal walls. Any factor that disrupts this balance places a person at increased risk for infection. For example, the use of broad-spectrum antibiotics for the treatment of infection eliminates or changes normal bacterial flora, often leading to suprainfection. Microorganisms resistant to antibiotics then cause serious infection.

PTS:    1                      DIF:    Cognitive Level: Remembering (Knowledge)

REF:    243

OBJ:    Explain conditions that promote development of health care–associated infections.

TOP:    Nursing Process: Planning                 MSC:   NCLEX: Safety and Infection Control