Infection Control and Patient Safety

Every question here, with the answer

1. An older adult living in a long-term care facility has chronic conditions and is being evaluated for a possible multidrug-resistant organism (MDRO). Which explanation should the nurse give a family member about why strict infection-prevention measures are especially important?

   1. Older adults have increased risk because they often spend more time in hospitals or long-term care facilities with chronic conditions, increasing exposure to pathogens.
   2. MDROs are usually easy to treat because the bacteria remain controlled by the same antibiotics.
   3. Age-related physiologic changes make older adults less vulnerable to infections.
   4. MDRO risk is limited to patients who are currently taking antibiotics, so isolation practices are not a priority.

   Answer: Older adults have increased risk because they often spend more time in hospitals or long-term care facilities with chronic conditions, increasing exposure to pathogens.

   The section states that older adults have increased MDRO risk related to more time in hospitals or long-term care facilities, more chronic conditions, and decreased immune system efficiency. The other options contradict the section by minimizing MDRO risk or misstating antibiotic resistance and older adult vulnerability.

2. A nurse is preparing care for a patient on airborne precautions who may need essential transport for a procedure. Which actions are appropriate? Select all that apply.

   1. Limit transport and only do it when essential.
   2. Place the patient in a negative pressure room when available.
   3. If a negative pressure room is unavailable, mask the patient and place them in a private room with the door closed.
   4. Wear a fit-tested NIOSH-approved N95 or higher-level respirator when entering the room.
   5. Use only gloves and an isolation gown when touching the patient; no respirator is needed.

   Answer: Limit transport and only do it when essential., Place the patient in a negative pressure room when available., If a negative pressure room is unavailable, mask the patient and place them in a private room with the door closed., Wear a fit-tested NIOSH-approved N95 or higher-level respirator when entering the room.

   Airborne precautions include a negative pressure room (or, if none is available, a masked patient in a private room with the door closed), a fit-tested N95 or higher-level respirator for staff, and limiting transport to essential trips. Gloves and an isolation gown alone describe contact-focused PPE and do not meet airborne precaution requirements.

3. A patient on droplet precautions must leave the room for an essential test. What should the nurse do before transport?

   1. Have the patient wear a surgical mask.
   2. Apply gloves and an isolation gown to the patient instead of a mask.
   3. Transport the patient without a mask because staff will wear PPE.
   4. Have the patient wear an N95 mask.

   Answer: Have the patient wear a surgical mask.

   For droplet precautions, the section specifies that patients must wear a surgical mask if transport outside the room is necessary. Transporting without a mask or putting gloves and a gown on the patient does not meet that requirement.

4. A patient is placed on contact precautions for a suspected infection that can spread through direct contact or contaminated equipment. Which nursing actions are appropriate? Select all that apply.

   1. Discard gloves and the isolation gown before exiting the room.
   2. Use a mask upon entering the room instead of gloves and a gown.
   3. Use disposable or dedicated patient equipment when possible.
   4. Wear gloves and an isolation gown whenever touching the patient.
   5. Clean and disinfect common-use equipment before it is used on another patient.

   Answer: Discard gloves and the isolation gown before exiting the room., Use disposable or dedicated patient equipment when possible., Wear gloves and an isolation gown whenever touching the patient., Clean and disinfect common-use equipment before it is used on another patient.

   Contact precautions require gloves and an isolation gown when touching the patient, discarding them before exit, and using disposable or dedicated equipment when possible. If common equipment must be used, it must be cleaned and disinfected before another patient; a mask alone is not the contact-precaution PPE described in the section.

5. A patient in an airborne isolation room says, “Everyone forgets about me in here,” has not eaten because the tray arrived cold, and cannot call family because the phone battery is dead. What is the best nursing response?

   1. Explain that isolation rooms are difficult and leave quickly to reduce time in the room.
   2. Tell the patient family should not be contacted until isolation is discontinued.
   3. Acknowledge the patient’s feelings, request a new hot tray, and help the patient charge the phone to contact loved ones.
   4. Remove isolation precautions briefly so the patient can feel less lonely.

   Answer: Acknowledge the patient’s feelings, request a new hot tray, and help the patient charge the phone to contact loved ones.

   The scenario in the section shows the nurse addressing both basic needs and emotional needs by replacing the cold tray and helping the patient stay connected with loved ones. Leaving quickly, discouraging contact, or removing precautions fails to support patient safety and psychosocial needs.

6. A nurse has just used a needle and is preparing to dispose of it. Which actions follow sharps safety principles? Select all that apply.

   1. Do not throw a needle or sharp in the trash.
   2. Never use force or reach into the sharps container.
   3. Dispose of the needle in a marked sharps container immediately after use.
   4. Immediately report a needlestick and follow facility guidelines and protocols.
   5. Recap the used needle before disposal to prevent injury.

   Answer: Do not throw a needle or sharp in the trash., Never use force or reach into the sharps container., Dispose of the needle in a marked sharps container immediately after use., Immediately report a needlestick and follow facility guidelines and protocols.

   The section directs nurses to place sharps in a marked container immediately, avoid force or reaching into the container, report needlesticks, and never throw sharps in the trash. Recapping a used needle is specifically identified as an unsafe action.