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Chapter 27 and 32

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Infection and Inflammation

Question 1 of 37

1

What are the smallest infectious agents capable of causing an infection?

Select one of the following:

  • Bacteria

  • Viruses

  • Molds

  • Yeasts

Explanation

Question 2 of 37

1

Your patient has developed a low-grade fever and states that she has felt very tired lately. You interpret these findings as indicating which stage of infection?

Select one of the following:

  • Incubation period

  • Prodromal stage

  • Full stage of illness

  • Convalescent period

Explanation

Question 3 of 37

1

Efforts by healthcare facilities to reduce the incidence of HAIs include an awareness of which of the following?

Select one of the following:

  • The CDC requires all states to report HAI rates from each hospital.

  • The gastrointestinal tract is a common site for HAIs.

  • Joint Commission considers death or serious injury from HAIs a sentinel event

  • The causal agent for most HAIs is viral.

Explanation

Question 4 of 37

1

A patient develops a urinary tract infection after an indwelling urinary catheter has been inserted. This would most accurately be termed as which type of infection?

Select one of the following:

  • A viral infection

  • A chronic infection

  • An iatrogenic infection

  • An opportunistic infection

Explanation

Question 5 of 37

1

The nurse has opened the sterile supplies and donned two sterile gloves to complete a sterile dressing change, a procedure that requires surgical asepsis. The nurse must do which of the following?

Select one of the following:

  • Keep splashes on the sterile field to a minimum

  • Cover the nose and mouth with gloved hands if a sneeze is imminent

  • Use forceps soaked in disinfectant

  • Consider the outer 1 inch of the sterile field as contaminated

Explanation

Question 6 of 37

1

The CDC standard precaution recommendations apply to which of the following?

Select one of the following:

  • Only patients with diagnosed infections

  • Only blood and body fluids with visible blood

  • All body fluids including sweat

  • All patients receiving care in hospitals

Explanation

Question 7 of 37

1

In addition to standard precautions, the nurse caring for a patient with rubella would plan to implement what type of precautions?

Select one of the following:

  • Droplet precautions

  • Airborne precautions

  • Contact precautions

  • Universal precautions

Explanation

Question 8 of 37

1

When caring for a patient with latex allergy, the nurse creates a latex-safe environment by doing which of the following?

Select one of the following:

  • Carefully cleaning the wall-mounted blood pressure device before using it

  • Donning latex gloves outside the room to limit powder dispersal

  • Using a latex-free pharmacy protocol

  • Placing the patient in a semiprivate room

Explanation

Question 9 of 37

1

Which organization(s) initially developed the guidelines for minimum protection standards for infection prevention and control?

Select one of the following:

  • OSHA

  • Individual healthcare facilities

  • The state governing body

  • The CDC

Explanation

Question 10 of 37

1

Which of the following lists the recommended sequence for removing soiled personal protective equipment when the nurse prepares to leave the patient’s room?

Select one of the following:

  • Gown, goggles, mask, gloves, and exit the room

  • Gloves, wash hands, remove gown, mask, and goggles

  • Gloves, goggles, gown, mask, and wash hands

  • Goggles, mask, gloves, gown, and wash hands

Explanation

Question 11 of 37

1

For a nurse under normal conditions with unsoiled hands, effective hand hygiene between patients requires which of the following?

Select one of the following:

  • At least a 15-second scrub with plain soap and water

  • At least a 23-minute scrub with an antimicrobial soap

  • Use of an alcohol-based antiseptic handrub

  • That a mask be worn when scrubbing

Explanation

Question 12 of 37

1

Which hospitalized patient is most at risk for developing a healthcare-associated infection?

Select one of the following:

  • Mr. Y, a 60-year-old patient who smokes two packs of cigarettes daily

  • Mrs. J, a 40-year-old patient who has a white blood cell count of 6,000/mm3

  • Mr. L, a 65-year-old patient who has an indwelling urinary catheter in place

  • Mrs. M, a 60-year-old patient who is a vegetarian and slightly underweight

Explanation

Question 13 of 37

1

A patient develops food poisoning from contaminated potato salad. What is the means of transmission for the infecting organism?

Select one of the following:

  • Direct contact

  • Vector

  • Vehicle

  • Airborne

Explanation

Question 14 of 37

1

A nurse is caring for an obese 62-year-old patient with arthritis who has developed an open reddened area over his sacrum. Which of the following is a priority nursing diagnosis?

Select one of the following:

  • Imbalanced Nutrition: More Than Body Requirements related to immobility

  • Impaired Physical Mobility related to pain and discomfort

  • Chronic Pain related to immobility

  • Risk for Infection related to altered skin integrity

Explanation

Question 15 of 37

1

The nurse teaches a patient at home to use clean technique when changing a wound dressing. This is which of the following?

Select one of the following:

  • The nurse's preference

  • Safe for the home setting

  • Unethical behavior

  • Grossly negligent

Explanation

Question 16 of 37

1

Thirty-six hours after having surgery, a patient has a slightly elevated body temperature and generalized malaise, as well as pain and redness at the surgical site. Which intervention is most important to include in this patient’s nursing care plan?

Select one of the following:

  • Document the findings and continue to monitor the patient.

  • Administer antipyretics, as ordered.

  • Increase the frequency of assessment to every hour and notify the patient’s physician.

  • Increase the frequency of wound care and contact the physician for an antibiotic order.

Explanation

Question 17 of 37

1

Which term would the nurse use to document wound drainage that is thick, odorous, and green?

Select one of the following:

  • Serous

  • Sanguineous

  • Serosanguineous

  • Purulent

Explanation

Question 18 of 37

1

A patient, age 16, was in an automobile accident and received a wound across her nose and cheek. After surgery to repair the wound, the patient says, “I am so ugly now.” Based on this statement, what nursing diagnosis would be most appropriate?

Select one of the following:

  • Pain

  • Impaired skin integrity

  • Disturbed body image

  • Disturbed thought process

Explanation

Question 19 of 37

1

A patient is admitted with a nonhealing surgical wound. Which nursing action is most effective in preventing a wound infection?

Select one of the following:

  • Using sterile dressing supplies

  • Suggesting dietary supplements

  • Applying antibiotic ointment

  • Performing careful hand hygiene

Explanation

Question 20 of 37

1

During a dressing change, inspection of the wound reveals what appears to be reddish-pink tissue in the wound. The nurse interprets this as most likely indicating:

Select one of the following:

  • A sign of infection

  • Eschar

  • Exudate

  • Granulation tissue

Explanation

Question 21 of 37

1

The nurse is performing a sterile irrigation of an open abdominal wound. Which intervention should be done first?

Select one of the following:

  • Direct a stream of solution into the wound.

  • Position the patient so the irrigation solution will flow from clean to dirty.

  • Assess the wound and surrounding tissue.

  • Put on sterile gloves.

Explanation

Question 22 of 37

1

The nurse is developing a plan of care for an 86-year-old woman who has been admitted for right hip arthroplasty (hip replacement). Which assessment finding(s) indicate a high risk for pressure ulcer development for this patient? Select all that apply.

Select one or more of the following:

  • The patient takes time to think about her responses to questions.

  • The patient’s age of 86 years.

  • Patient reports inability to control urine.

  • A scheduled hip arthroplasty

  • Lab findings include BUN 12 (elderly normal 8-23 mg/dL) and creatinine 0.9 (adult female normal 0.61.1 mg/dL).

  • Patient reports increased pain in right hip when repositioning in bed or chair.

Explanation

Question 23 of 37

1

The nurse is explaining to a patient the anticipated effect of the application of cold to an injured area. What response indicates the patient understands the explanation?

Select one of the following:

  • “I can expect to have more discomfort in the area where the cold is applied.”

  • “I should expect more drainage from the incision after the ice has been in place.”

  • “I should see less swelling and redness with the cold treatment.”

  • “My incision may bleed more when the ice is first applied.”

Explanation

Question 24 of 37

1

The nurse is providing patient teaching regarding the use of negative pressure wound therapy. Which explanation provides the most accurate information to the patient?

Select one of the following:

  • The therapy is used to collect excess blood loss and prevent the formation of a scab.

  • The therapy will prevent infection, ensuring the wound heals with less scar tissue.

  • The therapy provides a moist environment and stimulates blood flow to the wound.

  • The therapy irrigates the wound to keep it free from debris and excess wound fluid.

Explanation

Question 25 of 37

1

After an initial assessment, the nurse documents the presence of a reddened area that has blistered. According to recognized staging systems, as what stage would this ulcer be classified?

Select one of the following:

  • Stage 1

  • Stage 2

  • Stage 3

  • Stage 4

Explanation

Question 26 of 37

1

An older confused patient sits and slumps in her chair most of the day. She is most likely to develop a pressure ulcer because of what factor?

Select one of the following:

  • Malnutrition

  • Shearing forces

  • Edema

  • A chronic disease

Explanation

Question 27 of 37

1

The nurse assesses a stage III pressure ulcer manifested as:

Select one of the following:

  • Redness that persists when pressure is relieved

  • An open lesion with full thickness tissue loss and visible subcutaneous fat

  • A necrotic area extending through the fascia to bone

  • A reddened area with an abrasion and pain

Explanation

Question 28 of 37

1

Which action would be a priority in preventing a patient from developing a pressure ulcer?

Select one of the following:

  • Using waterproof material on the bed

  • Massaging any reddened area frequently

  • Using an air-inflated ring to relieve pressure on areas

  • Using a mild cleansing agent when cleansing the skin

Explanation

Question 29 of 37

1

A nurse is assessing a patient in the resolution stage of an infection. The nurse would anticipate

Select one of the following:

  • Vague, non specific signs and symptoms of early stages of infection.

  • Full presense of signs and symptoms anticipated with an infection.

  • No symptoms. This would be the interval between invasion of pathogens and the appearance of symptoms.

  • A period of recovery. Signs and symptoms disappear and the person returns to a healthy state.

Explanation

Question 30 of 37

1

A patient is 7 days post operative. Which stage of the wound healing process is the patient most likely experiencing currently?

Select one of the following:

  • Reconstruction or Proliferative Phase.

  • Remodeling or Maturation Phase

  • Inflammatory Phase

  • Hemostasis Phase

Explanation

Question 31 of 37

1

As a nurse knowledgeable about the chain of infection, you are concerned with reducing reservoirs which are necessary for an infection to develop. A way to reduce reservoirs would include to

Select one of the following:

  • Wear gloves and other personal protective wear when caring for the patient.

  • Wash hands, use antiseptics and disinfectants.

  • Empty the foley catheter bag regularly and keep the bag below bladder level.

  • Instruct the patient to cover his nose and mouth when sneezing.

Explanation

Question 32 of 37

1

Which nursing action prevents an organism from exiting a reservoir in the chain of infection?

Select one of the following:

  • Immunizations.

  • Using pesticides.

  • Use of disposible supplies.

  • Prompt, frequent administration of antibiotics.

Explanation

Question 33 of 37

1

A nurse is caring for a patient with a healing wound. The nurse is aware that multiple factors either promote or impede wound healing. Factors that can promote wound healing would include

Select one of the following:

  • A wound healing by secondary intention.

  • A clean surgical wound healing free of infection.

  • A past history of diabetes mellitus.

  • A past history of immunosuppressive therapy to promote healing.

Explanation

Question 34 of 37

1

A student nurse is teaching a new mother about immunizations. The student nurse knows teaching was effective when the new mother states that immunity acquired from either having the infection or being immunized and developing immunity is known as __________.

Select one of the following:

  • Active immunity

  • Passive immunity

  • Immune response

  • Tertiary response

Explanation

Question 35 of 37

1

As a nurse, you are aware that the CDC has identified two tiers of precautions to prevent the spread of infection. The second tier, transmission-based precautions includes all of the following except

Select one of the following:

  • Wearing gloves when emptying a urinal.

  • Wearing a mask when working within 3 feet of the patient.

  • Wearing a gown if in contact with infectious agent.

  • Wearing a specially fitted mask when entering the patient's room.

Explanation

Question 36 of 37

1

A infection control nurse is concerned about the incidence of nosocomial infection in a particular facility. Which of the following would be least likely to place the patient at risk for developing a nosocomial infection?

Select one of the following:

  • Admission for outpatient surgery.

  • Several invasive treatments while closely monitoring vital signs.

  • Insertion of a foley catheter after surgery.

  • Treatment with broad spectrum antibiotics to ward off nosocomial infection

Explanation

Question 37 of 37

1

The nurse has selected a health problem of risk for infection related to trauma (surgical incision). The behavior outcome that has been written for the patient is for the incision to remain free from signs and symptoms of infection over the next 5 days. The nurse would be alert for clinical cues that the goal might not be met if the patient's assessment reveals which of the following?

Select one of the following:

  • Wound edges approximated.

  • Redness beyond the edges of the wound.

  • Coolness felt around the wound, no drainage.

  • Decreased edema.

Explanation

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