Safety and Infection Control

1. In which order will the nurse take these actions before doing wound irrigation and a dressing
change for a client who has a wound infected with MRSA?
1. Don gloves
2. Put on gown
3. Place goggles over eyes
4. Put on mask to cover nose and mouth.
2. A client who has had recent exposure to Ebola while traveling in Africa arrives in the ED with
fever, headache, vomiting and multiple ecchymoses. Which action should the nurse take first?
1. Place the client in a private room.
2. Obtain heart rate and BP
3. Notify the hospital infection control nurse.
4. Ask the client to describe type of Ebola exposure.
3. A client who has been infected with the Ebola virus has a emesis of 750ml of bloody fluid and
complaints of headache, nausea and severe lightheadedness. Which action included in the
treatment protocol should the nurse take first?
1. Give acetaminophen 650mg PO.
2. Administer ondansetron 4mg IV.
3. Infuse normal saline at 500 mL/hr.
4. Increase oxygen flow rate to 6L/min.
4. The nurse is caring for a newly admitted client with increasing dyspnea, hypoxia, and dehydration
who has possible avian influenza (Bird Flu). Which of these prescribed actions will be the nurse
implement first?
1. Start oxygen using nonrebreather mask.
2. Infuse 5% dextrose in water at 100 mL/hr.
3. Administer the first dose of oral oseltamivir.
4. Obtain blood and sputum specimens for testing.
5. The Nurse is preparing to leave the room after performing oral suctioning on a client who is on
contact and airborne precautions. In which order will the nurse perform the following actions?
1. Remove N95 respirator
2. Take off the gloves.
3. Take off gown.
4. Perform hand washing.
6. A client has been diagnosed with disseminated herpes zoster. Which personal equipment (PPE)
will the nurse need to put on when preparing to assess the client? SATA
1. Surgical face mask
2. N95 respirator
3. Gown
4. Gloves
 5. Goggles
6. Shoe Covers
7. Four Clients arrive simultaneously at the ED. Which client requires the most rapid action by the
triage nurse to protect other clients from infection?
1. A 3-year-old client who has paroxysmal coughing and whose siblings has pertussis.
2. A 5-year-old client who has a new pruritic rash and a possible chickenpox client.
3. A 62-year-old client who has an ongoing methicillin-resistant Staphylococcus aureus
(MRSA) abdominal wound infection.
4. A 74-year-old client who needs Tuberculosis (TB) testing after being exposed to TB
during a recent international airplane flight.
8. The nurse is caring for four clients who are receiving IV infusions of normal saline. Which clients
is at highest risk for bloodstream infection?
1. Client with an implanted port in the right subclavian vein.
2. Client who has a midline IV catheter in the left antecubital fossa.
3. Client who has a non-tunneled central line in the left internal jugular vein.
4. Client with a peripherally inserted central catheter (PICC) line in the right upper arm.
9. The nurse is caring for a client who has been admitted to the hospital with a leg ulcer that is
infected with Vancomycin- resistant Staphylococcus Aureus (VRSA). Which nursing action can be
assigned to an LPN/LVN?
1. Planning ways to improve the client’s oral protein intake.
2. Teaching the client about home care of the leg ulcer.
3. Obtaining would cultures during dressing changes.
4. Assessing the risk for further skin breakdown.
10. A hospitalized 88 years old client who has been receiving antibiotics for 10 days tells the nurse
about having frequent watery stools. Which action will the nurse take first?
1. Notify the health care provider about the stools.
2. Obtain stools specimens for culture.
3. Instruct the client about correct hand washing.
4. Place the client on contact precautions.
11. The nurse notes the white powder on the arms and chest of a client who arrives at the ED and
reports possible anthrax contamination. Which actions included in the hospital protocol for
possible anthrax exposure will the nurse take first?
1. Notify the hospital security personnel about the client.
2. Escort the client in the decontamination room.
3. Give ciprofloxacin 500mg PO.
4. Assess the client for signs of infection.
12. A pregnant client in the first trimester tells the nurse that she was recently exposed to the zika
virus while travelling in Southeast Asia. Which action by the nurse is most important?
1. Arrange for testing for Zika virus infection.
2. Discuss need for multiple fetal ultrasounds during pregnancy.
3. Describe potentials impact of Zika infection on fetal development.
4. Assess the symptoms such as rash, joint pain, conjunctivitis and fever.
13. The nurse at the infectious disease clinic has four clients waiting to be see. Which client should
the nurse see first?
1. Client who has a 16 mm induration after a tuberculosis (TB) skin test
2. Client who has human immunodeficiency virus and a low CD4 count.
3. Client who has swine influenza (H1N1) and reports increased dyspnea.
4. Client who has been exposed to Zika virus and has a rash and joint paint.
14. The nurses notices that the health care provider omits hand hygiene after leaving a client’s
hospital room. Which action by the nurse is best at this time?
1. Report the health care provider to the infection control department.
2. Offer the health care provider an alcohol-based hand sanitizing fluid.
3. Prove the health care provider with a list of upcoming inservices on hand hygiene.
4. Remind the health care provider about the importance of minimizing infection spread.
15. A client with a vancomycin-resistant enterococcus (VRE) infection is admitted to the medical unit.
Which action can be delegated to the unlicensed assistive personnel (UAP) who is assisting with
the client’s care?
1. Teaching the client and family members about means to prevent transmission of VRE
2. Communicating with other departments when the client is transported for ordered tests.
3. Implementing contact precautions when providing care for the client
4. Monitoring the results of ordered laboratory culture and sensitivity tests
16. A client who has been diagnosed with possible avian influenza is admitted to the medical unit.
Which prescribed action will the nurse take first?
1. Place the client in an airborne isolation room.
2. Initiate infusion of 500 ml of normal saline bolus.
3. Ask the client about any recent travel to Asia.
4. Obtain sputum specimen and nasal cultures.
17. Which infection control activity should the charge nurse delegate to an experienced unlicensed
assistive personnel (UAP)?
1. Screening clients for upper respiratory tract symptoms
2. Asking clients about the use of immunosuppressant medications
3. Demonstrating correct hand washing to the clients’ visitors
4. Disinfecting blood pressure cuffs after clients are discharged
18. The nurse is preparing to change the linens on the bed of a client who has a sacral wound infected
by methicillin-resistant Staphylococcus aureus (MRSA). Which personal protective equipment
(PPE) items will be used? Select all that apply.
1. Gown
2. Gloves
3. Goggles
4. Surgical mask
5. N95 respirator
19. A client who has frequent watery stools and a possible Clostridium difficile infection is
hospitalized with dehydration. Which nursing action should the charge nurse assign to an
LPN/LVN?
1. Performing ongoing assessments to determine the client’s hydration status
2. Explaining the purpose of ordered stool cultures to the client and family
3. Administering the prescribed metronidazole 500 mg PO to the client
4. Reviewing the client’s medical history for any risk factors for diarrhea
20. Which action by the infection control nurse in an acute care hospital will be most effective in
reducing the incidence of health care-associated infections?
1. Require nursing staff to don gowns to change wound dressings for all clients
2. Ensure that dispensers for alcohol-based hand rubs are available in all client care areas
3. Screen all newly admitted clients for colonization or infection with methicillin-resistant
Staphylococcus aureus (MRSA).
4. Develop policies that automatically start antibiotic therapy for clients colonized by multi
drug-resistant organisms.
21. When the nurse is educating a group of women of childbearing age about the Zika virus, which
information will be included? Select all that apply.
1. Women who are pregnant will be asked about possible Zika exposure at each prenatal
visit.
2. Testing for recent infection with the Zika virus is available for women who may have been
exposed to Zika.
3. There is a high risk for maternal death when women are infected with the Zika virus during
pregnancy.
4. Women who are trying to get pregnant should avoid travel to geographic areas with active
Zika virus transmission.
5. Barrier methods such as condoms should be used during intercourse if the sex partner has
possible Zika exposure.
22. When the community health nurse is counseling a client who has an acute Zika virus infection,
which information is most important to include?
1. Drink fluids to prevent dehydration.
2. Use acetaminophen to reduce pain and fever.
3. Apply insect repellant frequently to prevent mosquito bites.
4. Symptoms of Zika infection include fever, red eyes, rash, and joint pains.
23. Which policy implemented by the infection control nurse will most effectively reduce the
incidence of catheter-associated urinary tract infections (CAUTIs)?
1. Limit the use of indwelling urinary catheters in all hospitalized clients.
2. Ensure that clients with catheters have at least a 1500-mL fluid intake daily.
3. Use urine dipstick testing to screen catheterized clients for asymptomatic bacteriuria.
4. Require the use of antimicrobial/antiseptic-impregnated catheters for catheterization.
24. The nurse admits four clients with infections to the medical unit, but only one private room is
available. Which client is most appropriate to assign to the private room?
1. Client with diarrhea caused by C. difficile.
2. Client with vancomycin-resistant enterococcus (VRE) infection.
3. Client with a cough who may have active tuberculosis (TB)
4. Client with toxic shock syndrome and fever
25. Which information about a client who has meningococcal meningitis is the best indicator that
the nurse can discontinue droplet precautions?
1. Pupils are equal and reactive to light.
2. Appropriate antibiotics have been given for 24 hours.
3. Cough is productive of clear, non-purulent mucus.
4. Temperature is lower than 100oF (37.8oC).
26. While administering vancomycin 500 mg IV to a client with a methicillin-resistant Staphylococcus
aureus (MRSA) wound infection, the nurse notices that the client’s neck and face are becoming
flushed. Which action should the nurse take next?
1. Discontinue the vancomycin infusion.
2. Slow the rate of the vancomycin infusion.
3. Obtain an order for an antihistamine.
4. Check the client’s temperature.
27. A healthy 65-year-old client who cares for a newborn grandchild has a clinic appointment in May.
The client needs several immunizations but tells the nurse, “I hate shots! I will only take one
today.” Which immunization is most important to give?
1. Influenza
2. Herpes zoster
3. Pneumococcal
4. Tetanus, diphtheria, pertussis
28. The nurse is caring for a client who is intubated and receiving mechanical ventilation. Which
nursing actions are most essential in reducing the client’s risk for ventilator-associated
pneumonia (VAP)? Select all that apply.
1. Keep the head of the client’s bed elevated to at least 30 degrees.
2. Assess the client’s readiness for extubation at least daily.
3. Ensure that the pneumococcal vaccine is administered.
4. Use a kinetic bed to continuously change the client’s position.
5. Provide oral care with chlorhexidine solution at least daily.
29. The nurse is preparing to insert a peripherally inserted central catheter (PICC) in a client’s left
forearm. Which solution will be best for cleaning the skin prior to the PICC insertion?
1. 70% isopropyl alcohol
2. Povidone-iodine solution
3. 0.5% chlorhexidine in alcohol
4. Betadine followed by 70% isopropyl alcohol
30. The nurse has received a needlestick injury after giving a client an intramuscular injection, but
has no information about whether the client has human immunodeficiency virus (HIV) infection.
What is the most appropriate method of obtaining this information about the client?
1. The nurse should personally ask the client to authorize HIV testing.
2. The charge nurse should tell the client about the need for HIV testing.
3. The occupational health nurse should discuss HIV status with the client.
4. HIV testing should be performed the next time blood is drawn for other tests.
31. Which medication order for a client with pulmonary embolism is most important to clarify with
the prescribing health care provider before administration?
1. Warfarin 1.0 mg PO
2. Morphine 2 to 4 mg IV
3. Cephalexin 250 mg PO
4. Heparin infusion at 900 units/hr
32. A client with atrial fibrillation is ambulating in the hallway on the coronary step-down unit and
suddenly tells the nurse, “I feel really dizzy.” Which action should the nurse take first?
1. Help the client to sit down.
2. Check the client’s apical pulse.
3. Take the client’s blood pressure.
4. Have the client breathe deeply.
33. The nurse is supervising an LPN/LVN who says, “I gave the client with myasthenia gravis 90 mg of
neostigmine instead of the ordered 45 mg!” In which order should the nurse perform the following
actions?
1. Assess the client’s heart rate.
2. Complete a medication error report.
3. Ask the LPN/LVN to explain how the error occurred.
4. Notify the health care provider of the incorrect medication dose.
_____, _____, _____, _____
34. The nurse is caring for a confused and agitated client who has wrist restraints in place on both
arms. Which action included in the client plan of care can be assigned to an LPN/LVN?
1. Determining whether the client’s mental status justifies the continued use of restraints
2. Undoing and retying the restraints to improve client comfort
3. Reporting the client’s status and continued need for restraints to the health care provider
4. Explaining the purpose of the restraints to the client’s family members
35. The nurse is checking medication prescriptions that were received by telephone for a client with
hypertensive crisis and tachycardia. Which medication is most important to clarify with the health
care provider?
1. Carvedilol 12.5 mg PO BID daily
2. Hydrochlorothiazide 25 mg PO daily
3. Labetalol 20 mg IV over a 2-min time period now
4. Hydroxyzine 50 mg PO as needed (PRN) systolic blood pressure greater than 160 mm Hg
36. A 70-kg patient who has had unprotected sexual intercourse with a partner who has hepatitis B
is to receive 0.06 mL/kg of hepatitis B immune globulin. The immune globulin is available in a 5-mL
vial. The nurse will plan to administer ______________ mL.

37. A 88-year-old client who has not yet had the influenza vaccine is admitted after reporting
symptoms of generalized muscle aching, cough, and runny nose starting about 24 hours previously.
Which of these prescribed medications is most important for the nurse to administer at this time?
1. Oseltamivir 75 mg PO
2. Guaifenesin 600 mg PO
3. Acetaminophen 650 mg PO
4. Influenza vaccine 180 mcg IM