ANSWER : 2, 3 6 - 1.The community health nurse is providing a tea...

NCLEX-RN: Infection Control

1.The community health nurse is providing a teaching session about anthrax to members of the community and asks the participants about the methods of transmission. Which answers by the participants would indicate that teaching was effective? Select all that apply.

• Bites from ticks or deer flies

2.Inhalation of bacterial spores 3.Through a cut or abrasion in the skin 4.Direct contact with an infected individual 5.Sexual contact with an infected individual 6.Ingestion of contaminated undercooked meat

ANSWER : 2, 3 & 6

Rationale: Anthrax is caused by Bacillus anthracis and can be contracted through the digestive system or abrasions in the skin, or inhaled through the lungs.

2.A client with tuberculosis whose status is being monitored in an ambulatory care clinic asks the nurse when it is permissible to return to work. What factor should the nurse include when responding to the client?

• Five blood cultures are negative.

2.Three sputum cultures are negative.

3.A blood culture and a chest x-ray are negative.

4.A sputum culture and a tuberculin skin test are negative.

ANSWER :2

Rationale: The client with tuberculosis must have sputum cultures performed every 2 to 4 weeks after initiation of antituberculosis medication therapy. The client may return to work when the results of three sputum cultures are negative because the client is considered noninfectious at that point.

3.The nurse is assisting a female client to collect a midstream urine specimen. How should the nurse implement aseptic technique?

• Cleansing the meatus with antiseptic pads using upward strokes

2.Letting go of the labia once this tissue is cleansed, to allow the client to urinate 3.Making sure that the fingers avoid touching the inside of the collection container

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4.Instructing the client to urinate in the container after the labia have been cleansed

ANSWER :3

Rationale: The inside of the container is sterile, and sterility must be maintained. Fingers touching the inside of the container would cause the container to become unsterile.

4.The nurse is preparing to care for a client with acquired immunodeficiency syndrome (AIDS). In planning infection control for this client, the nurse should implement which form of isolation to prevent the spread of the AIDS virus to others?

1.Strict isolation 2.Enteric precautions 3.Contact precautions 4.Blood and body fluid precautions

ANSWER : 4

Rationale: The AIDS virus is transmitted through contact with oral secretions, sexual contact with infected semen or vaginal secretions, through contact with infected blood or blood products, from mother to fetus during childbirth, or during breast-feeding.

5.The client seen in the health care clinic has tested positive for gonorrhea. The nurse anticipates that which medication will be prescribed based on this finding?

• Acyclovir

2.Ceftriaxone 3.Azithromycin 4.Penicillin G benzathine

ANSWER : 2

Rationale: Treatment for gonorrhea consists of antibiotic therapy, usually with ceftriaxone and doxycycline.

6.The nurse is providing home care instructions to the mother of a child who has bacterial conjunctivitis. The nurse should provide the mother with which information?

• The child may attend school if antibiotics have been started.
• Any unused eye medication should be saved in case a sibling gets the eye infection.

3.The child's towels and washcloths should not be used by other members of the household.

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4.Any crusted material should be wiped from the eye with a cotton ball soaked in warm water, starting at the outer aspect of the eye and moving toward the inner aspect.

ANSWER : 3

Rationale: Bacterial conjunctivitis is highly contagious, and infection control measures should be taught. These include good hand washing and not sharing towels or washcloths with others.

7.The nurse participating in a health fair is setting up a booth on prevention of human immunodeficiency virus (HIV) transmission. A poster is planned that will list sexual behaviors in 1 of 2 columns, "safe" and "not safe." Which behavior should the nurse place in the "not safe" column?

• Abstinence
• Mutual monogamy
• Use of latex condoms
• Use of natural skin condoms

ANSWER :4

Rationale: The use of natural skin condoms is not considered safe because the pores in the condom are large enough for the virus to pass through.

8.A female client seen in the ambulatory care clinic has a history of syphilis infection. The nurse assessing the client for reinfection would expect to observe a lesion on the labia that has which characteristic?

• Is painless and indurated

2.Has a cauliflower-like appearance 3.Is erythematous and papular in appearance 4.Appears as 1 or more vesicles that then rupture

ANSWER :1

Rationale: The characteristic lesion of syphilis is painless and indurated. The lesion is referred to as a chancre.Genital warts are characterized by cauliflower-like growths or growths that are soft and fleshy. Scabies is characterized by erythematous, papular eruptions. Genital herpes is accompanied by the presence of 1 or more vesicles that then rupture and heal.

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9.The nurse places a hospitalized client with active tuberculosis in a private, well-ventilated isolation room. In addition, which action should the nurse take before entering the client's room?

• Wash hands and don a surgical mask.

2.Wash hands and wear a gown and gloves.

3.Wash hands and place a high-efficiency particulate air (HEPA) respirator mask over the nose and mouth.

4.The nurse needs no precautions. The client is instructed to cover the mouth and nose when coughing.

ANSWER :3

Rationale: The nurse wears an HEPA respirator mask when caring for a client with active tuberculosis.

10.A client is being discharged to home after 2 weeks with a diagnosis of tuberculosis and is worried about the possibility of infecting family members and others. How should the nurse respond to provide reassurance?

• The family does not need therapy, and the client will not be contagious after 1 month of medication therapy.

2.The family does not need therapy, and the client will not be contagious after 6 consecutive weeks of medication therapy.

3.The family will be treated prophylactically, and the client will not be contagious after 1 continuous week of medication therapy.

4.The family will be treated prophylactically, and the client will not be contagious after 2 to 3 consecutive weeks of medication therapy.

ANSWER :4

Rationale: Family members or others who have been in close contact with a client diagnosed with tuberculosis are placed on prophylactic therapy with isoniazid for 6 to 12 months. The client usually is not contagious after taking the medication for 2 to 3 consecutive weeks. However, the client must take the full course of therapy (for

• months or longer) to prevent reinfection or medication-resistant tuberculosis.

11.The home health nurse visits a client with suspected scabies. Which precaution should the nurse institute during the assessment of the client?

• Wear gloves only.

2.Wear a mask and gloves.

3.Wear a gown and gloves.

4.Avoid touching the client's home furnishings.

ANSWER :3

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