CNA Isolation Precautions 2 — Questions and Answers
Question 1: A resident with a severely compromised immune system is placed in Protective (Reverse) Isolation. Which of the following items brought by family presents a significant risk and should not be placed in the resident's room?
- A sealed box of chocolates
- A new book from a bookstore
- A bouquet of fresh flowers in a vase (Correct answer)
- A framed photograph from home
Correct answer: A bouquet of fresh flowers in a vase
Fresh flowers, potted plants, and their water or soil can harbor fungi and bacteria, such as Pseudomonas aeruginosa, which can cause serious infections in individuals with weakened immune systems. Protective isolation is designed to protect the resident from outside pathogens.
Question 2: A long-term care facility is experiencing an influenza outbreak and must place two residents with confirmed influenza A in the same room. This practice is known as cohorting. What is the primary principle that allows for this practice?
- The residents are the same gender and have similar care needs.
- Both residents are actively infected with the same pathogen and private rooms are unavailable. (Correct answer)
- A privacy curtain can be kept between the beds to serve as a sufficient barrier.
- One resident is symptomatic while the other is recovering, creating a gradient of infectivity.
Correct answer: Both residents are actively infected with the same pathogen and private rooms are unavailable.
Cohorting is the practice of grouping patients infected or colonized with the same organism to confine their care to one area. It is an accepted infection control strategy when single-patient rooms are not available, but it requires that the patients have the same confirmed active infection.
Question 3: A CNA is preparing to transport a resident who is on Airborne Precautions for active pulmonary tuberculosis to the radiology department. Which action is the most critical to minimize transmission during transport?
- Placing an N95 respirator on the resident.
- Having the CNA wear a gown, gloves, and N95 respirator during the transport.
- Placing a standard surgical mask on the resident. (Correct answer)
- Covering the resident completely with a blanket and two sheets.
Correct answer: Placing a standard surgical mask on the resident.
When a patient on Airborne Precautions must leave their room, they should wear a surgical mask to contain their own respiratory secretions at the source. This prevents infectious particles from spreading into the environment during transport. The transporting staff does not typically need a respirator if the patient is properly masked.
Question 4: After providing care for a resident with a Clostridium difficile (C. diff) infection, the CNA must perform hand hygiene. Which of the following methods is required in this specific situation?
- Using an alcohol-based hand sanitizer with at least 70% alcohol.
- Washing hands vigorously with soap and water. (Correct answer)
- Wiping hands thoroughly with a disinfectant wipe.
- Rinsing hands with warm water for at least 20 seconds.
Correct answer: Washing hands vigorously with soap and water.
C. difficile forms spores that are resistant to alcohol-based hand sanitizers. The friction from washing hands with soap and water is necessary to physically remove the spores from the skin. Therefore, handwashing with soap and water is required after caring for a patient with C. diff.
Question 5: When a resident is on Contact Precautions for Methicillin-resistant Staphylococcus aureus (MRSA), which of the following describes the correct handling of non-critical, reusable equipment like a blood pressure cuff?
- The cuff can be used for other residents if it looks clean.
- The cuff should be dedicated for use on that single resident whenever possible. (Correct answer)
- Wipe the cuff with a paper towel before taking it to the next room.
- Place the cuff in a standard laundry bag for routine cleaning.
Correct answer: The cuff should be dedicated for use on that single resident whenever possible.
To prevent cross-contamination, non-critical patient-care equipment (like stethoscopes and blood pressure cuffs) should be dedicated to a single patient or a cohort of patients with the same pathogen. If equipment must be shared, it must be thoroughly cleaned and disinfected before being used on another resident.
Question 6: A CNA is exiting the room of a resident under combined Contact and Droplet precautions. After removing their gloves and gown inside the room and performing hand hygiene, what is the next step in the standard doffing sequence before leaving the room?
- Perform hand hygiene a second time.
- Remove the face mask/respirator.
- Exit the room and then remove the face mask.
- Remove eye protection (goggles or face shield). (Correct answer)
Correct answer: Remove eye protection (goggles or face shield).
The standard CDC sequence for doffing PPE is to remove the most contaminated items first. After gloves and gown are removed, the next item is eye protection (goggles or face shield), handled by the sides. The mask is typically removed last, often just outside the doorway, to protect the airway until clear of the contaminated environment.
CNA Isolation Precautions 2
A resident with a severely compromised immune system is placed in Protective (Reverse) Isolation.
Which of the following items brought by family presents a significant risk and should not be placed in the resident's room?