CNA Proper Hand Hygiene and PPE Usage 2 — Questions and Answers
Question 1: A CNA is providing care for a resident with scabies who is on contact precautions. Which of the following PPE actions is most appropriate in this specific situation?
- Wear a gown and gloves for any direct contact with the resident or their environment. (Correct answer)
- A standard surgical mask is required in addition to a gown and gloves.
- Double-gloving is recommended due to the contagious nature of scabies mites.
- PPE is only necessary if the resident has the more severe 'crusted' scabies.
Correct answer: Wear a gown and gloves for any direct contact with the resident or their environment.
For residents with scabies, contact precautions are necessary. This requires wearing a gown and gloves upon entering the room to prevent the spread of mites through direct skin-to-skin contact or contact with contaminated items like bedding and clothing. Masks are not typically required for scabies as it is not an airborne illness. Standard gloving procedure is sufficient; double-gloving is not standard practice for this condition.
Question 2: While caring for a resident, your gloves become visibly soiled with stool. The resident also needs their pillows repositioned. What is the correct sequence of actions?
- Wipe the gloves on a disposable towel before repositioning the pillows.
- Reposition the pillows quickly, then remove gloves and perform hand hygiene.
- Remove the soiled gloves, perform hand hygiene, don new gloves, and then reposition the pillows. (Correct answer)
- Finish repositioning the pillows, then remove gloves and use alcohol-based hand sanitizer.
Correct answer: Remove the soiled gloves, perform hand hygiene, don new gloves, and then reposition the pillows.
When gloves become soiled or when moving from a contaminated body site to a clean one (or to the patient's environment), the CNA must change them. The correct procedure is to remove the soiled gloves, perform hand hygiene, and then put on a new, clean pair before touching another surface or continuing care. This prevents cross-contamination.
Question 3: A CNA is leaving the room of a resident with a C. difficile infection. The CNA's hands are not visibly soiled. Which method of hand hygiene is required?
- Using an alcohol-based hand sanitizer is sufficient and preferred.
- No hand hygiene is needed if gloves were worn correctly.
- Vigorously washing hands with soap and water. (Correct answer)
- Applying an alcohol-based sanitizer, followed by washing with soap and water.
Correct answer: Vigorously washing hands with soap and water.
Alcohol-based hand sanitizers are not effective at killing C. difficile spores. Therefore, after caring for a patient with a known or suspected C. difficile infection, healthcare workers must wash their hands with soap and water to physically remove the spores through friction and rinsing. This should be done even if gloves were worn.
Question 4: When removing a full set of PPE (gown, mask, goggles, and gloves), which item should a CNA remove FIRST according to CDC guidelines to minimize self-contamination?
- Gown
- Mask or Respirator
- Goggles or Face Shield
- Gloves (Correct answer)
Correct answer: Gloves
According to CDC guidelines, gloves are typically removed first because they are considered the most contaminated items. The technique involves peeling one glove off with the other gloved hand, holding it, and then sliding the fingers of the ungloved hand under the remaining glove to peel it off. This sequence helps prevent the contaminated gloves from touching the face, hair, or clothing during the rest of the doffing process.
Question 5: A CNA is carrying clean linens into a resident's room. When is the most appropriate time to perform hand hygiene?
- Only after leaving the resident's room.
- Immediately after placing the linens down, before touching the resident. (Correct answer)
- Before gathering the clean linens from the supply cart.
- It is not necessary if the CNA does not touch the resident directly.
Correct answer: Immediately after placing the linens down, before touching the resident.
Hand hygiene should be performed upon entering a patient's room. When hands are full, the CNA should enter, place the items in a designated clean area, and then immediately perform hand hygiene before initiating any care or touching the resident or their immediate surroundings. This prevents transferring any pathogens from outside the room onto the resident's environment.
Question 6: After completing a routine check on a resident, a CNA uses a paper towel to turn off the handwashing faucet. What is the most critical subsequent step to prevent recontamination?
- Use the same paper towel to open the resident's door.
- Perform hand hygiene again using an alcohol-based rub.
- Wave hands in the air to ensure they are completely dry.
- Dispose of the paper towel without touching the waste receptacle with their clean hands. (Correct answer)
Correct answer: Dispose of the paper towel without touching the waste receptacle with their clean hands.
After using a paper towel to turn off the faucet, the CNA's hands are clean. The final step is to dispose of the towel in a waste receptacle. It is critical to do this without touching the receptacle (which is a contaminated surface) with their clean hands, thus completing the hand hygiene skill correctly and avoiding recontamination. Using the same towel on the door is also an acceptable practice, but the most crucial final action is the proper disposal of the towel without self-contamination.
CNA Proper Hand Hygiene and PPE Usage 2
A CNA is providing care for a resident with scabies who is on contact precautions.
Which of the following PPE actions is most appropriate in this specific situation?