CPAN Safety and Infection Control 3 — Questions and Answers
Question 1: During a PACU admission, a nurse identifies that antibiotic prophylaxis was NOT administered preoperatively per protocol. What is the MOST appropriate action?
- Administer the antibiotic immediately in the PACU
- Notify the surgeon and document the omission per facility policy (Correct answer)
- Document the finding and continue routine monitoring
- Contact pharmacy to prepare the antibiotic for next-dose timing
Correct answer: Notify the surgeon and document the omission per facility policy
The omission of prophylactic antibiotics is a reportable event; the surgeon must be notified to determine if post-incision administration is appropriate and the event documented per policy.
Question 2: A patient in the PACU suddenly pulls out their endotracheal tube. The IMMEDIATE nursing priority is:
- Notify the anesthesia provider
- Assess airway patency and oxygenation status (Correct answer)
- Prepare equipment for reintubation
- Administer supplemental oxygen via face mask
Correct answer: Assess airway patency and oxygenation status
Assessing airway patency and oxygenation is the first priority following unplanned extubation to determine whether the patient can maintain their own airway.
Question 3: Which of the following BEST describes the correct sequence for donning personal protective equipment (PPE) before entering a contact isolation room?
- Gloves, gown, mask, eye protection
- Gown, mask, eye protection, gloves (Correct answer)
- Mask, eye protection, gown, gloves
- Eye protection, gown, gloves, mask
Correct answer: Gown, mask, eye protection, gloves
The CDC-recommended donning sequence is gown first, then mask/respirator, then eye protection, then gloves, ensuring the most contaminated items are donned last.
Question 4: A nurse notices a colleague recapping a used needle with two hands. What is the BEST immediate response?
- Report the behavior anonymously to risk management later
- Intervene immediately and educate the colleague on safe needle handling (Correct answer)
- Allow it since the needle will go directly to the sharps container
- Document the observation in the patient's medical record
Correct answer: Intervene immediately and educate the colleague on safe needle handling
Two-handed needle recapping is a leading cause of needlestick injuries; immediate intervention and education are required to prevent harm.
Question 5: A post-anesthesia patient's wound dressing is saturated with serous drainage. The nurse should:
- Remove the dressing and apply a fresh sterile dressing
- Reinforce the dressing and notify the surgeon (Correct answer)
- Leave the dressing intact to maintain a protective barrier
- Apply a pressure dressing over the saturated one
Correct answer: Reinforce the dressing and notify the surgeon
A saturated dressing should be reinforced and the surgeon notified rather than removed, as the surgeon may want to assess the wound for bleeding or infection.
Question 6: Which intraoperative factor places a PACU patient at GREATEST risk for hypothermia-related complications including increased infection risk?
- Use of neuraxial anesthesia
- Prolonged surgery exceeding three hours with large body cavity exposure (Correct answer)
- Premedication with midazolam
- Use of a laryngeal mask airway instead of endotracheal tube
Correct answer: Prolonged surgery exceeding three hours with large body cavity exposure
Prolonged surgery with exposure of large body cavities causes significant heat loss, and hypothermia impairs neutrophil function and increases surgical site infection risk.
Question 7: Which action by a PACU nurse during a needlestick injury requires IMMEDIATE follow-up per occupational safety guidelines?
- Wash the wound thoroughly with soap and water
- Report the incident to the employee health department
- Receive baseline bloodwork and post-exposure prophylaxis counseling as indicated
- All of the above (Correct answer)
Correct answer: All of the above
OSHA and CDC guidelines require all three actions — wound washing, incident reporting, and baseline testing/PEP counseling — immediately following a needlestick injury.
CPAN Safety and Infection Control 3
During a PACU admission, a nurse identifies that antibiotic prophylaxis was NOT administered preoperatively per protocol.
What is the MOST appropriate action?