Infection Prevention and Control Flashcards

A practical nurse is caring for a client with confirmed pulmonary tuberculosis (TB) who must be transported to radiology for a chest X-ray. Which combination of precautions is correct for this transport?

Answer: The client wears a surgical mask; the transporting nurse wears an N95 respirator

For transporting a client with active pulmonary TB, the client should wear a surgical mask to contain droplet nuclei at the source. The transporting nurse wears a fit-tested N95 respirator because TB requires airborne precautions. The client does not need an N95 — a surgical mask at the source is sufficient — but the HCW requires the higher-filtration N95 due to the airborne transmission route.

A client on contact precautions for Clostridioides difficile (C. diff) infection requires blood glucose monitoring. After removing gloves and performing hand hygiene, the nurse notices a small, intact paper cut on her finger that was covered by the glove. What is the most appropriate next action?

Answer: Document the exposure, cleanse the site with soap and water, and notify the occupational health department per facility protocol

Even though the glove served as a barrier and the cut appears intact, any potential exposure to bodily fluids or pathogens while working with an infectious client must be reported and documented per occupational health protocol. C. diff spores are not typically a bloodborne concern, but proper wound cleansing with soap and water and formal reporting ensures the event is recorded and evaluated. Alcohol-based hand rub does not eliminate C. diff spores and is inappropriate for wound care. Double-gloving for the rest of the shift without reporting does not address the occupational health requirement.

A unit is experiencing a norovirus outbreak. The infection control team recommends discontinuing the use of alcohol-based hand rub (ABHR) for hand hygiene and switching exclusively to soap and water. A new practical nurse asks why ABHR is being avoided. What is the most accurate explanation?

Answer: Norovirus is a non-enveloped virus and ABHR is not reliably effective against non-enveloped viruses; soap and water physically removes the organism

Norovirus is a non-enveloped (naked) virus. Alcohol-based hand rubs are highly effective against enveloped viruses (e.g., influenza, COVID-19) but have reduced and inconsistent efficacy against non-enveloped viruses like norovirus and C. diff spores. Soap and water work by mechanically removing the virus from the skin surface and are the recommended hand hygiene method during norovirus outbreaks. ABHR does have some virucidal activity against enveloped viruses, so saying it has no effect on any virus is incorrect. Norovirus does not form spores.

A practical nurse is preparing to perform a sterile dressing change on a post-operative wound. Midway through the procedure, the nurse's sterile glove touches the outer edge of the sterile drape. Which statement best reflects correct sterile technique?

Answer: The glove is now considered contaminated because the outer border (approximately 2.5 cm / 1 inch) of a sterile field is considered non-sterile

By convention in sterile technique, the outer 2.5 cm (approximately 1 inch) border of any sterile drape or field is considered non-sterile because it is at risk of contact with non-sterile surfaces and personnel. Touching this border contaminates the glove regardless of visible soiling. The nurse must replace the contaminated glove before continuing. This principle is a standard component of surgical asepsis taught specifically to prevent this common error.

A client admitted with severe neutropenia (ANC < 500 cells/µL) is placed on protective (reverse) isolation. A practical nurse is assigned to this client. Which action by the nurse requires immediate correction?

Answer: Bringing a potted flowering plant sent by the client's family into the room

Potted plants and fresh flowers are contraindicated in the rooms of severely immunocompromised (neutropenic) clients because the soil and standing water in plant pots harbour Aspergillus species and Pseudomonas aeruginosa, which can cause life-threatening opportunistic infections in neutropenic patients. This is a well-established infection control restriction in oncology and transplant settings. Wearing a mask, using dedicated equipment, and proper hand hygiene before gloving are all appropriate protective measures for this population.

During a routine audit, an infection control nurse observes a practical nurse donning PPE before entering a room under droplet and contact precautions. The practical nurse puts on the gown first, then the mask, then the goggles, and finally the gloves. The infection control nurse intervenes. What is the correct rationale for the intervention?

Answer: The mask should be donned before the gown so that face and mucous membrane protection is established before the gown, which requires reaching over the face area to tie at the neck

The recommended PPE donning sequence per PIDAC and PHAC guidelines is: (1) gown, (2) mask/respirator, (3) eye protection (goggles/face shield), (4) gloves. However, some guidelines and facilities specify that the mask is donned first or second specifically so that tying the mask strings at the back of the head does not require reaching across an already-donned gown and contaminating it, or so the face/airway is protected before handling other PPE. The key principle the auditor is correcting is that the order must be intentional and consistent with the facility's protocol — sequence matters to prevent self-contamination. Gloves are always last to avoid contaminating other PPE during donning. The sequence absolutely matters; entering a room with incorrectly layered PPE can result in self-contamination during doffing.