Infection Prevention and Control Flashcards

A practical nurse is caring for a client with suspected Clostridioides difficile (C. diff) infection. The unit runs out of alcohol-based hand rub. Which action is the MOST appropriate?

Answer: Use soap and water exclusively for hand hygiene with this client

Clostridioides difficile forms spores that are NOT killed by alcohol-based hand rubs. Soap and water is the only effective hand hygiene method for C. diff because the mechanical friction physically removes spores from the skin. Alcohol-based products are ineffective against C. diff spores regardless of quantity used. Antiseptic wipes and double gloving do not address the fundamental need to remove spores through soap-and-water washing.

A nurse is performing a dressing change on a client with a surgical wound infected with methicillin-resistant Staphylococcus aureus (MRSA). After removing the soiled dressing with gloves on, the nurse needs to prepare new sterile supplies. What is the CORRECT sequence of actions?

Answer: Remove gloves, perform hand hygiene, don new sterile gloves before handling sterile supplies

Contact precautions require removing contaminated gloves immediately after handling infected material, followed by hand hygiene before touching any new supplies or surfaces. Keeping contaminated gloves on risks transferring MRSA to sterile equipment and the surrounding environment. Opening sterile packages before hand hygiene contaminates the sterile field. Double-gloving and removing only one layer is not an accepted technique for this scenario and does not eliminate contamination risk on the remaining glove.

A practical nurse working in a long-term care facility notices that a colleague re-caps used needles using the two-handed technique before disposal. What is the PRIORITY nursing action?

Answer: Immediately and respectfully address the colleague, reminding them that only the one-handed scoop technique is acceptable if recapping is absolutely necessary

The two-handed recapping technique poses a significant needlestick injury risk and is contraindicated. Needles should never be recapped unless clinically necessary, and only then using the single-handed scoop method or a mechanical recapping device. Addressing the colleague immediately is the priority because harm could occur before end of shift. Waiting to report delays corrective action and puts staff at risk. Modelling unsafe practice (even to contrast) is inappropriate and demonstrating two-handed recapping yourself would replicate the hazard.

A client on airborne precautions for active pulmonary tuberculosis (TB) requires transport to radiology for a chest X-ray. Which measure is MOST important to implement during transport?

Answer: Place a surgical mask on the client for the duration of transport

During transport of a client with active TB outside the airborne infection isolation room, the client must wear a surgical mask to contain respiratory droplet nuclei at the source. The healthcare worker transporting the client should also wear an N95 respirator, but the client masking is the critical intervention — the client is the source of infectious particles. Postponing transport is not always clinically feasible. Most facilities do not have negative-pressure transport corridors; source containment via client masking is the practical standard.

A practical nurse notices a break in sterile technique during catheter insertion: the sterile field was briefly touched by the client's bed sheet. The catheter has not yet been inserted. What is the CORRECT response?

Answer: Stop the procedure, discard all contaminated sterile supplies, obtain a new sterile kit, and restart

When a sterile field is contaminated, it must be considered entirely contaminated — sterility cannot be partially restored. Applying alcohol swabs does not re-establish sterility on a field that has been physically touched by a non-sterile item. Proceeding with the procedure risks introducing pathogens into the urinary tract, causing a healthcare-associated urinary tract infection (CAUTI). The only safe and professionally correct action is to stop, discard the contaminated kit, and begin again with a completely new sterile setup.

A nurse is assigned to care for four clients: one in contact precautions for VRE, one in droplet precautions for influenza, one requiring protective (reverse) isolation post-bone marrow transplant, and one with no precautions. In which order should the nurse see clients to minimize cross-contamination risk?

Answer: Immunocompromised client first, then standard precautions client, then influenza client, then VRE client last

Care should be prioritized to protect the most vulnerable clients first. The immunocompromised client post-bone marrow transplant has severely impaired immunity and is at the highest risk of acquiring any infection brought in from another client's room. The standard precautions client is seen next as they pose minimal risk. Clients on transmission-based precautions (influenza then VRE) are seen last to prevent carrying pathogens from infected rooms to vulnerable clients. Seeing the VRE client first is the highest-risk choice as resistant organisms can persist on skin and clothing despite PPE removal.