CRNI Infection Prevention and Control 5 — Questions and Answers
Question 1: Which of the following is the MOST effective strategy for preventing ventilator-associated pneumonia (VAP) in a critically ill patient receiving IV therapy?
- Daily sedation interruption combined with head-of-bed elevation to 30–45 degrees (Correct answer)
- Changing ventilator circuits every 24 hours
- Administering prophylactic IV antibiotics routinely
- Using a humidified oxygen mask instead of the ventilator
Correct answer: Daily sedation interruption combined with head-of-bed elevation to 30–45 degrees
VAP bundles include head-of-bed elevation (30–45°) and daily sedation interruptions; these are among the most evidence-supported non-pharmacologic VAP prevention measures.
Question 2: A patient's needleless connector appears to have blood residue inside it. What is the CORRECT action?
- Flush vigorously with 20 mL of saline to clear the residue
- Scrub the connector exterior and flush with heparin
- Replace the connector immediately with a new sterile one (Correct answer)
- Apply a sterile cap and document for later review
Correct answer: Replace the connector immediately with a new sterile one
Connectors with visible residue or debris inside them must be replaced immediately as they represent an infection risk that cannot be remediated by flushing or exterior scrubbing.
Question 3: During a CLABSI surveillance review, which pathogen is MOST commonly identified as the causative organism?
- Pseudomonas aeruginosa
- Coagulase-negative staphylococci (Correct answer)
- Escherichia coli
- Candida albicans
Correct answer: Coagulase-negative staphylococci
Coagulase-negative staphylococci (CoNS), particularly Staphylococcus epidermidis, are the most frequently identified pathogens in CLABSI, primarily due to biofilm formation on catheter surfaces.
Question 4: A nurse uses clean (non-sterile) gloves to remove an old central line dressing. For placing the new sterile dressing, which gloves should be used?
- The same clean gloves after wiping them with alcohol
- A new pair of clean gloves
- Sterile gloves only (Correct answer)
- Gloves are not required if hand hygiene was performed
Correct answer: Sterile gloves only
Central line dressing changes require sterile gloves to maintain sterile technique and prevent introducing organisms to the catheter exit site.
Question 5: What is the recommended maximum dwell time for a peripheral IV catheter in adults to reduce infection risk, per INS guidelines?
- 24 hours
- 48 hours
- 72–96 hours or when clinically indicated (Correct answer)
- 7 days
Correct answer: 72–96 hours or when clinically indicated
INS 2021 guidelines recommend replacing peripheral IV catheters when clinically indicated rather than on a routine schedule, though most sites are changed at 72–96 hours based on institutional policy.
Question 6: A CRNI working with a patient on contact precautions needs to transport the patient to radiology. Which action is MOST appropriate during transport?
- Remove all PPE before leaving the room to avoid alarming other patients
- Keep the patient in their room and cancel the radiology appointment
- Ensure the patient is covered or gowned and notify receiving department of precautions (Correct answer)
- Apply airborne precautions as a precaution during transport
Correct answer: Ensure the patient is covered or gowned and notify receiving department of precautions
During transport of a contact precautions patient, the patient should be covered to contain the organism, and the receiving department must be notified to prepare the area and don appropriate PPE.
Question 7: Which of the following BEST describes the concept of 'source control' in infection prevention for an IV therapy patient?
- Administering broad-spectrum antibiotics to eliminate all potential pathogens
- Removing or controlling the infectious source, such as removing an infected catheter (Correct answer)
- Placing the patient in isolation to prevent spread to others
- Using negative-pressure wound therapy over the IV insertion site
Correct answer: Removing or controlling the infectious source, such as removing an infected catheter
Source control refers to the physical removal or containment of the infectious focus—such as removing an infected catheter—to halt the ongoing seeding of pathogens into the bloodstream.
CRNI Infection Prevention and Control 5
Which of the following is the MOST effective strategy for preventing ventilator-associated pneumonia (VAP) in a critically ill patient receiving IV therapy?