DC Safety & Infection Control 3 — Questions and Answers
Question 1: A patient with MRSA bacteremia is on telemetry. Which PPE should the nurse don before entering the room to check lead placement?
- Surgical mask and eye shield only
- Gown and gloves (contact precautions) (Correct answer)
- N95 respirator and face shield only
- No additional PPE beyond standard precautions
Correct answer: Gown and gloves (contact precautions)
MRSA requires contact precautions — gown and gloves must be worn upon room entry to prevent transmission via skin or environmental surfaces.
Question 2: Which hand hygiene method is preferred immediately after removing gloves contaminated with C. difficile spores in a monitored patient's room?
- Alcohol-based hand rub for 20 seconds
- Soap and water for at least 20 seconds (Correct answer)
- Hand sanitizer with 62% ethanol
- Dry paper towel friction rub
Correct answer: Soap and water for at least 20 seconds
Alcohol-based hand rubs are ineffective against C. difficile spores; soap and water friction is required to mechanically remove spores.
Question 3: A nurse sustains a needlestick injury while inserting a temporary pacemaker wire. The FIRST action should be to:
- Complete the procedure, then report at end of shift
- Immediately stop, wash the wound with soap and water, and report to occupational health (Correct answer)
- Apply a tourniquet proximal to the puncture site
- Squeeze the wound vigorously to express blood
Correct answer: Immediately stop, wash the wound with soap and water, and report to occupational health
The first step after a needlestick is to wash the wound with soap and water immediately, followed by prompt reporting per OSHA bloodborne pathogen standards.
Question 4: Single-use ECG electrodes are labeled 'for single patient use only' primarily because:
- They are too expensive to reprocess
- Reuse can transmit pathogens and compromise adhesion leading to poor signal quality (Correct answer)
- They lack a second adhesive layer for reattachment
- Regulations require disposal after one use regardless of condition
Correct answer: Reuse can transmit pathogens and compromise adhesion leading to poor signal quality
Single-use electrodes risk pathogen transmission and lose adhesive integrity on reuse, degrading both infection control and signal quality.
Question 5: When transporting a monitored patient on airborne precautions to the cardiac catheterization lab, the nurse should:
- Remove the monitor leads to reduce contact points
- Place a surgical mask on the patient and notify the receiving area before transport (Correct answer)
- Transport only with a portable defibrillator and no mask needed
- Schedule transport during off-hours when hallways are empty
Correct answer: Place a surgical mask on the patient and notify the receiving area before transport
Patients on airborne precautions must wear a surgical mask during transport and the receiving department must be notified to prepare an appropriate environment.
Question 6: The primary purpose of using disposable lead wires for isolation patients in a cardiac care unit is to:
- Improve ECG signal amplitude in high-resistance rooms
- Eliminate the need for hand hygiene after removal
- Prevent cross-contamination between patients when wires cannot be adequately disinfected (Correct answer)
- Satisfy billing requirements for Medicare cardiac monitoring codes
Correct answer: Prevent cross-contamination between patients when wires cannot be adequately disinfected
Disposable lead wires prevent cross-contamination when thorough disinfection of reusable wires between patients cannot be assured.
Question 7: Which of the following represents a macroshock hazard during cardiac monitoring?
- A patient touching a properly grounded monitor with dry hands
- A patient simultaneously touching an ungrounded electrical device and a grounded conductor while connected to monitoring leads (Correct answer)
- Excessive electrode gel under a monitoring electrode
- A loose lead wire connection causing artifact
Correct answer: A patient simultaneously touching an ungrounded electrical device and a grounded conductor while connected to monitoring leads
Macroshock occurs when sufficient current passes through the body from an ungrounded device to ground, and monitoring leads increase vulnerability by providing a low-resistance path.
DC Safety & Infection Control 3
A patient with MRSA bacteremia is on telemetry.
Which PPE should the nurse don before entering the room to check lead placement?