RNC-NIC Infection Control 4

Question 1

A preterm neonate at 30 weeks gestation requires TPN through a PICC line. The nurse notices the insertion site is red, warm, and has purulent discharge. What is the FIRST nursing action?

Accepted Answer

Notify the physician, obtain blood cultures, and prepare for line removal

Answer

Signs of local infection at a PICC site with systemic risk require immediate provider notification, blood cultures before antibiotics, and likely line removal to prevent bacteremia.

Question 2

Which laboratory finding is MOST consistent with bacterial sepsis in a neonate?

Accepted Answer

Immature-to-total neutrophil ratio (I:T ratio) greater than 0.2

Answer

An elevated I:T ratio greater than 0.2 indicates a left shift with immature neutrophils released in response to bacterial infection and is a sensitive marker for neonatal sepsis.

Question 3

During an outbreak of Klebsiella pneumoniae in the NICU, which environmental control measure is MOST important to implement?

Accepted Answer

Perform enhanced environmental cleaning with EPA-approved disinfectants and cohort affected neonates

Answer

Cohorting infected neonates, enhanced environmental disinfection, and strict contact precautions are the cornerstone of NICU outbreak management for gram-negative organisms.

Question 4

A nurse is caring for a neonate with suspected meningitis. Which assessment finding would MOST likely be present in a neonate with bacterial meningitis rather than viral meningitis?

Accepted Answer

CSF glucose less than 40 mg/dL with CSF protein greater than 150 mg/dL

Answer

Bacterial meningitis in neonates typically produces low CSF glucose (bacteria consume it) and elevated protein, distinguishing it from viral meningitis.

Question 5

Which intervention is part of the evidence-based 'PICC bundle' to prevent CLABSI in the NICU?

Accepted Answer

Scrubbing the hub with antiseptic for at least 15 seconds before each access ('scrub the hub')

Answer

The 'scrub the hub' technique with 70% alcohol or chlorhexidine-alcohol for 15 seconds before each access is a critical CLABSI bundle element that reduces intraluminal contamination.

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

RNC-NIC Infection Control 4