RPN - Registered Practical Nurse Infection Prevention and Control Questions and Answers — Questions and Answers
Question 1: An RPN is caring for a client with a confirmed Clostridioides difficile (C. difficile) infection. In addition to using a private room, which of the following infection control measures are essential?
- Wearing an N95 respirator and using an alcohol-based hand rub upon exiting.
- Wearing a gown and gloves, and performing hand hygiene with soap and water. (Correct answer)
- Implementing Droplet Precautions and wearing a surgical mask.
- Using routine practices with the addition of eye protection.
Correct answer: Wearing a gown and gloves, and performing hand hygiene with soap and water.
Clostridioides difficile requires Contact Precautions, which includes wearing a gown and gloves. Crucially, C. difficile produces spores that are resistant to alcohol-based hand rubs. Therefore, hand hygiene must be performed with soap and water to mechanically remove the spores.
Question 2: An RPN is preparing to perform a sterile dressing change. After opening the sterile tray on the bedside table, the RPN turns away from the field to retrieve a bottle of saline from a supply cart. What is the most appropriate next action?
- Proceed with the dressing change as the field was only unattended for a moment.
- Discard the current sterile field and prepare a new one. (Correct answer)
- Pour the saline onto the dressing from a distance to avoid contamination.
- Ask a colleague to verify that the field was not touched while unattended.
Correct answer: Discard the current sterile field and prepare a new one.
A fundamental principle of surgical asepsis is that a sterile field must always be kept in sight. Turning your back on a sterile field renders it contaminated because you cannot ensure its sterility was maintained. The only safe and correct action is to discard the compromised field and set up a new one.
Question 3: Which of the following actions by an RPN is the MOST effective way to break the chain of infection at the 'mode of transmission' link?
- Ensuring clients are up-to-date on their immunizations.
- Administering antibiotics to a client with a bacterial infection.
- Performing diligent hand hygiene between all client encounters. (Correct answer)
- Covering a client's wound with an occlusive dressing.
Correct answer: Performing diligent hand hygiene between all client encounters.
Hand hygiene is the single most effective intervention to break the chain of infection by interrupting the mode of transmission. It prevents the transfer of microorganisms from the healthcare provider's hands to clients or between clients. Immunizations target the 'susceptible host', antibiotics target the 'infectious agent', and a dressing targets the 'portal of exit'.
Question 4: An RPN must enter the room of a client on Droplet Precautions for influenza. What is the minimum Personal Protective Equipment (PPE) required for routine care?
- Gloves and an N95 respirator.
- A gown and gloves only.
- A procedure/surgical mask and eye protection. (Correct answer)
- A procedure/surgical mask only if within one meter of the client.
Correct answer: A procedure/surgical mask and eye protection.
Droplet Precautions are required for pathogens transmitted by large respiratory droplets, such as influenza. When working within 2 meters of the client, the RPN must wear a procedure/surgical mask and eye protection (goggles or face shield) to protect the mucous membranes of the eyes, nose, and mouth from splashes or sprays. A gown and gloves would also be required based on a point-of-care risk assessment for contact with body fluids.
Question 5: According to the principles of Routine Practices, when is it mandatory for an RPN to perform hand hygiene?
- Only after removing gloves.
- Before initial client contact and after contact with the client's environment. (Correct answer)
- Only when hands are visibly soiled.
- At the beginning and end of the shift.
Correct answer: Before initial client contact and after contact with the client's environment.
Routine practices include the 4 Moments for Hand Hygiene. Key moments include before initial patient/client contact and after contact with the patient/client or their environment. Hand hygiene is required at many other points as well, including after removing gloves and before a clean/aseptic procedure, but this answer choice captures two of the most fundamental mandatory moments.
Question 6: An RPN is assigned to a newly admitted client who requires Airborne Precautions. Which of the following conditions would necessitate these specific precautions?
- Norovirus.
- Methicillin-resistant Staphylococcus aureus (MRSA).
- Pulmonary Tuberculosis. (Correct answer)
- Seasonal Influenza.
Correct answer: Pulmonary Tuberculosis.
Airborne Precautions are used for diseases transmitted by small droplet nuclei that can remain suspended in the air for long periods. Pulmonary Tuberculosis is a classic example requiring these precautions, which include a negative-pressure room and an N95 respirator. Influenza requires Droplet Precautions, while MRSA and Norovirus typically require Contact Precautions.
