RPN Infection Prevention and Control 4 — Questions and Answers
Question 1: When removing PPE after caring for a patient on contact precautions, which item should be removed first?
- Mask
- Goggles
- Gloves (Correct answer)
- Gown
Correct answer: Gloves
Gloves are removed first because they are the most contaminated item and removing them first prevents contaminating other surfaces during doffing.
Question 2: Which intervention is most effective at preventing central line-associated bloodstream infections (CLABSIs)?
- Flushing the line with heparin every shift
- Using maximum sterile barrier precautions during insertion (Correct answer)
- Changing the dressing every 24 hours
- Capping the line with a needleless connector
Correct answer: Using maximum sterile barrier precautions during insertion
Maximum sterile barrier precautions (sterile gown, gloves, mask, cap, and large drape) during insertion are the most effective CLABSI prevention strategy.
Question 3: A nurse is about to administer a subcutaneous injection. Which skin preparation is correct?
- Clean the site with a dry gauze pad
- Swab the site with alcohol and allow it to dry before injecting (Correct answer)
- Swab the site with alcohol and inject immediately while wet
- Apply povidone-iodine and wait 2 minutes
Correct answer: Swab the site with alcohol and allow it to dry before injecting
The alcohol must be allowed to dry completely before injection to ensure its antiseptic action and to prevent stinging.
Question 4: Which patient is at HIGHEST risk for developing a healthcare-associated infection?
- A 30-year-old ambulatory patient having elective surgery
- An 80-year-old patient with diabetes on immunosuppressive therapy post-transplant (Correct answer)
- A 45-year-old patient admitted for observation after a fall
- A 25-year-old patient receiving IV antibiotics for cellulitis
Correct answer: An 80-year-old patient with diabetes on immunosuppressive therapy post-transplant
Advanced age, diabetes, and immunosuppressive therapy each independently increase infection risk; together they create the highest vulnerability.
Question 5: Which action is part of the ventilator-associated pneumonia (VAP) prevention bundle?
- Positioning the patient supine at 0 degrees
- Elevating the head of the bed to 30–45 degrees (Correct answer)
- Suctioning the airway every hour
- Changing the ventilator circuit daily
Correct answer: Elevating the head of the bed to 30–45 degrees
Elevating the head of the bed 30–45 degrees reduces aspiration of oropharyngeal secretions, a key mechanism in VAP development.
Question 6: A nurse is caring for a patient who develops a fever, erythema, and purulent drainage at the IV insertion site. The nurse should first:
- Apply a warm compress and continue monitoring
- Administer acetaminophen for the fever
- Discontinue the IV catheter and notify the provider (Correct answer)
- Increase the IV fluid rate to flush the site
Correct answer: Discontinue the IV catheter and notify the provider
Signs of phlebitis or local infection require immediate removal of the catheter and provider notification to prevent systemic spread.
Question 7: Which characteristic distinguishes a healthcare-associated infection (HAI) from a community-acquired infection?
- HAIs are always caused by antibiotic-resistant organisms
- HAIs occur during or result from healthcare delivery in a facility (Correct answer)
- Community-acquired infections are always more severe
- HAIs can only occur in intensive care units
Correct answer: HAIs occur during or result from healthcare delivery in a facility
By definition, an HAI develops during the process of receiving health care and was not present or incubating at the time of admission.
RPN Infection Prevention and Control 4
When removing PPE after caring for a patient on contact precautions, which item should be removed first?