RPN Infection Prevention and Control 5 — Questions and Answers
Question 1: A nurse prepares to perform a urinary catheter insertion. Which action is essential to prevent CAUTI?
- Use the largest catheter size available for secure placement
- Maintain a closed drainage system and keep the bag below bladder level (Correct answer)
- Irrigate the catheter with normal saline every 8 hours
- Secure the catheter to the patient's abdomen
Correct answer: Maintain a closed drainage system and keep the bag below bladder level
A closed drainage system prevents retrograde bacterial entry, and keeping the bag below the bladder prevents reflux of contaminated urine.
Question 2: Which organism is the most common cause of healthcare-associated pneumonia?
- Streptococcus pneumoniae
- Staphylococcus aureus
- Pseudomonas aeruginosa (Correct answer)
- Escherichia coli
Correct answer: Pseudomonas aeruginosa
Pseudomonas aeruginosa is one of the most common and difficult-to-treat causes of healthcare-associated and ventilator-associated pneumonia.
Question 3: A nurse is assigned to a patient in protective (reverse) isolation. What is the primary purpose of this precaution?
- To prevent the patient from spreading infection to others
- To protect a severely immunocompromised patient from external pathogens (Correct answer)
- To contain airborne particles within the patient's room
- To reduce droplet transmission to staff
Correct answer: To protect a severely immunocompromised patient from external pathogens
Reverse isolation protects immunocompromised patients (e.g., those post-bone marrow transplant) from pathogens carried by visitors, staff, or the environment.
Question 4: When should the nurse perform hand hygiene according to WHO's Five Moments for Hand Hygiene?
- Only before and after direct patient contact
- Before patient contact, before an aseptic task, after body fluid exposure, after patient contact, and after contact with the patient's surroundings (Correct answer)
- Before and after each shift
- Whenever gloves are changed
Correct answer: Before patient contact, before an aseptic task, after body fluid exposure, after patient contact, and after contact with the patient's surroundings
WHO's Five Moments define all critical points during patient care where hand hygiene must occur to break the chain of infection.
Question 5: A nurse uses a reusable blood pressure cuff on a patient with VRE (vancomycin-resistant Enterococcus). What is required?
- The cuff can be reused on the next patient immediately
- Dedicate the cuff to that patient only and disinfect before reassignment (Correct answer)
- Sterilize the cuff in an autoclave after use
- Soak the cuff in bleach for 30 minutes
Correct answer: Dedicate the cuff to that patient only and disinfect before reassignment
Equipment used on a patient with VRE should be dedicated to that patient and properly disinfected before use on another patient to prevent cross-transmission.
Question 6: A patient asks why the nurse washes hands before and after wearing gloves. The best explanation is:
- Gloves are always sterile and hand hygiene is a formality
- Gloves may have microperforations and hands can be contaminated during removal (Correct answer)
- Hand hygiene is required by law only when gloves are worn
- Gloves eliminate all risk so washing is done as a courtesy
Correct answer: Gloves may have microperforations and hands can be contaminated during removal
Gloves can have invisible microperforations and hands become contaminated during doffing, so hand hygiene before and after glove use remains essential.
Question 7: Which statement about surgical asepsis is correct?
- It aims to reduce the number of pathogens to a safe level
- It requires the complete elimination of all microorganisms including spores (Correct answer)
- It is used for routine patient assessments
- It is the same as medical asepsis
Correct answer: It requires the complete elimination of all microorganisms including spores
Surgical asepsis (sterile technique) requires the complete absence of all microorganisms and spores, unlike medical asepsis which only reduces pathogen numbers.
RPN Infection Prevention and Control 5
A nurse prepares to perform a urinary catheter insertion.
Which action is essential to prevent CAUTI?