Video of Infection Control

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Sample questions from Video of Infection Control

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In the emergency department, a 6-month-old with suspected meningococcal meningitis has a temperature of 39.2 C, HR 174/min, RR 42/min, BP 78/44 mm Hg, and a nonblanching rash. A second nurse is available to assist. Which action should the charge nurse take first?

   • A.Send the infant to radiology for imaging before starting isolation
   • B.Place the infant in a negative-pressure room and initiate airborne precautions
   • C.Place the infant in a private room and initiate droplet precautions while arranging immediate evaluation and treatment
   • D.Ask the second nurse to obtain a detailed immunization history before room placement

   Rationale: Immediate droplet precautions in a private room reduce exposure while the infant receives urgent evaluation for a potentially life-threatening infection. A detailed history can be obtained after immediate containment and stabilization; airborne isolation is not the indicated transmission-based precaution for suspected meningococcal disease. Transporting the infant before precautions are established risks exposing others and delays safe care.

2. 2.At change of shift on a medical unit, a client with a draining MRSA-positive wound is stable, a client with new confusion and a temperature of 38.8 C has no isolation orders, a client receiving chemotherapy is neutropenic with an ANC of 400/mm3, and a client with influenza is coughing in a private room. Which client should the charge nurse assess first?

   • A.The neutropenic client with an ANC of 400/mm3
   • B.The client with new confusion and fever
   • C.The client with the MRSA-positive wound
   • D.The client with influenza who is already in a private room

   Rationale: New confusion with fever may indicate acute deterioration or sepsis, and the client needs prompt assessment and timely escalation while appropriate precautions are initiated. The neutropenic client requires protective measures and close monitoring, but the reported cues do not indicate a new change. The stable wound and the client already placed in a private room are lower immediate priorities.

3. 3.A provider prescribes IV vancomycin for a 47-year-old client with a bloodstream infection. The client has an estimated creatinine clearance of 24 mL/min, and a trough concentration from the previous dose is 23 mcg/mL; the next dose is due now. Which action should the nurse take?

   • A.Hold the dose and contact the prescriber or pharmacist to review the level and dosing plan
   • B.Reduce the infusion rate but give the full prescribed dose
   • C.Administer the prescribed dose and repeat the trough after the infusion
   • D.Ask the unlicensed assistive personnel to obtain another trough and administer the dose if the client is afebrile

   Rationale: A high vancomycin trough combined with markedly reduced renal clearance raises concern for toxicity, so the nurse should hold the dose and obtain a dosing review before administration. Slowing the infusion does not correct excessive drug exposure, and repeating a level without addressing the current result is not an adequate response. Delegating interpretation or medication administration to unlicensed personnel is outside their role.

4. 4.Refer to the client's chart. Which actions should the charge nurse direct the team to take now to reduce transmission risk and address the client's deterioration? Select all that apply.

   • A.Notify the rapid response team or provider promptly about the worsening mental status, hypotension, and rising lactate
   • B.Have staff use a fit-tested N95 respirator for every interaction because all resistant organisms require airborne precautions
   • C.Ask the client's roommate to remain in the room until a bed becomes available
   • D.Place the client in a single room and use contact and droplet precautions while the organism is being evaluated
   • E.Obtain ordered blood cultures using aseptic technique before the first antimicrobial dose, if this does not delay urgent treatment

   Answer and rationale are in the full material.

5. 5.During a home visit, a 72-year-old client with a draining diabetic foot ulcer says, "I use the same towel to dry the wound and then my hands." The client is afebrile with glucose 198 mg/dL and no surrounding erythema. Which teaching point is most important?

   • A.Apply an over-the-counter antibiotic ointment to the wound after every shower
   • B.Reuse the dressing if it appears clean after removal
   • C.Keep the wound uncovered so air can dry the drainage
   • D.Use a clean, single-use or dedicated clean towel for the wound and perform hand hygiene before and after wound care

   Answer and rationale are in the full material.