Sale!

Nursing Interventions and Clinical Skills 5th Edition Perry Potter Elkin Test Bank

$80.00 $12.99

Nursing Interventions and Clinical Skills 5th Edition Perry Potter Elkin Test Bank

ISBN-13: 978-0323069687

ISBN-10: 0323069681

 

Description

Nursing Interventions and Clinical Skills 5th Edition Perry Potter Elkin Test Bank

ISBN-13: 978-0323069687

ISBN-10: 0323069681

 

 

 

Be the best nurse you can be:

Nursing test banks are legit and very helpful. This test bank on this page can be downloaded immediately after you checkout today.

Here is the definition of nursing

Its true that you will receive the entire legit test bank for this book and it can happen today regardless if its day or night. We have made the process automatic for you so that you don’t have to wait.

We encourage you to purchase from only a trustworthy provider:

Our site is one of the most confidential websites on the internet. We maintain no logs and guarantee it. Our website is also encrypted with an SSL on the entire website which will show on your browser with a lock symbol. This means not a single person can view any information.

Have any comments or suggestions?

When you get your file today you will be able to open it on your device and start studying for your class right now.

Nursing Interventions and Clinical Skills 5th Edition Perry Potter Elkin Test BankRemember, this is a digital download that is automatically given to you after you checkout today.

Free Nursing Test Questions:

 

Perry: Nursing Interventions & Clinical Skills, 5th Edition

 

Chapter 05: Infection Control

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The patient is in isolation in a negative-pressure room for active tuberculosis. He coughs and spews large amounts of blood-tinged sputum but is too weak to cover his mouth and nose with a tissue. Which is the most important intervention for the nurse to implement for self-protection while providing nursing care?
A. Cover the patient’s mouth and nose snugly with a surgical mask.
B. Wear an N-95 mask, gloves, face shield, and isolation gown.
C. Place tissues and a contaminated waste container within reach.
D. Use a properly fitted surgical mask and gloves to help with tissues.

 

 

ANS:  B

Wearing suitable protective barriers is the most important intervention to implement because it protects the nurse from the airborne particles and the pathogens that can land on surfaces from droplets of the patient’s coughing. The nurse wears a mask suitable for airborne precautions to prevent inhalation of suspended Mycobacterium tuberculosis in the air and gloves, gown, and goggles to protect clothing and mucous membranes from droplet contamination. Respirator masks are used in airborne precautions because these masks filter what the wearer inhales. The patient should wear a mask if he or she must leave the room because a surgical mask controls what the wearer exhales; a mask is not indicated in the isolation room. The nurse can inhale airborne particles through the pores of a surgical mask, regardless of how well it fits, because a surgical mask controls what is exhaled.

 

PTS:   1                    DIF:    3                    REF:   Page 72-73     TOP:   Cognitive Level: Analysis

MSC:  Nursing Process: Implementation

 

  1. The nurse is caring for several patients under contact precautions. Which is the most important self-protective method for the nurse to use while caring for these patients?
A. Double gloving
B. Using a fluid-resistant gown
C. Cohorting same infection
D. Washing hands thoroughly

 

 

ANS:  D

Handwashing is the most effective method of self-protection from pathogens associated with direct nursing care of patients with and without infections. Handwashing helps to break the chain of infection by disrupting an effective mode of transmission for microorganisms, the hands. Double gloving provides a health care worker a thicker barrier to microorganisms and primarily is an efficient method of removing and reapplying gloves during a procedure. Clean, water-resistant gowns are used with respiratory isolation and direct contact with the patient on contact precautions. Used alone, gowns do not protect the hands, face, eyes, and mucous membranes. Having two patients in the same room with the same infection potentially helps health care workers protect themselves against infection if the worker notices that both patients have an infection.

 

PTS:   1                    DIF:    3                    REF:   Page 60-61     TOP:   Cognitive Level: Analysis

MSC:  Nursing Process: Planning

 

  1. The nurse bathes a patient who has an infection transmitted by the oral-fecal route and notes a small tear in one glove. Which group of interventions does the nurse use for self-protection?
A. Finish the bath, apply fresh gloves, and wash hands.
B. Continue the bath and change gloves when finished.
C. Apply a new glove over the torn one to finish the bath.
D. Remove the gloves, wash hands, and apply new gloves.

 

 

ANS:  D

For self-protection the nurse interrupts the bath to avoid additional exposure to a potential pathogen by removing the gloves, washing both hands with soap and water, and applying fresh gloves for protection against exposure so the nurse can finish the bath. The nurse risks infection by continuing the bath with a portal of entry on the glove. The nurse should perform hand hygiene before applying fresh gloves. Applying clean gloves over the torn gloves encases the potential pathogens and increases the risk of exposure to the pathogen.

 

PTS:   1                    DIF:    2                    REF:   Page 61

TOP:   Cognitive Level: Application           MSC:  Nursing Process: Implementation

 

  1. A patient is in isolation in a negative-pressure room for tuberculosis, and the nurse notes that the respirator mask is damaged slightly. What is the initial action that the nurse should take?
A. Ask to switch the assignment.
B. Check the mask for a tight seal.
C. Borrow a mask from a co-worker.
D. Use the mask if damage is minor.

 

 

ANS:  B

Before using the mask to enter the patient’s room, the nurse checks the fit to ensure a tight seal because the purpose of this mask in airborne precautions is to filter inhaled air and thereby protect the nurse against pathogens suspended in the air. The nurse can use the mask if the damage is minor and does not affect the seal. Co-workers do not share respirator masks because each employee is fitted individually. If the mask seal is affected, a new mask will be required. Switching assignments is not an appropriate request.

 

PTS:   1                    DIF:    1                    REF:   Page 72

TOP:   Cognitive Level: Comprehension     MSC:  Nursing Process: Planning

 

  1. The nurse completes care for the patient on droplet precautions. Which procedure does the nurse implement to prevent transmitting the pathogen to other people?
A. Removes gloves and mask at the bedside and gown in hallway
B. Removes all personal protective equipment (PPE) in the soiled utility room
C. Removes gloves first, mask second, and gown third in the patient’s doorway
D. Removes mask first, gloves second, and gown third outside the patient’s room

 

 

ANS:  C

The nurse removes PPE to prevent self-contamination. He or she removes the gloves first to avoid contaminating the head, allows the mask to fall away from the face for removal after untying the strings, and finally removes the gown. These actions occur in the patient’s doorway to contain the pathogen and prevent transmission to people outside the room. The nurse risks contamination if the gloves and mask are removed at the bedside; if the mask is removed before the contaminated gloves, the nurse risks contaminating the head while untying the strings of the mask. PPE should be removed together, at the same location, and away from the source of contamination to facilitate containment of the pathogen. Removing PPE in the hallway or utility room would risk transmitting the pathogen to others.

 

PTS:   1                    DIF:    2                    REF:   Page 68-71

TOP:   Cognitive Level: Application           MSC:  Nursing Process: Implementation

 

  1. A patient on isolation precautions tries to leave the isolation room because of loneliness despite repeated instructions to remain in the room. Which action should the nurse implement as a patient advocate?
A. Allow visitors to remove masks while in the patient’s room.
B. Talk with the patient about ways to reduce the sense of loneliness.
C. Remind the patient that the isolation is for the patient’s benefit.
D. Leave the door open slightly so the patient can see into hallway.

 

 

ANS:  B

The nurse sets specific times to remain in the patient’s room as a patient advocate to help him or her develop coping strategies for handling the loneliness from isolation and provide periodic company. Visitors should not enter the room without a properly fitting respirator mask for their own protection. The nurse can remind the patient about the purpose of isolation to help him or her understand the plan of care. The door cannot remain ajar because the risk of transmitting the infection is increased with the door open.

PTS:   1                    DIF:    2                    REF:   Page 71

TOP:   Cognitive Level: Application           MSC:  Nursing Process: Planning

 

  1. Gloves are effective protective barriers from pathogens when caring for patients in isolation. Which patient factor associated with the gloves should the nurse investigate for patients in isolation?
A. Patient resistance to therapy
B. Transmission mode of organism
C. Patient potential for latex allergy
D. Virulence of infectious organism

 

 

ANS:  C

The patient potential for latex allergy is the most important patient factor related to using gloves with patients in isolation. Allergic reactions to latex may be triggered even if latex does not touch the patient. Inhaling the cornstarch or powder used on gloves can lead to anaphylaxis and death. Several alternatives to latex gloves exist. If the patient is allergic to latex, the nurse can use nonlatex gloves to prevent hypersensitivity reactions. Neither virulence nor transmission mode of a pathogen is a patient factor.

 

PTS:   1                    DIF:    1                    REF:   Page 77-78

TOP:   Cognitive Level: Comprehension     MSC:  Nursing Process: Assessment

 

  1. The nurse is getting ready to provide a sterile dressing change. Which nursing action is consistent with principles used to prepare a sterile field?
A. Identify that items below waist height are contaminated.
B. Use opened packages of dressing supplies within the same shift.
C. Identify that sterile drapes have a 5.08 cm 2-inch contaminated border.
D. Replace bottle caps if the inside of the cap is not touched.

 

 

ANS:  A

Items below waist level are considered contaminated and are discarded quickly to avoid contaminating the rest of the sterile field. Packages of sterile supplies must be sealed to be considered sterile. Sterile drapes have a 2.54 cm (1-inch) perimeter that is considered contaminated. Replace bottle caps if the inside of the cap and the edge of the bottle remain sterile.

 

PTS:   1                    DIF:    1                    REF:   Page 75

TOP:   Cognitive Level: Comprehension     MSC:  Nursing Process: Assessment

 

  1. The nurse teaches the patient handwashing before discharge and asks for a return demonstration. Which hand hygiene technique indicates that patient teaching by the nurse is effective?
A. The patient washes hands with running water.
B. Soap, water, and friction are used by the patient.
C. The patient washes hands with very hot water.
D. A basin with warm soapy water is used.

 

 

 

ANS:  B

The patient understands that proper handwashing requires soap, water, and friction to remove microorganisms from the skin and rinse them away. Running water is insufficient to wash hands properly because water alone cannot remove as many microorganisms as soap and water can remove. The patient risks tissue damage, dry skin, and irritation from hot water. Washing hands in a basin may remove surface debris, but the hands are not decontaminated because the debris remains in the rinse water.

 

PTS:   1                    DIF:    1                    REF:   Page 63-63

TOP:   Cognitive Level: Comprehension     MSC:  Nursing Process: Evaluation

 

  1. The nurse cared for a patient diagnosed with tuberculosis (TB) 3 days ago. Which of the following actions should the nurse implement in response to the potential exposure?
A. Take a leave of absence.
B. Have a chest x-ray taken.
C. Request a sputum culture.
D. Get a QFT-G blood test.

 

 

ANS:  D

The CDC now recommends the QFT-G blood test to determine the presence of TB antibodies followed by a sputum test or a chest x-ray to confirm the presence of Mycobacterium tuberculosis. A leave of absence is not necessary unless the nurse displays clinical indicators of TB such as fever, night sweats, weight loss, and coughing.

 

PTS:   1                    DIF:    2                    REF:   Page 72

TOP:   Cognitive Level: Application           MSC:  Nursing Process: Planning

 

  1. The nurse is caring for a patient who is 4 years old and in isolation. Which approach should the nurse implement to reduce the patient’s anxiety?
A. Put the child in a room with a locked door.
B. Ask the parents to keep the child in the room.
C. Explain isolation to the child by using a cartoon.
D. Put the mask, gown, and gloves on in view of the child.

 

 

ANS:  D

The nurse should let the child see her face before putting on the mask so the child knows who is behind the mask and is not frightened. The nurse could even bring a mask for the child to play with in the nurse’s presence to reduce anxiety. The nurse should explain isolation to the child and use educational material suitable to the patient’s developmental level.  However, the child is unlikely to grasp the meaning and implications of isolation, necessitating repeated explanations and guidance. Although the nurse may ask for the parents’ help in keeping the child in the room, the nurse retains the responsibility for maintaining transmission precautions and the child’s safety. Locking the door is a restraint and puts the child at risk in an emergency.

 

PTS:   1                    DIF:    2                    REF:   Page 72

TOP:   Cognitive Level: Application           MSC:  Nursing Process: Planning

 

  1. Which is the best explanation for the nurse’s need to identify the chain of infection for a specific pathogen?
A. Identifies potentially successful therapies
B. Clarifies points to stop or prevent infection
C. Creates hostile environment for the pathogen
D. Individualizes infection-prevention strategies

 

 

ANS:  B

The nurse identifies the chain of infection for a specific pathogen to match nursing care to specific prevention and eradication strategies for a specific pathogen. Creating a hostile environment is one aspect of breaking the chain of infection. The sensitivity test and provider expertise identify antimicrobial therapies to which the pathogen is susceptible. Individualizing prevention strategies is one aspect of identifying elements of the chain of infection.

 

PTS:   1                    DIF:    3                    REF:   Page 59-60     TOP:   Cognitive Level: Analysis

MSC:  Nursing Process: Diagnosis

 

  1. The nurse is caring for a 4-year-old child who has rubella. Which transmission precautions should the nurse implement to prevent rubella exposure?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Standard precautions

 

 

ANS:  B

The nurse implements droplet precautions for the patient with rubella because large droplets expelled by the patient during coughing, talking, or sneezing transmit the virus. Contact and airborne precautions are not indicated because rubella is not transmitted by direct contact or suspended particles in the air. Standard precautions are suitable for all patients but do not prevent rubella transmission without addition droplet precautions.

 

PTS:   1                    DIF:    2                    REF:   Page 68

TOP:   Cognitive Level: Application           MSC:  Nursing Process: Planning

 

  1. The nurse evaluates the handwashing technique of nursing assistive personnel (NAP). Which behavior by NAP requires additional training by the nurse?
A. Rubs sudsy hands for 5 to 10 seconds
B. Uses warm running water and soap
C. Dries the hands from the fingers to the wrists
D. Keeps the hands and forearms below the elbows

 

 

ANS:  A

The nurse improves the NAP’s handwashing technique by providing feedback to increase the length of hand scrubbing to 15 to 30 seconds for thorough removal of microorganisms. The nurse finishes the feedback by directing the NAP to rinse the hands under running water without recontaminating them. Using warm, running water and soap effectively loosens microorganisms from the skin and rinses them off the hands. Drying hands from fingers to wrists is good technique because the hands are dried from the cleanest to the least clean area. Keeping the hands in a dependent position is good handwashing technique because it prevents hand contamination from water that touched the unwashed section of the arm.

 

PTS:   1                    DIF:    1                    REF:   Page 68

TOP:   Cognitive Level: Comprehension     MSC:  Nursing Process: Evaluation

 

  1. The nurse assists the health care provider during the insertion of a central venous catheter. Which is the most effective intervention for the nurse to implement to prevent patient infection?
A. Adhere to the principles of surgical asepsis.
B. Close the door of the sterile procedure room.
C. Sterilize working surfaces for the procedure.
D. Restrict foot traffic into sterile procedure room.

 

 

ANS:  A

Adhering to principles of surgical asepsis is the best method of preventing an infection during a sterile procedure because it is the most comprehensive step. The remaining options are proper actions for the nurse who is adhering to the principles of the surgical asepsis.

 

PTS:   1                    DIF:    3                    REF:   Page 60          TOP:   Cognitive Level: Analysis

MSC:  Nursing Process: Implementation

 

  1. The nurse sets up a sterile field and notes several tiny holes in the sterile drape of the table that served as the wrap for the pack. What does the nurse do to facilitate completion of the procedure?
A. Uses a sterile towel to cover the existing holes
B. Replaces the entire sterile field and the supplies
C. Moves the sterile supplies to a replacement drape
D. Avoids using any of the sterile items near the holes

 

 

ANS:  B

The nurse removes the entire sterile field, including any supplies added to the setup, because the holes compromised the sterility of the pack and its contents; in addition, contacting the contaminated drape contaminates every sterile item added to the sterile field. Even if the contents of the pack remained sterile, once the drape was used as a sterile field, the field was contaminated by the holes. The nurse cannot proceed with a sterile procedure using a contaminated field despite the goal of facilitating the procedure. Ignoring the potential contamination increases the risk of infection.

 

PTS:   1                    DIF:    2                    REF:   Page 60, 73

TOP:   Cognitive Level: Application           MSC:  Nursing Process: Implementation

 

  1. The nurse completes preparation of the sterile field to change a patient’s dressing when the patient’s dinner tray arrives. Which action should the nurse take?
A. Use the sterile field on another patient in another room.
B. Change the dressing using clean technique to save time.
C. Set the tray aside and proceed with the dressing change.
D. Cover the setup with a sterile drape and let the patient eat.

 

 

ANS:  C

The nurse should set the dinner tray aside and proceed with the dressing change. Discarding the sterile setup would waste both time and money. The nurse avoids moving the sterile field to another patient’s room to decrease the risk of contamination from air currents and accidental contact. The nurse should explain to the patient why the dinner tray is being set aside, efficiently finish the dressing, offer to rewarm the meal, delegate serving the tray to nursing assistive personnel (NAP), and thank the patient for patience and understanding. The timing of the dressing change should be rescheduled to prevent this from happening again.

 

PTS:   1                    DIF:    2                    REF:   Page 74

TOP:   Cognitive Level: Application           MSC:  Nursing Process: Planning

 

  1. While setting up a sterile field for a procedure, the nurse knocks a linen-wrapped sterile package to the floor. Which reaction allows the nurse to maintain safe practice?
A. Inspect the package for tears.
B. Brush away the visible debris.
C. Record the procedure as clean.
D. Replace the sterile package.

 

 

ANS:  D

The nurse replaces the linen-wrapped sterile package dropped on the floor because touching the floor contaminates the package. If the package had a plastic wrapper, the contents may be usable, depending on agency policy, because dust and moisture do not penetrate plastic like they can penetrate the linen. Clean technique may not be substituted when sterile technique is required.

 

PTS:   1                    DIF:    2                    REF:   Page 60, 73

TOP:   Cognitive Level: Application           MSC:  Nursing Process: Implementation

 

  1. The nurse helps the health care provider get supplies and monitor the patient during an emergency insertion of a femoral line at the patient’s bedside. Which nursing behavior helps to maintain the sterile environment?
A. Avoid reaching over the field.
B. Wear a sterile cap and booties.
C. Use sterile examination gloves.
D. Place a face mask on the patient.

 

 

ANS:  A

The nurse avoids reaching over the sterile field to avoid contamination. A head cover and booties are not sterile, even when used during in a sterile procedure. Sterile gloves are not indicated for the tasks the nurse is performing to assist the health care provider. There is no need to place a face mask on the patient for a procedure occurring on the upper thigh.

 

PTS:   1                    DIF:    2                    REF:   Page 75

TOP:   Cognitive Level: Application           MSC:  Nursing Process: Evaluation

 

  1. The nurse is preparing to put on sterile gloves. What should the nurse do to begin this procedure?
A. Pull the first glove up and over the nondominant hand.
B. Place the fingers of the dominant hand under the cuff of the first glove.
C. Let the cuff of the glove roll up over the hand for more coverage.
D. Hold the inside surface of the first glove to pull over the hand.

 

 

ANS:  D

To begin donning sterile gloves, the nurse slips the fingers of the nondominant hand into the glove to lift it and pull it over the dominant hand. As long as the cuff does not roll up and the glove remains intact, the exterior of the glove remains sterile.

 

PTS:   1                    DIF:    1                    REF:   Page 75          TOP:   Cognitive Level: Knowledge

MSC:  Nursing Process: Planning

 

  1. The nurse has just finished a sterile dressing change. Which technique should he or she use to remove sterile gloves?
A. Pull the first glove off with the sterile glove hand.
B. Reach inside the first glove to pull it off quickly.
C. Pull the edge of the glove down to create a cuff.
D. Wipe off the gloves with an antiseptic wipe first.

 

 

ANS:  A

To remove sterile gloves, the nurse pulls the first glove off with the opposite sterile hand and discards the glove; then he or she inserts a bare finger under the remaining glove to pull it down and inside out. The nurse discards this glove as well. He or she avoids reaching inside the first glove with a gloved hand to prevent self-contamination.

 

PTS:   1                    DIF:    1                    REF:   Page 80          TOP:   Cognitive Level: Knowledge

MSC:  Nursing Process: Implementation

 

  1. The nurse giving the hand-off report tells the incoming nurse where to find an open bottle of sterile normal saline solution for the patient’s wound irrigation. The arriving nurse finds four bottles labeled with the patient’s name at the bedside. Which bottle should the nurse use for the patient’s sterile wound irrigation?
A. The bottle with the label that has a time written
B. The bottle with the label, “Use this bottle next.”
C. The bottle with the label that has the previous nurse’s initials
D. The bottle of normal saline solution with an unbroken seal

 

 

ANS:  D

The best guarantee of a sterile solution is a bottle with an unbroken seal. If a previously used bottle is resealed, labeled properly, handled using sterile technique, and has not expired, the nurse should use the bottle with the proper label to prevent waste. “Use this bottle next” is not properly labeled and should be considered contaminated. A correctly labeled sterile container must include a label with the date and time so the next nurse can determine the integrity of the bottle.

 

PTS:   1                    DIF:    2                    REF:   Page 60, 76

TOP:   Cognitive Level: Application           MSC:  Nursing Process: Planning

 

  1. The nurse is preparing a sterile field with several items on it. Which action should the nurse implement to maintain a sterile field?
A. Flip sterile objects onto the sterile field.
B. Put fluid holders near the edge of the field.
C. Wear sterile gloves to open sterile packs.
D. Open the inner flaps of the sterile packages first.

 

 

ANS:  B

The nurse places holders for fluid near the edge of the sterile field, allowing the circulating nurse to pour fluids into the holders without reaching over and contaminating the sterile field. Flipping sterile objects onto the sterile field increases the risk of contamination. Sterile gloves are unnecessary to open sterile packages because the outside of the package is clean; the nurse can use bare hands to open the package and retain package sterility. The nurse opens the outer flaps of sterile packages first because it is impossible to open the inner flaps first since they are covered with an outer wrap.

 

PTS:   1                    DIF:    1                    REF:   Page 76

TOP:   Cognitive Level: Comprehension     MSC:  Nursing Process: Planning

 

  1. A patient has stated that sometimes the elastic band in underwear causes redness and swelling around the waist. Which clinical indicators are consistent with a type I allergic reaction to latex?
A. Runny nose and itchy, watery eyes
B. Diarrhea and hypertension
C. Wheezing and hypotension
D. Skin redness and itching

 

 

ANS:  B

Delayed skin redness and itching are consistent with an irritant reaction. Clinical indicators of a type I allergic reaction to latex include diarrhea, hypotension, and wheezing. A massive release of inflammatory mediators, including histamine, causes these clinical indicators by hyperstimulation of the bowels, vasodilation, and bronchospasm, respectively. Runny nose and itchy, watery eyes are consistent with a type IV hypersensitivity reaction. Hives are consistent with type IV hypersensitivity reactions and a type I allergic reaction; runny nose and coughing are consistent with a type IV hypersensitivity reaction.

PTS:   1                    DIF:    2                    REF:   Page 78          TOP:   Cognitive Level: Knowledge

MSC:  Nursing Process: Assessment

 

  1. The nurse is preparing to transfer a sterile voided urine specimen from the patient’s bathroom to the laboratory. What supplies should he or she gather to complete this procedure?
A. Clean gloves, biohazard bag, mask
B. Plastic bag, gown, gloves
C. Sterile gloves, gown, biohazard bag
D. Clean gloves, plastic bag, biohazard label

 

 

ANS:  D

Clean gloves are used even though the specimen is sterile. After the outside of the container is dried, the clean gloves are removed; the specimen container is placed in a plastic bag, and a biohazard label is attached if not already printed on the bag. A mask or gown is not needed unless splashing is a possibility, and there is no information in the question about the chance of splashing. Sterile gloves are not needed to obtain a sterile voided urine specimen.

 

PTS:   1                    DIF:    2                    REF:   Page 70

TOP:   Cognitive Level: Application           MSC:  Nursing Process: Planning

 

Reviews

There are no reviews yet.

Be the first to review “Nursing Interventions and Clinical Skills 5th Edition Perry Potter Elkin Test Bank”

Your email address will not be published. Required fields are marked *