CHAPTER 16

Infection Prevention and Control: Protective Mechanisms and Asepsis

REVIEW QUESTIONS FOR THE NCLEX® EXAMINATION

Directions: Choose the best answer(s) for each of the following questions.

1. In the home care setting, contaminated dressings should be handled by ____________ before
disposal. (237)

1. boiling them for 10 minutes

2. treating them with a 1:10 chlorine solution

3. securing them in plastic zip-closure bags

4. washing in hot soapy water

2. Which put the hospital patient at high risk for a health care–associated infection? (Select all that
apply.) (237)

1. hospitalized more than 3 days

2. has another chronic illness

3. an indwelling urinary catheter

4. is eating little after surgery

5. has an intravenous line for IV fluids

6. has a surgical wound

7. is older than 50 years of age

3. Alcohol-based hand rubs are appropriate for hand hygiene because they are (227, Box 16.2)

1. more effective than handwashing for ridding the hands of microorganisms.

2. as effective as handwashing, and are more convenient and cost-effective.

3. the most effective way to rid the hands of Clostridium difficile.

4. the most effective way to rid the hands of tuberculosis spore–forming microorganisms.
4. Considering the chain of infection and the way pathogens are transmitted, which is considered a
reservoir? (220)

1. contaminated water

2. mosquito

3. contaminated metal instrument

4. contaminated dressings

5. Many gram-negative bacteria are more dangerous than gram-positive bacteria because they (217)

1. multiply more rapidly.

2. produce a dangerous endotoxin.

3. cause severe diarrhea.

4. are more virulent.

6. The liver participates in protection of the body against infection by (224)

1. phagocytic action in the liver tissue.

2. action of bile inactivating bacteria.

3. flushing bacteria from the blood.

4. destroying bacteria via the Kupffer cells.

7. Another body defense occurs in the gastrointestinal system as the (224)

1. hydrochloric acid in the stomach destroys pathogens.

2. bile in the stool kills bacteria.

3. digestive enzymes in the small intestine kill bacteria.

4. peristaltic action of the intestines eliminates pathogens.

8. Fever helps fight infection because heat (224)

1. kills most pathogens.

2. slows the growth of pathogens.

3. causes diaphoresis and flushing out of bacteria.

4. causes more water consumption and urine production.

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9. The redness and warmth in an inflamed area is due to (224)

1. dilation of blood vessels and increased blood flow.

2. increased temperature in the affected tissues.

3. phagocytosis and chemical action against pathogens.

4. formation of debris, causing tissue swelling.

10. Normally, the immune system does not attack the self because (224)

1. only microorganisms cause antibody production.

2. macrophages never attack one’s own cells.

3. cellular antigens help in distinguishing self from nonself.

4. only foreign proteins cause antibody reaction.

11. Effective disinfection of surfaces contaminated with blood and other potentially infectious material
is accomplished by (236)

1. scrubbing with soap and hot water for 3 minutes.

2. soaking with 70% alcohol solution for 10 minutes.

3. washing with iodine solution and then swabbing with alcohol.

4. cleansing with a solution of 1:10 chlorine bleach and water.

12. Performing a culture and sensitivity test when a patient has a wound infection is important because
(218)

1. antibiotics will kill the bacteria.

2. different organisms are killed by specific antibiotics.

3. some wound infections should not be treated.

4. cleansing alone will not cure the infection.

13. Various microorganisms cause different problems. Diarrhea is often caused by (219)

1. Rickettsia.

2. fungi.

3. protozoa.

4. helminths.

14. Various types of organisms cause different disorders. Vaginal Candidiasis is caused by ____________.
(Fill in the blank.) (219)

15. Nurses pay great attention to skin care for patients because (Select all that apply.) (221-223)

1. cleanliness reduces the chance of infection.

2. dirty skin predisposes to skin breakdown.

3. everyone should have a bath every day.

4. the skin is the first line of defense against infection.

5. cleansing removes dead skin cells.

16. Giving a patient a serum immune globulin injection will provide (226)

1. passive acquired immunity.

2. naturally acquired passive immunity.

3. artificially acquired immunity.

4. passive artificially acquired immunity.

17. Considering hand hygiene as a measure to prevent infection, important guidelines are that (Select all
that apply.) (227, Box 16.2)
1. a 5-minute scrub is always appropriate.

2. handwashing time should be adjusted to the amount of contamination of the hands.

3. hands should be washed with soap and running water to wash away microbes.

4. only special antimicrobial soap will sufficiently kill the microbes on the hands.

5. alcohol rub must be applied to all hand surfaces.

18. Standard Precautions were developed by the CDC to (231)

1. protect patients.

2. protect health care workers.

3. break the chain of infection.

4. prevent health care–associated infection.

19. Hand hygiene is necessary after removing gloves because (234)

1. powder from the gloves remains on the hands.

2. gloves are not 100% protective.

3. contamination occurs when removing the gloves.

4. otherwise the gloves irritate the hands.

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20. In what order would you put on the following personal protective equipment needed to care for
your patient? (232-233)

a. gloves

b. mask

c. gown

d. goggles or face shield

1. c, d, a, b
2. c, b, d, a

3. b, d, c, a

4. b, c, d, a

21. Before sterilizing instruments, you should (236)

1. rinse off all visible matter with cold water.

2. soak them in cool water.

3. soak them in alcohol.

4. soak them in hot water.

CRITICAL THINKING ACTIVITIES

1. Give specific examples of the methods of medical asepsis and surgical asepsis used in the health care
setting to which you are assigned.

2. Explain to a family member how the body’s protective mechanisms work to prevent infection.

3. Explain to a patient why the use of Standard Precautions is essential to both the health care worker’s
and the patient’s protection.