CHAPTER 26: Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford

Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford Chapter 26: Asepsis and Infection Control Multiple Choice Questions 1. The nurse recognizes which term identifies the body's second line of defense involving capillary dilation and leukocyte infiltration? A. Normal flora B. Inflammatory response C. Immune response D. Humoral immunity Answer: B Explanation: The inflammatory response is the second line of defense, characterized by localized capillary dilation and leukocyte migration to injured or infected tissues. Why Other Options Are Wrong: A describes the first line (non-pathogenic microorganisms). C involves adaptive immunity. D refers to antibody-mediated immunity. 2. The nurse knows the antigen-antibody reaction exemplifies which type of immunity? A. Humoral B. Cellular C. Innate D. Passive Answer: A Explanation: Humoral immunity involves B lymphocytes producing antibodies to neutralize circulating pathogens. Why Other Options Are Wrong: B involves T cells targeting infected cells. C provides nonspecific defense. D involves receiving preformed antibodies. 3. The nurse uses which term to describe a disease-causing microorganism? A. Pathogen B. Normal flora C. Germ D. Microorganism Answer: A Explanation: Pathogens specifically cause disease, whereas normal flora are benign microorganisms. Why Other Options Are Wrong: B refers to non-harmful microbes. C and D are overly broad terms. 4. The nurse explains antibiotics are effective against which microorganisms? A. Viruses B. Fungi C. Parasites D. Bacteria Answer: D Explanation: Antibiotics target bacterial infections, with sensitivity testing guiding specific prescriptions. Why Other Options Are Wrong: A requires antivirals. B needs antifungals. C necessitates anti parasitics. 5. The nurse anticipates treating athlete's foot with which medication category? A. Antiviral B. Antibiotic C. Antihelminth D. Antifungal Answer: D Explanation: Athlete's foot is a fungal infection, requiring antifungal treatment. Why Other Options Are Wrong: A–C are ineffective against fungi. 6. The nurse identifies the stethoscope as which link in the infection chain? A. Source B. Portal of exit C. Portal of entry D. Mode of transmission Answer: D Explanation: The stethoscope can transmit pathogens between patients, acting as a fomite. Why Other Options Are Wrong: A–C describe reservoir, exit, or entry points, not transmission vehicles. 7. The nurse uses which term for ticks spreading disease between hosts? A. Vectors B. Bacteria C. Viruses D. Fungi Answer: A Explanation: Vectors like ticks carry pathogens from one host to another. Why Other Options Are Wrong: B–D are pathogen types, not transmission agents. 8. The nurse identifies which method as most effective for preventing hospital acquired infections? A. Sterile technique B. Isolation protocols C. Antibiotic use D. Handwashing Answer: D Explanation: Handwashing is universally effective in reducing pathogen transmission. Why Other Options Are Wrong: A–C are situation-specific and less broadly applicable. 9. The nurse recognizes which patient has the highest infection risk? A. 80-year-old male with enlarged prostate B. 24-year-old female runner C. 50-year-old obese male D. 40-year-old sexually active female Answer: A Explanation: Advanced age and urinary stasis from prostate enlargement compound infection risk. Why Other Options Are Wrong: B–D lack multiple risk factors. 10. The nurse identifies which vital signs most likely indicate infection? A. T: 98.6°F, P: 75, R: 18, BP: 120/80 B. T: 99°F, P: 80, R: 18, BP: 110/70 C. T: 100.5°F, P: 96, R: 22, BP: 150/100 D. T: 98.9°F, P: 66, R: 18, BP: 98/62 Answer: C Explanation: Fever, tachycardia, tachypnea, and hypertension are classic signs of systemic infection. Why Other Options Are Wrong: A–B show normal or mild elevations. D reflects hypotension, atypical for infection. 11. The nurse sets which priority goal for a postoperative patient with infection risk? A. Ambulate hallway this shift B. Consume 20% of meals weekly C. Maintain infection-free incision D. Stop antibiotics when asymptomatic Answer: C Explanation: Preventing surgical site infection is critical for recovery. Why Other Options Are Wrong: A–B are secondary goals. D promotes antibiotic resistance. 12. The nurse provides oral care to a comatose patient at which frequency? A. Every shift B. Twice daily C. Every 4 hours D. Daily Answer: C Explanation: Q4H oral care prevents bacterial colonization and aspiration pneumonia. Why Other Options Are Wrong: Less frequent care increases infection risk. 13. The nurse knows which procedure does not require sterile technique? A. NG tube insertion B. Foley catheterization C. Tracheostomy care D. PICC line insertion Answer: A Explanation: The GI tract is non-sterile, requiring clean technique for NG insertion. Why Other Options Are Wrong: B–D involve sterile body cavities or devices. 14. The nurse avoids alcohol sanitizer for which patient? A. Pneumonia B. Clostridium difficile C. Post-appendectomy D. HIV Answer: B Explanation: C. diff spores resist alcohol; soap and water are required. Why Other Options Are Wrong: A, C, D permit sanitizer use. 15. The nurse wears which PPE for tracheostomy suctioning with secretion expulsion risk? A. Gloves and eyewear B. Gloves, gown, and mask C. Eyewear and gown D. Eyewear, mask, gown, and gloves Answer: D Explanation: Full PPE protects against airborne and contact transmission. Why Other Options Are Wrong: A–C lack complete protection. 16. The nurse implements which isolation for hepatitis A? A. Airborne B. Contact C. Droplet D. Protective Answer: B Explanation: Hepatitis A spreads via fecal-oral contact, requiring contact precautions. Why Other Options Are Wrong: A–C are for respiratory pathogens. D protects immunocompromised patients. 17. The nurse uses which isolation for pertussis? A. Droplet B. Airborne C. Contact D. Protective Answer: A Explanation: Pertussis spreads via respiratory droplets. Why Other Options Are Wrong: B is for smaller airborne particles. C/D are incorrect for respiratory transmission. 18. The nurse teaches which order for PPE removal? A. Gloves, eyewear, gown, mask B. Mask, eyewear, gown, gloves C. Gown, mask, eyewear, gloves D. Gloves, gown, mask, eyewear Answer: A Explanation: Gloves are removed first to prevent self-contamination during mask/gown removal. Why Other Options Are Wrong: B–D risk contaminating clean areas during removal. 19. The nurse knows sterile gloves become contaminated by which action? A. Folding hands until procedure B. Changing dressing aseptically C. Placing hands below waist D. Donning gloves correctly Answer: C Explanation: The waist-level boundary demarcates the sterile field; crossing it breaks asepsis. Why Other Options Are Wrong: A, B, D maintain sterility. MULTIPLE RESPONSE QUESTIONS 1. The nurse identifies which elderly patient factors increase respiratory infection risk? A. Decreased cough reflex B. Decreased lung elasticity C. Increased cilia activity D. Abnormal swallowing E. Increased sputum Answer: A, B, D Explanation: Age-related declines in cough, lung function, and swallowing elevate aspiration and infection risks. Why Other Options Are Wrong: C is incorrect (cilia activity decreases). E is atypical in elderly. 2. The nurse notes which antibiotic statements require re-education? A. Take antibiotics when sick B. Complete all prescribed doses C. Save unused antibiotics D. Stop when symptoms resolve E. Report rash to provider Answer: A, C, D Explanation: Antibiotics are pathogen-specific; incomplete courses or hoarding fuels resistance. Why Other Options Are Wrong: B and E reflect appropriate use. 3. The nurse corrects which handwashing errors? A. Wash hands before wrists B. Rinse fingertips to wrists C. Dry with scrubbing motion D. Use towel to turn faucet E. Dry wrists to fingertips Answer: A, B, C Explanation: Proper technique: wash wrists first, rinse wrist-to-fingertips, and pat dry. Why Other Options Are Wrong: D and E are correct steps. 4. The nurse applies standard precautions to which patients? A. All patients B. HIV patients C. MRSA patients D. Tuberculosis patients E. Bleeding patients Answer: A, E Explanation: Standard precautions are universal; additional measures (B–D) are pathogen specific. Why Other Options Are Wrong: B–D require transmission-based precautions. 5. The nurse knows which statements about protective precautions are true? A. HEPA-filtered positive-pressure room B. One-size-fits-all respirators C. No live plants in room D. Unrestricted diet E. Masks required for all entrants Answer: C, E Explanation: Protective isolation restricts potential contaminants (plants) and requires masks. Why Other Options Are Wrong: A is sometimes used but not universal. B is false (fit-testing required). D is incorrect (dietary restrictions apply).