Select All That Apply Practice Test #1: Safety and Infection Control

Correct answers (B, C, E):
B. Put on a gown and gloves before entering the room.
C. Keep a dedicated stethoscope and blood pressure cuff in the client's room.
E. Clean and disinfect any shared equipment before it is used for another client.

Rationale: MRSA spreads by direct contact with the client and by touching contaminated surfaces and equipment. Under CDC contact precautions, the nurse puts on a gown and gloves when entering the room (B), keeps non-critical equipment such as a stethoscope and BP cuff dedicated to that client (C), and cleans and disinfects anything that must be shared before another client uses it (E). Hand hygiene is still done after removing the gloves. Option A is wrong because an N95 respirator is used for airborne diseases such as tuberculosis and measles, not MRSA. Option D is wrong because a negative-pressure (airborne infection isolation) room is for airborne diseases; a private room, or cohorting with another client who has the same organism, is used for contact precautions. Follow facility policy for when precautions can be stopped.

Correct answers (A, C, D):
A. Place the child in an airborne infection isolation room (negative pressure).
C. Keep the door to the room closed.
D. Have the child wear a surgical mask if transport out of the room is needed.

Rationale: Measles is spread by the airborne route and is one of the most contagious diseases. CDC airborne precautions call for an airborne infection isolation room with negative pressure (A) and a closed door so air does not flow into the hallway (C). If the child must leave the room, the child wears a surgical mask and transport is kept to a minimum (D). Option B is wrong because staff need a fit-tested N95 or higher-level respirator, not a surgical mask. Option E is wrong because the respirator is removed after leaving the room and closing the door, so the nurse is not breathing room air without protection. When possible, only staff with evidence of measles immunity should care for the child; follow facility policy.

Correct answers (A, D, E):
A. Put on a surgical mask when entering the infant's room.
D. Use a private room, or share a room only with a client who has the same infection.
E. Limit transport, and have the infant wear a mask during transport if one can be tolerated.

Rationale: Pertussis spreads through large respiratory droplets from coughing and sneezing, so droplet precautions are used. The nurse wears a surgical mask on entering the room (A), the client is placed in a private room or cohorted with a client who has the same infection (D), and transport is limited, with the client masked when that is possible and safe (E). CDC guidance keeps droplet precautions in place for pertussis until the client has had 5 days of effective antibiotic therapy; follow facility policy. Options B and C are wrong because an N95 respirator and a negative-pressure room are needed for airborne diseases, not droplet diseases. Very young infants can stop breathing with coughing spells, so close monitoring is part of care.

Correct answers (B, E):
B. Working oxygen and suction set up at the bedside.
E. The bed kept in the lowest position with the wheels locked.

Rationale: Seizure precautions aim to protect the airway and prevent injury. Oxygen and suction are set up and checked so the nurse can clear secretions and give oxygen after a seizure (B), and the bed is kept low and locked to reduce injury from a fall (E). Other common measures, depending on facility policy, include IV access and padding side rails. Option A is wrong because nothing is put in the mouth during a seizure; it can break teeth, injure the mouth, or block the airway. Option C is wrong because holding down or restraining a client during a seizure can cause fractures and other injuries; the nurse moves objects away, guides the client to the side if possible, and times the seizure. Option D is wrong because a client could bite a glass thermometer during a seizure; another route or device is used.

Correct answers (A, C, D):
A. The client's full name
C. The client's date of birth
D. The medical record number assigned by the facility

Rationale: The Joint Commission National Patient Safety Goals require at least two person-specific identifiers before giving medications, blood or treatments, or collecting specimens. Name (A), date of birth (C), and a facility-assigned medical record number (D) belong to the person. The facility decides which two identifiers are used; follow facility policy, ask the client to state the information when able, and compare it with the ID band and the medication record. Options B and E are wrong because a room number or bed location belongs to a place, not a person. Clients are moved, and two clients can be in the same room, so a location can lead to a wrong-client error.

Correct answers (B, C, E):
B. No one should smoke in the home, and post 'No Smoking' signs.
C. Keep the oxygen away from open flames and heat sources, such as gas stoves, candles and fireplaces.
E. Keep cylinders upright and secured in a stand or cart.

Rationale: Oxygen does not burn by itself, but it makes fire start more easily and burn hotter and faster. No smoking by anyone in the home, with signs posted (B), and keeping oxygen away from open flames and heat sources (C) help prevent fires and burns. The oxygen supplier's instructions say how far equipment should be kept from heat sources. Cylinders are kept upright and secured in a stand or cart (E), because a cylinder that falls can damage the valve and become dangerous. Option A is wrong because petroleum-based products such as petroleum jelly are flammable; a water-based lubricant is used instead. Option D is wrong because loose cylinders can roll, be knocked over or damaged; they are stored secured, in a well-ventilated area, as the supplier directs.

Correct answers (A, B, D):
A. Banana
B. Avocado
D. Kiwi

Rationale: Some proteins in latex are similar to proteins in certain foods, which is called the latex-fruit syndrome. The foods most often linked are banana (A), avocado (B), kiwi (D) and chestnut. Not everyone with a latex allergy reacts to these foods, so the nurse asks about past reactions, documents them, and reports them. Options C and E are wrong because rice and plain chicken are not commonly linked to latex allergy. For any client with a latex allergy, the nurse uses latex-free gloves and equipment, places an allergy band, and follows the facility's latex-safe policy.

Correct answers (B, D, E):
B. Wash the site with soap and water.
D. Report the injury right away to the supervisor or employee health, following facility policy.
E. Get evaluated promptly, because preventive medicine (post-exposure prophylaxis) works best when started quickly.

Rationale: The CDC advises washing a needlestick or cut with soap and water (B). Reporting the injury right away (D) starts the facility's exposure process, including testing of the source client when that is allowed. Prompt medical evaluation (E) matters because HIV post-exposure prophylaxis works best when started within hours; CDC guidance says it should be started as soon as possible and no later than 72 hours after the exposure. The need for hepatitis B or C follow-up is also decided at this visit. Option A is wrong because squeezing the wound has not been shown to lower infection risk and is not recommended. Option C is wrong because bleach and other caustic agents are not recommended and can damage tissue.

Correct answers (A, C, D, E):
A. Household members and close contacts should be treated at the same time.
C. Wash clothing, towels and bedding used in the 3 days before treatment in hot water, and dry them on high heat.
D. Itching may continue for several weeks after successful treatment.
E. Items that cannot be washed can be sealed in a plastic bag for at least 72 hours.

Rationale: These points follow CDC scabies guidance. Close contacts are treated at the same time so the mites are not passed back and forth (A). Items used in the 3 days before treatment are washed in hot water and dried on high heat (C), and items that cannot be washed are sealed in a plastic bag for at least 72 hours, because mites usually do not survive more than 2 to 3 days away from human skin (E). Itching can last 2 to 4 weeks after treatment works, because it is a reaction to the mites and their waste, so continued itching alone does not mean treatment failed (D). Option B is wrong because fumigating or spraying the home is not needed. In the hospital, contact precautions are used until treatment is effective; follow facility policy.

Correct answers (A, B, D):
A. Check cords and plugs for fraying or damage before using equipment.
B. Use equipment with grounded, three-prong plugs.
D. Take a device that shocked someone out of use, label it, and report it to biomedical engineering.

Rationale: Damaged cords and plugs can cause shocks and fires, so they are checked before use (A). Grounded three-prong plugs carry stray current safely to the ground (B). A device that gave a shock, sparked, or smells like it is burning is removed from use, labeled, and reported so biomedical or clinical engineering can check it (D). Option C is wrong because pulling the cord damages the wires; the nurse grasps the plug. Option E is wrong because power strips and extension cords from home have not been safety checked, and most facilities do not allow them in client care areas. Personal electrical devices are usually inspected per facility policy before use.