IAHCSMM Infection Prevention and Control Exam 1 Practice Questions and Answers, Exams of Community Health

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IAHCSMM Infection Prevention and Control

Exam 1 Practice Questions and Answers

100% Pass | Graded A+

David Mungai [Date] [Course title]

IAHCSMM Infection Prevention and

Control Exam 1 Practice Questions and

Answers 100% Pass | Graded A+

Infection - Answer>> invasion of a susceptible host by pathogens or microorganisms, resulting in disease Colonization - Answer>> occurs when a microorganism invades the host but does not cause infection Communicable infectious disease - Answer>> transmitted from one person to another Symptomatic pathogens - Answer>> multiply and cause clinical signs and symptoms Non-symptomatic pathogens - Answer>> multiply but clinical signs and symptoms are not present Hand hygiene is... - Answer>> the most important technique used in preventing and controlling transmission of infection Chain of infection - Answer>> - infectious agent or pathogen

• reservoir or source for pathogen growth
• portal of exit
• mode of transmission
• portal of entry
• susceptible host Immunocompromised - Answer>> an impaired immune system
• stress, HIV/AIDS, age, etc. Virulence - Answer>> the ability to produce disease

Modes of Transmission: vehicles - Answer>> - contaminated items

• water
• drugs, solutions
• blood
• food (improperly handled, stored, or cooked; fresh or thawed meat) Modes of Transmission: vector - Answer>> - external mechanical transfer (flies)
• internal transmission such as parasitic conditions between vector and host such as: mosquito, louse, flea
• tick A patient is admitted to a medical unit for a home-acquired pressure ulcer. The patient has Alzheimer's disease and has been incontinent of urine. The nurse inserts a Foley catheter. A link in the infection chain is A. restraints B. Poor hygiene C. Foley catheter bag D. Improper positioning - Answer>> Answer: C Four stages of infectious process - Answer>> incubation period, prodromal stage, illness stage, convalescence Incubation period - Answer>> Interval between entrance of pathogen into body and appearance of first symptoms

Prodromal stage - Answer>> intervals from onset of nonspecific signs and symptoms (malaise, low-grade fever, fatigue) to more specific symptoms (During this time microorganisms grow and multiply, and patient may be capable of spreading disease to others.)

• herpes simplex begins with itching and tingling at the site before the lesion appears Illness stage - Answer>> Interval when patient manifests signs and symptoms specific to type of infection.
• strep throat is manifested by sore throat, pain, and swelling; mumps is manifested by high fever, parotid, and salivary gland swelling Convalescence - Answer>> Interval when acute symptoms of infection disappear (Length of recover depends on severity of infection and pt's host resistance; recovery may take several days to months.) localized infection - Answer>> affects local region systemic infection - Answer>> affects entire body Normal flora - Answer>> microorganisms that reside on or in the body that do not usually cause disease when residing in their usual area of body but instead participate in maintaining health Suprainfection - Answer>> new infection that appears during the course of treatment for a primary infection

Types of HAI infections: Endogenous - Answer>> when the patient's flora becomes altered and an overgrowth results Risk Factors for HAIs - Answer>> - Number of health care employees with direct contact with the patient

• Types and numbers of invasive procedures
• Therapy received
• Length of hospitalization Major Sites for HAI Infection: Urinary Tract - Answer>> - unsterile insertion of urinary catheter
• improper positioning of the draining tubing
• open draining system
• catheter and tubing becoming disconnected
• drainage bag port touching contaminated surface
• improper specimen collecting technique
• obstructing or interfering with urinary drainage
• urine in catheter or drainage tube being allowed to reenter bladder (reflux)
• repeated catheter irrigations
• improper perineal hygiene Major Sites for HAI Infection: Surgical or Traumatic Wounds - Answer>> - improper skin preparation before surgery (eg shaving versus clipping hair; not performing a preoperative bath or shower)
• failure to clean skin surface properly
• failure to use aseptic technique during operative procedures and dressing changes
• use of contaminated antiseptic solutions Major Sites for HAI Infection: Respiratory Tract - Answer>> - contaminated respiratory therapy equipment

• failure to use aseptic technique while suctioning airway
• improper disposal of secretions Major Sites for HAI Infection: Bloodstream - Answer>> - contamination of IV fluids by tubing
• insertion of drug additives to IV fluid
• addition of connecting tube or stopcocks to IV system
• improper care of needle insertion site
• contaminated needles or catheters
• failure to change IV access at first sign of infection or at recommended intervals
• improper technique during administration of multiple blood products
• improper care of peritoneal or hemodialysis shunts
• improper assessing an IV port Factors influencing infection prevention and control - Answer>>
• Age
• Nutritional status: illness = increased protein or calorie requirements; impaired intake
• Stress; increased metabolic rate
• Disease process: disease of immune system, inability to produce WBCs; general debilitation and nutritional impairment from disease; treatments that reduce immune responses (chemotherapy) Nursing process - Answer>> Assessment Diagnosis Planning Implementation Evaluation

D. Place the patient on isolation precautions - Answer>> ANSWER: C Nursing Process: Planning - Answer>> - goals of care applicable to patients with infection

• setting priorities
• teamwork and collaboration Planning: Common goals of care applicable to patients with infection often include the following - Answer>> - preventing exposure to infectious organisms
• controlling or reducing the extent of infection
• maintaining resistance to infection
• verbalizing understanding of infection prevention and control techniques (eg hand hygiene) Planning: Setting priorities - Answer>> establish priorities for each diagnosis and for related goals of care Planning: teamwork and collaboration - Answer>> plan care with pt, family and other HCPs Nursing Process: Implementation - Answer>> - Health Promotion
• Acute care Implementation: Health promotion - Answer>> Preventing an infection from developing or spreading
• hygiene
• vaccinations
• nutrition support
• rest, stress-reduction

Implementation: acute care - Answer>> Treating an infectious process includes eliminating the infectious organisms and supporting the patient's defenses

• identify organisms (culture, laboratory)
• promote healing (vitamins, diet)
• support patient's own body defense mechanisms When implementing care, consider: - Answer>> - control or elimination of infectious agents
• control or elimination of reservoirs
• control of portals of exit and entry
• control of transmission (hand hygiene, isolation precautions, medical and surgical asepsis) Asepsis - Answer>> absence of pathogenic (disease- producing) microorganisms Aseptic technique - Answer>> practices/procedures that assist in reducing the risk for infection Medical asepsis (clean technique) - Answer>> includes procedures for reducing the number of organisms present a preventing the transfer of organisms Surgical asepsis (sterile technique) - Answer>> prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery Standard precautions - Answer>> Prevent and control infection and its spread

Surgical asepsis Cough Etiquette - Answer>> Coughing/sneezing into a tissue to prevent microorganisms from spreading to others. Includes properly disposing of tissue into waste receptacle and washing hands as soon as possible. Isolation and Isolation Precautions - Answer>> Isolation is the separation and restriction of movement of ill persons with contagious diseases. -Barrier precautions -Standard precautions -Isolation precautions: airborne, droplet, contact, and protective environment Airborne - Answer>> TB, chickenpox Droplet - Answer>> Flu, whooping cough, bacterial meningitis Contact - Answer>> C. difficile, MRSA, VRE, norovirus, RSV Isolation - Answer>> - psychological implications

• isolation environment
• personal protective equipment
• specimen collection
• bagging of trash or linen
• patient transport Surgical asepsis - Answer>> - patient preparation
• sterile field: free of microorganisms and prepared to receive sterile items
• principles
• performing sterile procedures

Principles of Surgical Asepsis - Answer>> 1. A sterile object remains sterile only when touched by another sterile object.

2. Only sterile objects may be placed on a sterile field.
3. A sterile object or field out of the range of vision or an object held below a person's waist is contaminated.
4. A sterile object or field becomes contaminated by prolonged exposure to air.
5. When a sterile surface comes in contact with a wet, contaminated surface, the sterile object or field becomes contaminated by capillary action.
6. Fluid flows in the direction of gravity.
7. The edges of a sterile field or container are considered to be contaminated. Nursing Process: Evaluation - Answer>> See through the patient's eyes:

• have the pt's expectations been met? Patient outcomes
• measure the success of the infection control techniques
• compare the pt's actual response with expected outcomes
• if goals are not achieved, determine what steps must be taken reservoir - Answer>> a place where microorganisms survive, multiply, and await transfer to a susceptible host Ex: humans and animals (hosts), insects, food, water, and organic matter on inanimate surfaces (fomites) frequent reservoirs for HAIs - Answer>> healthcare workers, patients, equipment, and the environment Portal of exit - Answer>> any body opening on an infected person that allows pathogens to leave

Indication of infection:

• decreased in chronic infection Cultures of urine and blood - Answer>> Normal adult values:
• normally sterile, without microorganisms growth Indication of infection:
• presence of infectious microorganism growth Cultures and gram stain of wound, sputum, and throat - Answer>> Normal adult values:
• no WBCs on Gram stain, possible normal flora Indication of infection:
• presence of infectious microorganism growth and WBCs on Gram stain WBC: Neutrophils - Answer>> 55%-70%
• increased in acute suppurative (pus-forming) infection,
• decreased in overwhelming bacterial infection (older adult) WBC: Lymphocytes - Answer>> 20%-40%
• Increased in chronic bacterial and viral infection
• decreased in sepsis WBC: Monocytes - Answer>> 2%-8%
• increased in protozoan, rickettsial, and tuberculosis infection WBC: Eosinphils - Answer>> 1%-4%

• Increased in parasitic infection WBC: Basophils - Answer>> 0.5%-1.5%
• normal during infection Airborne precautions (droplet nuclei smaller than 5 microns) - Answer>> Infection/condition:
• measles, chickenpox (varicella), disseminated varicella zoster, pulmonary or laryngeal tuberculosis Barrier protection:
• private room, negative-pressure airflow of at least 6 to 12 exchanges per hour via high-efficiency particulate air (HEPA) filtration
• mask or respiratory protection device, N95 respirator (depending on condition) Droplet precautions (droplets larger than 5 microns; being within 3 ft of the pt) - Answer>> Infection/condition:
• diphtheria (pharyngeal ), rubella, streptococcal pharyngitis, pneumonia or scarlet fever in infants and young children, pertussis, mumps, mycoplasma pneumonia, meningococcal pneumonia or sepsis, pneumonic plague Barrier protection:
• private room or cohort patients
• mask or respirator required (depending on condition) Contact precautions (direct patient or environmental contact) - Answer>> Infection/condition: