Fundamentals Question #15

Question

The charge nurse is evaluating infection control practices on the unit. Which action by a nursing assistant indicates a need to provide additional education?

Answers

  1. Applying hand sanitizer before entering and upon leaving the client room.
    • Rationale:

      This answer is not correct because there is no need for additional education if a nursing assistant applies hand sanitizer before entering and upon leaving the client room. This is considered standard precautions to act as if everyone is infected and always perform hand hygiene.

  2. Discarding personal protective equipment (PPE) inside the room after care of a client with C. difficile
    • Rationale:

      This answer is not correct because discarding personal protective equipment (PPE) inside the room after care of a client with C. difficile is the correct procedure so the nursing assistant does not need further education. Contact precautions are instituted for the prevention of transference of infections that are at increased risk of contact transmission. Examples of infections that have the potential to be transmitted through contact include MRSA, VRE, open wounds, RSV, diarrheal illnesses, including C. diff.

  3. Washing hands and wearing gloves and mask before entering reverse isolation.
    • Rationale:

      This answer is not correct because washing hands and wearing gloves and masks before entering reverse isolation is the correct procedure so the nursing assistant does not need further education. Reverse isolation is an isolation precaution that protects the client from infection while other isolation precautions are implemented with the intent of protecting the caregiver from being infected by the client.

  4. Completing oral care of a client diagnosed positive for influenza with a face shield.
    • Rationale:

      This answer is correct because additional education is needed for a nursing assistant who completes oral care of a client positive for influenza with just a face shield. If contact with body fluids are a possibility, a gown, gloves, and goggles or eye protection should be donned before entering the room.

Overview

Additional education is needed for a nursing assistant who completes oral care of a client positive for influenza with a face shield. Wearing a mask, face shield, and gown will protect the health care worker against the influenza virus when completing oral care.

Explanation

Learning Outcomes

Proper infection control practices keep caregivers safe and prevent the spread of infections. For example, droplet precautions should be instituted if a client has probable or confirmed influenza or influenza-like symptoms. This should continue for 7 days from the onset of the infection or until symptoms have resolved over 24 hours. If contact with body fluids are a possibility, a gown, gloves, and goggles or eye protection should be donned before entering the room. For instance, if a caregiver is completing oral care on a client positive with influenza, a mask, face shield, and gown will protect the health care worker against the influenza virus. Standard precautions should always be implemented which is to act as though every person is infectious and perform hand hygiene before and after being around them. The PPE should be removed before leaving the client’s room and hand hygiene performed.

Test Taking Tip

Be very familiar with the various isolation precautions because NCLEX questions consistently address this.

Video Rationale