Fundamentals of Nursing Review Questions Part II | NCLEX Review

1. Which of the following procedures always requires surgical asepsis?
1. Vaginal instillation of conjugated estrogen
2. Urinary catheterization
3. Nasogastric tube insertion
4. Colostomy irrigation
2. Sterile technique is used whenever:
1. Strict isolation is required
2. Terminal disinfection is performed
3. Invasive procedures are performed
4. Protective isolation is necessary
3. Which of the following constitutes a break in sterile technique while preparing a sterile field for a dressing change?
1. Using sterile forceps, rather than sterile gloves, to handle a sterile item
2. Touching the outside wrapper of sterilized material without sterile gloves
3. Placing a sterile object on the edge of the sterile field
4. Pouring out a small amount of solution (15 to 30 ml) before pouring the solution into a sterile container
4. A natural body defense that plays an active role in preventing infection is:
1. Yawning
2. Body hair
3. Hiccupping
4. Rapid eye movements
5. All of the following statement are true about donning sterile gloves except:
1. The first glove should be picked up by grasping the inside of the cuff.
2. The second glove should be picked up by inserting the gloved fingers under the cuff outside the glove.
3. The gloves should be adjusted by sliding the gloved fingers under the sterile cuff and pulling the glove over the wrist
4. The inside of the glove is considered sterile

1. B. The urinary system is normally free of microorganisms except at the urinary meatus. Any procedure that involves entering this system must use surgically aseptic measures to maintain a bacteria-free state.
2. C. All invasive procedures, including surgery, catheter insertion, and administration of parenteral therapy, require sterile technique to maintain a sterile environment. All equipment must be sterile, and the nurse and the physician must wear sterile gloves and maintain surgical asepsis. In the operating room, the nurse and physician are required to wear sterile gowns, gloves, masks, hair covers, and shoe covers for all invasive procedures. Strict isolation requires the use of clean gloves, masks, gowns and equipment to prevent the transmission of highly communicable diseases by contact or by airborne routes. Terminal disinfection is the disinfection of all contaminated supplies and equipment after a patient has been discharged to prepare them for reuse by another patient. The purpose of protective (reverse) isolation is to prevent a person with seriously impaired resistance from coming into contact who potentially pathogenic organisms.
3. C. The edges of a sterile field are considered contaminated. When sterile items are allowed to come in contact with the edges of the field, the sterile items also become contaminated.
4. B. Hair on or within body areas, such as the nose, traps and holds particles that contain microorganisms. Yawning and hiccupping do not prevent microorganisms from entering or leaving the body. Rapid eye movement marks the stage of sleep during which dreaming occurs.
5. D. The inside of the glove is always considered to be clean, but not sterile. 

Fundamentals of Nursing Review Questions Part I

1. Which element in the circular chain of infection can be eliminated by preserving skin integrity? 
a. Host
b. Reservoir
c. Mode of transmission
d. Portal of entry

2. Which of the following patients is at greater risk for contracting an infection? 
a. A patient with leukopenia
b. A patient receiving broad-spectrum antibiotics
c. A postoperative patient who has undergone orthopedic surgery
d. A newly diagnosed diabetic patient

3. Which of the following will probably result in a break in sterile technique for respiratory isolation? 
a. Opening the patient’s window to the outside environment
b. Turning on the patient’s room ventilator
c. Opening the door of the patient’s room leading into the hospital corridor
d. Failing to wear gloves when administering a bed bath

4. Effective hand washing requires the use of: 
a. Soap or detergent to promote emulsification
b. Hot water to destroy bacteria
c. A disinfectant to increase surface tension
d. All of the above

5. After routine patient contact, hand washing should last at least: 
a. 30 seconds
b. 1 minute
c. 2 minute
d. 3 minutes

1. D. In the circular chain of infection, pathogens must be able to leave their reservoir and be transmitted to a susceptible host through a portal of entry, such as broken skin.
2. A. Leukopenia is a decreased number of leukocytes (white blood cells), which are important in resisting infection. None of the other situations would put the patient at risk for contracting an infection; taking broad-spectrum antibiotics might actually reduce the infection risk.
3. C. Respiratory isolation, like strict isolation, requires that the door to the door patient’s room remain closed. However, the patient’s room should be well ventilated, so opening the window or turning on the ventricular is desirable. The nurse does not need to wear gloves for respiratory isolation, but good hand washing is important for all types of isolation.
4. A. Soaps and detergents are used to help remove bacteria because of their ability to lower the surface tension of water and act as emulsifying agents. Hot water may lead to skin irritation or burns.
5. A. Depending on the degree of exposure to pathogens, hand washing may last from 10 seconds to 4 minutes. After routine patient contact, hand washing for 30 seconds effectively minimizes the risk of pathogen transmission