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An adult patient in the ICU has a central venous catheter in place. Over the past 24 hours, the patient has developed signs and symptoms that are suggestive of a central line associated bloodstream infection (CLABSI). What aspect of the patients care may have increased susceptibility to CLABSI?
- A. The patients central line was placed in the femoral vein.
- B. The patient had blood cultures drawn from the central line.
- C. The patient was treated for vancomycin-resistant enterococcus (VRE) during a previous admission.
- D. The patient has received antibiotics and IV fluids through the same line.
Correct Answer: A
Rationale: Femoral vein catheter placement increases CLABSI risk due to higher bacterial colonization. Blood cultures, prior VRE treatment, or combined IV fluids do not directly increase risk.
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A nurse is caring for a child who was admitted to the pediatric unit with infectious diarrhea. The nurse should be alert to what assessment finding as an indicator of dehydration?
- A. Labile BP
- B. Weak pulse
- C. Fever
- D. Diaphoresis
Correct Answer: B
Rationale: Weak pulse is a key sign of dehydration in children, along with thirst, dry mucous membranes, and poor skin turgor. Labile BP, fever, and diaphoresis are not specific to dehydration.
A patient has presented at the ED with copious diarrhea and accompanying signs of dehydration. During the patients health history, the nurse learns that the patient recently ate oysters from the Gulf of Mexico. The nurse should recognize the need to have the patients stool cultured for microorganisms associated with what disease?
- A. Ebola
- B. West Nile virus
- C. Legionnaires disease
- D. Cholera
Correct Answer: D
Rationale: Cholera is associated with shellfish consumption from the Gulf of Mexico, causing watery diarrhea. Ebola, West Nile, and Legionnaires have different transmission modes.
A long-term care facility is the site of an outbreak of infectious diarrhea. The nurse educator has emphasized the importance of hand hygiene to staff members. The use of alcohol-based cleansers may be ineffective if the causative microorganism is identified as what?
- A. Shigella
- B. Escherichia coli
- C. Clostridium difficile
- D. Norovirus
Correct Answer: C
Rationale: C. difficile spores resist alcohol-based cleansers, requiring soap and water handwashing. Shigella, E. coli, and Norovirus are susceptible to alcohol-based products.
A student nurse completing a preceptorship is reviewing the use of standard precautions. Which of the following practices is most consistent with standard precautions?
- A. Wearing a mask and gown when starting an IV line
- B. Washing hands immediately after removing gloves
- C. Recapping all needles promptly after use to prevent needlestick injuries
- D. Double-gloving when working with a patient who has a blood-borne illness
Correct Answer: B
Rationale: Handwashing after glove removal is a core standard precaution to prevent contamination. Masks, gowns, needle recapping, and double-gloving are not standard practices.
The nurse receives a phone call from a clinic patient who experienced fever and slight dyspnea several hours after receiving the pneumococcus vaccine. What is the nurses most appropriate action?
- A. Instruct the patient to call 911.
- B. Inform the patient that this is an expected response to vaccination.
- C. Encourage the patient to take NSAIDs until symptoms are relieved.
- D. Ensure that the adverse reaction is reported.
Correct Answer: D
Rationale: Fever and dyspnea post-vaccination require reporting via VAERS for monitoring. These are not expected reactions, and NSAIDs or 911 calls are not the first steps.