An 84-year-old patient is hospitalized for an infected stasis ulcer on his ankle. The nurse is aware that this patient is at risk for a hospital-acquired infection (HAI) because the:
Stasis ulcers predispose the older adult to pneumonia and urinary infections.
Patient's defenses are already engaged with the initial infection.
Ulcer will make this patient bedfast.
Patient already has a blood-borne infection.
Patient already has a blood-borne infection.
The Correct Answer is B
Choice A rationale
Stasis ulcers do not specifically predispose older adults to pneumonia and urinary infections. These infections have different primary risk factors and are not directly related to the presence of stasis ulcers.
Choice B rationale
The patient's defenses are already engaged with the initial infection, which can weaken the immune response and make the body more susceptible to additional infections, such as hospital-acquired infections (HAIs).
Choice C rationale
While being bedfast can increase the risk of pressure sores and related infections, it is not directly caused by the presence of a stasis ulcer. The patient's mobility status and overall health condition are more relevant factors.
Choice D rationale
The patient does not have a blood-borne infection. The presence of a stasis ulcer indicates a local infection, not a systemic blood-borne infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
While disposable gloves can reduce the transmission of pathogens, they should not replace proper hand hygiene. Gloves should be used when handling bodily fluids or when contact with infectious materials is likely, not necessarily for feeding an infant.
Choice B rationale
Keeping fingernails short and avoiding rings reduces the risk of harboring pathogens under nails and jewelry, which can be difficult to clean properly. This measure helps prevent the transmission of infections.
Choice C rationale
Washing hands up to the elbows is not necessary for routine home care and can cause skin irritation. Hand washing should focus on the hands and wrists, and the duration should be at least 20 seconds.
Choice D rationale
Home care still requires strict attention to medical asepsis, especially when caring for infants. Hand hygiene is necessary not only after toileting or handling soiled diapers but also before and after preparing food, feeding, and other activities.
Correct Answer is D
Explanation
Choice A rationale
Gloves should be removed before other PPE to prevent contamination from potentially dirty gloves. However, they are not the last piece to be removed.
Choice B rationale
Gowns should be removed after gloves to avoid contaminating the clothing and skin. However, the mask, which prevents inhalation of contaminants, should be the last to be removed.
Choice C rationale
Eyewear should be removed before the mask to prevent contamination from the hands. However, they are not the last piece to be removed.
Choice D rationale
The mask should be removed last to ensure that the respiratory system is protected until all other contaminated PPE has been removed. This helps reduce the risk of inhaling any remaining airborne contaminants.
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