For each asepsis example, click to specify whether it describes medical asepsis or surgical asepsis.

Disinfecting a client's counter before administering oral medications

Covering the client and surrounding area with sterile drapes

Coving mouth and nose with a sue or elbow when coughing or sneezing

Allowing only sterile-to-sterile contact

Using sterile packaging for instruments and supplies

Using an autoclave to sterilize surgical instruments

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"B"},"F":{"answers":"B"}}

• Disinfecting a client's counter before administering oral medications: This practice reduces the number of microorganisms on surfaces to prevent infection, which is the principle of medical asepsis. It focuses on cleanliness and reducing contamination rather than creating a completely sterile environment.

• Covering the client and surrounding area with sterile drapes: Sterile drapes create a sterile field and prevent contamination of surgical or invasive sites. This is a key component of surgical asepsis, ensuring that instruments, supplies, and the environment remain free from microorganisms during procedures.

• Covering mouth and nose with a sleeve or elbow when coughing or sneezing: This prevents the spread of pathogens via droplets and maintains a clean environment. It is a basic principle of medical asepsis, which aims to reduce infection transmission through routine hygiene practices.

• Allowing only sterile-to-sterile contact: Maintaining a sterile field requires that sterile items only touch other sterile items. This is fundamental to surgical asepsis, preventing introduction of microorganisms during invasive procedures. Any break in sterile technique increases the risk of infection.

• Using sterile packaging for instruments and supplies: Sterile packaging preserves sterility until use, which is critical for surgical asepsis. It ensures that instruments and supplies remain free from microorganisms until the moment of use in invasive procedures.

• Using an autoclave to sterilize surgical instruments: Autoclaving uses high-pressure steam to destroy all microorganisms, achieving complete sterility. This process is a core component of surgical asepsis, making instruments safe for invasive procedures.

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Correct Answer is C

Explanation

A. Complete every dressing change using sterile technique: Not all wounds require sterile technique; many chronic or noninvasive wounds are appropriately managed with clean technique. Using sterile technique unnecessarily increases cost and does not improve outcomes for all wound types. Best practice involves selecting technique based on wound type and setting.

B. Quickly remove any tape from the client's skin before beginning: Rapid tape removal increases the risk of skin tears, especially in older adults or those with fragile skin. Proper technique involves supporting the skin and removing tape slowly in the direction of hair growth.

C. Gather supplies before beginning wound care procedures: Organizing all necessary supplies in advance maintains asepsis, prevents interruption of the procedure, and reduces the risk of contamination. This approach promotes efficiency, client safety, and adherence to infection prevention principles. Preparation is a foundational element of best practice nursing care.

D. Document wound care at the end of the shift to save time: Delayed documentation increases the risk of omitted or inaccurate information regarding wound appearance and interventions. Wound care findings should be documented promptly after completion to ensure accuracy and continuity of care. Timely documentation supports clinical decision-making.

A. Contact B. Standard C. Droplet D. Airborne

Correct Answer is D

Explanation

A. Contact: Contact precautions are used for infections transmitted by direct or indirect contact with the client or their environment, such as MRSA or C. difficile. Measles is not primarily spread through direct contact, so contact precautions alone are insufficient.

B. Standard: Standard precautions apply to all clients to prevent transmission of bloodborne and body fluid pathogens. While essential, standard precautions alone do not prevent airborne spread of highly contagious respiratory viruses like measles.

C. Droplet: Droplet precautions are used for pathogens transmitted via large respiratory droplets, such as influenza or pertussis. Measles virus is smaller than droplet size and can remain suspended in the air, so droplet precautions alone do not provide adequate protection.

D. Airborne: Measles is highly contagious via airborne transmission. Airborne precautions, including placement in a negative-pressure room and use of an N95 respirator by healthcare personnel, prevent inhalation of aerosolized virus particles. This is the required precaution for measles.

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For each asepsis example, click to specify whether it describes medical asepsis or surgical asepsis.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing to provide wound care for a group of clients in the outpatient setting. The nurse understands which action is considered best practice when providing wound care?

Correct Answer is C

Explanation

A nurse is caring for a client with measles. Which isolation precautions should the nurse implement?

Correct Answer is D

Explanation

The nurse observes a visitor of a client with meningitis. Which finding should concern the nurse?

The nurse plans care for a client with a wound positive for methicillin-resistant Staphylococcus aureus (MRSA). What action should the nurse include in the care of this client?

A nurse completes an assessment of a client just admitted from the emergency department. Which assessment finding(s) should concern the nurse? Select all that apply.

What is the most important action to prevent the transmission of microorganisms in the hospital setting?

Which statement(s) uphold the principles of sterility? Select all that apply.

Date/Time: 4/11/XXX 1402 Review the electronic health record. What is the client's risk for falls?

A nurse is planning client education about active range of motion (ROM) exercises. Which instruction should the nurse plan to include in the teaching?

The nurse is preparing to teach a client about modifiable defense mechanisms to prevent infection. Which modifiable defense mechanism should the nurse include in the teaching?