Put the following steps for removal of protective barriers after leaving an isolation room in order.

Remove and dispose of gloves.

Perform hand hygiene.

Remove eyewear or goggles.

Untie bottom and then top mask strings and remove from face.

Untie waist and neck strings of gown. Remove gown, rolling it onto itself without touching the contaminated side.

Answer and Explanation

The Correct Answer is A,C,E,D,B

Correct doffing (removal) of PPE is just as important as donning it. Most PPE surfaces are contaminated after client care; removing them in the wrong order greatly increases the risk of self-contamination and transmission to others. Move from clean to dirty.

Rationale for correct answer:

Step 1: Remove and dispose of gloves.

Gloves are typically the most contaminated item. Removing them first immediately lowers the bioburden on your hands (while using proper glove-removal technique to avoid touching the outside surface).

Step 2: Remove eyewear or goggles.

Eye protection may be contaminated by droplets/splashes. With gloves off, your (now cleaner) hands are less likely to contaminate your face when taking goggles off by the side arms/strap.

Step 3: Untie waist and neck strings of gown. Remove gown, rolling it onto itself without touching the contaminated side.

The gown’s front and sleeves are contaminated. Untie, then peel it away from the body, turning the contaminated surface inward to contain pathogens.

Step 4: Untie bottom and then top mask strings and remove from face.

Masks (or respirators) are removed last to maintain respiratory protection while you’re still handling other potentially contaminated PPE. Untying the bottom first, then top prevents the mask from falling forward against your face.

Step 5: Perform hand hygiene.

Always the final step to remove any microorganisms acquired during PPE removal.

Take home points:

Doff the dirtiest first (gloves) and finish with hand hygiene.
Never touch the contaminated fronts of gowns, masks, or goggles; handle by clean ties, straps, or inside surfaces only.

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Correct Answer is ["B","D"]

Explanation

Multidrug-resistant organisms (MDROs) are strains of bacteria that have developed resistance to multiple antibiotics, particularly broad-spectrum agents that are typically used as first-line treatments. These organisms pose a significant public health threat because they are harder to treat, often require more toxic or expensive medications.

Rationale for correct answer:

B. The antibiotics the patient has received are not strong enough to kill the organism: MDROs have developed resistance to antibiotics that would normally be effective. This resistance means that the usual antibiotics are no longer strong enough to treat the infection.

D. The organism has developed a resistance to one or more broad-spectrum antibiotics, indicating that the organism will be hard to treat effectively: These organisms are difficult to treat precisely because they have adapted to survive exposure to multiple common antibiotics.

Rationale for incorrect answers:

A. There is more than one organism in the wound that is causing the infection: This describes a polymicrobial infection, not a multidrug-resistant organism. MDRO refers to a single organism that is resistant to several antibiotics.

E. There are no longer any antibiotic options available to treat the patient’s infection: While MDROs are difficult to treat, there are usually still some options available, though they may be more limited or have greater side effects.

Take home points:

MDROs are single organisms resistant to multiple antibiotics, making infections harder to treat and control.
Educating patients about antibiotic resistance and the importance of completing prescribed antibiotics helps prevent the emergence of MDROs.

A. Last tetanus booster was at age 50 B. Receives a flu shot every year C. Has not received the hepatitis B vaccine D. Has not received the hepatitis A vaccine E. Has not received the herpes zoster vaccine

Correct Answer is ["B","C","D"]

Explanation

Immunization in older adults is a key preventive strategy to reduce morbidity and mortality from vaccine-preventable diseases. For adults 65 years and older without specific risk factors, ensuring up-to-date status on influenza, tetanus, and zoster vaccines is crucial.

Rationale for correct answer:

B. Receives a flu shot every year: Annual influenza vaccination is strongly recommended for all individuals aged 6 months and older, and especially for adults over 65, due to higher risk of severe complications.

C. Has not received the hepatitis B vaccine: Hepatitis B vaccination is not routinely indicated for adults unless they are in a high-risk group (e.g., healthcare workers, IV drug users, diabetics under 60). This client has no risk factors, so it's not required.

D. Has not received the hepatitis A vaccine: Hepatitis A vaccine is given to those at increased risk (e.g., travelers to endemic areas, people with chronic liver disease, drug users). It's not a routine vaccine for healthy older adults with no risk.

Rationale for incorrect answers:

A. Last tetanus booster was at age 50: Tetanus boosters (Td or Tdap) are recommended every 10 years. Since the client received the last booster at age 50, another is due by age 60.

E. Has not received the herpes zoster vaccine: The Shingrix vaccine (2 doses, 2–6 months apart) is recommended for all adults aged 50 and above, regardless of prior shingles history. The absence of this vaccine means the client is not current.

Take home points:

Adults aged 65 and above should receive:

the annual flu vaccine
stay up-to-date on tetanus boosters (every 10 years)
receive the shingles vaccine even if they’ve had shingles before.

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Put the following steps for removal of protective barriers after leaving an isolation room in order.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is diagnosed with a multidrug-resistant organism (MDRO) in his surgical wound and asks the nurse what this means. What is the nurse’s best response? Select all that apply

Correct Answer is ["B","D"]

Explanation

The nurse evaluates the chart of a 65-year-old client with no apparent risk factors and concludes that which immunizations are current? Select all that apply

Correct Answer is ["B","C","D"]

Explanation

In caring for a client on contact precautions for a draining infected foot ulcer, which action should the nurse perform?

A patient is placed on airborne precautions for pulmonary tuberculosis. The nurse notes that the patient seems to be angry, but the nurse recognizes that this is a normal response to isolation. Which is the nurse’s best intervention?

The client is a chronic carrier of infection. To prevent the spread of the infection to other clients or health care providers, the nurse emphasizes interventions that do which of the following?

Which is the most effective nursing action for preventing and controlling the spread of infection?

A patient who has been placed on contact precautions for Clostridium difficile (C. difficile) asks you to explain what he should know about this organism. Which statements made by the patient show an understanding of the patient teaching? Select all that apply

The nurse assesses the following data from a patient with diabetes mellitus who is 4 days postoperative for repair of an abdominal aortic aneurysm. Which assessment finding is of greatest concern for the nurse?

Which type of personal protective equipment should the nurse wear when caring for a pediatric patient who is placed on airborne precautions for confirmed chickenpox/herpes zoster? Select all that apply

A patient is diagnosed with meningitis. Which type of isolation precaution is most appropriate for this patient?