Your friend Joe recently visited the doctor for steroid injections into his knee to reduce swelling due to previous knee injury. Within a couple of days, he had an infection caused by Pseudomonas, a very pathogenic and drug resistant bacterium. Luckily, Joe went to the doctor immediately and received antibiotics. The doctor tells him that problem has occurred to many other people across the U.S. Predict the most likely cause of this situation:
The staff giving the steroid injections did not use proper aseptic technique.
The steroid was contaminated at the production plant, so all batches of that drug made at that plant were contaminated with the bacterium.
The bacterium is normally on the skin of people, so can easily access the patient's blood during the needle stick.
The needles were re-used and already contaminated before being used on the patients.
The Correct Answer is B
A. The staff giving the steroid injections did not use proper aseptic technique: Improper aseptic technique at a single clinic could cause local infections, but widespread cases across the U.S. point to a source affecting multiple clinics or batches rather than isolated procedure lapses.
B. The steroid was contaminated at the production plant, so all batches of that drug made at that plant were contaminated with the bacterium: Contamination during manufacture or compounding that led to distribution of contaminated batches nationwide can explain many cases across broad geographic areas and rapid onset after administration.
C. The bacterium is normally on the skin of people, so can easily access the patient's blood during the needle stick: While skin flora can cause infections after injections, Pseudomonas is primarily environmental and widespread patient infections clustered nationally are less consistent with routine skin flora transmission.
D. The needles were re-used and already contaminated before being used on the patients: Reused needles can cause outbreaks but would more likely produce clusters tied to a particular clinic or practitioner rather than many unrelated patients across the country.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Use a pressure cooker to sterilize the bottles, in steam: Steam under pressure (autoclaving or a pressure cooker) achieves high temperatures (e.g., 121 °C / 250 °F) with moist heat that inactivates microbes and spores much faster than dry heat ovens; switching to steam under pressure will greatly shorten sterilization time.
B. Increase the temperature of the oven by 5 degrees: A 5 °F increase is negligible relative to the large temperature and time changes required for faster sterilization and would not meaningfully speed up the process.
C. Pour an antimicrobial chemical into the bottles before placing into the oven: Adding chemicals may leave residues that are unsafe for baby feeding and would not substitute for validated sterilization; it also may not speed thermal sterilization.
D. Place the bottles outside in the sunlight and then place in the oven: Sunlight has limited disinfection ability (UV exposure) and will not meaningfully reduce the time required for oven sterilization; this step would not reliably speed the process.
Correct Answer is C
Explanation
A. The temperature of their environment: Temperature strongly affects enzyme activity, membrane fluidity, and overall metabolism, and thus directly influences microbial growth.
B. The acidity of their environment: Environmental pH affects enzyme function and membrane stability and is therefore a key factor in microbial growth.
C. The presence of non-essential nutrients: Non-essential nutrients are those the organism can synthesize or do not require for growth; their presence typically does not determine whether growth occurs, so they have minimal influence compared with essential factors.
D. The other microbes sharing their environment: Interactions with other microbes (competition, cooperation, predation, antibiotic production) can strongly influence growth rates and community composition.
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