Examkin

Question

Difficulty: HardStandard and Transmission-Based Precautions

While coordinating client care assignments and evaluating clinical protocols on a busy telemetry unit, the charge nurse observes several interactions involving transmission-based precautions. Which of the following actions by the nursing staff demonstrate appropriate adherence to infection control guidelines? Select all that apply.

  1. Leaving a dedicated stethoscope and blood pressure cuff inside the room of a client who is isolated for a vancomycin-resistant Enterococcus (VRE) infection.Answer
  2. Placing a standard surgical mask over the face of a client with Bordetella pertussis while they are being transported to the radiology department.Answer
  3. Utilizing soap and water for hand hygiene instead of an alcohol-based rub after exiting the room of a client with a Clostridioides difficile infection.Answer
  4. D
    Removing a fit-tested N95 respirator while still inside the negative-pressure room of a client being treated for measles.
  5. E
    Admitting a client with disseminated herpes zoster to a semi-private room alongside a client recovering from an uncomplicated appendectomy.
  6. F
    Delegating an unlicensed assistive personnel (UAP) to provide initial education to visitors regarding gown and glove use for a contact precaution room.

Answer

The appropriate actions are leaving dedicated equipment in the VRE client's room, placing a surgical mask on the pertussis client during transport, and using soap and water for hand hygiene after caring for the C. difficile client.
The correct selections represent exact adherence to evidence-based infection control standards: utilizing dedicated equipment for contact precaution organisms (VRE), applying source control by masking droplet precaution clients (pertussis) during transport, and employing mechanical friction with soap and water to eradicate spore-forming organisms (C. difficile).

Step-by-Step Solution

1
Identify the transmission-based precaution category required for each specific pathogen mentioned in the clinical scenario.
VRE (Contact), B. pertussis (Droplet), C. difficile (Contact-Enteric), Measles (Airborne), Disseminated Herpes Zoster (Airborne + Contact).
Accurate identification of the isolation tier is the foundational step in determining the correct environmental, equipment, and PPE protocols.
2
Evaluate the equipment handling and hand hygiene interventions.
Dedicating equipment for VRE prevents surface transmission. Washing hands with soap and water effectively mechanically removes C. difficile spores, whereas alcohol rubs do not.
These actions perfectly align with standard Contact and Enteric precaution protocols.
3
Analyze the transport procedures and PPE doffing sequences.
Masking the client with pertussis properly contains droplets during transport. However, removing an N95 respirator inside a measles room violates airborne protocols.
Airborne pathogens remain suspended in the negative-pressure room air; removing respiratory protection before exiting exposes the nurse to infection.
4
Assess the room placement choices and delegation decisions.
Disseminated herpes zoster cannot be placed in a semi-private room due to airborne transmission risk. Delegating initial isolation education to a UAP is outside their scope of practice.
Safe rooming and appropriate delegation are critical responsibilities of the RN that prioritize client safety and adhere to legal practice boundaries.

Key Concept

Application of precise transmission-based precautions (Airborne, Droplet, Contact) including PPE sequences, hand hygiene nuances, safe cohorting, and appropriate delegation boundaries.
Rate this question

Topics

Standard and Transmission-Based Precautions

More questions from this topic