Examkin

Question

Difficulty: HardStandard and Transmission-Based Precautions

An infection control nurse conducting a unit audit observes healthcare team members caring for a client placed on both airborne and enteric contact precautions due to suspected pulmonary tuberculosis and a confirmed Clostridioides difficile infection. Which of the following observed actions indicate a breach in infection control protocols that require immediate intervention? Select all that apply.

  1. An unlicensed assistive personnel (UAP) removes their N95 respirator inside the client's room immediately before exiting into the hallway.Answer
  2. A phlebotomist performs hand hygiene using an alcohol-based hand sanitizer in the hallway immediately after removing gloves.Answer
  3. A healthcare provider leaves the door to the client's room slightly ajar while reviewing the electronic health record on a workstation near the doorway.Answer
  4. D
    The registered nurse places a standard medical-surgical mask on the client prior to transport to the radiology department.
  5. E
    A respiratory therapist dons a disposable fluid-resistant gown, clean gloves, and a fit-tested N95 respirator prior to entering the client's room.
  6. F
    The charge nurse ensures that a dedicated disposable stethoscope and blood pressure cuff remain inside the client's room for all assessments.

Answer

The actions requiring intervention are: removing the N95 respirator inside the room, using an alcohol-based hand sanitizer instead of soap and water, and leaving the isolation room door ajar.
The selected actions indicate breaches in infection control. Airborne precautions require the N95 respirator to be removed only after exiting the negative-pressure room, and the room door must remain fully closed to maintain negative pressure. Enteric contact precautions for C. difficile require hand hygiene with soap and water, as alcohol-based sanitizers do not kill spores.

Step-by-Step Solution

1
Analyze the client's isolation requirements based on the diagnoses.
The client requires airborne precautions (for suspected tuberculosis) and enteric contact precautions (for Clostridioides difficile).
Identifying the correct precaution categories determines the required PPE and infection control protocols.
2
Evaluate each observed action against airborne precaution standards.
Removing the N95 inside the room and leaving the door ajar violate airborne precautions. Applying a standard mask to the client for transport is correct.
Airborne precautions require negative pressure (closed door) and respiratory protection until outside the contaminated environment.
3
Evaluate each observed action against enteric contact precaution standards.
Using alcohol-based sanitizer violates enteric contact precautions. Donning gown/gloves before entry and using dedicated equipment are correct.
C. difficile spores are resistant to alcohol and must be physically removed with soap and water.
4
Select the actions that represent breaches requiring intervention.
The correct selections are the respirator removal inside the room, use of alcohol sanitizer, and the open door.
The question specifically asks to identify the incorrect actions (breaches) performed by the staff.

Key Concept

When a client has multiple infectious processes, the healthcare team must implement protocols for all indicated transmission-based precautions simultaneously, understanding specific nuances like proper PPE doffing sequences and pathogen-specific hand hygiene requirements.
Rate this question

Topics

Standard and Transmission-Based Precautions

More questions from this topic