NACE Safety and Infection Control 2 — Questions and Answers
Question 1: Which type of isolation precaution is required for a patient diagnosed with tuberculosis?
- Contact precautions
- Droplet precautions
- Airborne precautions (Correct answer)
- Standard precautions only
Correct answer: Airborne precautions
Tuberculosis is transmitted via airborne droplet nuclei that remain suspended in the air, requiring airborne precautions including an N95 respirator and negative pressure room.
Airborne precautions are required for pathogens transmitted via droplet nuclei (less than 5 micrometers) that remain suspended in air. TB, measles, and varicella require airborne precautions: negative pressure room, N95 respirator, and surgical mask on patient during transport.
Question 2: A nurse is implementing fall prevention for a patient taking multiple medications. Which medication class poses the greatest fall risk?
- Antibiotics
- Benzodiazepines (Correct answer)
- Proton pump inhibitors
- Thyroid hormones
Correct answer: Benzodiazepines
Benzodiazepines cause sedation, impaired balance, dizziness, and muscle relaxation, significantly increasing fall risk, especially in elderly patients.
Benzodiazepines are among the highest-risk medications for falls due to their CNS depressant effects: sedation, impaired psychomotor function, decreased reaction time, ataxia, and muscle relaxation. The Beers Criteria identifies benzodiazepines as potentially inappropriate for older adults.
Question 3: A patient's culture results show Clostridioides difficile (C. diff) infection. Which precaution must the nurse implement?
- Airborne precautions with N95 respirator
- Contact precautions with soap and water hand hygiene (Correct answer)
- Droplet precautions with surgical mask
- Standard precautions with alcohol-based hand rub
Correct answer: Contact precautions with soap and water hand hygiene
C. difficile forms spores that are resistant to alcohol-based hand sanitizers. Contact precautions with soap and water hand washing are required to physically remove spores.
C. difficile spores are highly resistant to alcohol-based hand sanitizers. Required precautions: contact isolation (gown and gloves), dedicated patient care equipment, soap and water hand hygiene, and bleach-based environmental cleaning.
Question 4: A nurse accidentally sustains a needlestick injury from a contaminated needle. What is the priority first action?
- Report to the supervisor immediately
- Wash the site thoroughly with soap and water (Correct answer)
- Go to the emergency department for testing
- File an incident report
Correct answer: Wash the site thoroughly with soap and water
The immediate first action after a needlestick injury is to wash the wound thoroughly with soap and water to reduce the risk of pathogen transmission.
After a needlestick injury, wash the wound site immediately with soap and water for at least 20 seconds. Do NOT squeeze the wound. Then report to the supervisor and occupational health, and arrange for source patient testing and post-exposure prophylaxis if indicated.
Question 5: What is the correct method for performing surgical hand antisepsis before an operative procedure?
- Apply alcohol-based hand rub for 15 seconds
- Scrub hands and arms to 2 inches above the elbows for 2-6 minutes (Correct answer)
- Wash hands with regular soap for 30 seconds
- Apply gloves without hand washing if hands appear clean
Correct answer: Scrub hands and arms to 2 inches above the elbows for 2-6 minutes
Surgical hand antisepsis requires scrubbing hands and forearms to 2 inches above the elbows with an antimicrobial agent for 2-6 minutes to reduce transient and resident flora.
Surgical hand antisepsis involves scrubbing from fingertips to 2 inches above the elbows using an antimicrobial agent for 2-6 minutes. Hands must be kept higher than elbows throughout to prevent contaminated water from flowing back.
Question 6: A nurse discovers that the wrong patient received a medication intended for another patient in the same room. After assessing the patient, what documentation is required?
- Document the event in the patient's medical record and file an incident report (Correct answer)
- Document only in the incident report to protect against litigation
- Do not document the error to avoid legal liability
- Document in the medical record only with no additional reporting
Correct answer: Document the event in the patient's medical record and file an incident report
Both medical record documentation (factual account of what occurred, assessment findings, and interventions) and an incident report (for quality improvement and risk management) are required.
After a medication error, two types of documentation are required: (1) Medical record: factual account of what was administered, patient assessment, physician notification, and treatments. (2) Incident report: completed for risk management and quality improvement. Do NOT reference the incident report in the medical record.
NACE Safety and Infection Control 2
Which type of isolation precaution is required for a patient diagnosed with tuberculosis?