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Competency Appraisal

1
SAFETY AND INFECTION CONTROL
EXAMINATION

1. The use of interpersonal


decision making, psychomotor
skills,
and
application
of
knowledge expected in the role
of a licensed health care
professional in the context of
public health welfare and safety
is an example of:
A. Delegation
B. Responsibility
C. Supervision

Answer:
D.
Competence

2. Which of the following


should be given highest
priority
when
receiving
patient in the OR?
A. Assess
level
consciousness

of

B. Verify patient identification


and informed consent
C. Assess vital signs
D. Check for jewelry, gown,

Answer:
B. Verify
patient
identification
and informed
consent

3. Surgeries like I and D


(incision and drainage) and
debridement are relatively
short
procedures
but
considered
dirty
cases.
When are these procedures
best scheduled?
A. Last case
B. In between cases
C. According to availability of

Answer:
A. Last case

4. OR nurses should be aware that maintaining the clients


safety is the overall goal of nursing care during the
intraoperative phase. As the circulating nurse, you make
certain that throughout the procedure
A. the surgeon greets his client before induction of anesthesia
B. the surgeon and anesthesiologist are in tandem
C. strap made of strong non-abrasive materials are fastened
securely around the joints of the knees and ankles and around
the 2 hands around an arm board.
D. Client is monitored throughout the surgery by the assistant

Answer:
C. strap made of strong nonabrasive materials are fastened
securely around the joints of
the knees and ankles and
around the 2 hands around an
arm board.

5. Another nursing check that


should not be missed before
the induction of general
anesthesia is:
A. check
for
underwear

presence

B. check
dentures

presence

for

C. check patients ID

Answer:
D. check
baseline vital
signs

6. Some lifetime habits and


hobbies affect postoperative
respiratory function. If your
client smokes 3 packs of
cigarettes a day for the past 10
years, you will anticipate
increased risk for:
A. perioperative
stress

anxiety

and

B. delayed coagulation time

Answer:
D.
Postoperative
respiratory
infection

7. There are 3 general types of


sterilization use in the hospital,
which one is not included?
A. Steam sterilization
B. Physical sterilization
C. Chemical sterilization
D. Sterilization by boiling

Answer:
D.
Sterilization
by boiling

8. It is important that before a


nurse prepares the material to
be
sterilized,
a
chemical
indicator strip should be placed
above the package, preferably,
Muslin sheet. What is the color
of the striped produced after
autoclaving?
A. Black
B. Blue

Answer:
A. Black

9. Which of the following role


would be the responsibility of
the scrub nurse?
A. Assess the readiness of the
client prior to surgery
B. Ensure that the airway is
adequate
C. Account for the number of
sponges,
needles, supplies,
used
during
the
surgical

Answer:
C. Account for the
number of
sponges, needles,
supplies, used
during the surgical
procedure.

10. As a perioperative nurse,


how can you best meet the
safety need of the client after
administering
preoperative
narcotic?
A. Put side rails up and ask the
client not to get out of bed
B. Send the client to OR with
the family
C. Allow client to get up to go

Answer:
A. Put side rails
up and ask the
client not to
get out of bed

11. It is also the nurses


function to determine when
infection is developing in the
surgical
incision.
The
perioperative
nurse
should
observe for what signs of
impending infection?
A. Localized heat and redness
B. Serosanguinous
and skin blanching

exudates

Answer:
A. Localized
heat and
redness

12. Which of the following


nursing interventions is done
when examining the incision
wound
and
changing
the
dressing?
A. Observe the dressing and
type and odor of drainage if
any
B. Get patients consent
C. Wash hands

Answer:
A. Observe the
dressing and
type and odor
of drainage if
any

13. Rosie, 57, who is diabetic is for debridement if incision


wound. When the circulating nurse checked the present IV
fluid, she found out that there is no insulin incorporated as
ordered. What should the circulating nurse do?
A. Double check the doctors order and call the attending MD
B. Communicate with the ward nurse to verify if insulin was
incorporated or not
C. Communicate with the client to verify if insulin was
incorporated
D. Incorporate insulin as ordered.

Answer:
A. Double check
the doctors order
and call the
attending MD

14. The nursing management of


anxiety
related
with
posttraumatic stress disorder includes
all of the following EXCEPT:
A. Encourage participation in
recreation or sports activities
B. Reassure clients safety while
touching client
C. Speak in a calm soothing voice
D. Remain with the client while

Answer:
B. Reassure
clients safety
while touching
client

15. Nurse Ron is assisting with transferring a client from the


operating room table to a stretcher. To provide safety to the
client, the nurse should:
A. Moves the client rapidly from the table to the stretcher.
B. Uncovers the client completely before transferring to the
stretcher.
C. Secures the client safety belts after transferring to the
stretcher.
D. Instructs the client to move self from the table to the

Answer:
C.
Secures the client safety
transferring to the stretcher.

belts

after

Rationale: At the time of the transfer from the


surgery table to the stretcher, the client is still
affected by the effects of the anesthesia;
therefore, the client should not move self. Safety
belts can prevent the client from falling off the

Answer:
16. Nurse Myrna is providing
instructions to a nursing assistant
assigned to give a bed bath to a
client
who
is
on
contact
precautions.
Nurse
Myrna
instructs the nursing assistant to
use which of the following
protective items when giving bed
bath?
A. Gown and goggles
B. Gown and gloves

B. Gown and gloves


Rationale: Contact
precautions require the
use of gloves and a gown
if direct client contact is
anticipated. Goggles are
not necessary unless the
nurse anticipates the
splashes of blood, body
fluids, secretions, or
excretions may occur.
Shoe protectors are not

17.
Mr.
Regalado
will
be
discharged from your unit within
the hour. Nursing actions when
preparing a client for discharge
include all EXCEPT:
A. Making a final physical
assessment before client leaves
the hospital
B. Giving instructions about his
medication regimen

Answer:
C. Walking the
client to the
hospital exit
to ensure his
safety

18. To ensure the client safety before starting blood


transfusion the following are needed before the procedure can
be done EXCEPT:
A. take baseline vital signs
B. blood should be warmed to room temperature for 30
minutes before blood transfusion is administered
C. have two nurses verify client identification, blood type, unit
number and expiration date of blood
D. get a consent signed for blood transfusion

Answer:
D. get a consent
signed
for
blood
transfusion

19. Part of standards of care has


to do with the use of restraints.
Which of the following statements
is NOT true?
A. Doctors order for restraints
should be
signed within 24
hours
B. Remove and reapply restraints
every two hours
C. Check clients pulse, blood

Answer:
C. Check
clients pulse,
blood pressure
and circulation
every four hours

20. As a nurse. You reviewed


infant safety procedures with
Bryan's mother. What are two of
the most common types of
accidents among infants?
A. Aspiration and falls
B. Falls and auto accidents
C. Poisoning and burns
D. Drowning and homicide

Answer:
A. Aspiration
and falls

21. As a nurse, your primary focus


in the workplace is the client's
safety. However, personal safety
is also a concern. You can
communicate hazards to your
coworkers through the use of the
following EXCEPT:
A. Formal training
B. Posters
C. Posting IR in the bulletin board

Answer:
C. Posting IR in
the bulletin
board

22. Before bedtime, you went to


ensure Kyle's safety in 'bed. You
will do which of the following:
A. Put the lights on
B. Put the side rails up
C. Test the call system
D. Lock the doors

Answer:
B. Put the side
rails up

23. Randy has chest tubes


attached to a pleural drainage
system. When caring for him you
should:
A. empty the drainage system at
the end of the shift
B. clamp the chest tube when
suctioning
C. palpate the surrounding areas
for crepitus

Answer:
C. palpate the
surrounding
areas for
crepitus

24. Using the principles of


standard precautions, the nurse
would wear gloves in what
nursing interventions?
A. Providing a back massage
B. Feeding a client
C. Providing hair care
D. Providing oral hygiene

Answer:
D. Providing
oral hygiene

25. The nurse is preparing to take


vital sign in an alert client
admitted to the hospital with
dehydration
secondary
to
vomiting and diarrhea. What is
the best method used to assess
the clients temperature?
A. Oral
B. Axillary
C. Radial

Answer:
B. Axillary

26. Which of the following actions


should the nurse take to use a
wide base support when assisting
a client to get up in a chair?
A. Bend at the waist and place
arms
under the clients arms
and lift
B. Face the client, bend knees and
place hands on clients forearm
and lift

Answer:
B. Face the
client, bend
knees and place
hands on clients
forearm and lift

27. A client is hospitalized for the


first time, which of the following
actions ensure the safety of the
client?
A. Keep unnecessary furniture out
of the way
B. Keep the lights on at all time
C. Keep side rails up at all time
D. Keep all equipment out of view

Answer;
C. Keep side
rails up at all
time

28. When performing oral care to


an unconscious client, which of the
following is a special consideration
to prevent aspiration of fluids into
the lungs?
A. Put the client on a side lying
position with head of bed
lowered
B. Keep the client dry by placing
towel under the chin
C. Wash

hands

and

observes

Answer:
A. Put the
client on a side
lying position
with head of
bed lowered

29. The advantages of oral care


for a client include all of the
following, EXCEPT:
A. decreases bacteria
mouth and teeth

in

the

B. reduces
need
to
use
commercial mouthwash which
irritate the buccal mucosa
C. improves clients appearance
and self- confidence

Answer:
B. reduces need
to use
commercial
mouthwash
which irritate the
buccal mucosa

30.
How
will
you
prevent
ascending infection to Eileen who
has an indwelling catheter?
A. see to it that the drainage
tubing touches the level of the
urine
B. change he catheter every eight
hours
C. see to it that the drainage
tubing does not touch the level of

Answer:
C. see to it that
the drainage
tubing does not
touch the level
of the urine

31. Which element in the circular


chain
of
infection
can
be
eliminated by preserving skin
integrity?
A. Host
B. Reservoir
C. Mode of transmission
D. Portal of entry

Answer:
D. In the circular
chain of infection,
pathogens must be
able to leave their
reservoir and be
transmitted to a
susceptible host
through a portal of
entry, such as
broken skin.

Answer:

32. Which of the following will


probably result in a break in sterile
technique for respiratory isolation?
A. Opening the patients window to
the outside environment
B. Turning on the patients room
ventilator
C. Opening the door of the
patients room leading into the
hospital corridor

C. Respiratory isolation,
like strict isolation,
requires that the door to
the door patients room
remain closed. However,
the patients room should
be well ventilated, so
opening the window or
turning on the ventricular
is desirable. The nurse
does not need to wear
gloves for respiratory
isolation, but good hand
washing is important for
all types of isolation.

33. Which of the following


patients is at greater risk for
contracting an infection?
A. A patient with leukopenia
B. A patient receiving
spectrum antibiotics

broad-

C. A postoperative patient who


has
undergone
orthopedic
surgery
D. A

newly

diagnosed

diabetic

A. Leukopenia is a
decreased number
of leukocytes (white
blood cells), which
are important in
resisting infection.
None of the other
situations would put
the patient at risk
for contracting an
infection; taking
broad-spectrum
antibiotics might
actually reduce the

Answer:
34.
Effective
hand
requires the use of:

washing

A. Soap or detergent to promote


emulsification
B. Hot water to destroy bacteria
C. A disinfectant
surface tension
D. All of the above

to

increase

A. Soaps and
detergents are used
to help remove
bacteria because of
their ability to lower
the surface tension
of water and act as
emulsifying agents.
Hot water may lead
to skin irritation or

Answer:

35. Which of the


procedures
always
surgical asepsis?

following
requires

A. Vaginal
instillation
conjugated estrogen
B. Urinary catheterization
C. Nasogastric tube insertion
D. Colostomy irrigation

of

B. The urinary
system is normally
free of
microorganisms
except at the
urinary meatus. Any
procedure that
involves entering
this system must
use surgically
aseptic measures to
maintain a bacteria-

Answer:

36. Sterile
whenever:

technique

is

used

A. Strict isolation is required


B. Terminal
performed

disinfection

is

C. Invasive
performed

procedures

are

D. Protective
necessary

isolation

is

C. All invasive
procedures, including
surgery, catheter
insertion, and
administration of
parenteral therapy,
require sterile
technique to maintain
a sterile environment.
All equipment must be
sterile, and the nurse
and the physician must
wear sterile gloves and
maintain surgical

37. Which of the following constitutes a break in


sterile technique while preparing a sterile field for
a dressing change?
A. Using sterile forceps, rather than sterile gloves,
to handle a sterile item
B. Touching the outside wrapper of sterilized
material without sterile gloves
C. Placing a sterile object on the edge of the sterile
field

Answer:
C. The edges of a sterile field are
considered contaminated. When sterile
items are allowed to come in contact
with the edges of the field, the sterile
items also become contaminated.

38. A natural body defense that


plays an active role in preventing
infection is:
A. Yawning
B. Body hair
C. Hiccupping
D. Rapid eye movements

B. Hair on or within
body areas, such as
the nose, traps and
holds particles that
contain
microorganisms.
Yawning and
hiccupping do not
prevent
microorganisms from
entering or leaving the
body. Rapid eye
movement marks the
stage of sleep during

39. All of the following statement are true about


donning sterile gloves except:
A. The first glove should be picked up by grasping
the inside of
the cuff.
B. The second glove should be picked up by
inserting the
gloved fingers under the cuff
outside the glove.
C. The gloves should be adjusted by sliding the
gloved fingers under the sterile cuff and pulling
the glove over the wrist

Answer:
D. The inside of the
glove is always
considered to be clean,
but not sterile

40.
When
removing
a
contaminated gown, the nurse
should be careful that the first
thing she touches is the:
A. Waist tie and neck tie at the
back of the gown
B. Waist tie in front of the gown
C. Cuffs of the gown
D. Inside of the gown

A. The back of the gown


is considered clean, the
front is contaminated. So,
after removing gloves and
washing hands, the nurse
should untie the back of
the gown; slowly move
backward away from the
gown, holding the inside
of the gown and keeping
the edges off the floor;
turn and fold the gown
inside out; discard it in a
contaminated linen
container; then wash her

41. Which of the following nursing


interventions is considered the
most effective form or universal
precautions?
A. Cap all used needles before
removing
them
from
their
syringes
B. Discard all used uncapped
needles and syringes in an
impenetrable
protective
container

B. According to the Centers


for Disease Control (CDC),
blood-to-blood contact occurs
most commonly when a
health care worker attempts
to cap a used needle.
Therefore, used needles
should never be recapped;
instead they should be
inserted in a specially
designed puncture resistant,
labeled container. Wearing
gloves is not always
necessary when
administering an I.M.
injection. Enteric precautions
prevent the transfer of

42. Effective skin disinfection before a surgical procedure


includes which of the following methods?
A. Shaving the site on the day before surgery
B. Applying a topical antiseptic to the skin on the evening
before surgery
C. Having the patient take a tub bath on the morning of
surgery
D. Having the patient shower with an antiseptic soap on the
evening before and the morning of surgery

Answer:
D. Studies have shown that showering with an
antiseptic soap before surgery is the most effective
method of removing microorganisms from the skin.
Shaving the site of the intended surgery might cause
breaks in the skin, thereby increasing the risk of
infection; however, if indicated, shaving, should be
done immediately before surgery, not the day before. A
topical antiseptic would not remove microorganisms
and would be beneficial only after proper cleaning and

43. When transferring a patient


from a bed to a chair, the nurse
should use which muscles to
avoid back injury?
A. Abdominal muscles
B. Back muscles
C. Leg muscles
D. Upper arm muscles

Answer:
C. The leg muscles
are the strongest
muscles in the body
and should bear the
greatest stress
when lifting.
Muscles of the
abdomen, back, and
upper arms may be
easily injured.

44. Bernadette is a 22-year old


woman. Which condition would
make her more prone than others
to developing a Candida infection
during pregnancy?
A. Her husband plays gold 6 days
a week
B. She was over 35 when she
became pregnant
C. She usually drinks tomato juice

Answer:
D. She has
developed
gestational
diabetes

45. The most dependable sign of


infection in the older patient is:
A. change in mental status

Answer:

B. fever

A. change in
mental status

C. Pain
D. decreased breath sound with
crackles

46. You are a member of the infection control team, of the


hospital. Based on a feedback during the meeting of the
committee there is an increased incidence of pseudomonas
infection in the Burn Unit (3 out of 10 patients had positive
blood and wound culture). What is your priority activity?
A. Establish policies for surveillance and monitoring
B. Do data gathering about the possible sources of infection
(observation, chart review, interview)
C. Assign point persons who can implement policies
D. Meet with the nursing group working in the burn unit and

Answer:
A. Establish policies for surveillance
and monitoring

47. Which of the following term


most precisely refer to an
infection acquired in the hospital
that
was
not
present
or
incubating at the time of hospital
admission?
A. Secondary
infection

bloodstream

B. Nosocomial infection
C. Emerging infectious disease

Answer:
B. Nosocomial
infection

48. A client is experiencing


anxiety
attack.
The
most
appropriate nursing intervention
should include?
A. Turning on the television
B. Leaving the client alone
C. Staying with the client and
speaking in short sentences
D. Ask the client to play with

Rationale:
Appropriate
nursing
interventions for
an anxiety attack
include using
short sentences,
staying with the
client, decreasing
stimuli, remaining
calm and
medicating as
needed.

49. The physician requests a pair of sterile scissors. A pair of


scissors found at the bedside is in an original factory wrapping
that has been opened but taped closed again. Which of the
following should the nurse do?
A. Check the hospital policy manual regarding use of opened
supplies.
B. Obtain a pair of sterile scissors that have not been opened.
C. Provide the scissors to the physician because they are
available and probably have not been used.

Answer:
B. Obtain a pair of sterile
scissors that have not been
opened.

50. A nurse is pulled from a


medical/surgical floor to the
psychiatric unit. Which client
would the nurse manager assign
to this nurse?
A. A chronically depressed client.
B. An actively psychotic client.
C. A client experiencing paranoid
thinking
D. A client diagnosed with cluster

Answer:
A. Because there is no
indication that this
client is suicidal, of the
four clients presented,
this client is most
appropriate to assign
to the medical/surgical
nurse.

Thank You!

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