Test Bank for Fundamental Nursing Skills and Concepts Tenth Edition

Test Bank for Fundamental Nursing Skills and

Concepts Tenth Edition

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1. A nurse is caring for a client with Lyme disease. Which of the following causes Lyme
disease?
A) Rickettsiae
B) Fungi
C) Protozoans
D) Mycoplasmas
Ans: A
Feedback:
Rickettsiae that resemble bacteria cause Lyme disease. Intermediate life forms such as
fleas, ticks, lice, or mites transmit rickettsial diseases to humans. Fungi include yeasts
and molds, which cause infections in the skin, mucous membranes, hair, and nails.
Examples of fungal infections include ringworm, athlete's foot, and vaginal yeast
infection. Protozoans are single-celled animals classified according to their ability to
move. Mycoplasmas infect the surface linings of the respiratory, genitourinary, and
gastrointestinal tracts. Fungi, protozoans, and mycoplasmas do not cause Lyme disease.

2. A nurse is attending to a client with an infectious disease. After changing the linen and
caring for the patient, the nurse uses an alcohol-based hand rub. Which of the following
is a reason for the nurse to use an alcohol-based hand rub?
A) It destroys microbial spores on the skin.
B) It provides the greatest reduction in microbial counts.
C) It destroys potentially harmful keratin skin cells.
D) It alters viral replication on the skin.
Ans: B
Feedback:
The nurse uses an alcohol-based hand rub as it provides the fastest and greatest
reduction in microbial counts on the skin. Other advantages include: alcohol-based hand
rubs are more accessible because they do not require sinks or water; they increase
compliance because they are easier to perform; they reduce costs by eliminating paper
towels and waste management; and they are less irritating and drying than soap because
they contain emollients. They can kill viruses but do not alter viral replication. They do
not kill skin cells and they are ineffective against some spores.

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3. A nurse is observing the housekeeping staff when they are cleaning the premises of a
health care facility. Which of the following principles should the housekeeping staff
follow for medical asepsis?
A) Wet-mop floors to avoid distributing microorganisms.
B) Clean grossly dirty areas before less-soiled areas.
C) Dust the furniture with a dry cloth to avoid spreading microorganisms.
D) Place clean items carefully on the floor.
Ans: A
Feedback:
Housekeepers who follow the principles of medical asepsis carry out concurrent
disinfection methods. The housekeeping personnel should wet-mop floors and
damp-dust furniture to avoid distributing microorganisms on dust and air currents. They
should never place clean items on the floor or on the furniture. They should always
clean less-soiled areas before grossly dirty ones.

4. A home-care nurse is caring for an elderly client with a throat infection at the client's
residence. The nurse uses a stainless steel instrument to examine the client's throat. At
what temperature should the device be boiled to sterilize it?
A) 5 minutes at 152°F
B) 15 minutes at 152°F
C) 5 minutes at 212°F
D) 15 minutes at 212°F
Ans: D
Feedback:
Boiling water is a convenient way to sterilize items used at home. To be effective,
contaminated equipment needs to be boiled for 15 minutes at 212°F or longer in places
at higher altitudes.

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5. After assisting with lancing a client's cyst in a clinic, the nurse is responsible for
sterilizing some of the nondisposable equipment. The nurse needs to ensure that the
cutting edges of some instruments are not damaged. Which of the following is the best
technique to sterilize the sharp instruments to get this effect?
A) Free-flowing steam
B) Steam under pressure
C) Chemical sterilization
D) Dry heat
Ans: D
Feedback:
Dry heat is a good technique for sterilizing sharp instruments and reusable syringes,
because moist heat damages cutting edges and the ground surfaces of glass.
Free-flowing steam is a method in which items are exposed to the heated vapor that
escapes from boiling water. Steam under pressure is the most dependable method for
destroying all forms of organisms and spores. Both gas and liquid chemicals are used to
sterilize invasive equipment and may not be suitable for sterilizing instruments with a
sharp edge.

6. When sterilizing the endoscope used for a client; which of the following should be
used?
A) Peracetic acid
B) Hydrogen peroxide
C) Acetic acid
D) Sulfuric acid
Ans: A
Feedback:
Peracetic acid is a reliable method for sterilizing heat-sensitive instruments such as
endoscopes. It is a combination of acetic acid and hydrogen peroxide. Sulfuric acid is
not used to sterilize any instrument.

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7. A nurse is required to clean the open wounds of a client who has been involved in an
automobile accident. What intervention would the nurse need to perform when cleaning
a client's open wounds to protect himself or herself from infection?
A) Wash hands with alcohol-based hand wash after the procedure.
B) Wear a clean pair of latex or latex-free gloves.
C) Use sterilizing acid to clean the injury.
D) Use sterile solutions such as normal saline.
Ans: B
Feedback:
In order to protect themselves from infections when dealing with open wounds, nurses
should wear gloves. Though washing hands with an alcohol-based hand wash helps kill
the microorganisms, it will not protect the nurse from being infected during the cleaning
of the wound. Sterilizing acid is used to sterilize heat-sensitive instruments and is not
applied to wounds. Sterile solutions such as normal saline are used to avoid
contamination of the wound itself, not to protect the nurse.

8. A nurse is preparing a sterile field in order to perform a dressing change for a client.
Which of the following steps should the nurse take pouring a sterile solution into the
dressing tray?
A) Shake the solution vigorously prior to use.
B) Grasp the lip of the container when pouring.
C) First pour and discard a small amount of the solution.
D) Clean the lip of the container with a damp cloth.
Ans: C
Feedback:
Before each use of a sterile solution, the nurse should pour and discard a small amount
to wash away airborne contaminants from the mouth of the container. The nurse should
not clean the nozzle area with a damp cloth or grasp it, as this would lead to
contamination of the solution. Solutions should not normally be shaken prior to use.

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 9. An operating room nurse is preparing an operation theater for a surgical procedure.
Which of the following points regarding the principles of surgical asepsis should the
nurse heed when preparing sterilized surgical instruments?
A) When a sterile item touches something that is not sterile, it may or may not be
contaminated.
B) Any partially uncovered sterile package is still considered to be sterile.
C) A commercially packaged surgical item is not considered sterile if it is past the
expiry date.
D) Sterility may not be preserved even when one sterile item touches another sterile
item.
Ans: C
Feedback:
When preparing the operation theater for a surgical procedure, the nurse should
remember that a commercially packaged surgical item is not considered sterile if it has
passed its recommended expiry date. When a sterile item touches an item that is not
sterile, then the sterile item is contaminated. If a sterile item touches another sterile
item, it is not considered contaminated. A partially uncovered sterile package is
considered contaminated.

10. A nurse is caring for a client with ringworm. Which of the following microorganisms
causes ringworm in a client?
A) Fungi
B) Rickettsiae
C) Protozoans
D) Helminths
Ans: A
Feedback:
Ringworm is caused by a fungal infection. Fungi include yeasts and molds, which cause
infections in the skin, mucous membranes, hair, and nails. Rickettsiae are
microorganisms that resemble bacteria but cannot survive outside of another living
species. They are responsible for Lyme disease. Protozoans are single-celled animals
classified according to their ability to move. They do not cause ringworm. Helminths
are infectious worms that may or may not be microscopic. They include roundworms,
tapeworms, and flukes.

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11. When caring for a client with a bacterial respiratory infection and an active cough, what
action should the nurse take in order to prevent becoming infected?
A) Get monthly immunizations against infections
B) Wear a mask when caring for the client
C) Wear sterile gloves when touching the client
D) Avoid all physical contact with the client
Ans: B
Feedback:
When caring for a client with a respiratory infection, the nurse washes his or her hands
frequently and thoroughly and wears a mask. The nurse need not get monthly
immunizations against infections. Avoiding contact with the client is also not a good
alternative, as the nurse needs to be near the client to provide adequate care. Gloves may
be necessary, but these do not need to be sterile.

12. Health care professionals are required to follow certain principles to ensure that
nosocomial infections do not occur in the health care facility. Which of the following
contributes to infections in health care settings?
A) Health professionals with short hair
B) Health professionals donning artificial nails
C) Health professionals with leather footwear
D) Health professionals with earrings
Ans: B
Feedback:
In order to ensure that nosocomial infections do not occur at the health care facility,
nurses are prohibited from wearing artificial nails. Health professionals with short hair,
earrings, or leather footwear do not contribute inordinately to infections.

13. A nurse is informing a nursing student about the Centers for Disease Control and
Prevention (CDC) guidelines for hand asepsis. Which guideline is in compliance with
the CDC guidelines for hand washing?
A) Washing when hands are visibly soiled
B) Washing only after removing gloves
C) Washing hands for 5 to 10 seconds
D) Washing when initiating contact with another client
Ans: A
Feedback:
The CDC recommends hand washing when hands are visibly soiled, before and after
contacts with all clients, after contact with any source of microorganisms, before and
after performing invasive procedures, and before and after removing gloves. The CDC
does not recommend hand washing only after removing gloves, but rather both before
and after removing gloves. Hand asepsis with soap and water should not take less than
15 seconds.

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14. A nurse is explaining the different procedures used to break the chain of infection to a
nursing student. Which of the following links in the chain of infection is addressed
when a nurse attempts to contain a client's diarrhea?
A) Exit route
B) Reservoir
C) Portal of entry
D) Susceptible host
Ans: A
Feedback:
When addressing the exit route, the nurse should provide special attention to the
respiratory and gastrointestinal tracts and to body fluids. Portal of entry involves nursing
procedures that help to prevent pathogens from being allowed to enter a client's system.
Susceptible host involves nursing actions that are aimed at increasing the client's
resistance to disease. A reservoir is a place where microbes grow and reproduce,
providing a haven for their survival.

15. A client has a diagnosis of HIV and has been admitted to the hospital with an
opportunistic infection that originated with the client's normal flora. Why did this client
most likely become ill from his resident microorganisms?
A) The resident microorganisms mutated and became virulent
B) The client's immune system became further weakened
C) The client's normal flora proliferated because of a nutritional deficit
D) The client's normal flora began producing spores
Ans: B
Feedback:
Unless the supporting host becomes weakened, normal flora remains controlled. If the
host's defenses are weakened, as in cases of HIV/AIDS, even benign microorganisms
can cause opportunistic infections. This phenomenon is not due to mutations, spore
production or the direct effects of a nutritional deficit.

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16. A client has tested positive for methicillin-resistant Staphylococcus aureus after being
swabbed on admission to the hospital. Bacterial resistance to antibiotics is an example
of:
A) Means of transmission
B) Spore production
C) Aerobic activity
D) Survival adaptation
Ans: D
Feedback:
An example of adaptation for survival is the development of antibiotic-resistant
bacterial strains of Staphylococcus aureus, Enterococcus faecalis, E. faecium, and
Streptococcus pneumoniae. Bacterial resistance is not demonstrated by aerobic activity.
Spore production is another form of adaptation. Means of transmission is a component
of the chain of infection, not an example of bacterial resistance.

17. Following treatment in an inpatient setting, a client has recovered from cellulitis. The
nurse recognizes that the client's recovery is partially attributable to the restoration of
the client's biologic defense mechanisms. What is an example of a mechanical defense
mechanism?
A) Maintenance of intact skin surfaces
B) Adequate production of appropriate antibodies
C) Secretion of lysozyme in response to microorganisms
D) Synthesis of gastric acid by cells in the stomach
Ans: A
Feedback:
Mechanical defense mechanisms are physical barriers that prevent microorganisms from
entering the body or expel them before they multiply. Examples include intact skin and
mucous membranes. Antibodies, enzymes and secretions are all examples of chemical
defense mechanisms.

18. A nurse is conscientious about implementing the principles of asepsis while providing
care for clients. The principles of asepsis include which of the following?
A) Visibly clean objects are considered to be sterile.
B) It is impossible to completely eliminate microorganisms from an object.
C) Blood and body fluids are major reservoirs for microorganisms.
D) All nonsterilized surfaces are considered to be equally contaminated.
Ans: C
Feedback:
Blood, body fluids, cells, and tissues are considered major reservoirs of
microorganisms. Visible cleanliness is not synonymous with sterility, though it is
possible to sterilize (eliminate microorganisms from) certain objects. Nonsterilized
objects are considered contaminated, but some objects and areas are considered to be
more contaminated than others.

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Test Bank for Fundamental Nursing Skills and Concepts Tenth Edition

19. A labor and delivery nurse will be participating in a client's emergency caesarean
section and intends to apply the principles of surgical asepsis appropriately. Surgical
asepsis is most clearly characterized by which of the following?
A) Antibiotics are applied as a preventative measure against infection.
B) The principles of medical asepsis will be applied in a surgical setting.
C) Viral contamination takes precedence over bacterial contamination.
D) Steps are taken to render an item completely free of microorganisms.
Ans: D
Feedback:
Surgical asepsis means those measures that render supplies and equipment totally free of
microorganisms. This exceeds the standards of medical asepsis and both viral and
bacterial contaminations are vigilantly addressed. Prophylactic antibiotics are not
normally a component of surgical asepsis.

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