A charge nurse is teaching a newly licensed nurse about health care-associated infections (HAIs). Which of the following should the nurse include in the teaching as examples of HAIS?
A client who has pneumonia after being on a ventilator
A client who has a bladder infection and has an indwelling urinary catheter
A client who has a surgical site infection
A client who has influenza acquired from a coworker
A client who has an infection at their central-line insertion site
Correct Answer : A,B,C,E
A. Ventilator-associated pneumonia (VAP) is a common HAI that occurs in patients who have been mechanically ventilated for an extended period. The presence of a ventilator increases the risk of introducing pathogens into the lower respiratory tract, leading to pneumonia.
B. Catheter-associated urinary tract infection (CAUTI) is an HAI that occurs due to the use of urinary catheters. Indwelling urinary catheters can introduce bacteria into the urinary tract, increasing the risk of infection.
C. Surgical site infections (SSIs) are infections that occur after surgery in the part of the body where the surgery took place. They are a significant cause of morbidity and mortality and are considered HAIs when they occur in healthcare settings.
D. Influenza acquired from a coworker is not typically considered a healthcare-associated infection. It is usually acquired in community settings rather than healthcare facilities.
E. Central line-associated bloodstream infections (CLABSIs) occur when bacteria or other pathogens enter the bloodstream through a central venous catheter. These infections are considered HAIs because they are associated with the presence of a central venous catheter used for medical treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A decrease in systolic blood pressure from 140 mm Hg to 120 mm Hg could indicate hypotension. Postoperatively, especially after receiving a spinal anesthetic, hypotension can occur due to vasodilation or decreased sympathetic tone. This change in blood pressure warrants notification of the provider because significant hypotension can lead to inadequate perfusion to vital organs and tissues.
B. A slight increase in temperature from 37.2°C to 37.5°C (99.0°F to 99.5°F) is a mild elevation and may not necessarily require immediate notification unless accompanied by other signs of infection or instability. It could be related to the stress response post-surgery. However, if there are other concerning signs (e.g., increased heart rate, worsening pain), the nurse should reassess and consider further action.
C. A decrease in pulse oximetry from 98% to 96% indicates a mild decrease in oxygen saturation. While this change alone may not be alarming, the nurse should assess the client's respiratory status and potential causes (e.g., positioning, respiratory depression from anesthesia). Oxygen saturation levels below 95% generally require intervention, but 96% is still within a normal range for most clients.
D. An increase in pain from 4/10 to 6/10 indicates worsening pain. Postoperatively, increasing pain may indicate inadequate pain management, worsening condition at the surgical site, or other complications such as hematoma or infection.
Correct Answer is D
Explanation
A. An inguinal hernia typically does not directly contribute to an increased risk of falls. It is a condition where tissues, such as part of the intestine, protrude through a weak spot in the abdominal muscles. While it may require caution with certain movements or heavy lifting to prevent exacerbation, it is not typically associated with balance or mobility issues that would increase fall risk.
B. Hyperthyroidism is a condition where the thyroid gland produces excessive thyroid hormone. Symptoms may include nervousness, tremors, rapid heart rate (palpitations), and muscle weakness. While muscle weakness could potentially contribute to an increased fall risk, it's not typically a primary factor unless the weakness is severe or affecting lower extremity strength significantly.
C. Hyperlipidemia refers to elevated levels of lipids (fats) in the blood, such as cholesterol and triglycerides. While it is a risk factor for cardiovascular disease, it does not directly increase the risk of falls.
D. Multiple sclerosis (MS) is a neurological condition that can cause a wide range of symptoms, including muscle weakness, coordination problems, and balance issues. These neurological impairments significantly increase the risk of falls due to impaired mobility and balance control.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.