1. A nurse is caring for a patient who has a central venous catheter (CVC)

and is receiving total parenteral nutrition (TPN). The nurse notices that the

dressing around the CVC site is wet and soiled. What should the nurse do

first?

A) Change the dressing using sterile technique.

B) Notify the health care provider of the situation.

C) Stop the infusion of TPN and flush the CVC with normal saline.

D) Obtain a blood culture from the CVC and start antibiotic therapy.

Answer: A

Rationale: The nurse should change the dressing using sterile technique as

soon as possible to prevent infection. Wet and soiled dressings increase

the risk of bacterial growth and contamination of the CVC site. The other

actions are not appropriate as the first step.

2. A nurse is teaching a group of nursing students about standard

precautions for infection control. Which of the following statements by a

student indicates a need for further teaching?

A) "I should wear gloves when I touch any body fluids, secretions, or

excretions."

B) "I should wear a mask when I care for a patient who has tuberculosis."

C) "I should wash my hands before and after I touch any patient or

equipment."

D) "I should dispose of sharps in a puncture-resistant container."

Answer: B

Rationale: The student should wear a mask when caring for a patient who

has tuberculosis, but this is not part of standard precautions. This is an

example of transmission-based precautions, which are used in addition to

standard precautions for patients who have infections that can spread

through contact, droplet, or airborne routes. The other statements are

correct examples of standard precautions.

3. A nurse is preparing to administer an intramuscular injection to a

patient who has methicillin-resistant Staphylococcus aureus (MRSA) in a

wound. The nurse has donned gloves and a gown. What else should the

nurse do to prevent the spread of infection?