Pharmacological Aspects of Nursing Care 8e Broyles Reiss Evans Test bank

Pharmacological Aspects of Nursing Care  8e Broyles Reiss Evans  Test bank
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CHAPTER 9: ANTISEPTICS AND DISINFECTANTS

TRUE/FALSE

1. If home care clients can properly demonstrate wound care, it is not necessary to send written instructions home with them.

ANS: F

Feedback
Correct
Home care clients should receive written, as well as verbal and demonstration instructions.
Incorrect

PTS: 1 REF: p. 255 OBJ: Cognitive Level: Application

2. Clients should be encouraged to use contact lens supplies that contain thimerosal, because it is a safe antiseptic agent.

ANS: F

Feedback
Correct
Because of hypersensitivity responses, contact lens wearers are encouraged to avoid contact lens products with thimerosal in them.
Incorrect

PTS: 1 REF: p. 247 OBJ: Cognitive Level: Comprehension

3. Silver-containing compounds become rapidly inactivated in the presence of body fluids.

ANS: T PTS: 1 REF: p. 247 OBJ: Cognitive Level: Knowledge

4. To be most effective, alcohol-containing products need to be rubbed on the skin for at least two minutes.

ANS: T PTS: 1 REF: p. 245 OBJ: Cognitive Level: Knowledge

5. Triclosan (Septisol) is commonly added to toothpaste to aid in the prevention of periodontal disease.

ANS: T PTS: 1 REF: p. 245, Table 9-1
OBJ: Cognitive Level: Knowledge

MULTIPLE CHOICE

1. Which of the following agents is not related chemically to phenol (carbolic acid)?
a.
hexachlorophene (pHisoHex)
c.
cresol (Lysol)
b.
resorcinol
d.
chlorhexidine (Hibiclens)

ANS: D

Feedback
A
Incorrect: This is related to phenol as a bisphenol composed of two phenolic groups.
B
Incorrect: Used in the topical treatment of psoriasis, this is related to phenol.
C
Incorrect: Lysol is a phenol.
D
Correct: Hibiclens is a cationic bisbiguanide, not related chemically to phenol.

PTS: 1 REF: p. 245 OBJ: Cognitive Level: Knowledge

2. An agent that has been shown to cause central nervous system toxicity in infants is:
a.
silver nitrate.
c.
mandelic acid (Mandelamine).
b.
hexachlorophene (pHisoHex).
d.
thimerosal (Merthiolate).

ANS: B

Feedback
A
Incorrect: Silver nitrate has not shown evidence of CNS toxicity when used according to manufacturers instructions.
B
Correct: Risk for CNS toxicity resulted in stopping hexachlorophene use for bathing.
C
Incorrect: Mandelic acid has not shown evidence of CNS toxicity when used according to manufacturers instructions.
D
Incorrect: Thimersol has not shown evidence of CNS toxicity when used according to manufacturers instructions.

PTS: 1 REF: p. 245 | p. 249
OBJ: Cognitive Level: Comprehension

Because of a recent outbreak of nosocomial infections, the charge nurse on a surgical floor at a general hospital reviews information on antiseptics, disinfectants, and handwashing technique with her staff.

3. When teaching a client about using iodine, the nurse should include which of the following:
a.
monitor for hypersensitivity response.
b.
iodine does not stain skin, but it does stain clothing.
c.
avoid getting iodine products directly on the skin.
d.
iodine is not effective against viruses.

ANS: A

Feedback
A
Correct: Hypersensitivity to iodine is a common and potentially serious.
B
Incorrect: Iodine stains both skin and clothing.
C
Incorrect: Iodine products are used on the skin.
D
Incorrect: Iodine products are effective against a broad range of organisms, including viruses.

PTS: 1 REF: p. 243, Table 9-1
OBJ: Cognitive Level: Application

4. Benzalkonium chloride (Zephiran) can be classified as a(n):
a.
phenol.
c.
oxidizing agent.
b.
surface-active agent.
d.
chloroform.

ANS: B

Feedback
A
Incorrect: It is not a phenol.
B
Correct: It is a surface-active agent, also referred to as a wetting agent.
C
Incorrect: It is not an oxidizing agent.
D
Incorrect: It is not a chloroform.

PTS: 1 REF: p. 247 OBJ: Cognitive Level: Knowledge

5. The optimal strength of ethanol for instrument disinfection and storage is:
a.
50%.
c.
95%.
b.
70%.
d.
10%.

ANS: A

Feedback
A
Correct: Fifty percent concentration of ethanol appears to be a more effective germicide (than 70%), when long contact can be maintained.
B
Incorrect: This is most appropriate for rapid skin disinfection.
C
Incorrect: This is not an appropriate concentration.
D
Incorrect: This is not an appropriate concentration.

PTS: 1 REF: p. 245 OBJ: Cognitive Level: Knowledge

6. For optimal disinfection using formaldehyde, the nurse knows that:
a.
objects must be exposed to the solution for a very short time.
b.
objects must be exposed to the solution for a prolonged period of time.
c.
tissue must be prepared in advance.
d.
clients report burning when the skin comes in contact with the solution.

ANS: B

Feedback
A
Incorrect: For effectiveness, formaldehyde needs prolonged contact with objects.
B
Correct: For effectiveness formaldehyde needs prolonged exposure to the object.
C
Incorrect: Formaldehyde is a used to disinfect inanimate objects.
D
Incorrect: This statement is true, but it does not answer the question.

PTS: 1 REF: p. 245-246 OBJ: Cognitive Level: Comprehension

7. Which of the following is not true about the storage of antiseptic and disinfectant agents on a hospital ward?
a.
All containers must be labeled with the name and strength of the contents.
b.
Storage must be in an area away from persons who might accidentally or purposefully ingest the substances.
c.
Containers must be labeled as to whether the agent is safe for internal or external use.
d.
Over-exposure to the skin of many clients will cause irritation.

ANS: D

Feedback
A
Incorrect: This is a true statement.
B
Incorrect: This is a true statement.
C
Incorrect: This is a true statement.
D
Correct: Although a true statement, it does not address antiseptic and disinfectant storage.

PTS: 1 REF: p. 249 OBJ: Cognitive Level: Comprehension

8. When instruments are to be disinfected, the nurse must perform what action before immersing them in disinfectant?
a.
Sterilize them.
b.
Wash with soap using friction, rinse, and dry them.
c.
Wash them in soapy water, then immerse them.
d.
Nothing needs to be done other than immersing them.

ANS: B

Feedback
A
Incorrect: This is an inappropriate nursing action before disinfecting instruments.
B
Correct: The instruments must be thoroughly washed with soap using friction, rinsed, and dried.
C
Incorrect: This is not the correct action.
D
Incorrect: This is not correct.

PTS: 1 REF: p. 250 OBJ: Cognitive Level: Application

9. The least important factor in decreasing microorganisms in handwashing is:
a.
frequency of washing.
c.
the nature of the product used.
b.
duration of washing.
d.
technique of washing.

ANS: C

Feedback
A
Incorrect: This is a priority factor.
B
Incorrect: This is a priority factor.
C
Correct: The nature of the product is less important than frequency, duration, and technique of handwashing.
D
Incorrect: This is a priority factor.

PTS: 1 REF: p. 250, Safe Nursing Practice 9-3
OBJ: Cognitive Level: Comprehension

10. The nurse should consider all of the following in selecting an antiseptic or disinfectant for use, except:
a.
client history of sensitivity to a particular product.
b.
nature of the organism to be destroyed.
c.
storage requirements of the agent.
d.
health care providers previous experience with the product.

ANS: D

Feedback
A
Incorrect: This is an important consideration.
B
Incorrect: This is an important consideration.
C
Incorrect: This is an important consideration.
D
Correct: This factor should be considered least, if at all, when selecting an antiseptic or disinfectant.

PTS: 1 REF: p. 250 OBJ: Cognitive Level: Application

11. Which of the following substances rapidly deteriorates upon exposure to air?
a.
alcohol
c.
hexachlorophene
b.
iodine
d.
hydrogen peroxide

ANS: D

Feedback
A
Incorrect: Although alcohol evaporates, it does not evaporate as quickly as hydrogen peroxide inactivates.
B
Incorrect: Iodine action does not deteriorate with exposure to the air.
C
Incorrect: Hexachlorophene does not deteriorate with exposure to the air.
D
Correct: Hydrogen peroxide should be used immediately after dilution with normal saline.

PTS: 1 REF: p. 247 OBJ: Cognitive Level: Knowledge

12. Which of the following requires careful reporting of sensitivity reactions because of its use in media for X-rays?
a.
alcohol
c.
silver nitrate
b.
iodine
d.
hydrogen peroxide

ANS: B

Feedback
A
Incorrect: This is not used in radiologic media.
B
Correct: The most serious disadvantage to iodine is hypersensitivity.
C
Incorrect: This is not used in radiologic media.
D
Incorrect: This is not used in radiologic media.

PTS: 1 REF: p. 249 OBJ: Cognitive Level: Comprehension

13. The nurse can used alcohol on the skin to decolor:
a.
iodine.
c.
hexachlorophene.
b.
silver nitrate.
d.
hydrogen peroxide.

ANS: A

Feedback
A
Correct: Alcohol can be used to decolorize skin that has been stained by iodine.
B
Incorrect: Alcohol is not used to decolorize skin that has been stained by silver nitrate.
C
Incorrect: Hexachlorophene does not stain the skin.
D
Incorrect: Hydrogen peroxide does not stain the skin.

PTS: 1 REF: p. 250, Safe Nursing Practice 9-2
OBJ: Cognitive Level: Application

14. An agent that can produce bleeding at injection sites is:
a.
iodine.
c.
silver nitrate.
b.
alcohol.
d.
hydrogen peroxide.

ANS: B

Feedback
A
Incorrect: Iodine does not cause bleeding.
B
Correct: Alcohol causes local vasodilation, producing bleeding at injection sites.
C
Incorrect: Silver nitrate does not cause bleeding.
D
Incorrect: Hydrogen peroxide does not cause bleeding.

PTS: 1 REF: p. 245 | p. 250, Safe Nursing Practice 9-2
OBJ: Cognitive Level: Knowledge

15. Disinfectant products are licensed and monitored by which government regulatory agency?
a.
Food and Drug Administration (FDA)
b.
Occupational Safety and Health Administration (OSHA)
c.
U.S. Environmental Protection Agency (EPA)
d.
Bureau of Alcohol, Tobacco and Firearms (ATF)

ANS: C

Feedback
A
Incorrect: The FDA does not regulate disinfectant products.
B
Incorrect: OSHA does not regulate disinfectant products.
C
Correct: The U.S. Environmental Protection Agency regulates disinfectants.
D
Incorrect: The ATF does not regulate disinfectant products.

PTS: 1 REF: p. 239 OBJ: Cognitive Level: Knowledge

16. Which topical antiseptic is commonly used for treatment of burns?
a.
silver nitrate
c.
silver protein
b.
silver sulfadiazine
d.
resorcinol

ANS: B

Feedback
A
Incorrect: Silver nitrate is used to prevent ophthalmia neonatorum in the newborn.
B
Correct: This is one of the most frequently used products in burn care.
C
Incorrect: This is not used for burn care.
D
Incorrect: This is not used for burn care.

PTS: 1 REF: p. 244, Table 9-1 OBJ: Cognitive Level: Knowledge

17. Sodium hypochlorite solution (Dakins solution) is used as for wound irrigation or packing. The nurse knows this solution:
a.
may touch healthy tissue for brief periods of time.
b.
has little effect on healing of injured tissues.
c.
supports healing of surgical wounds.
d.
may delay the clotting process.

ANS: D

Feedback
A
Incorrect: It can injure healthy tissue.
B
Incorrect: It is very effective in healing injured tissue.
C
Incorrect: This is not a true statement.
D
Correct: This solution may delay the clotting process.

PTS: 1 REF: p. 249 OBJ: Cognitive Level: Knowledge

18. Hibiclens is currently one of the most frequently used solutions for performing preoperative skin scrubs. The nurse knows that the most important advantage of using Hibiclens for this purpose is:
a.
it stays on the skin to provide continuous antibacterial effects.
b.
it does not stain the skin.
c.
it is not regulated by any governmental agency.
d.
it has weak antimicrobial activity, so it is less toxic.

ANS: A

Feedback
A
Correct: This is the most important advantage; its antibacterial effects remain on the skin but it does not absorb through the skin.
B
Incorrect: This is not the most important advantage.
C
Incorrect: This is a false statement.
D
Incorrect: This is a false statement.

PTS: 1 REF: p. 247 OBJ: Cognitive Level: Comprehension

19. When teaching wound care in the home, the nurse instructs the caregiver about all the following except the:
a.
safe storage and use of antiseptics and disinfectants in the home.
b.
need to isolate the client from other family members.
c.
importance of handwashing before and after wound care.
d.
need to wash contaminated linen separate from household linen.

ANS: B

Feedback
A
Incorrect: This information needs to be supplied.
B
Correct: Clients requiring isolation are not treated at home.
C
Incorrect: This information needs to be supplied.
D
Incorrect: This information needs to be supplied.

PTS: 1 REF: p. 255 OBJ: Cognitive Level: Application

20. For handwashing between clients to be effective, the agent should be in contact with the skin for at least:
a.
5 seconds.
c.
30 seconds.
b.
10 seconds.
d.
60 seconds.

ANS: B

Feedback
A
Incorrect: This is not enough time.
B
Correct: Ten seconds is the minimum exposure the agent must have with the nurses skin when handwashing between clients.
C
Incorrect: Although this would be good, it is not practical.
D
Incorrect: Although this would be good, it is not practical.

PTS: 1 REF: p. 250 OBJ: Cognitive Level: Knowledge

21. While povidone-iodine is often used for its germicidal effect, the nurse knows:
a.
that it exerts its maximum effect when it is dry.
b.
that it exerts its maximum effect when it remains wet.
c.
that it is less effective than isopropyl alcohol.
d.
that it exerts a cumulative effect over time.

ANS: A

Feedback
A
Correct: In solution, povidone-iodine is bacteriostatic; when left to dry on a surface it becomes bacteriocidal.
B
Incorrect: This is not a true statement.
C
Incorrect: This is not true.
D
Incorrect: This is not true.

PTS: 1 REF: p. 246 OBJ: Cognitive Level: Comprehension

22. Mandelic acid is most commonly used:
a.
to sterilize the urinary tract prior to surgery.
b.
for treatment of chronic urinary tract infections.
c.
for burn wound care.
d.
to sterilize surgical equipment.

ANS: B

Feedback
A
Incorrect: The urinary tract should be sterile.
B
Correct: It is used for treating chronic urinary tract infections.
C
Incorrect: It is not used for this purpose.
D
Incorrect: It is not used for this purpose.

PTS: 1 REF: p. 246 OBJ: Cognitive Level: Knowledge

23. The nurse instructs the client about inner cannula care for a tracheostomy. Which of the following teaching points is important for the nurse to convey to the client about the use of hydrogen peroxide?
a.
It may be poured up to 30 minutes prior to the procedure.
b.
Solutions of 1/2 strength H2O2 may be prepared 24 hours in advance.
c.
It should be stored in a dark, tightly-capped container.
d.
It should be left on the wound for at least 10 minutes.

ANS: C

Feedback
A
Incorrect: H2O2 deactivates rapidly when exposed to the air.
B
Incorrect: Even in a closed container, solutions should not be prepared 24 hours in advance, unless they are enclosed in an airtight container that protects the solution from light.
C
Correct: H2O2 needs to be stored in a dark, tightly-capped container.
D
Incorrect: H2O2 acts immediately and should be rinsed off with normal saline.

PTS: 1 REF: p. 249-250 OBJ: Cognitive Level: Application

24. Benzoyl peroxide (Benoxyl) is primarily used to treat:
a.
fungal disorders.
c.
urinary tract infections.
b.
ophthalmic infections.
d.
acne.

ANS: D

Feedback
A
Incorrect: It is not effective against fungi.
B
Incorrect: Benzoyl peroxide should not be allowed to get into a clients eyes.
C
Incorrect: It is not used for this purpose.
D
Correct: Many acne medications contain benzoyl peroxide.

PTS: 1 REF: p. 247 OBJ: Cognitive Level: Knowledge

25. To protect against one of the adverse effects of using sodium hypochlorite for wound care the nurse should:
a.
cleanse the wound with iodine prior to packing with sodium hypochlorite.
b.
monitor serum electrolyte level and hemoglobin and hematocrit levels.
c.
apply petroleum jelly to the skin around the wound.
d.
monitor for CNS symptoms

ANS: C

Feedback
A
Incorrect: The sodium hypochlorite cleanses the wound.
B
Incorrect: Sodium hypochlorite used in wound care does not impact electrolytes or hemoglobin/hematocrit levels.
C
Correct: This action is to protect the healthy tissues surrounding the wound, because sodium hypochlorite can injure healthy tissue.
D
Incorrect: Sodium hypochlorite used in wound care does not cause CNS dysfunction.

PTS: 1 REF: p. 249 | p. 250, Safe Nursing Practice 9-2
OBJ: Cognitive Level: Application

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