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CNA exam topic: PPE and isolation precautions

29 exam-style questions with the answer and the exact rule from federal regulations or CDC guidance.

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1. A patient is suspected of being infected with pathogens transmitted by respiratory droplets. What is the primary source control measure the nurse aide should ensure for this patient?Put a mask on the patient. The rule specifically lists putting a mask on the patient as the source control measure for Droplet Precautions.
   CDC — Transmission-Based Precautions: “Source control: put a mask on the patient.”
2. Which of the following is a correct practice regarding the reuse of disposable gloves according to infection prevention guidelines?Do not wash gloves for the purpose of reuse. The rule clearly instructs that disposable gloves should not be washed for reuse, emphasizing single-use hygiene practices.
   CDC — CDC's Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings: “Do not wash gloves for the purpose of reuse.”
3. According to the definition provided, which of the following individuals is considered a 'licensed health professional'?A registered respiratory therapist. The rule lists registered respiratory therapists as licensed health professionals, while distinguishing them from nurse aides and volunteers.
   42 CFR § 483.5: “Licensed health professional. A licensed health professional is a physician; physician assistant; nurse practitioner; physical, speech, or occupational therapist; physical or occupational therapy assistant; registered professional nurse; licensed practical nurse; or licensed or certified social worker; or registered respiratory therapist or certified respiratory therapy technician.”
4. In a facility with limited engineering resources that lacks an Airborne Infection Isolation Room (AIIR), how should a nurse aide manage a patient suspected of having measles?Mask the patient and place them in a private room with the door closed. The guidance specifies that when an AIIR is unavailable, the aide should mask the patient and keep them in a private room with the door closed.
   CDC — Transmission-Based Precautions: “In settings where Airborne Precautions cannot be implemented due to limited engineering resources, masking the patient and placing the patient in a private room with the door closed will reduce the likelihood of airborne transmission until the patient is either transferred to a facility with an AIIR or returned home.”
5. What is the correct procedure for removing gloves to prevent hand contamination?Remove gloves carefully to prevent hand contamination. The guidance instructs aides to remove gloves carefully because dirty gloves can soil hands if removed improperly.
   CDC — Clinical Safety: Hand Hygiene for Healthcare Workers: “Remember to remove gloves carefully to prevent hand contamination as dirty gloves can soil hands.”
6. When providing care to a patient on Airborne Precautions, what type of respiratory protection must the nurse aide wear?A fit-tested NIOSH-approved N95 or higher level respirator. The rule specifies that healthcare personnel must use a fit-tested NIOSH-approved N95 or higher level respirator for Airborne Precautions.
   CDC — Transmission-Based Precautions: “Use personal protective equipment (PPE) appropriately, including a fit-tested NIOSH-approved N95 or higher level respirator for healthcare personnel.”
7. Under what specific circumstance is an employee permitted to temporarily decline using appropriate personal protective equipment?When, under rare and extraordinary circumstances, it was the employee's professional judgment that its use would have prevented the delivery of health care or public safety services or would have posed an increased hazard to the safety of the worker or co-worker. Declining PPE is only allowed under rare, extraordinary circumstances based on professional judgment regarding service delivery or safety hazards, not personal preference.
   29 CFR § 1910.1030(d): “When the employee makes this judgement, the circumstances shall be investigated and documented in order to determine whether changes can be instituted to prevent such occurances in the future.”
8. What is the primary basis for Standard Precautions in healthcare settings?A risk assessment using common sense practices and PPE. Standard Precautions are defined in the rule as being based on risk assessment and common sense practices to protect both providers and patients.
   CDC — Standard Precautions for All Patient Care: “They're based on a risk assessment and make use of common sense practices and personal protective equipment use that protect healthcare providers from infection and prevent the spread of infection from patient to patient.”
9. According to infection prevention protocols, what is the primary requirement regarding the duration and restrictiveness of isolation for a resident?Isolation must be the least restrictive possible for the resident under the circumstances. The regulation mandates that isolation measures must be the least restrictive option available to balance infection control with resident comfort and autonomy.
   42 CFR § 483.80(a): “A requirement that the isolation should be the least restrictive possible for the resident under the circumstances.”
10. When transferring a resident with a suspected infectious illness to another facility, what information should the nurse aide ensure is communicated to the accepting facility?The need for transmission-based precautions based on suspected infections. The guidance requires notifying accepting facilities about the need for transmission-based precautions when transferring patients with suspected infections.
    CDC — CDC's Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings: “Notify accepting facilities and the transporting agency about the need for transmission-based precautions based on suspected or confirmed infections or presence of targeted multidrug-resistant pathogens when patients are transferred.”
11. A patient on Droplet Precautions needs to be transported to another department. What instruction should the nurse aide give the patient regarding respiratory hygiene?Follow Respiratory Hygiene/Cough Etiquette. The guidelines instruct aides to tell patients to follow Respiratory Hygiene/Cough Etiquette when moving outside the room.
    CDC — Transmission-Based Precautions: “If transport or movement outside of the room is necessary, instruct patient to wear a mask and follow Respiratory Hygiene/Cough Etiquette.”
12. When differentiating between types of body fluids is difficult or impossible, how should a nurse aide treat these fluids under Universal Precautions?Consider all body fluids as potentially infectious materials. The rule states that when differentiation is difficult, all body fluids must be treated as potentially infectious.
    29 CFR § 1910.1030(d): “Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials.”
13. Which specific program, established under the Older Americans Act, must be included in the contact information provided to residents regarding advocacy?The State Long-Term Care Ombudsman program. The rule names the State Long-Term Care Ombudsman program as a required contact entity for advocacy information.
    42 CFR § 483.10(g): “Information and contact information for State and local advocacy organizations, including but not limited to the State Survey Agency, the State Long-Term Care Ombudsman program (established under section 712 of the Older Americans Act of 1965, as amended 2016 (42 U.S.C. 3001 et seq.)”
14. In an outpatient setting, how frequently must a nurse aide ensure the room of a patient on Contact Precautions is cleaned and disinfected?At least daily or prior to use by another patient. The rule states that in outpatient settings, rooms should be cleaned and disinfected at least daily or before another patient uses the space.
    CDC — Transmission-Based Precautions: “Prioritize cleaning and disinfection of the rooms of patients on contact precautions ensuring rooms are frequently cleaned and disinfected (e.g., at least daily or prior to use by another patient if outpatient setting)”
15. A nurse aide finishes a shift and is preparing to leave the work area. They are still wearing their gown and gloves. What must the aide do before leaving?Remove all personal protective equipment prior to leaving the work area. The standard requires that all personal protective equipment be removed before the employee exits the designated work area.
    29 CFR § 1910.1030(d): “All personal protective equipment shall be removed prior to leaving the work area.”
16. Under what condition is a facility permitted to charge a resident for a private room?When the room is therapeutically required, such as for isolation for infection control. Charges for private rooms are generally not allowed unless there is a specific therapeutic need, such as isolation for infection control.
    42 CFR § 483.10(f): “Private room, except when therapeutically required (for example, isolation for infection control).”
17. Which of the following is listed as a contact entity that must be included in the posted list of pertinent State agencies?The State Long-Term Care Ombudsman program. The rule specifically lists the Office of the State Long-Term Care Ombudsman program as a required entity to be included in the posted contact list.
    42 CFR § 483.10(g): “A list of names, addresses (mailing and email), and telephone numbers of all pertinent State agencies and advocacy groups, such as the State Survey Agency, the State licensure office, adult protective services where state law provides for jurisdiction in long-term care facilities, the Office of the State Long-Term Care Ombudsman program”
18. A patient with suspected tuberculosis is being transported from their room to another area for a medically necessary procedure. The patient is wearing a surgical mask and their infectious skin lesions are covered. What is the appropriate action for the nurse aide transporting the patient?The aide does not need to wear a mask or respirator during the transport. The rule states that healthcare personnel do not need to wear masks or respirators during transport if the patient is masked and lesions are covered.
    CDC — Transmission-Based Precautions: “Healthcare personnel transporting patients who are on Airborne Precautions do not need to wear a mask or respirator during transport if the patient is wearing a mask and infectious skin lesions are covered.”
19. According to the provided guidelines, when should a nurse aide use personal protective equipment (PPE)?Whenever there is an expectation of possible exposure to an infectious material. The rule states that PPE should be used whenever there is an expectation of possible exposure to infectious material, regardless of other factors.
    CDC — Standard Precautions for All Patient Care: “Use personal protective equipment (PPE) whenever there is an expectation of possible exposure to an infectious material.”
20. A nurse aide is caring for two different residents in a shared living area. After completing care for the first resident, the aide’s gloves are still clean and intact. What is the correct action regarding the gloves before caring for the second resident?Remove and discard the gloves before attending to the second resident. The rule states that gloves should not be reused across different patients, requiring removal and disposal between patients.
    CDC — CDC's Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings: “Do not use the same gown or pair of gloves for care of more than one patient.”
21. A nurse aide with hand irritation needs to wear gloves. What accessory does the guidance recommend using underneath the gloves?Cotton glove liners. The rule advises healthcare personnel with hand irritation to use cotton glove liners.
    CDC — Clinical Safety: Hand Hygiene for Healthcare Workers: “Healthcare personnel with hand irritation should use cotton glove liners and follow guidance on their: Laundering”
22. A resident enters the facility with a fever and rash. While awaiting further clinical assessment, what is the recommended placement strategy for this resident to minimize transmission risk?Place the resident into a single-patient room. The guidance advises placing patients who may need transmission-based precautions in a single-patient room to help contain potential spread while waiting for assessment.
    CDC — CDC's Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings: “To the extent possible, place patients who may need transmission-based precautions into a single-patient room while awaiting clinical assessment.”
23. An employee is allergic to the standard latex gloves provided at the facility. What must the employer ensure regarding alternative protective equipment?Hypoallergenic gloves, glove liners, powderless gloves, or other similar alternatives shall be readily accessible. The regulation lists specific hypoallergenic alternatives that must be made readily accessible to employees with allergies.
    29 CFR § 1910.1030(d): “Hypoallergenic gloves, glove liners, powderless gloves, or other similar alternatives shall be readily accessible to those employees who are allergic to the gloves normally provided.”
24. According to the curriculum requirements for nurse aide training, which specific skill must be included in the training prior to any direct contact with a resident?Communication and interpersonal skills. The regulation lists communication and interpersonal skills as a required training area before direct resident contact.
    42 CFR § 483.152(b): “At least a total of 16 hours of training in the following areas prior to any direct contact with a resident: (i) Communication and interpersonal skills;”
25. In an ambulatory setting, where should a nurse aide place a patient who requires Droplet Precautions?In an exam room or cubicle as soon as possible. The guidelines specify that ambulatory patients requiring Droplet Precautions should be placed in an exam room or cubicle promptly.
    CDC — Transmission-Based Precautions: “In ambulatory settings, place patients who require Droplet Precautions in an exam room or cubicle as soon as possible”
26. A nurse aide is caring for a patient on Contact Precautions in a long-term care facility. A single private room is unavailable. How should the aide determine the patient's room placement?Make room placement decisions balancing risks to other patients. The rule specifies that in long-term care settings without single rooms, the aide must balance the risks to other patients when deciding placement.
    CDC — Transmission-Based Precautions: “In long-term and other residential settings, make room placement decisions balancing risks to other patients.”
27. A nurse aide is entering a patient's room where Contact Precautions are in effect. According to the guidelines, when should the aide don their Personal Protective Equipment (PPE)?Upon entry into the room. The rule states that PPE should be put on upon entering the room to contain pathogens.
    CDC — Transmission-Based Precautions: “Donning PPE upon room entry and properly discarding before exiting the patient room is done to contain pathogens.”
28. According to infection prevention protocols, when must staff prohibit employees with infected skin lesions from having direct contact with residents?When direct contact will transmit the disease. The regulation specifies that prohibition of contact is required specifically when direct contact will transmit the disease.
    42 CFR § 483.80(a): “The circumstances under which the facility must prohibit employees with a communicable disease or infected skin lesions from direct contact with residents or their food, if direct contact will transmit the disease;”
29. When handling infected animals or unavoidable skin contact with infectious materials in a containment module, what protective measure is required?Wear gloves. The standard mandates the use of gloves when direct skin contact with infectious materials or infected animals cannot be avoided.
    29 CFR § 1910.1030(e): “Gloves shall be worn when handling infected animals and when making hand contact with other potentially infectious materials is unavoidable.”

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