- A patient care technician is caring for three patients during their shift: Patient A has active tuberculosis, Patient B has a surgical wound infection with MRSA, and Patient C requires routine vital signs. The technician must visit all three patients within the next hour. Which sequence of PPE changes demonstrates the most appropriate infection control practice?
Answer: Gloves only for Patient C, then gloves and gown for Patient B, then gloves, gown, and N95 for Patient A
The correct sequence follows the principle of moving from least contaminated to most contaminated patients. Patient C (routine care) requires standard precautions only. Patient B (MRSA wound infection) requires contact precautions (gloves and gown). Patient A (active TB) requires airborne precautions (gloves, gown, and N95). This sequence minimizes cross-contamination risk. Choice A uses incorrect PPE for MRSA (surgical mask instead of gown). Choice B places the TB patient in the middle, creating unnecessary exposure risk. Choice D places the cleanest patient last, violating the clean-to-dirty principle.
- During a code blue emergency, a patient care technician arrives to assist with CPR on a patient whose infectious disease status is unknown. The patient has visible oral secretions, and the technician may be asked to provide bag-mask ventilation. Other team members are already performing chest compressions. What PPE should the technician don before joining the resuscitation effort?
Answer: Full PPE including gown, gloves, N95, and face shield before participating
When you encounter emergency scenarios involving unknown infectious status, think about maximum protection principles. Code blue situations require rapid response, but you must balance urgency with safety protocols, especially when respiratory secretions are present and airway management is likely.
Answer D is correct because full PPE (gown, gloves, N95, and face shield) provides comprehensive protection before any patient contact when infectious status is unknown. During CPR with visible oral secretions, you're at high risk for exposure to bloodborne and respiratory pathogens through splashing, aerosolization, and direct contact. Since you may be assigned ventilation duties immediately upon arrival, you need complete protection from the start rather than adding PPE incrementally.
Answer A fails because a surgical mask provides insufficient protection against airborne pathogens that may be aerosolized during CPR and ventilation. Answer B is problematic because approaching the patient to assess PPE needs creates unnecessary exposure risk during the assessment period, and you should arrive fully protected. Answer C is dangerous because it assumes you can safely approach with minimal protection initially - but CPR itself generates aerosols and splashing even before formal ventilation begins.
Remember this rule for emergency scenarios: when infectious status is unknown and respiratory/airway procedures are involved, always err on the side of maximum protection. You can't pause a code blue to add PPE once you discover you need it, so assume the worst-case scenario and protect accordingly from your first step into the room.
- A patient care technician is preparing to assist with a sterile dressing change on a patient with a central line infection. The nurse will perform the sterile procedure while the technician provides support. The patient is also on droplet precautions for influenza. Which PPE combination is most appropriate for the technician during this procedure?
Answer: Clean gloves, clean gown, surgical mask, and eye protection
The technician is assisting, not performing the sterile procedure, so clean (non-sterile) gloves and gown are appropriate for their role. Droplet precautions require surgical mask and eye protection. Only the person performing the sterile procedure needs sterile PPE. Choice A uses unnecessary sterile PPE for the assistant role. Choice C uses N95 (needed for airborne, not droplet precautions). Choice D incorrectly combines sterile gown with clean gloves, which doesn't match the assistant's role in the procedure.
- A patient care technician is caring for a patient with C. difficile infection who requires assistance with toileting. After helping the patient, the technician removes their gown and gloves. The alcohol-based hand sanitizer dispenser is broken, but soap and water are available at the sink. Which hand hygiene approach is most appropriate?
Answer: Use soap and water for at least 20 seconds, as alcohol-based sanitizers are ineffective against C. difficile spores
C. difficile produces alcohol-resistant spores that require mechanical removal through soap and water handwashing for at least 20 seconds. Alcohol-based sanitizers are ineffective against C. difficile spores and should not be used as primary hand hygiene after caring for these patients. CDC guidelines specifically require soap and water after C. difficile patient contact. Choice B suggests using ineffective alcohol sanitizer. Choices C and D incorrectly assume alcohol adds benefit against C. difficile spores and use insufficient washing time.
- Drawing blood from a suspected TB patient: which respiratory protection is required?
Answer: N95 respirator
TB spreads by airborne droplet nuclei, so you need an N95 respirator that filters those particles. A surgical mask only blocks large droplets and doesn't seal to the face, so it can't protect you from inhaling TB. Gown, gloves, and face shield address splash or contact, not airborne inhalation.
- A patient care technician is assigned to transport a patient with VRE (vancomycin-resistant enterococcus) urinary tract infection from their room to radiology. The patient is ambulatory and continent. The transport route passes through two nursing units and the main hospital corridor. Which PPE approach is most appropriate for this transport?
Answer: Gloves only for the technician; no PPE required for the patient during transport
VRE requires contact precautions, but an ambulatory, continent patient with a urinary tract infection poses minimal transmission risk during transport when they're not in direct contact with environmental surfaces. The technician needs gloves for any direct patient contact but doesn't need a gown during transport if not providing hands-on care. The patient doesn't require special covering for VRE UTI. Choice A over-protects for the transport situation. Choice C unnecessarily covers the patient. Choice D incorrectly suggests no precautions are needed.
- Irrigating a draining wound that splashes. Which PPE set is appropriate?
Answer: Gloves, gown, face shield
Irrigating a draining wound creates splash risk to your skin, clothing, and face, so you need gloves for hands, a gown for body coverage, and a face shield to protect eyes, nose, and mouth together. The tempting choice is gloves, mask, and safety glasses because it seems to cover the face, but it leaves gaps and does not provide the full splash protection a face shield does.
- Each time you don an N95, which final step is required before contact?
Answer: Perform user seal check
Before every N95 use, you must check the seal around your face to confirm there are no leaks. Fit testing is done once to find your size and model, not repeated each time you put one on, so it can't be the final step. Alcohol hand rub and shoe covers don't relate to the respirator seal. Perform the user seal check each time you don the mask.
- A patient care technician enters a room to collect vital signs and discovers the patient coughing up blood. The patient's chart indicates a history of chronic cough, but no current isolation precautions are ordered. The technician notices droplets of blood on the bedside table within 4 feet of the patient. What is the most appropriate immediate PPE response?
Answer: Leave the room immediately, don N95 respirator and eye protection, then return to assess the patient
Hemoptysis (coughing blood) in a patient without isolation orders suggests possible undiagnosed airborne infectious disease (like tuberculosis). The presence of blood droplets indicates active transmission risk. The technician should exit, don appropriate airborne precautions (N95 and eye protection), and return to assess. The nurse must be notified immediately as isolation orders may be needed. Choice A uses inadequate protection for potential airborne disease. Choice B focuses on cleaning rather than proper protection and assessment. Choice D includes unnecessary gown and delays critical notification.
- During a busy shift, a patient care technician notices their N95 respirator has become damp from perspiration while caring for a patient with suspected COVID-19. The technician has two more airborne precaution patients to see before the end of shift, and the supply room has both new N95 respirators and surgical masks available. What is the most appropriate action?
Answer: Replace the damp N95 with a new N95 respirator before continuing patient care activities
A damp or wet N95 respirator loses its filtration efficiency and seal integrity, compromising protection against airborne pathogens. CDC guidelines require immediate replacement of damaged or wet respirators. Since airborne precaution patients require N95 protection and new N95s are available, replacement is mandatory. Choice A ignores safety protocols for compromised PPE. Choice C substitutes inadequate protection (surgical masks don't provide airborne protection). Choice D continues unsafe practice and then switches to inadequate protection.
- A patient care technician is caring for a patient with both MRSA pneumonia and norovirus gastroenteritis. The patient requires oral care, linen changes due to diarrhea, and assistance with using the incentive spirometer. The technician plans to complete all tasks in one room entry. Which PPE combination addresses both infection risks appropriately?
Answer: Gloves, fluid-resistant gown, surgical mask, and eye protection
MRSA pneumonia requires contact precautions (gloves and gown). Norovirus requires contact precautions with emphasis on fluid-resistant gown due to vomiting/diarrhea exposure risk. Neither condition requires airborne precautions, so surgical mask with eye protection is appropriate for droplet protection during oral care and close contact. Choice B uses unnecessary N95 for non-airborne conditions. Choice C over-protects with N95. Choice D uses regular gown which may not provide adequate fluid protection for norovirus care.
- A patient care technician working the night shift discovers that the only N95 respirators available are from a box that expires in 2 hours. The technician needs to care for a patient with confirmed pulmonary tuberculosis and cannot wait for the day shift to bring new supplies. The supply room also has surgical masks and P100 respirators available. What is the most appropriate respiratory protection choice?
Answer: Use a P100 respirator as it provides superior filtration compared to the expiring N95
P100 respirators provide superior protection (99.97% filtration) compared to N95 respirators (95% filtration) and are appropriate for tuberculosis protection. When proper PPE is unavailable or compromised, using superior protection is appropriate. Expiration dates indicate the manufacturer's guarantee period; using soon-to-expire PPE is not recommended when alternatives exist. Choice A ignores available superior protection. Choice B provides inadequate airborne protection. Choice D does not provide equivalent airborne protection to N95 respirators.
- Your gloves tear during an IV start. What should you do?
Answer: Remove, wash, apply new gloves
When your gloves tear, the barrier is broken. Stop the IV start, remove the torn gloves, wash your hands, and apply new sterile gloves before continuing. The tempting mistake is to finish the procedure and then change, but that lets blood or body fluid contact your skin and exposes the patient to contamination. Replace immediately.
- A patient care technician is working in the emergency department when a trauma patient arrives with multiple open wounds and unknown infectious disease status. Blood is actively spurting from a leg wound, and the technician is asked to assist with immediate bleeding control. No time is available for extensive PPE donning. Which PPE represents the minimum essential protection for this emergent situation?
Answer: Full face shield, gloves, and fluid-resistant gown
Spurting blood creates high-risk exposure to bloodborne pathogens through splash and spray. Minimum protection requires barrier protection for hands (gloves), body (fluid-resistant gown), and face/eyes (full face shield provides both eye and respiratory protection). Face shields are preferred over separate mask and eye protection in high-splash situations. Choice A takes too much time with double gloving. Choice B lacks body protection against blood spray. Choice C delays essential protection and may allow exposure during the delay period.
- Entering a room with a C. difficile patient who has diarrhea: which PPE is required?
Answer: Isolation gown and gloves
C. difficile spreads by contact with stool, so you need gloves and an isolation gown to protect your hands and clothing from contamination. A mask and N95 protect against airborne droplets, not contact with diarrhea, and gloves alone leave your clothes exposed, so those are not enough.
