Question

question 1 of 10

imagine youre working in an emergency department of a large hospital. the paramedics call the ed to tell them they are about to arrive with an unconscious woman who suffered severe injuries in a car accident. the woman is a patient at the hospital and you have easy access to her medical records. as you check them, you see the woman is being treated for hepatitis a. fortunately, the hospital requires all employees to be vaccinated for the most common infectious diseases, including hepatitis a. thus, when you ask a nurse to help stop the patients bleeding and he begins to treat her without wearing gloves, you dont bother saying anything since you know he must be vaccinated and has no risk of contracting hepatitis a. why is this the wrong action to take?

a. its possible that the nurse lied on his application when he was hired at the hospital and has not actually received his hepatitis a vaccination.
b. even though the nurse is protected against hepatitis a infections, it is possible that the patient is carrying other infectious pathogens, some of which have no vaccine, such as hiv. she may have contracted them since her last visit to the hospital.
c. even though there is no risk to the nurse himself, he increases the risk of transferring the hepatitis pathogen to others in the hospital by not wearing gloves.
d. protective equipment like latex gloves helps protect health care employees against cuts from sharps, and its likely the nurse will be handling needles as he treats the patient.

Explanation:

Analyze the clinical scenario

The scenario describes an emergency department setting where a nurse begins treating a bleeding, unconscious trauma patient without wearing gloves. The justification given for not intervening is that the patient is known to have hepatitis A, and the nurse is vaccinated against hepatitis A.

Evaluate infection control principles

In healthcare, Standard Precautions dictate that all bodily fluids, especially blood, must be treated as potentially infectious. A patient can carry multiple pathogens simultaneously, some of which may be undiagnosed or contracted after their last medical record update.

Assess bloodborne pathogen risks

Hepatitis A is primarily transmitted via the fecal-oral route, whereas blood exposure carries a high risk for bloodborne pathogens such as Hepatitis B, Hepatitis C, and HIV. There is currently no vaccine for HIV or Hepatitis C.

Compare the multiple-choice options

• Option A focuses on the nurse lying about vaccination, which is highly unlikely and not the primary clinical reason for standard precautions.
• Option B correctly identifies that while protected against hepatitis A, the patient may carry other unvaccinated bloodborne pathogens (like HIV) that could infect the nurse.
• Option C focuses on transferring hepatitis to others, which is less immediate than the direct risk of bloodborne transmission to the nurse.
• Option D mentions protection against sharps, but gloves do not prevent needlesticks; they primarily prevent blood-to-skin contact.

Determine the correct answer

Option B is the most accurate and clinically sound reason because it highlights the necessity of standard precautions against other potential bloodborne pathogens.

Answer:

• (A) It's possible that the nurse lied on his application when he was hired at the hospital and has not actually received his hepatitis A vaccination.
• (B) Even though the nurse is protected against hepatitis A infections, it is possible that the patient is carrying other infectious pathogens, some of which have no vaccine, such as HIV. She may have contracted them since her last visit to the hospital. (Correct answer)
• (C) Even though there is no risk to the nurse himself, he increases the risk of transferring the hepatitis pathogen to others in the hospital by not wearing gloves.
• (D) Protective equipment like latex gloves helps protect health care employees against cuts from sharps, and it's likely the nurse will be handling needles as he treats the patient.