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Managing the Threat of Methicillin-Resistant Staphylococcus aureus in Home Care

Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional: June 2008 - Volume 26 - Issue 6 - p 365–366
doi: 10.1097/01.NHH.0000324310.45910.ed

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To increase registered professional nurses' awareness of community-acquired methicillin-resistant Staphylococcus aureus, while offering suggestions for preventing and managing this infectious process in the home.


After reading this article and taking this test, you should be able to:

  1. Discuss methicillin-resistant Staphylococcus aureus (MRSA) infection, including types, incidence, and manifestations.
  2. Plan the appropriate interventions for caring for a patient infected with MRSA.

1. Which statement about methicillin-resistant Staphylococcus aureus (MRSA) is correct?

a. It can live harmlessly on the skin.

b. It is not considered a multidrug-resistant organism (MDRO).

c. If a patient is colonized with MRSA, an actual infection is inevitable.

d. The organism cannot survive on inanimate objects.

2. Of the following, the greatest risk factor for community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is

a. respiratory infection.

b. Caucasian heritage.

c. open wounds.

d. age between 2 and 4 years.

3. Staphylococcus aureus is considered MRSA when

a. the mecA gene mutates.

b. it is resistant to multiple drugs.

c. those affected have been hospitalized.

d. it is epidemic in the general population.

4. According to McDonald and colleagues, healthcare-associated (HA) MRSA is the appropriate term when the infection occurs in patients who

a. have been immunocompromised for more than 1 week.

b. have a history of treatment for chronic illnesses.

c. were admitted to a long-term care facility in the past 2 days.

d. are having intravenous therapy at home.

5. According to the article, all of these infections are associated with CA-MRSA except

a. empyema

b. encephalitis

c. fasciitis

d. folliculitis

6. Of the following, CA-MRSA is most common with

a. urinary tract infections.

b. soft-tissue infections.

c. upper respiratory infections.

d. gastrointestinal infections.

7. A study by van Duijkeren and colleagues demonstrated that MRSA can be transmitted to humans by

a. cats.

b. dogs.

c. birds.

d. rodents.

8. In the United States, the incidence of CA-MRSA

a. and HA-MRSA are both increasing.

b. is increasing and HA-MRSA incidence is decreasing.

c. and HA-MRSA are both decreasing.

d. is decreasing and HA-MRSA incidence is increasing.

9. About what percentage of hospital-acquired infections is caused by MRSA?

a. 40%

b. 50%

c. 60%

d. 70%

10. When compared with people with methicillin-sensitive Staphylococcus aureus (MSSA) infections, the mortality rate for people with MRSA infections is

a. higher.

b. lower.

c. about the same.

d. there is insufficient data to make a determination.

11. Compared with MRSA, MSSA is more common among people who

a. have asthma.

b. are women.

c. have diabetes.

d. are younger.

12. Compared with other wounds, MRSA infected wounds characteristically

a. are more edematous.

b. are warmer.

c. have a dark red border.

d. are soft to the touch.

13. CA-MRSA should be suspected when patients with a Staphylococcus aureus infection do not respond to initial treatment with a

a. tetracycline.

b. sulfonamide.

c. fluoroquinolone.

d. beta lactam.

14. Inanimate objects that might have come in contact with MRSA

a. should be disinfected with a 1:100 bleach/water dilution.

b. should be washed with soap and hot water.

c. must be discarded by a person wearing gloves.

d. cannot transmit the bacteria.

15. To avoid contaminating their nursing bag, home care clinicians should

a. remove all disposable equipment from the home.

b. wash all non-disposable items in the bag with hot, soapy water.

c. place the nursing bag on top of a barrier.

d. remove any items needed from the bag before entering the home.

16. In general when caring for a MRSA-infected wound in the home, how should the clinician dispose of the soiled dressings?

a. Bag them and dispose of them as household waste.

b. Double-bag all dressing materials.

c. Bag them and remove them for incineration.

d. Ask the patient or family to dispose of them.

17. The most common route of transmission of MRSA is

a. droplet to skin.

b. blood to skin.

c. object to skin.

d. skin to skin.

18. A MRSA-infected wound should be

a. left open to the air.

b. covered with a clean, dry bandage.

c. treated with wet-to-dry dressings.

d. covered with a transparent film dressing.



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