# A nurse cares for a client newly admitted with a positive surveillance culture for vancomycin-resistant enterococcus (VRE) of the rectum. Which infection prevention measures should the nurse implement? Select all that apply. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=366709&lang=en > language: en > subject: Standard/Transmission-Based Precautions/Surgical Asepsis > category: SIPC ## Question A nurse cares for a client newly admitted with a positive surveillance culture for vancomycin-resistant enterococcus (VRE) of the rectum. Which infection prevention measures should the nurse implement? Select all that apply. 1 Place the client in a negative-pressure airborne isolation room 2 Place the client on contact precautions in a private room or cohort with another VRE client 3 Allow the client to leave the room freely for ambulation in the hallway 4 Wear gown and gloves before every entry into the room 5 Dedicate equipment (BP cuff, stethoscope, thermometer) to this client ## Explanation VRE is a multidrug-resistant organism (MDRO) transmitted by direct or indirect contact. CDC contact precautions: private room or cohort, gown and gloves on entry, dedicated equipment. Free ambulation in hallway is contraindicated for active MDRO precautions; the client may ambulate within the room or with cohort-specific protocols. Negative-pressure airborne isolation is for true airborne pathogens (TB, measles, varicella) — VRE is contact, not airborne. ## In-depth explanation Clinical Judgment VRE is contact-transmitted MDRO: private room or cohort, gown and gloves on entry, dedicated equipment. Hand hygiene with alcohol-based sanitizer or soap and water is acceptable (unlike C. diff which requires soap and water only). Surface disinfection with EPA-registered hospital-grade disinfectant. Memory Tip VRE: Contact + Gown/Gloves + Dedicated equipment. Alcohol OK (unlike C. diff) KR vs U CDC and Korean Society for Healthcare-Associated Infection Control share the same VRE protocol. Both jurisdictions report VRE bloodstream infections to surveillance systems and use active surveillance cultures in high-risk units (ICU, transplant). ## Clinical scenario Clinical Practice Guide CDC contact precautions for MDROs (MRSA, VRE, CRE): - Private room or cohort with same MDRO - Gown and gloves for every room entry - Dedicated equipment; if shared, disinfect between clients with EPA-registered product - Hand hygiene: alcohol-based sanitizer or soap and water (alcohol effective for MRSA/VRE/CRE; soap and water mandatory only for C. diff and norovirus due to spores) - Environmental cleaning: high-touch surfaces with EPA-registered hospital disinfectant - Active surveillance in high-risk units (ICU, transplant, dialysis) - Discontinue per facility protocol with negative cultures (typically 2-3 negative) Caution VRE bloodstream infections in immunocompromised clients carry mortality up to 40 percent. Linezolid or daptomycin are typical first-line treatments; consult ID specialist. Hand hygiene compliance audit is the single most effective MDRO control intervention. ## Key concepts - **VRE** — Vancomycin-resistant enterococcus, MDRO. Most often E. faecium or E. faecalis. Colonizes GI tract and skin; bloodstream infection in immunocompromised clients. Contact precautions, dedicated equipment, hand hygiene with alcohol or soap and water. - **MDRO** — Multidrug-resistant organism. Includes MRSA, VRE, ESBL-producing organisms, CRE, MDR Pseudomonas/Acinetobacter, MDR-TB. CDC and Korean infection control require contact precautions; some require enhanced precautions per facility policy. - **Active surveillance culture** — Routine screening of asymptomatic high-risk clients (ICU admission, transplant, recent hospitalization) for MDROs. Positive screen triggers contact precautions, decolonization protocols, and isolation. Reduces transmission and bloodstream infection rates. ## Related questions - [A nurse is caring for a client newly admitted with suspected methicillin-resistant Staphyl…](https://mymerci.kr/pages/nclex_q.php?qn_id=360517&lang=en) - [A nurse is about to enter the room of a client with Clostridioides difficile infection dur…](https://mymerci.kr/pages/nclex_q.php?qn_id=361226&lang=en) - [A 22-year-old female client presents to the emergency department with a 4-week history of …](https://mymerci.kr/pages/nclex_q.php?qn_id=361677&lang=en) - [A 65-year-old client admitted to the medical ICU with sepsis and acute delirium has just p…](https://mymerci.kr/pages/nclex_q.php?qn_id=361679&lang=en) - [A new graduate registered nurse (RN) on a medical unit just hung an intravenous antibiotic…](https://mymerci.kr/pages/nclex_q.php?qn_id=361710&lang=en) - [A nurse is caring for a client newly admitted with active Clostridioides difficile infecti…](https://mymerci.kr/pages/nclex_q.php?qn_id=363996&lang=en) - [A nurse is caring for an adult client newly admitted with suspected active pulmonary tuber…](https://mymerci.kr/pages/nclex_q.php?qn_id=366306&lang=en) - [A nurse is assigning rooms for clients with multidrug-resistant organisms: MRSA wound infe…](https://mymerci.kr/pages/nclex_q.php?qn_id=368203&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=366709&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=366709&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=366709&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=366709&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=366709&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._