# A nurse is caring for a patient with hepatitis B. Which action by the nurse demonstrates the most appropriate infection control practice? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=540574 > language: ko > subject: Adult Health ## 문제 A nurse is caring for a patient with hepatitis B. Which action by the nurse demonstrates the most appropriate infection control practice? ## 보기 1. Wearing only gloves when handling the patient's blood specimens 2. Using alcohol-based hand sanitizer instead of soap and water after patient contact 3. Placing the patient in droplet precautions with a surgical mask 4. Following standard precautions and treating all body fluids as potentially infectious **✔ 정답** **정답: 4** ## 해설 Standard precautions are the foundation of infection control for hepatitis B, as it is transmitted through blood and body fluids. Other options are insufficient or inappropriate for hepatitis B transmission routes. ## 심화 해설 Correct Answer: 4 Explanation of the Best Practice The most appropriate infection control practice when caring for a patient with hepatitis B is to consistently follow standard precautions and treat all body fluids as potentially infectious. This principle is the foundation of modern infection prevention and is explicitly mandated by federal regulations and guidelines designed to protect healthcare workers from bloodborne pathogens like the hepatitis B virus (HBV) [1,2]. Hepatitis B is a bloodborne pathogen, meaning it is present in blood and certain other body fluids and can cause life-threatening liver disease [1]. The core concept of standard precautions, which evolved from the universal precautions introduced by the CDC in 1985, is a single, consistent level of infection control to be used for all patients, regardless of their known or suspected infection status [2]. This approach eliminates the risk of relying on incomplete patient histories and ensures safety by treating all blood and other potentially infectious materials (OPIM) as hazardous. OPIM includes semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, and any body fluid visibly contaminated with blood [2]. By adopting this mindset and its associated practices, the nurse creates a safe environment for themselves, their colleagues, and other patients, effectively breaking the chain of infection transmission. Analysis of Incorrect Options Option 1: Wearing only gloves when handling the patient's blood specimens. This practice is incomplete and unsafe. While gloves are a critical component of standard precautions for anticipated contact with blood, they are not the only barrier required. The OSHA Bloodborne Pathogens Standard mandates a comprehensive approach that includes hand hygiene, appropriate personal protective equipment (PPE) such as gowns, masks, and eye protection when splashes or sprays are anticipated, safe handling of sharps, and proper waste disposal [1]. Relying on gloves alone ignores the risk of exposure to mucous membranes or non-intact skin from a splash, which would necessitate additional barriers. A quasi-experimental study on nursing students demonstrated that clinical training improves compliance with the full scope of standard precautions, highlighting that it is a multi-faceted practice, not just a single action like donning gloves . Option 2: Using alcohol-based hand sanitizer instead of soap and water after patient contact. This option presents a false choice and an incorrect practice. Hand hygiene is a cornerstone of standard precautions, but the method must be appropriate for the situation. Alcohol-based hand sanitizers are effective against many microorganisms, but they are not the recommended primary method when hands are visibly soiled or after contact with blood or body fluids. In such cases, washing with soap and water is required. The protocol is not an "either-or" choice; it is a specific sequence. Furthermore, multifaceted interventions to improve nurse compliance with standard precautions have shown that education on the correct application of practices, including hand hygiene protocols, is essential for effectiveness . Option 3: Placing the patient in droplet precautions with a surgical mask. This action applies an incorrect transmission-based precaution. Hepatitis B is a bloodborne pathogen, not a droplet-borne pathogen. Its primary mode of transmission in healthcare settings is through percutaneous (e.g., needlestick) or mucosal exposure to infected blood or OPIM [1,2]. Droplet precautions, which involve a surgical mask and are designed for pathogens transmitted via large respiratory droplets (e.g., influenza, pertussis), are not indicated for HBV. Placing the patient on inappropriate precautions would misuse resources and does not address the actual mechanism of transmission. The correct approach is strict adherence to standard precautions, which is the single-level strategy intended to prevent bloodborne pathogen transmission from all patients [2].References (research sources) - [1]OSHA Bloodborne Pathogen StandardsResearch articleDenault D, Goldin J. (2026) - [2]Universal PrecautionsResearch articleKopitnik NL, Kahwaji CI. (2026) ## 임상 시나리오 Standard Precautions for Bloodborne PathogensTreating all blood and OPIM as infectious The single most critical practice is applying Standard Precautions to every patient, regardless of diagnosis. This means treating all blood and OPIM as potentially infectious. Key components include performing hand hygiene before and after patient contact, and using appropriate personal protective equipment (PPE) such as gloves, gowns, masks, and eye protection when anticipating exposure to blood or body fluids. CautionHepatitis B is a bloodborne pathogen, not transmitted via droplets. Droplet precautions are unnecessary. Use soap and water for hand hygiene if hands are visibly soiled, even if an alcohol-based sanitizer is available. ## 핵심 개념 - **Standard Precautions** — A set of infection control practices used for all patients to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin, and mucous membranes. - **Bloodborne Pathogens** — Pathogenic microorganisms present in human blood that can cause disease in humans, such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). - **OPIM (Other Potentially Infectious Materials)** — Body fluids and materials considered potentially infectious for bloodborne pathogens, including semen, vaginal secretions, cerebrospinal fluid, and any body fluid visibly contaminated with blood. - **Hepatitis B Virus (HBV)** — A serious liver infection caused by the hepatitis B virus; a major occupational hazard for healthcare workers transmitted through blood and OPIM. ## 같은 주제 문제 - [A nurse is assessing a 35-year-old patient who presents to the emergency department with a…](https://mymerci.kr/pages/nclex_q.php?qn_id=540559) - [A nurse is assessing a 60-year-old patient with suspected hepatitis B who presents with ja…](https://mymerci.kr/pages/nclex_q.php?qn_id=540560) - [A nurse is caring for a client with acute hepatitis B. 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