# A nurse is caring for a client with a central venous catheter. After adjusting the infusion pump without touching the client, the nurse plans to access the catheter hub to change the dressing. Which actions are appropriate for hand hygiene? Select all that apply. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=558416&lang=en > language: en > subject: Standard/Transmission-Based Precautions/Surgical Asepsis > category: SIPC ## Question A nurse is caring for a client with a central venous catheter. After adjusting the infusion pump without touching the client, the nurse plans to access the catheter hub to change the dressing. Which actions are appropriate for hand hygiene? Select all that apply. 1 Perform hand hygiene after adjusting the pump, gather the dressing supplies, and consider that action sufficient before hub access if clean gloves are worn. 2 Perform hand hygiene immediately before accessing the catheter hub, even if clean gloves will be worn. 3 Use an alcohol-based handrub if the hands become visibly soiled during the dressing change, provided the hands are rubbed until dry. 4 Perform hand hygiene after removing gloves if the dressing change involves contact with blood or body fluids. 5 Use clean nonsterile gloves instead of hand hygiene for hub access because sterile supplies will be used for the dressing change. 6 Wash hands with soap and water if they become visibly soiled during the dressing change. ## Explanation Central-line care requires hand hygiene at the moment immediately before the aseptic task, even when gloves will be worn (Choice 2). After a dressing change with possible blood or body-fluid exposure, the nurse performs hand hygiene after glove removal (Choice 4). Visibly soiled hands require soap and water (Choice 6). Hand hygiene performed earlier, before handling supplies, cannot be treated as sufficient for later hub access (Choice 1). Alcohol handrub does not remove visible soil (Choice 3), and clean gloves never replace hand hygiene (Choice 5). ## In-depth explanation Correct Answer Choices 2, 4, 6 Clinical Reasoning Central-line care requires hand hygiene at the moment immediately before the aseptic task, even when gloves will be worn (Choice 2). After a dressing change with possible blood or body-fluid exposure, the nurse performs hand hygiene after glove removal (Choice 4). Visibly soiled hands require soap and water (Choice 6). Hand hygiene performed earlier, before handling supplies, cannot be treated as sufficient for later hub access (Choice 1). Alcohol handrub does not remove visible soil (Choice 3), and clean gloves never replace hand hygiene (Choice 5). Option Review - Incorrect — Hand hygiene after pump contact does not remain sufficient if the nurse then handles supplies. Hand hygiene must occur again immediately before the aseptic hub-access step, and gloves do not replace it. - Correct — Hand hygiene must be performed immediately before any clean or aseptic task, such as accessing a central venous catheter hub, regardless of glove use. - Incorrect — Visible soil or organic material must be removed with soap and water; extending alcohol handrub contact time does not substitute for washing visibly soiled hands. - Correct — Hand hygiene is indicated after any task involving risk of exposure to blood or body fluids, including after glove removal following a dressing change. - Incorrect — Clean gloves do not replace hand hygiene before an aseptic task. The nurse performs hand hygiene immediately before hub access and then dons the gloves required by the procedure. - Correct — If hands become visibly soiled during care, they should be washed with soap and water rather than using alcohol-based handrub. Sources 12026 NCLEX-RN Test Plan 2WHO: Five moments for hand hygiene 3WHO: Hand hygiene and glove use FAQ ## Clinical scenario A nurse is caring for a client with a central venous catheter in a medical-surgical unit. 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