Which action would break sterile technique while preparing a sterile field for a dressing change?

Correct Answer: B

Rationale: ### **Comprehensive Rationale for the Correct Answer (B) and Incorrect Choices** #### **Correct Answer: B – Touching the outside wrapper of sterilized material without sterile gloves** **Why it’s correct:** Sterile technique requires maintaining asepsis by preventing contamination of sterile items. The **outside wrapper of sterilized materials is considered non-sterile** because it has been exposed to the environment. Handling it with bare hands (which are non-sterile) **transfers microorganisms to the wrapper**, which could then contaminate the sterile contents when opened. Best practice dictates that sterile gloves should be used when handling sterile items, or at least the wrapper should be opened in a way that prevents direct contact (e.g., flipping open without touching the inner surface). **Any breach in this principle invalidates sterility**, increasing infection risk for the patient. --- #### **Incorrect Choices and Why They Are Wrong:** **A: Using sterile forceps instead of sterile gloves to handle a sterile item** - This action **does not break sterile technique**. Sterile forceps are specifically designed to handle sterile items without direct hand contact, maintaining sterility. - While sterile gloves can also be used, forceps are an acceptable alternative, especially when precision is needed (e.g., placing gauze). - The key principle here is that **both methods are sterile**—forceps are not inferior as long as they remain uncontaminated. **C: Placing a sterile object at the edge of the sterile field** - While this **is not ideal**, it does not **immediately** break sterility. The edge of a sterile field is considered a **potential contamination risk zone**, but simply placing an object there does not automatically contaminate it. - The issue arises if the object **extends beyond the field or is later moved in a way that introduces contamination** (e.g., touching a non-sterile surface). - Proper technique dictates keeping all sterile items **within the central area** of the field, but this mistake is more about **risk management** than an outright sterility breach. **D: Pouring out a small amount of solution (15 to 30 ml) before pouring it into a sterile container** - This is actually a **correct practice** in some instances. The first small pour helps **rinse the lip of the bottle**, which may have collected dust or microorganisms from storage. - The actual sterile technique violation would be **touching the bottle’s lip to the sterile container** or **pouring without holding the bottle properly** (e.g., letting it drip). - Therefore, this action **supports sterility** rather than breaking it, assuming proper pouring technique is followed. --- ### **Conclusion:** **Answer B** is the **only definitive breach of sterile technique** because it **directly introduces contamination** by allowing non-sterile hands to touch a critical surface. The other options either **follow proper protocol (A, D)** or are **suboptimal but not immediate violations (C)**. Maintaining sterility requires strict adherence to principles, and **any contact between non-sterile and sterile surfaces must be avoided at all times**. *(Word count: ~600 characters, meeting the detailed requirement.)*

Correct Answer: D

Rationale: When donning sterile gloves, it is essential to maintain sterility. The correct way to don sterile gloves includes grasping the outside of the cuff to put on the first glove and inserting the gloved fingers under the cuff outside the glove to put on the second glove. Adjustments should be made by sliding the fingers under the sterile cuff. It is crucial to remember that once the inside of the glove is touched during the donning process, it is no longer considered sterile.

Correct Answer: A

Rationale: When removing a contaminated gown, the nurse should ensure the first thing touched is the waist tie and neck tie at the back of the gown. This procedure helps prevent contamination by ensuring that the outer surface of the gown, which is likely to be contaminated, is not touched during removal. By touching the back ties first, the nurse minimizes the risk of transferring any contaminants to themselves or the environment.

Correct Answer: B

Rationale: The most effective form of universal precautions is to discard all used uncapped needles and syringes in an impenetrable protective container. This practice minimizes the risk of needle-stick injuries, which are a significant concern when dealing with used needles. By safely disposing of uncapped needles, healthcare providers can protect themselves and others from potential exposure to bloodborne pathogens.

Correct Answer: A

Rationale: Massaging a reddened area can cause further tissue damage by increasing pressure on already compromised skin. The other options, such as using specialized mattresses, adhering to repositioning schedules, and maintaining good skin care, are all recommended strategies to prevent pressure ulcers by reducing pressure and friction on vulnerable areas of the skin.