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NCLEX · Reduction of Risk Potential

A client is on contact precautions for Clostridioides difficile (C. diff). Which hand hygiene method is required?

Correct answer

Soap and water handwashing — alcohol-based sanitizers do NOT kill C. diff spores; mechanical removal by washing with soap and water is required after caring for a C. diff patient

  1. A Alcohol-based hand sanitizer is sufficient
  2. B Soap and water handwashing — alcohol-based sanitizers do NOT kill C. diff spores; mechanical removal by washing with soap and water is required after caring for a C. diff patient
  3. C No hand hygiene needed if gloves were worn
  4. D Hand sanitizer followed by lotion

Why this is the answer

C. DIFF HAND HYGIENE — A CLASSIC NCLEX POINT: C. difficile forms SPORES that are resistant to alcohol — alcohol-based hand sanitizers do NOT kill C. diff spores; SOAP AND WATER required — the mechanical action of washing physically removes spores from hands; ALWAYS wash with soap and water before and after C. diff patient contact, even if gloves were worn (gloves can have micro-tears, and removal can contaminate hands); CONTACT PRECAUTIONS for C. diff: gown and gloves; dedicated equipment; private room (or cohort with other C. diff patients); ENVIRONMENTAL CLEANING: C. diff spores survive on surfaces — use a sporicidal agent (bleach-based) for room cleaning (regular disinfectants don't kill spores); TRANSMISSION: Fecal-oral; spores spread via contaminated hands and surfaces; RISK FACTORS: Recent antibiotic use (disrupts normal gut flora), hospitalization, advanced age; this soap-vs-sanitizer distinction is tested on nearly every NCLEX exam.
Source: NCLEX-PN Physiological — Reduction of Risk, C. diff Hand Hygiene

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