1Formulas and methods
Infection control & patient safety
Method
- Start with standard precautions for every patient: hand hygiene, PPE for the expected exposure, safe sharps.
- Add precautions by route: contact (gown, gloves), droplet (surgical mask), airborne (N95, negative-pressure room).
- Keep sterile items sterile: if in doubt, it is not sterile; replace, never wipe.
- Prevent harm in the environment: fall measures, restraints only as a last resort, RACE and PASS for fire.
- Check the rights of medication administration, two identifiers and extra safeguards for high-alert drugs; report errors and near misses.
2Practice problems
1.Infection control & patient safetyMedium
The barcode scanner warns that the medication does not match the patient’s record. What should the nurse do?
- AScan a different patient’s wristband
- BGive the medication and report the warning later in the shift
- COverride the warning and give the medication
- DStop and find out why before giving the medication
2.Infection control & patient safetyHard
A visitor is receiving an electric shock from a faulty lamp and is still touching it. What should the nurse do first?
- AStart chest compressions straight away
- BPull the visitor away from the lamp by the arm as quickly as possible
- CSwitch off the power or unplug the lamp without touching the person
- DThrow water over the lamp to stop the current
3.Nursing fundamentalsMedium
Which behaviour shows active listening?
- ALooking at the computer screen to take notes during the conversation
- BPlanning your reply while the patient is talking
- CParaphrasing what the patient said to check understanding
- DChanging the subject when emotions come up
4.Nursing fundamentalsHard
In English law, giving a treatment to a competent adult who has clearly refused it may amount to:
- ADefamation of character
- BBattery (trespass to the person)
- CBreach of an employment contract
- DTheft
5.MicrobiologyMedium
In which phase of the bacterial growth curve do the cells divide at their fastest constant rate?
- ALag (adaptation) phase
- BStationary (plateau) phase
- CDeath phase
- DLog (exponential) phase
6.MicrobiologyHard
Joseph Lister reduced infection after surgery in the 1860s. What was his main innovation?
- AUsing steam autoclaves to sterilise all surgical instruments before each operation
- BUsing carbolic acid (phenol) as an antiseptic on wounds and instruments
- CVaccinating surgeons against staphylococci
- DGiving sulfonamide antibiotics after every operation
3Solutions
1.Infection control & patient safety
Answer: D · Stop and find out why before giving the medication
Why this is the answer
Barcode warnings exist to catch wrong-patient, wrong-drug and wrong-dose errors. The nurse stops and checks the order and the product, and contacts the pharmacy or prescriber. Overriding warnings out of habit causes errors.
D · Stop and find out why before giving the medication
2.Infection control & patient safety
Answer: C · Switch off the power or unplug the lamp without touching the person
Why this is the answer
The rescuer must not touch someone still in contact with live current. The power is switched off or the plug pulled first, then the person is assessed and resuscitation is started if needed.
C · Switch off the power or unplug the lamp without touching the person
3.Nursing fundamentals
Answer: C · Paraphrasing what the patient said to check understanding
Why this is the answer
Active listening includes attention, appropriate eye contact, nodding, reflecting and paraphrasing. It helps patients feel heard and gives the nurse accurate information.
C · Paraphrasing what the patient said to check understanding
4.Nursing fundamentals
Answer: B · Battery (trespass to the person)
Why this is the answer
Touching or treating a person without valid consent can be battery, even if the treatment was meant to help. This is why consent is needed before care.
B · Battery (trespass to the person)
5.Microbiology
Answer: D · Log (exponential) phase
Why this is the answer
After the lag phase of adjustment, cells enter the log phase and grow exponentially. Growth stops in the stationary phase as nutrients run out and waste builds up.
D · Log (exponential) phase
6.Microbiology
Answer: B · Using carbolic acid (phenol) as an antiseptic on wounds and instruments
Why this is the answer
Lister applied carbolic acid to wounds, dressings and instruments, which greatly reduced post-operative infection. This started antiseptic surgery.
B · Using carbolic acid (phenol) as an antiseptic on wounds and instruments