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
When should a nurse use an extinguisher on a fire?
- AOnly if the fire is small, the alarm is raised and the exit is clear
- BWhenever there is smoke, even if the exit is blocked
- CNever; only firefighters may use fire extinguishers
- DAlways, even before the alarm has been raised, to save time
2.Infection control & patient safetyHard
A nurse teaches a patient going home with an MRSA wound infection. Which statement shows a need for further teaching?
- A“I will keep the wound covered with a clean, dry dressing.”
- B“I will put used dressings in a sealed bag before throwing them out.”
- C“I will wash my hands after touching my dressing.”
- D“I can share towels with my family if I wash them every week.”
3.Nursing fundamentalsMedium
A patient arrives back on the ward after surgery. What does the nurse assess first?
- APain score
- BThe wound dressing
- CAirway and breathing
- DFluid balance chart
4.Nursing fundamentalsHard
A nurse has a needlestick injury from a used needle. What is the correct first action?
- AScrub the area hard with a brush and alcohol, then report it at the end of the shift
- BLet it bleed freely, wash with soap and running water, then report it urgently
- CFinish the shift and report it the next day
- DSuck the wound to remove the blood
5.MicrobiologyMedium
Which white blood cells are the main phagocytes in an acute bacterial infection and the main component of pus?
- AEosinophils
- BBasophils
- CB lymphocytes
- DNeutrophils
6.MicrobiologyHard
Which bacterial toxin causes the muscle spasms of tetanus?
- ACholera toxin, which activates adenylate cyclase
- BTetanospasmin, which blocks inhibitory neurotransmitter release
- CEndotoxin from the outer membrane
- DBotulinum toxin, which blocks acetylcholine release at the neuromuscular junction
3Solutions
1.Infection control & patient safety
Answer: A · Only if the fire is small, the alarm is raised and the exit is clear
Why this is the answer
Staff may attempt to put out a small, contained fire once people are safe and the alarm has been raised, keeping an exit behind them. Otherwise, they close doors and evacuate.
A · Only if the fire is small, the alarm is raised and the exit is clear
2.Infection control & patient safety
Answer: D · “I can share towels with my family if I wash them every week.”
Why this is the answer
MRSA spreads by direct contact and shared items, so towels, razors and linen should not be shared. Hand hygiene, covering the wound and bagging dressings are correct.
D · “I can share towels with my family if I wash them every week.”
3.Nursing fundamentals
Answer: C · Airway and breathing
Why this is the answer
After anaesthesia the airway and breathing are checked first, then circulation, consciousness, pain, the wound, drains and fluids.
4.Nursing fundamentals
Answer: B · Let it bleed freely, wash with soap and running water, then report it urgently
Why this is the answer
First aid is to let the wound bleed freely without squeezing, wash it with soap and running water and cover it, without scrubbing or sucking. Reporting straight away allows a risk assessment and, if needed, post-exposure prophylaxis.
B · Let it bleed freely, wash with soap and running water, then report it urgently
5.Microbiology
Answer: D · Neutrophils
Why this is the answer
Neutrophils arrive quickly at sites of infection and engulf bacteria. Dead neutrophils, bacteria and tissue debris form pus.
6.Microbiology
Answer: B · Tetanospasmin, which blocks inhibitory neurotransmitter release
Why this is the answer
Tetanospasmin from Clostridium tetani blocks the release of GABA and glycine from inhibitory interneurons, causing spastic paralysis. Botulinum toxin, by contrast, causes flaccid paralysis.
B · Tetanospasmin, which blocks inhibitory neurotransmitter release