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
A patient on oxygen is being taken to another department by wheelchair. What should the nurse check first?
- AThat the cylinder is the largest size available
- BThat the portable cylinder has enough oxygen for the whole trip
- CThat the cylinder is placed on the patient’s lap
- DThat the oxygen is turned off during the transfer to save the supply in the tank
2.Infection control & patient safetyHard
A patient who speaks little English is being discharged with new medications. The patient’s 12-year-old child offers to interpret. What should the nurse do?
- AUse simple English and many hand gestures
- BGive written instructions in English only
- CLet the child interpret, because the family prefers it
- DUse a professional medical interpreter
3.Nursing fundamentalsMedium
How should a patient walk with a standard (non-wheeled) walking frame?
- APush the frame along the floor while walking quickly
- BLift the frame forward, then step into it
- CStep forward first, then pull the frame after
- DLean forward on the frame and slide the feet
4.Nursing fundamentalsHard
A patient with diabetes is found unresponsive with a very low blood glucose and cannot swallow. What is the correct approach?
- AGive the patient's usual dose of insulin
- BPour sugary juice into the patient's mouth
- CWait for the patient to wake up and then give food
- DCall for help and give glucose by another route, such as IV glucose or IM glucagon, as per protocol
5.MicrobiologyMedium
Which organism is a common cause of infection in burns and in people with cystic fibrosis, and can produce a green pigment?
- AStreptococcus pyogenes
- BHelicobacter pylori
- CClostridium tetani
- DPseudomonas aeruginosa
6.MicrobiologyHard
Which hepatitis viruses are mainly spread through contaminated food and water?
- AHepatitis C and E
- BHepatitis A and E
- CHepatitis B and D
- DHepatitis B and C
3Solutions
1.Infection control & patient safety
Answer: B · That the portable cylinder has enough oxygen for the whole trip
Why this is the answer
The nurse checks the cylinder gauge and makes sure there is enough oxygen for the trip and possible delays. The cylinder is secured in a holder on the chair, not on the patient’s lap.
B · That the portable cylinder has enough oxygen for the whole trip
2.Infection control & patient safety
Answer: D · Use a professional medical interpreter
Why this is the answer
Professional medical interpreters reduce errors and protect privacy. Children and other family members may translate wrongly, leave things out or be placed in a difficult position.
D · Use a professional medical interpreter
3.Nursing fundamentals
Answer: B · Lift the frame forward, then step into it
Why this is the answer
The frame is lifted a short step forward with all four feet placed down, then the patient steps into it, usually leading with the weaker leg.
B · Lift the frame forward, then step into it
4.Nursing fundamentals
Answer: D · Call for help and give glucose by another route, such as IV glucose or IM glucagon, as per protocol
Why this is the answer
Oral glucose risks aspiration when a patient cannot swallow. Following local protocol, the nurse calls for help, protects the airway and gives IV glucose or IM glucagon, then rechecks glucose.
D · Call for help and give glucose by another route, such as IV glucose or IM glucagon, as per protocol
5.Microbiology
Answer: D · Pseudomonas aeruginosa
Why this is the answer
Pseudomonas aeruginosa is an opportunistic pathogen of burns, ventilated patients and cystic fibrosis lungs. It is naturally resistant to many antibiotics.
D · Pseudomonas aeruginosa
6.Microbiology
Answer: B · Hepatitis A and E
Why this is the answer
Hepatitis A and E spread by the faecal–oral route. B, C and D spread through blood and body fluids and can cause chronic infection.