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
Which drugs are used as antidotes for nerve agent poisoning?
- AAtropine and pralidoxime
- BNaloxone and flumazenil
- CVitamin K and protamine
- DAcetylcysteine and charcoal
2.Infection control & patient safetyHard
Who should mark the operative site before surgery?
- AAny member of the operating room team after anesthesia starts
- BThe person who will perform the procedure, with the patient involved where possible
- CThe patient, alone, using a marker pen at home on the night before surgery
- DThe admitting clerk, using the information written on the consent form
3.Nursing fundamentalsMedium
Which behaviour shows active listening?
- AParaphrasing what the patient said to check understanding
- BChanging the subject when emotions come up
- CPlanning your reply while the patient is talking
- DLooking at the computer screen to take notes during the conversation
4.Nursing fundamentalsHard
A patient with diabetes is found unresponsive with a very low blood glucose and cannot swallow. What is the correct approach?
- APour sugary juice into the patient's mouth
- BCall for help and give glucose by another route, such as IV glucose or IM glucagon, as per protocol
- CWait for the patient to wake up and then give food
- DGive the patient's usual dose of insulin
5.MicrobiologyMedium
What is the main difference between innate and adaptive immunity?
- AAdaptive immunity acts within minutes of infection
- BInnate immunity develops only after vaccination
- CInnate immunity uses antibodies and forms memory; adaptive immunity does not
- DAdaptive immunity is specific and forms memory; innate immunity does not
6.MicrobiologyHard
What did Pasteur's swan-neck flask experiment demonstrate?
- ABoiling cannot kill microorganisms
- BMicroorganisms need light to grow
- CAir itself produces microorganisms
- DMicroorganisms come from other microorganisms, not from spontaneous generation
3Solutions
1.Infection control & patient safety
Answer: A · Atropine and pralidoxime
Why this is the answer
Nerve agents inhibit acetylcholinesterase, causing excess acetylcholine. Atropine blocks muscarinic effects such as secretions and bradycardia, and pralidoxime helps to reactivate the enzyme.
A · Atropine and pralidoxime
2.Infection control & patient safety
Answer: B · The person who will perform the procedure, with the patient involved where possible
Why this is the answer
Under the Universal Protocol, the site is marked by the person performing the procedure, or an authorized delegate, ideally while the patient is awake and can confirm it. This helps prevent wrong-site surgery.
B · The person who will perform the procedure, with the patient involved where possible
3.Nursing fundamentals
Answer: A · 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.
A · Paraphrasing what the patient said to check understanding
4.Nursing fundamentals
Answer: B · 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.
B · Call for help and give glucose by another route, such as IV glucose or IM glucagon, as per protocol
5.Microbiology
Answer: D · Adaptive immunity is specific and forms memory; innate immunity does not
Why this is the answer
Innate defences (barriers, phagocytes, complement) act fast and in the same way each time. Adaptive immunity (B and T cells) takes days, is specific to each antigen and forms memory.
D · Adaptive immunity is specific and forms memory; innate immunity does not
6.Microbiology
Answer: D · Microorganisms come from other microorganisms, not from spontaneous generation
Why this is the answer
Boiled broth in a flask with a curved neck stayed sterile because dust and microbes were trapped in the bend. When the neck was broken, microbes entered and grew, disproving spontaneous generation.
D · Microorganisms come from other microorganisms, not from spontaneous generation