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?
- AWhenever there is smoke, even if the exit is blocked
- BNever; only firefighters may use fire extinguishers
- CAlways, even before the alarm has been raised, to save time
- DOnly if the fire is small, the alarm is raised and the exit is clear
2.Infection control & patient safetyHard
A nurse who has a cold sore (herpes labialis) is assigned to the newborn nursery. What is most appropriate?
- ATell no one, and cover the lesion with makeup during shifts
- BInform the manager, who may reassign the nurse for now
- CWear gloves and carry on as usual
- DWork as usual, since cold sores are very common
3.Nursing fundamentalsMedium
Why must oxygen be prescribed with a target saturation range?
- AOxygen is expensive and must be counted
- BIt is a drug, and too much or too little can harm the patient
- CPrescriptions are needed only for oxygen used at home, not in hospital
- DOxygen is only allowed for surgical patients
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
- BSuck the wound to remove the blood
- CFinish the shift and report it the next day
- DLet it bleed freely, wash with soap and running water, then report it urgently
5.MicrobiologyMedium
Pneumocystis jirovecii pneumonia in a person with advanced HIV is an example of:
- AA food-borne infection
- BAn opportunistic infection
- CA zoonotic infection
- DA vector-borne infection
6.MicrobiologyHard
After eating home-canned vegetables, a patient develops double vision, difficulty swallowing and a descending flaccid paralysis. What is the most likely cause?
- ABotulinum toxin, which blocks acetylcholine release
- BA viral infection of the motor neurons
- CTetanus toxin, which blocks inhibitory neurotransmitters
- DEndotoxin from Gram-negative bacteria
3Solutions
1.Infection control & patient safety
Answer: D · 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.
D · Only if the fire is small, the alarm is raised and the exit is clear
2.Infection control & patient safety
Answer: B · Inform the manager, who may reassign the nurse for now
Why this is the answer
Herpes simplex can cause severe infection in newborns. Staff with active lesions inform their manager and follow occupational health advice, which often means avoiding contact with newborns and other high-risk patients until the lesion has healed.
B · Inform the manager, who may reassign the nurse for now
3.Nursing fundamentals
Answer: B · It is a drug, and too much or too little can harm the patient
Why this is the answer
Oxygen is treated as a medicine. A target range guides the nurse to adjust the flow, avoiding both hypoxaemia and harm from excess oxygen, for example in patients who retain CO₂.
B · It is a drug, and too much or too little can harm the patient
4.Nursing fundamentals
Answer: D · 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.
D · Let it bleed freely, wash with soap and running water, then report it urgently
5.Microbiology
Answer: B · An opportunistic infection
Why this is the answer
Opportunistic infections take advantage of a weakened immune system. In HIV they become common when the CD4 count falls to low levels.
B · An opportunistic infection
6.Microbiology
Answer: A · Botulinum toxin, which blocks acetylcholine release
Why this is the answer
Clostridium botulinum can grow in poorly canned, low-acid foods and produce botulinum toxin. The toxin blocks acetylcholine release at nerve endings, causing descending flaccid paralysis.
A · Botulinum toxin, which blocks acetylcholine release