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 about care of a surgical incision at home. Which statement shows a need for further teaching?
- A“I will wash my hands with soap before I touch or change the dressing.”
- B“I will keep the dressing clean and dry as I was shown.”
- C“I will call the clinic if I get a fever or more pain around the wound.”
- D“If the wound gets red and drains pus, I will wait for my appointment next month.”
3.Nursing fundamentalsMedium
Why is high-flow oxygen often humidified?
- ATo make the oxygen more concentrated before it reaches the lungs
- BTo cool the patient's temperature
- CTo stop the airways and secretions from drying out
- DTo add medicine to the oxygen
4.Nursing fundamentalsHard
Over 24 hours a patient takes in 2400 mL and has a total measured output of 1800 mL. What is the fluid balance?
- APositive 600 mL
- BNegative 600 mL
- CPositive 4200 mL
- DBalanced, because both values are high
5.MicrobiologyMedium
Which statement is one of Koch's postulates?
- AThe organism must be visible with the naked eye
- BThe organism must be found in healthy people as well
- CThe organism must cause the same disease when introduced into a healthy susceptible host
- DThe disease must respond to antibiotics
6.MicrobiologyHard
Why can an HIV antibody test be negative in the first weeks after infection?
- AHIV does not trigger antibody production at all
- BThe virus hides only in red blood cells during the first weeks
- CThe body has not yet produced enough antibodies to detect
- DThe antibodies are destroyed by the test reagents
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 · “If the wound gets red and drains pus, I will wait for my appointment next month.”
Why this is the answer
Increasing redness, purulent drainage, fever and worsening pain are signs of surgical site infection and should be reported promptly. Waiting a month could allow the infection to spread.
D · “If the wound gets red and drains pus, I will wait for my appointment next month.”
3.Nursing fundamentals
Answer: C · To stop the airways and secretions from drying out
Why this is the answer
Dry gas at high flow dries the mucous membranes and thickens secretions. Humidification keeps the airways moist and secretions easier to clear.
C · To stop the airways and secretions from drying out
4.Nursing fundamentals
Answer: A · Positive 600 mL
Why this is the answer
2400 − 1800 = +600 mL, a positive balance. Insensible losses such as sweat and breathing are not measured, so true balance is lower than the chart shows.
5.Microbiology
Answer: C · The organism must cause the same disease when introduced into a healthy susceptible host
Why this is the answer
Koch's postulates say the microbe must be found in every case, grown in pure culture, cause the disease in a healthy host and be recovered again from that host. Some pathogens cannot be cultured, so the postulates have limits.
C · The organism must cause the same disease when introduced into a healthy susceptible host
6.Microbiology
Answer: C · The body has not yet produced enough antibodies to detect
Why this is the answer
Antibodies take several weeks to appear. Combined tests that also detect the p24 antigen, or tests for viral RNA, shorten this window period.
C · The body has not yet produced enough antibodies to detect