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 is on suicide precautions. Which room safety measure is appropriate?
- AAllow glass bottles if the patient seems calm
- BLet the patient keep a personal razor for shaving, as long as staff are told
- CRemove items that could be used for self-harm, such as belts and cords
- DKeep the door closed at all times so the patient has privacy
2.Infection control & patient safetyHard
A patient on chemotherapy develops shingles over several areas on both sides of the body. Which precautions are needed?
- ADroplet precautions until the pain settles
- BAirborne and contact precautions until all lesions are crusted
- CContact precautions only, with gloves for dressing changes
- DStandard precautions only, with the lesions covered
3.Nursing fundamentalsMedium
A goal states: "The patient will report pain of 3/10 or less within one hour of analgesia." After one hour the patient reports 6/10. What should the nurse do?
- ARecord the goal as not met and review the plan
- BWait until the next day to evaluate again
- CChange the goal to 6/10 or less so that it counts as met
- DRecord the goal as met, as the pain has gone down
4.Nursing fundamentalsHard
An 86-year-old has new confusion and a temperature of 37.1 °C. Why should infection still be considered?
- AOlder adults often have a weaker fever response to infection
- BOlder adults normally have a higher body temperature
- CA temperature of 37.1 °C is a fever in older adults
- DConfusion is always caused by infection in older adults
5.MicrobiologyMedium
Transfer of bacterial genes from one bacterium to another by a virus is called:
- ATransduction
- BConjugation
- CTransformation
- DTranscription
6.MicrobiologyHard
In 1854 John Snow traced a cholera outbreak in London to the Broad Street water pump. Why is this study important?
- AIt showed that cholera spreads through "bad air" (miasma)
- BIt proved that cholera is caused by a virus
- CIt led directly to the first cholera vaccine
- DIt showed that cholera spreads through contaminated water, founding modern epidemiology
3Solutions
1.Infection control & patient safety
Answer: C · Remove items that could be used for self-harm, such as belts and cords
Why this is the answer
Patients at risk of suicide need a safe environment, with belts, cords, sharp objects and glass removed, and observation at the level ordered. Privacy is secondary to safety in this situation.
C · Remove items that could be used for self-harm, such as belts and cords
2.Infection control & patient safety
Answer: B · Airborne and contact precautions until all lesions are crusted
Why this is the answer
Lesions over several areas on both sides mean disseminated zoster, which can spread through the air like chickenpox. Airborne and contact precautions are used until all lesions are dry and crusted. Localized zoster in an immunocompromised patient also needs airborne and contact precautions, but only until dissemination is ruled out.
B · Airborne and contact precautions until all lesions are crusted
3.Nursing fundamentals
Answer: A · Record the goal as not met and review the plan
Why this is the answer
Evaluation compares the outcome with the goal. The goal was not met, so the nurse reassesses, reports and revises the plan, for example with a different analgesic.
A · Record the goal as not met and review the plan
4.Nursing fundamentals
Answer: A · Older adults often have a weaker fever response to infection
Why this is the answer
Older adults may not mount a fever, and infection can show up as confusion, falls or reduced eating instead. A normal temperature does not rule out infection in this group.
A · Older adults often have a weaker fever response to infection
5.Microbiology
Answer: A · Transduction
Why this is the answer
In transduction a bacteriophage accidentally packages bacterial DNA and delivers it to the next cell it infects. Transformation is uptake of free DNA and conjugation uses direct contact.
6.Microbiology
Answer: D · It showed that cholera spreads through contaminated water, founding modern epidemiology
Why this is the answer
Snow mapped cases around the pump and linked them to its water. Removing the pump handle is a classic example of using epidemiology to find and stop a source, before the bacterium was identified.
D · It showed that cholera spreads through contaminated water, founding modern epidemiology