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 with difficulty swallowing is prescribed an extended-release tablet. What should the nurse do?
- ACrush the tablet finely and mix it into a spoonful of applesauce or yogurt
- BDissolve the tablet in a glass of hot water
- CCut the tablet in half so it is easier to swallow
- DAsk the prescriber or pharmacist for another form and not crush the tablet
2.Infection control & patient safetyHard
A night nurse suggests restraining a calm but wandering patient “so we can manage with fewer staff tonight”. Which response is correct?
- ARestraints are acceptable at night when staffing is low
- BRestraint is never for staff convenience; use rounding or a sitter
- CRestraints are acceptable if the family agrees to them in writing first
- DRestraints are acceptable if removed in the morning
3.Nursing fundamentalsMedium
What makes "Risk for falls" a risk nursing diagnosis rather than an actual one?
- AThe patient has already fallen several times
- BThe doctor has confirmed the diagnosis with tests and a scan
- CThe fall has not happened yet, but risk factors are present
- DThe problem can never be prevented
4.Nursing fundamentalsHard
A patient with COPD and a known risk of hypercapnia is acutely breathless with an SpO₂ of 82%. What is correct?
- AWithhold oxygen completely, because oxygen is dangerous in COPD
- BWait for an arterial blood gas result before giving any oxygen at all
- CGive the highest oxygen flow possible and aim for 100%
- DGive controlled oxygen, e.g. via a Venturi mask, aiming for 88–92%
5.MicrobiologyMedium
Which virus family includes the viruses that cause cold sores and chickenpox?
- ARetroviruses
- BCoronaviruses
- CHerpesviruses
- DPicornaviruses
6.MicrobiologyHard
Why can an HIV antibody test be negative in the first weeks after infection?
- AThe body has not yet produced enough antibodies to detect
- BThe virus hides only in red blood cells during the first weeks
- CHIV does not trigger antibody production at all
- DThe antibodies are destroyed by the test reagents
3Solutions
1.Infection control & patient safety
Answer: D · Ask the prescriber or pharmacist for another form and not crush the tablet
Why this is the answer
Crushing or splitting an extended-release product can release the whole dose at once and cause toxicity. The nurse asks for a suitable alternative, such as a liquid or immediate-release form.
D · Ask the prescriber or pharmacist for another form and not crush the tablet
2.Infection control & patient safety
Answer: B · Restraint is never for staff convenience; use rounding or a sitter
Why this is the answer
Restraint is allowed only to protect the patient or others from immediate harm when less restrictive measures have failed, never for convenience or discipline. Rounding, a bed alarm, a sitter and a calm environment are alternatives.
B · Restraint is never for staff convenience; use rounding or a sitter
3.Nursing fundamentals
Answer: C · The fall has not happened yet, but risk factors are present
Why this is the answer
A risk diagnosis describes a problem the patient is vulnerable to, based on risk factors, with no signs yet. Care aims to prevent the problem from occurring.
C · The fall has not happened yet, but risk factors are present
4.Nursing fundamentals
Answer: D · Give controlled oxygen, e.g. via a Venturi mask, aiming for 88–92%
Why this is the answer
Oxygen must not be withheld from a hypoxic patient. In those at risk of hypercapnia it is given in a controlled way to a target of 88–92%, with blood gases checked.
D · Give controlled oxygen, e.g. via a Venturi mask, aiming for 88–92%
5.Microbiology
Answer: C · Herpesviruses
Why this is the answer
Herpes simplex (cold sores) and varicella-zoster (chickenpox, shingles) are herpesviruses that remain latent in sensory ganglia and can reactivate.
6.Microbiology
Answer: A · 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.
A · The body has not yet produced enough antibodies to detect