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 colleague has drawn up a medication and asks the nurse to give it to her patient. What should the nurse do?
- ADecline, and give only medications that the nurse prepared or checked personally
- BGive it, as long as the syringe has a label with the drug name on it
- CGive it, and document that the colleague prepared it
- DGive it, because the colleague is experienced
2.Infection control & patient safetyHard
A nurse teaches a patient with neutropenia about preventing infection at home. Which statement shows a need for further teaching?
- A“I will check my temperature and call if I have a fever.”
- B“I will avoid crowds and people who have colds.”
- C“I will wash my hands often and ask visitors to do the same.”
- D“I can clean the cat’s litter box if I wear a face mask.”
3.Nursing fundamentalsMedium
What is a portable bladder scanner used for?
- AChecking the urine for blood and protein
- BDetecting kidney stones
- CMeasuring how much urine is in the bladder without a catheter
- DTaking a sterile sample of urine for culture without a catheter
4.Nursing fundamentalsHard
A pressure ulcer shows full-thickness skin loss with visible fat, but no bone, tendon or muscle is exposed. Which category is it?
- ACategory 2
- BCategory 4
- CCategory 1
- DCategory 3
5.MicrobiologyMedium
Why are Gram-negative bacteria often harder to treat with antibiotics?
- AThey have no ribosomes
- BThey have a thicker peptidoglycan layer
- CThey divide much more slowly
- DTheir outer membrane blocks many drugs
6.MicrobiologyHard
Which hepatitis viruses are mainly spread through contaminated food and water?
- AHepatitis C and E
- BHepatitis B and D
- CHepatitis A and E
- DHepatitis B and C
3Solutions
1.Infection control & patient safety
Answer: A · Decline, and give only medications that the nurse prepared or checked personally
Why this is the answer
Nurses give only medicines they prepared themselves or verified fully, because they are accountable for what they give. A drug prepared by someone else may be wrong in ways the nurse cannot see.
A · Decline, and give only medications that the nurse prepared or checked personally
2.Infection control & patient safety
Answer: D · “I can clean the cat’s litter box if I wear a face mask.”
Why this is the answer
Immunocompromised patients should avoid cleaning litter boxes and other animal waste, because of organisms such as Toxoplasma. Another person should do it. The other statements are correct.
D · “I can clean the cat’s litter box if I wear a face mask.”
3.Nursing fundamentals
Answer: C · Measuring how much urine is in the bladder without a catheter
Why this is the answer
A bladder scanner uses ultrasound to estimate bladder volume, for example after a patient has voided. It helps detect retention and avoids unnecessary catheterisation.
C · Measuring how much urine is in the bladder without a catheter
4.Nursing fundamentals
Answer: D · Category 3
Why this is the answer
Category 3 involves full-thickness skin loss with subcutaneous fat visible. Category 2 is partial-thickness loss, and category 4 exposes bone, tendon or muscle.
5.Microbiology
Answer: D · Their outer membrane blocks many drugs
Why this is the answer
The outer membrane of Gram-negative bacteria, with lipopolysaccharide and porins, keeps many antibiotics out and adds efflux and enzyme defences.
D · Their outer membrane blocks many drugs
6.Microbiology
Answer: C · Hepatitis A and E
Why this is the answer
Hepatitis A and E spread by the faecal–oral route. B, C and D spread through blood and body fluids and can cause chronic infection.