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
Which technique is used for suctioning a tracheostomy in hospital?
- ASterile technique, with a sterile catheter and sterile glove
- BClean technique, reusing the catheter during the shift
- CNo gloves at all, because the airway already contains bacteria
- DClean technique, with the catheter rinsed in tap water
2.Infection control & patient safetyHard
A nurse has given a medication to the wrong patient. The patient seems well. What is the first priority?
- AWait until the end of the shift to tell anyone
- BSay nothing to the patient, in order to avoid worrying them
- CAssess the patient and monitor for effects of the drug
- DComplete the incident report before anything else
3.Nursing fundamentalsMedium
What is the main aim of "protected mealtimes" on hospital wards?
- ATo stop visitors from bringing any food into hospital
- BTo make sure all patients eat the same meal at once
- CTo give staff a fixed break while the patients are eating their meals
- DTo let patients eat without interruptions, with help where needed
4.Nursing fundamentalsHard
A patient has had a stroke. Why must swallowing be screened before giving food, drink or oral medicine?
- ADysphagia is common after stroke and can cause aspiration pneumonia
- BSwallowing checks are only needed if the patient asks
- CPatients after a stroke are always kept nil by mouth for at least a week
- DOral medicines are never used after a stroke
5.MicrobiologyMedium
What is the main virulence factor of Streptococcus pneumoniae, and the target of its vaccines?
- AIts flagella
- BIts endospores
- CIts polysaccharide capsule
- DIts cholera-like toxin
6.MicrobiologyHard
Why are penicillins ineffective against Mycoplasma pneumoniae?
- AIt has a thick waxy mycolic acid layer that blocks entry
- BIt has no cell wall for penicillin to act on
- CIt produces large amounts of beta-lactamase
- DIt lives only inside red blood cells
3Solutions
1.Infection control & patient safety
Answer: A · Sterile technique, with a sterile catheter and sterile glove
Why this is the answer
In hospital, tracheal suctioning uses sterile technique to avoid introducing organisms into the lower airway. Clean technique may be taught for long-term home care, according to policy.
A · Sterile technique, with a sterile catheter and sterile glove
2.Infection control & patient safety
Answer: C · Assess the patient and monitor for effects of the drug
Why this is the answer
The first priority is the patient’s safety: assess, monitor and inform the prescriber, who decides on any treatment. The error is then reported through the hospital’s system and the patient is told according to policy.
C · Assess the patient and monitor for effects of the drug
3.Nursing fundamentals
Answer: D · To let patients eat without interruptions, with help where needed
Why this is the answer
Ward rounds and tests can interrupt meals, and patients then eat less. Protected mealtimes pause non-urgent activity so staff can focus on helping patients eat.
D · To let patients eat without interruptions, with help where needed
4.Nursing fundamentals
Answer: A · Dysphagia is common after stroke and can cause aspiration pneumonia
Why this is the answer
Stroke often affects swallowing, and silent aspiration is possible. A swallow screen, with referral to a speech and language therapist if needed, guides safe food textures and routes for medicines.
A · Dysphagia is common after stroke and can cause aspiration pneumonia
5.Microbiology
Answer: C · Its polysaccharide capsule
Why this is the answer
The capsule protects S. pneumoniae from phagocytosis. There are many capsular types, and pneumococcal vaccines contain capsular polysaccharides from the most common ones.
C · Its polysaccharide capsule
6.Microbiology
Answer: B · It has no cell wall for penicillin to act on
Why this is the answer
Mycoplasma lacks a cell wall, so beta-lactams have no target. Macrolides or tetracyclines, which act on the ribosome, are used instead.
B · It has no cell wall for penicillin to act on