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 PPE does a nurse wear when giving an IV chemotherapy drug?
- AA surgical mask and no gloves
- BTwo pairs of chemotherapy-tested gloves and a disposable impermeable gown
- CA reusable cloth gown and one pair of gloves
- DOne pair of standard latex gloves, changed after the infusion is started
2.Infection control & patient safetyHard
In START triage at a mass-casualty incident, a casualty cannot walk, breathes 20 times a minute, has a radial pulse and follows simple commands. Which category applies?
- ABlack (expectant or dead)
- BRed (immediate)
- CYellow (delayed)
- DGreen (minor)
3.Nursing fundamentalsMedium
A patient arrives back on the ward after surgery. What does the nurse assess first?
- AAirway and breathing
- BPain score
- CFluid balance chart
- DThe wound dressing
4.Nursing fundamentalsHard
In a patient with sepsis, what does a raised blood lactate suggest?
- AThe infection has been cured
- BThe kidneys are making too much urine
- CThe patient has eaten recently
- DThe tissues are not getting enough oxygen
5.MicrobiologyMedium
Transfer of bacterial genes from one bacterium to another by a virus is called:
- AConjugation
- BTranscription
- CTransduction
- DTransformation
6.MicrobiologyHard
In the 1840s Ignaz Semmelweis lowered deaths from puerperal fever in a Vienna maternity clinic. What did he introduce?
- ATreating mothers with penicillin
- BKeeping mothers in separate isolation rooms after delivery
- CHandwashing with chlorinated lime before examining women
- DVaccination of all mothers before birth
3Solutions
1.Infection control & patient safety
Answer: B · Two pairs of chemotherapy-tested gloves and a disposable impermeable gown
Why this is the answer
Hazardous drugs can be absorbed through the skin or inhaled. Staff wear double chemotherapy-tested gloves and a disposable, low-permeability gown, with eye and face protection if splashing is possible.
B · Two pairs of chemotherapy-tested gloves and a disposable impermeable gown
2.Infection control & patient safety
Answer: C · Yellow (delayed)
Why this is the answer
The casualty cannot walk, so is not green. Breathing is under 30 a minute, perfusion is adequate and they obey commands, so none of the red criteria apply. This makes them yellow, delayed.
3.Nursing fundamentals
Answer: A · Airway and breathing
Why this is the answer
After anaesthesia the airway and breathing are checked first, then circulation, consciousness, pain, the wound, drains and fluids.
4.Nursing fundamentals
Answer: D · The tissues are not getting enough oxygen
Why this is the answer
When tissues are poorly perfused they switch to anaerobic metabolism and produce lactate. A raised lactate in sepsis signals higher risk and the need for urgent treatment.
D · The tissues are not getting enough oxygen
5.Microbiology
Answer: C · 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: C · Handwashing with chlorinated lime before examining women
Why this is the answer
Semmelweis noticed higher mortality in the ward run by doctors who also did autopsies. Hand disinfection with chlorinated lime sharply reduced deaths, long before germ theory was accepted.
C · Handwashing with chlorinated lime before examining women