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 instruction about using a standard walker is correct?
- AMove the walker forward, then step into it
- BCarry the walker and use it only when tired
- CWalk well ahead of the walker for balance
- DPush up from the walker to stand from a chair
2.Infection control & patient safetyHard
A patient weighs 180 kg and needs to be moved from bed to chair. The standard ceiling lift on the unit has a lower weight limit. What should the nurse do?
- AUse bariatric-rated equipment and enough trained staff
- BHave two staff lift the patient by hand
- CAsk the patient to stand and pivot without help
- DUse the standard lift, because limits include a safety margin
3.Nursing fundamentalsMedium
An IV cannula site is swollen, cool and pale, and the infusion has slowed. What should the nurse do first?
- AApply a warm pack and keep the infusion running
- BIncrease the infusion rate to clear the blockage
- CStop the infusion and remove the cannula
- DFlush the cannula hard with saline
4.Nursing fundamentalsHard
A patient says, "I've bought nicotine patches and I'm stopping smoking on Monday." Which stage of change is this?
- APreparation
- BAction
- CMaintenance
- DContemplation
5.MicrobiologyMedium
In which phase of the bacterial growth curve do the cells divide at their fastest constant rate?
- ALog (exponential) phase
- BLag (adaptation) phase
- CStationary (plateau) phase
- DDeath phase
6.MicrobiologyHard
A healthcare worker's blood test is positive for anti-HBs (hepatitis B surface antibody) and negative for HBsAg and anti-HBc. What does this most likely mean?
- AImmunity from hepatitis B vaccination
- BPast natural infection that has cleared
- CCurrent acute hepatitis B infection
- DChronic hepatitis B infection
3Solutions
1.Infection control & patient safety
Answer: A · Move the walker forward, then step into it
Why this is the answer
The patient moves the walker forward, sets it down with all legs on the floor and then steps into it. To stand, they push up from the chair arms, because a walker can tip if used to pull up.
A · Move the walker forward, then step into it
2.Infection control & patient safety
Answer: A · Use bariatric-rated equipment and enough trained staff
Why this is the answer
Using equipment above its rated capacity can cause collapse and injury. Bariatric lifts, chairs and beds are used, with enough trained staff and a plan agreed in advance.
A · Use bariatric-rated equipment and enough trained staff
3.Nursing fundamentals
Answer: C · Stop the infusion and remove the cannula
Why this is the answer
These are signs of infiltration. The infusion is stopped, the cannula removed, the limb elevated and the event documented. A new cannula is sited elsewhere if still needed.
C · Stop the infusion and remove the cannula
4.Nursing fundamentals
Answer: A · Preparation
Why this is the answer
In preparation the person intends to act soon and has taken small steps, such as buying patches. Action begins when they actually stop smoking.
5.Microbiology
Answer: A · Log (exponential) phase
Why this is the answer
After the lag phase of adjustment, cells enter the log phase and grow exponentially. Growth stops in the stationary phase as nutrients run out and waste builds up.
A · Log (exponential) phase
6.Microbiology
Answer: A · Immunity from hepatitis B vaccination
Why this is the answer
The vaccine contains HBsAg, so a vaccinated person makes anti-HBs but no anti-HBc. Past natural infection gives both anti-HBs and anti-HBc, and ongoing infection shows HBsAg.
A · Immunity from hepatitis B vaccination