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 has orthostatic hypotension. Which teaching helps to prevent falls?
- AGet out of bed quickly so the dizziness passes sooner
- BAvoid drinking fluids in the morning to reduce trips to the toilet
- CSit on the edge of the bed for a short time before standing up slowly
- DStand up straight after a hot shower to increase blood flow
2.Infection control & patient safetyHard
Which action best prevents a wrong-route error with an epidural infusion?
- ALabel the epidural line and keep it on its own dedicated pump
- BUse the same pump type and tubing for all of the patient’s infusions
- CUse a free IV port if the epidural port becomes blocked
- DTape all the lines together to keep them tidy
3.Nursing fundamentalsMedium
Which of these is part of the UK "Sepsis Six"?
- AWaiting for a chest X-ray before antibiotics
- BGiving a sedative
- CRestricting IV fluids
- DMeasuring urine output
4.Nursing fundamentalsHard
A dehydrated patient is receiving IV fluids. Which finding best shows the treatment is working?
- AUrine output rises and the heart rate falls towards normal
- BThe heart rate rises and the skin becomes cooler
- CThe urine becomes darker and more concentrated
- DThe patient feels more thirsty than before the fluids started
5.MicrobiologyMedium
Which organism is a common cause of infection in burns and in people with cystic fibrosis, and can produce a green pigment?
- APseudomonas aeruginosa
- BHelicobacter pylori
- CStreptococcus pyogenes
- DClostridium tetani
6.MicrobiologyHard
How do high-risk HPV types contribute to cervical cancer?
- AThe virus kills cells so quickly that they are replaced by cancer cells
- BThe virus produces an endotoxin that damages DNA
- CViral E6 and E7 proteins inactivate the tumour suppressors p53 and Rb
- DThe virus destroys CD4 T cells in the cervix
3Solutions
1.Infection control & patient safety
Answer: C · Sit on the edge of the bed for a short time before standing up slowly
Why this is the answer
Changing position slowly, dangling the legs first and getting up with help give the circulation time to adjust. Rapid standing, heat and dehydration make orthostatic hypotension worse.
C · Sit on the edge of the bed for a short time before standing up slowly
2.Infection control & patient safety
Answer: A · Label the epidural line and keep it on its own dedicated pump
Why this is the answer
Labeling lines at the connection end, using distinct (non-Luer) connectors and separate, clearly marked pumps make wrong-route connections much less likely. Lines are traced from the patient to the source before connecting.
A · Label the epidural line and keep it on its own dedicated pump
3.Nursing fundamentals
Answer: D · Measuring urine output
Why this is the answer
The Sepsis Six are: give oxygen if needed, take blood cultures, give IV antibiotics, give IV fluids, check lactate and monitor urine output, ideally within the first hour.
D · Measuring urine output
4.Nursing fundamentals
Answer: A · Urine output rises and the heart rate falls towards normal
Why this is the answer
With effective fluid replacement, perfusion improves: urine output increases, the heart rate settles and the blood pressure stabilises. Watching for fluid overload is also important.
A · Urine output rises and the heart rate falls towards normal
5.Microbiology
Answer: A · Pseudomonas aeruginosa
Why this is the answer
Pseudomonas aeruginosa is an opportunistic pathogen of burns, ventilated patients and cystic fibrosis lungs. It is naturally resistant to many antibiotics.
A · Pseudomonas aeruginosa
6.Microbiology
Answer: C · Viral E6 and E7 proteins inactivate the tumour suppressors p53 and Rb
Why this is the answer
E6 promotes the breakdown of p53 and E7 binds Rb, removing controls on cell division and DNA repair. Infected cells can then accumulate mutations and become cancerous over years.
C · Viral E6 and E7 proteins inactivate the tumour suppressors p53 and Rb