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 patient-controlled analgesia (PCA). A family member presses the button while the patient sleeps. What should the nurse explain?
- AOnly the patient should press it, because this keeps the system safe
- BFamily can press it as long as they count the presses
- CThe pump will always stop any overdose
- DPressing it while the patient sleeps prevents the pain from getting worse later
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 avoid crowds and people who have colds.”
- B“I will check my temperature and call if I have a fever.”
- 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
A patient with expressive aphasia after a stroke understands speech but struggles to find words. Which approach helps most?
- ASpeak louder and more slowly than usual
- BTalk to the family instead of the patient
- CAsk simple yes/no questions and allow plenty of time
- DFinish their sentences quickly for them to save them frustration
4.Nursing fundamentalsHard
A runner collapses on a hot day with a temperature of 40.5 °C and confusion. Why will paracetamol (acetaminophen) not help much?
- AParacetamol makes the body produce more heat
- BThe heat comes from failed heat loss, not a raised set point
- CParacetamol only lowers temperature in children, not in adults
- DParacetamol needs a temperature below 37 °C to work
5.MicrobiologyMedium
How does an autoclave sterilise instruments?
- AWith steam under pressure at about 121 °C
- BWith ultraviolet light only
- CWith alcohol vapour at room temperature
- DWith dry heat at about 60 °C
6.MicrobiologyHard
What is the key difference between bactericidal and bacteriostatic antibiotics?
- ABactericidal drugs kill bacteria; bacteriostatic drugs stop growth and rely on the immune system to clear them
- BBacteriostatic drugs always work faster than bactericidal drugs
- CBactericidal drugs work only outside the body
- DBactericidal drugs work only on viruses; bacteriostatic drugs work on bacteria
3Solutions
1.Infection control & patient safety
Answer: A · Only the patient should press it, because this keeps the system safe
Why this is the answer
PCA is safe because a patient who becomes drowsy stops pressing the button. When others press it (“PCA by proxy”), sedation and respiratory depression can occur.
A · Only the patient should press it, because this keeps the system safe
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 · Ask simple yes/no questions and allow plenty of time
Why this is the answer
Short questions that can be answered with yes, no or a gesture, picture boards and patience let the patient communicate. Hearing is not the problem, so shouting does not help.
C · Ask simple yes/no questions and allow plenty of time
4.Nursing fundamentals
Answer: B · The heat comes from failed heat loss, not a raised set point
Why this is the answer
In fever the hypothalamus raises the set point, and antipyretics lower it. In heatstroke the set point is normal but heat cannot be lost, so active cooling is needed.
B · The heat comes from failed heat loss, not a raised set point
5.Microbiology
Answer: A · With steam under pressure at about 121 °C
Why this is the answer
Pressurised steam reaches about 121 °C and kills all microorganisms, including spores, typically in about 15 minutes or more depending on the load.
A · With steam under pressure at about 121 °C
6.Microbiology
Answer: A · Bactericidal drugs kill bacteria; bacteriostatic drugs stop growth and rely on the immune system to clear them
Why this is the answer
Bacteriostatic drugs halt multiplication so host defences can eliminate the bacteria. Bactericidal drugs are preferred when defences are weak or hard to reach, such as in endocarditis or neutropenia.
A · Bactericidal drugs kill bacteria; bacteriostatic drugs stop growth and rely on the immune system to clear them