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 family member tells the nurse, “My father is not himself. Something is wrong.” The hospital has a family-activated rapid response system. What is correct?
- AOnly doctors may call the rapid response team
- BThe family can call the rapid response team if they are worried and staff have not responded
- CThe family must wait for the next scheduled ward round to raise the concern with a doctor
- DThe family should call emergency services from outside the hospital
2.Infection control & patient safetyHard
A patient on oxygen needs an MRI scan. Which plan is safe?
- AUse only MRI-safe equipment, and never take a standard steel oxygen cylinder into the scanner room
- BTake the usual steel cylinder into the room if it is tightly strapped to the trolley frame
- CLeave the steel cylinder on the patient’s bed during the scan
- DRemove the oxygen for the scan without telling anyone
3.Nursing fundamentalsMedium
Which early warning sign often appears first when a patient's condition worsens?
- ALower heart rate
- BImproving appetite
- CA rising respiratory rate
- DA falling body temperature
4.Nursing fundamentalsHard
Why must concentrated potassium chloride never be given as a quick intravenous injection?
- AIt can cause a fatal cardiac arrest
- BIt makes the vein turn blue for a week
- CIt stops the kidneys from working at once
- DIt makes the potassium inactive in the blood
5.MicrobiologyMedium
How does an mRNA vaccine produce immunity?
- AThe mRNA kills the virus directly in the blood
- BBody cells use the mRNA to make a viral protein that the immune system learns to recognise
- CThe mRNA contains weakened live virus
- DThe mRNA is inserted permanently into human DNA
6.MicrobiologyHard
After eating home-canned vegetables, a patient develops double vision, difficulty swallowing and a descending flaccid paralysis. What is the most likely cause?
- AA viral infection of the motor neurons
- BEndotoxin from Gram-negative bacteria
- CTetanus toxin, which blocks inhibitory neurotransmitters
- DBotulinum toxin, which blocks acetylcholine release
3Solutions
1.Infection control & patient safety
Answer: B · The family can call the rapid response team if they are worried and staff have not responded
Why this is the answer
Family-activated rapid response systems allow patients and families to call for help directly when they notice a worrying change. The nurse should also take the concern seriously and assess the patient.
B · The family can call the rapid response team if they are worried and staff have not responded
2.Infection control & patient safety
Answer: A · Use only MRI-safe equipment, and never take a standard steel oxygen cylinder into the scanner room
Why this is the answer
Steel oxygen cylinders can become projectiles in an MRI room and cause fatal injuries. Only equipment labeled MRI-safe is used, and the patient’s oxygen needs are planned with the MRI team.
A · Use only MRI-safe equipment, and never take a standard steel oxygen cylinder into the scanner room
3.Nursing fundamentals
Answer: C · A rising respiratory rate
Why this is the answer
Tachypnoea is one of the earliest and most sensitive signs of deterioration and scores highly in early warning systems such as NEWS2.
C · A rising respiratory rate
4.Nursing fundamentals
Answer: A · It can cause a fatal cardiac arrest
Why this is the answer
A sudden rise in blood potassium can stop the heart. IV potassium is given diluted, by a controlled infusion and following strict policy, which is why concentrated forms are tightly controlled.
A · It can cause a fatal cardiac arrest
5.Microbiology
Answer: B · Body cells use the mRNA to make a viral protein that the immune system learns to recognise
Why this is the answer
The mRNA is translated by cells into an antigen, such as a coronavirus spike protein. The immune system responds to it. The mRNA is broken down and does not enter the nucleus.
B · Body cells use the mRNA to make a viral protein that the immune system learns to recognise
6.Microbiology
Answer: D · Botulinum toxin, which blocks acetylcholine release
Why this is the answer
Clostridium botulinum can grow in poorly canned, low-acid foods and produce botulinum toxin. The toxin blocks acetylcholine release at nerve endings, causing descending flaccid paralysis.
D · Botulinum toxin, which blocks acetylcholine release