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 is admitted to an inpatient mental health unit. Why are personal belongings checked?
- ATo find out what the patient likes to wear during the hospital stay
- BTo make a list of valuable items for insurance
- CTo remove items that could be used to harm self or others
- DTo decide which family members may visit
2.Infection control & patient safetyHard
A nurse teaches new parents how to cope with an infant’s crying. Which statement shows a need for further teaching?
- A“I will check whether he is hungry, wet or too warm.”
- B“If he won’t stop crying, a quick shake will get his attention.”
- C“If I get frustrated, I will put him safely in the crib and take a short break.”
- D“I can call a friend or family member to help when I am tired.”
3.Nursing fundamentalsMedium
Why are many modern wound dressings designed to keep the wound moist?
- ADry wounds never become infected
- BA moist environment supports faster healing
- CMoist dressings never need changing
- DMoisture kills all bacteria in the wound
4.Nursing fundamentalsHard
Under the Mental Capacity Act 2005 (England and Wales), which of these is part of the test of whether a person can make a decision?
- AWhether they are over 65 years old
- BWhether they can understand, retain and weigh the information and communicate a decision
- CWhether the decision they make agrees with the advice given by the doctor and the care team
- DWhether they have a diagnosis of dementia
5.MicrobiologyMedium
Which antibody class is the first to rise in a new infection?
- AIgG
- BIgE
- CIgM
- DIgA
6.MicrobiologyHard
Primary syphilis typically presents with:
- AA widespread rash on the palms and soles
- BA painless ulcer (chancre) at the site of infection
- CA painful cluster of small blisters on the genitals or the mouth
- DDamage to the heart and brain
3Solutions
1.Infection control & patient safety
Answer: C · To remove items that could be used to harm self or others
Why this is the answer
Belongings are searched with the patient, according to policy, for items such as sharp objects, cords, drugs and lighters. These are stored safely to reduce the risk of self-harm or violence.
C · To remove items that could be used to harm self or others
2.Infection control & patient safety
Answer: B · “If he won’t stop crying, a quick shake will get his attention.”
Why this is the answer
Shaking an infant can cause bleeding in the brain, permanent disability or death. Parents are taught to put the baby down safely and step away if they feel overwhelmed, and to ask for help.
B · “If he won’t stop crying, a quick shake will get his attention.”
3.Nursing fundamentals
Answer: B · A moist environment supports faster healing
Why this is the answer
Moist wound healing helps epithelial cells migrate and reduces scab formation and pain. The dressing should still manage excess exudate to protect the surrounding skin.
B · A moist environment supports faster healing
4.Nursing fundamentals
Answer: B · Whether they can understand, retain and weigh the information and communicate a decision
Why this is the answer
A person lacks capacity for a decision if, because of an impairment of the mind or brain, they cannot understand, retain, use or weigh the information, or communicate their decision. An unwise choice does not by itself show lack of capacity.
B · Whether they can understand, retain and weigh the information and communicate a decision
5.Microbiology
Answer: C · IgM
Why this is the answer
IgM appears first in a primary response; IgG follows and provides long-term protection. A positive IgM therefore suggests recent infection.
6.Microbiology
Answer: B · A painless ulcer (chancre) at the site of infection
Why this is the answer
Treponema pallidum causes a painless chancre in the primary stage. The secondary stage brings rash and systemic symptoms, and tertiary syphilis can damage the heart and nervous system. Painful blisters suggest herpes.
B · A painless ulcer (chancre) at the site of infection