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
Hair must be removed from a planned surgical site. Which method reduces the risk of surgical site infection?
- AShaving with a disposable razor the night before surgery
- BShaving with a razor just before the incision
- CUsing wax strips on the morning of surgery
- DClipping with electric clippers just before surgery
2.Infection control & patient safetyHard
Who should mark the operative site before surgery?
- AThe patient, alone, using a marker pen at home on the night before surgery
- BThe admitting clerk, using the information written on the consent form
- CAny member of the operating room team after anesthesia starts
- DThe person who will perform the procedure, with the patient involved where possible
3.Nursing fundamentalsMedium
Why is early mobilisation important for older inpatients?
- AOlder patients do not need sleep during the day
- BWalking makes older patients' bones grow longer
- CIt lets staff change the beds more easily while patients are up
- DBed rest quickly causes loss of strength and independence
4.Nursing fundamentalsHard
Two days after surgery a patient has a temperature of 37.9 °C and reduced breath sounds at the lung bases. What is the most helpful nursing action, alongside reporting it?
- AEncourage deep breathing, coughing and getting out of bed
- BRestrict all fluids to dry the secretions
- CStop all pain relief so the patient stays alert
- DKeep the patient lying flat in bed so they can rest and save energy
5.MicrobiologyMedium
Which virus family includes the viruses that cause cold sores and chickenpox?
- APicornaviruses
- BRetroviruses
- CHerpesviruses
- DCoronaviruses
6.MicrobiologyHard
A urinary catheter has become colonised by bacteria in a biofilm. Why is the catheter usually replaced instead of just giving antibiotics?
- AAntibiotics damage the catheter material
- BBiofilms contain only viruses, so antibiotics do not work
- CBiofilm bacteria cannot cause disease
- DBacteria in biofilms are protected and much harder for antibiotics to kill
3Solutions
1.Infection control & patient safety
Answer: D · Clipping with electric clippers just before surgery
Why this is the answer
Razors cause tiny skin cuts that bacteria can colonize, which raises the infection risk. If hair must be removed, clippers are used close to the time of surgery.
D · Clipping with electric clippers just before surgery
2.Infection control & patient safety
Answer: D · The person who will perform the procedure, with the patient involved where possible
Why this is the answer
Under the Universal Protocol, the site is marked by the person performing the procedure, or an authorized delegate, ideally while the patient is awake and can confirm it. This helps prevent wrong-site surgery.
D · The person who will perform the procedure, with the patient involved where possible
3.Nursing fundamentals
Answer: D · Bed rest quickly causes loss of strength and independence
Why this is the answer
Older adults lose muscle strength quickly in bed, which leads to falls and loss of independence. Getting up, dressed and moving as soon as safe helps prevent this deconditioning.
D · Bed rest quickly causes loss of strength and independence
4.Nursing fundamentals
Answer: A · Encourage deep breathing, coughing and getting out of bed
Why this is the answer
These signs suggest atelectasis or early chest infection. Deep breathing, coughing, adequate pain relief and mobilisation help re-expand the lungs.
A · Encourage deep breathing, coughing and getting out of bed
5.Microbiology
Answer: C · Herpesviruses
Why this is the answer
Herpes simplex (cold sores) and varicella-zoster (chickenpox, shingles) are herpesviruses that remain latent in sensory ganglia and can reactivate.
6.Microbiology
Answer: D · Bacteria in biofilms are protected and much harder for antibiotics to kill
Why this is the answer
In a biofilm, bacteria live in a protective matrix, grow slowly and can tolerate high antibiotic levels. Removing the device removes the source of infection.
D · Bacteria in biofilms are protected and much harder for antibiotics to kill