Infection Control and Patient Safety: cram pack

Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.

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1Formulas and methods

Infection control & patient safety

Method

  1. Start with standard precautions for every patient: hand hygiene, PPE for the expected exposure, safe sharps.
  2. Add precautions by route: contact (gown, gloves), droplet (surgical mask), airborne (N95, negative-pressure room).
  3. Keep sterile items sterile: if in doubt, it is not sterile; replace, never wipe.
  4. Prevent harm in the environment: fall measures, restraints only as a last resort, RACE and PASS for fire.
  5. 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

Which practice is safe when transferring a patient from a bed to a stretcher?

  1. AHave the patient slide across without help or a slide sheet
  2. BLower the stretcher side rails during transport
  3. CLeave the stretcher wheels unlocked so it can move with the patient
  4. DLock the wheels of both the bed and the stretcher before moving the patient
2.Infection control & patient safetyHard

A patient’s WBC is 4,000/mm3, with 30% neutrophils and 5% bands. What is the absolute neutrophil count (ANC)?

  1. A3,500/mm3
  2. B1,400/mm3
  3. C1,200/mm3
  4. D140/mm3
3.Nursing fundamentalsMedium

A patient has pneumonia in the right lung only. In which side-lying position is oxygenation usually best?

  1. ALying face down
  2. BLying on the right side
  3. CLying flat on the back
  4. DLying on the left side
4.Nursing fundamentalsHard

Which action is most effective in preventing catheter-associated urinary tract infection?

  1. AChanging the drainage bag every few hours to keep the system fresh
  2. BWashing out the bladder every day
  3. CGiving antibiotics to every catheterised patient
  4. DRemoving the catheter as soon as it is no longer needed
5.MicrobiologyMedium

Which organism causes tuberculosis, and what makes it hard to stain with the Gram method?

  1. AMycoplasma pneumoniae, which has no cell wall to take up the stain
  2. BLegionella pneumophila, which lives inside amoebae
  3. CMycobacterium tuberculosis, which has a waxy mycolic acid wall
  4. DStreptococcus pneumoniae, which has a capsule
6.MicrobiologyHard

Which feature distinguishes most exotoxins from endotoxin?

  1. AExotoxins are only released when bacteria die
  2. BExotoxins are lipopolysaccharides of the Gram-negative outer membrane
  3. CExotoxins are heat-stable lipids
  4. DExotoxins are proteins and can be turned into toxoid vaccines

3Solutions

1.Infection control & patient safety

Answer: D · Lock the wheels of both the bed and the stretcher before moving the patient

Why this is the answer

Both surfaces are locked and at the same height before the transfer, a slide sheet is used and enough staff help. Side rails are raised on the stretcher during transport.

Answer

D · Lock the wheels of both the bed and the stretcher before moving the patient
2.Infection control & patient safety

Answer: B · 1,400/mm3

Why this is the answer

ANC = 4,000 × (0.30 + 0.05) = 1,400/mm3. This is below normal (neutropenia), so the patient has a raised risk of infection.

Answer

B · 1,400/mm3
3.Nursing fundamentals

Answer: D · Lying on the left side

Why this is the answer

Gravity sends more blood to the lower lung. Placing the healthy lung down matches more blood flow to the lung that is ventilating well, improving oxygenation.

Answer

D · Lying on the left side
4.Nursing fundamentals

Answer: D · Removing the catheter as soon as it is no longer needed

Why this is the answer

The infection risk grows with each day of catheterisation, so the most effective step is avoiding unnecessary catheters and removing them early. Routine bladder washouts and frequent bag changes break the closed system and add risk.

Answer

D · Removing the catheter as soon as it is no longer needed
5.Microbiology

Answer: C · Mycobacterium tuberculosis, which has a waxy mycolic acid wall

Why this is the answer

M. tuberculosis has a cell wall rich in mycolic acids, so it resists Gram staining and is identified with acid-fast stains.

Answer

C · Mycobacterium tuberculosis, which has a waxy mycolic acid wall
6.Microbiology

Answer: D · Exotoxins are proteins and can be turned into toxoid vaccines

Why this is the answer

Exotoxins are secreted proteins with specific actions and are often very potent; many can be inactivated into toxoids. Endotoxin is lipopolysaccharide, more heat-stable and cannot be made into a toxoid.

Answer

D · Exotoxins are proteins and can be turned into toxoid vaccines

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