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
Which PPE does a nurse wear when giving an IV chemotherapy drug?
- AA reusable cloth gown and one pair of gloves
- BTwo pairs of chemotherapy-tested gloves and a disposable impermeable gown
- COne pair of standard latex gloves, changed after the infusion is started
- DA surgical mask and no gloves
2.Infection control & patient safetyHard
Which pairing of an organism with its transmission-based precautions is correct?
- AMeasles – contact only
- BInfluenza – airborne only
- CC. difficile – airborne
- DMumps – droplet
3.Nursing fundamentalsMedium
Why are patients with a new ileostomy at risk of dehydration?
- AThey are not allowed to drink for several weeks after surgery
- BThe colon removes too much water from the stool
- CThe output is liquid and contains a lot of water and salt
- DThe stoma absorbs water from the body
4.Nursing fundamentalsHard
A potassium result is unexpectedly high and the lab reports that the sample was haemolysed. What does this mean?
- AThe result is accurate and needs no follow-up
- BThe patient definitely has low potassium
- CThe patient definitely has dangerous hyperkalaemia needing treatment
- DThe result may be falsely high and the test should be repeated
5.MicrobiologyMedium
Which organism is a common cause of infection in burns and in people with cystic fibrosis, and can produce a green pigment?
- AHelicobacter pylori
- BStreptococcus pyogenes
- CPseudomonas aeruginosa
- DClostridium tetani
6.MicrobiologyHard
A child develops bloody diarrhoea after eating an undercooked burger, then a week later has kidney failure, anaemia and a low platelet count. Which organism is most likely?
- AShiga toxin-producing E. coli such as O157:H7
- BClostridium perfringens
- CRotavirus
- DStaphylococcus aureus
3Solutions
1.Infection control & patient safety
Answer: B · Two pairs of chemotherapy-tested gloves and a disposable impermeable gown
Why this is the answer
Hazardous drugs can be absorbed through the skin or inhaled. Staff wear double chemotherapy-tested gloves and a disposable, low-permeability gown, with eye and face protection if splashing is possible.
B · Two pairs of chemotherapy-tested gloves and a disposable impermeable gown
2.Infection control & patient safety
Answer: D · Mumps – droplet
Why this is the answer
Mumps spreads by respiratory droplets, so droplet precautions are used. Measles is airborne, C. difficile needs contact precautions, and influenza needs droplet precautions.
3.Nursing fundamentals
Answer: C · The output is liquid and contains a lot of water and salt
Why this is the answer
The colon normally reabsorbs water and salt. An ileostomy bypasses it, so high output can quickly cause dehydration and low sodium; output is monitored and fluids encouraged.
C · The output is liquid and contains a lot of water and salt
4.Nursing fundamentals
Answer: D · The result may be falsely high and the test should be repeated
Why this is the answer
Red cells contain a lot of potassium, so haemolysis during collection can falsely raise the result. The sample is repeated, with the patient assessed in the meantime.
D · The result may be falsely high and the test should be repeated
5.Microbiology
Answer: C · Pseudomonas aeruginosa
Why this is the answer
Pseudomonas aeruginosa is an opportunistic pathogen of burns, ventilated patients and cystic fibrosis lungs. It is naturally resistant to many antibiotics.
C · Pseudomonas aeruginosa
6.Microbiology
Answer: A · Shiga toxin-producing E. coli such as O157:H7
Why this is the answer
Shiga toxin-producing E. coli damages the bowel and the small blood vessels of the kidney, causing haemolytic uraemic syndrome. Cattle are a reservoir, so undercooked minced beef is a classic source.
A · Shiga toxin-producing E. coli such as O157:H7