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 has shingles (herpes zoster) on one area of the chest, has a normal immune system and the lesions can be fully covered. Which precautions are usually needed?
- ADroplet precautions only
- BProtective environment with positive pressure
- CAirborne precautions in a negative-pressure room
- DStandard precautions, with the lesions covered
2.Infection control & patient safetyHard
In START triage at a mass-casualty incident, a casualty cannot walk, breathes 20 times a minute, has a radial pulse and follows simple commands. Which category applies?
- AGreen (minor)
- BYellow (delayed)
- CRed (immediate)
- DBlack (expectant or dead)
3.Nursing fundamentalsMedium
A patient with capacity wants to leave hospital against medical advice. What should the nurse do?
- ALock the ward door to keep the patient in until the doctor arrives
- BHide the patient's clothes so they cannot leave
- CLet them go without telling anyone
- DExplain the risks, inform the doctor and document the discussion
4.Nursing fundamentalsHard
In the SBAR communication tool, what does the "A" stand for?
- AAdmission
- BAllergies
- CAssessment
- DAction
5.MicrobiologyMedium
What is the incubation period?
- AThe time an antibiotic takes to work
- BThe time between infection and the first symptoms
- CThe time a culture needs in the laboratory
- DThe time during which a patient remains infectious to others
6.MicrobiologyHard
Why is Chlamydia trachomatis usually diagnosed with nucleic acid amplification tests instead of routine culture on agar?
- AIt is a virus and has no DNA
- BIt is too large to grow on agar plates
- CIt dies immediately in the presence of oxygen
- DIt is an obligate intracellular bacterium that cannot grow on ordinary media
3Solutions
1.Infection control & patient safety
Answer: D · Standard precautions, with the lesions covered
Why this is the answer
Localized zoster in an immunocompetent patient, with lesions that can be covered, is managed with standard precautions. Disseminated zoster needs airborne and contact precautions until all lesions are dry and crusted, and localized zoster in an immunocompromised patient needs them until dissemination is ruled out. Staff without immunity to varicella should not provide care.
D · Standard precautions, with the lesions covered
2.Infection control & patient safety
Answer: B · Yellow (delayed)
Why this is the answer
The casualty cannot walk, so is not green. Breathing is under 30 a minute, perfusion is adequate and they obey commands, so none of the red criteria apply. This makes them yellow, delayed.
3.Nursing fundamentals
Answer: D · Explain the risks, inform the doctor and document the discussion
Why this is the answer
An adult with capacity can discharge themselves. The nurse explains the risks, involves the doctor, offers follow-up and documents the decision; detaining them would be unlawful.
D · Explain the risks, inform the doctor and document the discussion
4.Nursing fundamentals
Answer: C · Assessment
Why this is the answer
SBAR: Situation, Background, Assessment (your clinical judgement of the problem) and Recommendation (what you need).
5.Microbiology
Answer: B · The time between infection and the first symptoms
Why this is the answer
The incubation period runs from exposure to the onset of symptoms. People can sometimes already transmit the infection during it.
B · The time between infection and the first symptoms
6.Microbiology
Answer: D · It is an obligate intracellular bacterium that cannot grow on ordinary media
Why this is the answer
Chlamydia replicates only inside host cells, so it cannot be grown on agar. NAATs such as PCR on urine or swabs are sensitive and are the standard diagnostic test.
D · It is an obligate intracellular bacterium that cannot grow on ordinary media