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 nurse who never had BCG vaccine has a positive tuberculin skin test for the first time. The chest x-ray is clear and there are no symptoms. What does this most likely mean?
- ALatent TB infection, which is not contagious
- BImmunity to TB from a past exposure
- CA failed test that must be repeated next year
- DActive TB, which needs airborne isolation
2.Infection control & patient safetyHard
A nurse asks a colleague to “just glance” at an insulin infusion before starting it. What makes a check truly independent?
- AThe second nurse looks at the bag label from the doorway
- BThe second nurse signs the record after the infusion has already been started by the first
- CThe first nurse reads the details aloud and the second agrees
- DThe second nurse checks the order, drug, dose and pump settings separately without being told the answer
3.Nursing fundamentalsMedium
Which patient goal is written in a SMART way?
- AThe patient will improve mobility
- BThe patient will feel better soon
- CThe patient will try to eat more
- DThe patient will walk 20 metres with a frame by Friday
4.Nursing fundamentalsHard
A patient has a generalised tonic-clonic seizure in bed. What should the nurse do?
- AGive a drink of water as soon as the jerking starts
- BHold the arms and legs firmly so that the jerking movements stop more quickly
- CPut a spoon between the teeth to stop tongue biting
- DProtect the head, move objects away, time it and do not restrain
5.MicrobiologyMedium
Which organism causes typhoid fever?
- ASalmonella Typhi
- BShigella dysenteriae
- CVibrio cholerae
- DCampylobacter jejuni
6.MicrobiologyHard
A patient with suspected infectious pulmonary tuberculosis is admitted. Which precautions are needed?
- AContact precautions only, with gloves and an apron
- BAirborne precautions, ideally a negative-pressure room and respirator masks for staff
- CDroplet precautions with a surgical mask, and only within one metre
- DNo special precautions, because TB spreads only by blood
3Solutions
1.Infection control & patient safety
Answer: A · Latent TB infection, which is not contagious
Why this is the answer
A positive skin test with no symptoms and a normal chest x-ray suggests latent TB infection. The person cannot spread TB but should be evaluated for treatment to prevent active disease later.
A · Latent TB infection, which is not contagious
2.Infection control & patient safety
Answer: D · The second nurse checks the order, drug, dose and pump settings separately without being told the answer
Why this is the answer
In an independent double check, the second person works through each step on their own, then the two results are compared. Reading the answer aloud or glancing invites confirmation bias.
D · The second nurse checks the order, drug, dose and pump settings separately without being told the answer
3.Nursing fundamentals
Answer: D · The patient will walk 20 metres with a frame by Friday
Why this is the answer
A SMART goal states exactly what is expected, how it will be measured and by when. "Walk 20 metres with a frame by Friday" can be checked; "feel better" cannot.
D · The patient will walk 20 metres with a frame by Friday
4.Nursing fundamentals
Answer: D · Protect the head, move objects away, time it and do not restrain
Why this is the answer
During a seizure the nurse keeps the patient safe, notes the time and the features, and never puts anything in the mouth. Afterwards the patient is placed in the recovery position and the airway checked.
D · Protect the head, move objects away, time it and do not restrain
5.Microbiology
Answer: A · Salmonella Typhi
Why this is the answer
Salmonella enterica serotype Typhi causes typhoid fever, a systemic illness with prolonged fever. Some people become chronic carriers, often in the gallbladder.
6.Microbiology
Answer: B · Airborne precautions, ideally a negative-pressure room and respirator masks for staff
Why this is the answer
M. tuberculosis spreads in airborne droplet nuclei that can stay suspended for long periods. Patients need a single room with negative pressure where possible, and staff wear FFP2/FFP3 or N95 respirators.
B · Airborne precautions, ideally a negative-pressure room and respirator masks for staff