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?
- AProtective environment with positive pressure
- BStandard precautions, with the lesions covered
- CAirborne precautions in a negative-pressure room
- DDroplet precautions only
2.Infection control & patient safetyHard
A nurse teaches parents about firearm safety at home. Which statement shows a need for further teaching?
- A“We keep all the ammunition locked away separately from the gun.”
- B“We store the gun unloaded in a locked safe in the bedroom.”
- C“We will ask other parents about guns before play dates.”
- D“We keep the gun loaded in the nightstand, and the children know not to touch it.”
3.Nursing fundamentalsMedium
What is the main aim of "protected mealtimes" on hospital wards?
- ATo give staff a fixed break while the patients are eating their meals
- BTo let patients eat without interruptions, with help where needed
- CTo stop visitors from bringing any food into hospital
- DTo make sure all patients eat the same meal at once
4.Nursing fundamentalsHard
Four patients need you at the same time. Who should you see first?
- AA patient asking about their discharge time
- BA patient due for a routine oral medicine
- CA patient who has developed noisy, high-pitched breathing (stridor)
- DA patient with pain of 6/10 who was given oral analgesia 20 minutes ago
5.MicrobiologyMedium
What is the main difference between innate and adaptive immunity?
- AInnate immunity develops only after vaccination
- BAdaptive immunity is specific and forms memory; innate immunity does not
- CInnate immunity uses antibodies and forms memory; adaptive immunity does not
- DAdaptive immunity acts within minutes of infection
6.MicrobiologyHard
Which hepatitis viruses are mainly spread through contaminated food and water?
- AHepatitis A and E
- BHepatitis B and C
- CHepatitis B and D
- DHepatitis C and E
3Solutions
1.Infection control & patient safety
Answer: B · 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.
B · Standard precautions, with the lesions covered
2.Infection control & patient safety
Answer: D · “We keep the gun loaded in the nightstand, and the children know not to touch it.”
Why this is the answer
Firearms in homes with children should be stored unloaded and locked, with ammunition stored separately and locked. Telling children not to touch a gun does not reliably prevent injuries.
D · “We keep the gun loaded in the nightstand, and the children know not to touch it.”
3.Nursing fundamentals
Answer: B · To let patients eat without interruptions, with help where needed
Why this is the answer
Ward rounds and tests can interrupt meals, and patients then eat less. Protected mealtimes pause non-urgent activity so staff can focus on helping patients eat.
B · To let patients eat without interruptions, with help where needed
4.Nursing fundamentals
Answer: C · A patient who has developed noisy, high-pitched breathing (stridor)
Why this is the answer
Stridor signals a partly blocked upper airway, which can quickly become life-threatening. Airway problems come before breathing, circulation and other needs.
C · A patient who has developed noisy, high-pitched breathing (stridor)
5.Microbiology
Answer: B · Adaptive immunity is specific and forms memory; innate immunity does not
Why this is the answer
Innate defences (barriers, phagocytes, complement) act fast and in the same way each time. Adaptive immunity (B and T cells) takes days, is specific to each antigen and forms memory.
B · Adaptive immunity is specific and forms memory; innate immunity does not
6.Microbiology
Answer: A · Hepatitis A and E
Why this is the answer
Hepatitis A and E spread by the faecal–oral route. B, C and D spread through blood and body fluids and can cause chronic infection.