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 statement about the use of physical restraints is correct?
- ARestraints are checked once at the end of each shift
- BStanding as-needed restraint orders are good practice
- CAlternatives come first, and a time-limited order is needed
- DRestraints can be used whenever the unit is short of nursing staff
2.Infection control & patient safetyHard
A nurse teaches new parents how to cope with an infant’s crying. Which statement shows a need for further teaching?
- A“I can call a friend or family member to help when I am tired.”
- B“I will check whether he is hungry, wet or too warm.”
- C“If I get frustrated, I will put him safely in the crib and take a short break.”
- D“If he won’t stop crying, a quick shake will get his attention.”
3.Nursing fundamentalsMedium
How should the heels of a bedbound patient at high risk be protected?
- AWrap them tightly in bandages
- BRest them on a rolled towel placed directly under each heel
- CRub them with cream several times a day
- DLift them off the mattress with a pillow under the calves
4.Nursing fundamentalsHard
What is the best way to check that a patient has learned to use an inhaler correctly?
- AAsk whether they have any questions
- BAsk the patient to show how they use it
- CAsk them to repeat the drug's name
- DAsk whether they have read the leaflet
5.MicrobiologyMedium
Why does high vaccination coverage also protect babies too young to be vaccinated?
- AFewer people can pass on the infection, so it spreads less
- BVaccines kill the pathogen in the environment
- CVaccinated people pass antibodies to everyone they meet
- DBabies are naturally immune to all vaccine-preventable diseases
6.MicrobiologyHard
Gram-positive cocci are found. Which test quickly separates staphylococci from streptococci?
- AGrowth on MacConkey agar
- BThe catalase test
- CThe coagulase test
- DThe acid-fast stain
3Solutions
1.Infection control & patient safety
Answer: C · Alternatives come first, and a time-limited order is needed
Why this is the answer
Restraints are used only when other measures have failed and the patient or others are at risk. An order that is time-limited and regularly reviewed is needed, “as needed” orders are not allowed, and the patient is monitored often.
C · Alternatives come first, and a time-limited order is needed
2.Infection control & patient safety
Answer: D · “If he won’t stop crying, a quick shake will get his attention.”
Why this is the answer
Shaking an infant can cause bleeding in the brain, permanent disability or death. Parents are taught to put the baby down safely and step away if they feel overwhelmed, and to ask for help.
D · “If he won’t stop crying, a quick shake will get his attention.”
3.Nursing fundamentals
Answer: D · Lift them off the mattress with a pillow under the calves
Why this is the answer
Heels have little padding and develop ulcers quickly. "Floating" them, with the support under the calves and the knee slightly bent, removes pressure from the heel.
D · Lift them off the mattress with a pillow under the calves
4.Nursing fundamentals
Answer: B · Ask the patient to show how they use it
Why this is the answer
A return demonstration shows whether a psychomotor skill has been learned and lets the nurse correct mistakes. Saying "yes, I understand" does not prove the technique is right.
B · Ask the patient to show how they use it
5.Microbiology
Answer: A · Fewer people can pass on the infection, so it spreads less
Why this is the answer
When enough people are immune, chains of transmission break and the pathogen rarely reaches susceptible people, such as young babies or immunosuppressed patients.
A · Fewer people can pass on the infection, so it spreads less
6.Microbiology
Answer: B · The catalase test
Why this is the answer
Staphylococci produce catalase, which breaks hydrogen peroxide into water and oxygen bubbles; streptococci do not. The coagulase test is then used to identify S. aureus among staphylococci.