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
An order reads “Give potassium chloride by IV push.” What should the nurse do?
- ANot give it, and contact the prescriber, because it is never given by IV push
- BGive half by IV push and the rest later
- CDilute it in a small syringe and push it
- DGive it slowly by IV push over two minutes while watching the cardiac monitor
2.Infection control & patient safetyHard
A nursing student describes how they remove PPE (gown, gloves and a mask worn for splash protection) at the doorway before leaving a contact precautions room. Which statement shows a need for further teaching?
- A“I remove my gloves without touching the outside with my bare hand.”
- B“I roll the gown inward as I take it off.”
- C“I take off my mask first, and then I take off my gloves.”
- D“I clean my hands as soon as all the PPE is off.”
3.Nursing fundamentalsMedium
A patient has just died. What should the nurse find out before starting last offices?
- AThe family's religious and cultural wishes
- BThe patient's blood group
- CThe patient's favourite food
- DWhether the patient's bills had all been paid
4.Nursing fundamentalsHard
Under the Mental Capacity Act 2005 (England and Wales), a patient with capacity makes a decision staff think is unwise. What follows?
- AThe family must be asked to make the decision instead
- BAn unwise decision alone does not mean the person lacks capacity
- CAn unwise decision on its own proves that the person lacks capacity
- DStaff may override any decision they think is unwise
5.MicrobiologyMedium
Many antifungal drugs target ergosterol. Why does this work?
- AErgosterol is in fungal cell membranes but not in human cells
- BErgosterol is only found in viruses
- CHuman cells use ergosterol to make energy
- DErgosterol is the main structural component of bacterial cell walls
6.MicrobiologyHard
Why can a person get influenza many times but measles usually only once?
- AMeasles is caused by a bacterium
- BMeasles virus has no surface antigens
- CInfluenza viruses change their surface antigens often
- DInfluenza attacks and destroys the memory cells formed after infection
3Solutions
1.Infection control & patient safety
Answer: A · Not give it, and contact the prescriber, because it is never given by IV push
Why this is the answer
Potassium chloride given by IV push can cause fatal cardiac arrhythmias and arrest. It is only given diluted by controlled infusion, so the nurse does not give it and contacts the prescriber.
A · Not give it, and contact the prescriber, because it is never given by IV push
2.Infection control & patient safety
Answer: C · “I take off my mask first, and then I take off my gloves.”
Why this is the answer
Gloves are the most contaminated item and are removed first, so dirty gloves do not touch the face or mask. Gown and gloves are taken off at the doorway before leaving the room, and hand hygiene follows. The other steps are correct.
C · “I take off my mask first, and then I take off my gloves.”
3.Nursing fundamentals
Answer: A · The family's religious and cultural wishes
Why this is the answer
Some faiths have specific rules, for example about who may touch or wash the body and how soon burial should happen. Asking first respects the person and the family.
A · The family's religious and cultural wishes
4.Nursing fundamentals
Answer: B · An unwise decision alone does not mean the person lacks capacity
Why this is the answer
One of the Act's principles is that a person is not treated as lacking capacity just because they make an unwise decision. Staff can explain risks, but the decision is the patient's.
B · An unwise decision alone does not mean the person lacks capacity
5.Microbiology
Answer: A · Ergosterol is in fungal cell membranes but not in human cells
Why this is the answer
Fungal membranes contain ergosterol, while human membranes contain cholesterol. Azoles block ergosterol synthesis and amphotericin binds ergosterol, so they target fungi selectively.
A · Ergosterol is in fungal cell membranes but not in human cells
6.Microbiology
Answer: C · Influenza viruses change their surface antigens often
Why this is the answer
Influenza haemagglutinin and neuraminidase change through drift (small mutations) and shift (reassortment), so old antibodies may not recognise new strains. Measles is antigenically stable.
C · Influenza viruses change their surface antigens often