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 practice reduces back strain when a nurse moves a patient or heavy object?
- AStand with the feet close together for balance
- BKeep the load close to the body and avoid twisting
- CBend at the waist and keep both knees straight
- DHold the load at arm’s length to keep it steady
2.Infection control & patient safetyHard
A newly hired nurse has these hepatitis B results: HBsAg negative, anti-HBs positive, anti-HBc negative. What do they show?
- AA current hepatitis B infection
- BImmunity from hepatitis B vaccination
- CPast infection that has now cleared
- DNo immunity, so the vaccine is needed
3.Nursing fundamentalsMedium
In adult basic life support, how long should the rescuer take to check for normal breathing?
- AAbout 30 seconds
- BAs long as it takes to be certain
- CNo more than 10 seconds
- DAt least one minute
4.Nursing fundamentalsHard
A patient rescued from a house fire has a pulse oximetry reading of 99% but is drowsy and has a headache. Why may the reading be falsely reassuring?
- ASmoke makes the oximeter read too low
- BThe patient's heart rate is too fast for the device to give an accurate reading
- CCarbon monoxide bound to haemoglobin is read by the oximeter as oxygen
- DBurns make the skin conduct light better
5.MicrobiologyMedium
Why are Gram-negative bacteria often harder to treat with antibiotics?
- AThey have a thicker peptidoglycan layer
- BTheir outer membrane blocks many drugs
- CThey divide much more slowly
- DThey have no ribosomes
6.MicrobiologyHard
What did Pasteur's swan-neck flask experiment demonstrate?
- AMicroorganisms come from other microorganisms, not from spontaneous generation
- BBoiling cannot kill microorganisms
- CAir itself produces microorganisms
- DMicroorganisms need light to grow
3Solutions
1.Infection control & patient safety
Answer: B · Keep the load close to the body and avoid twisting
Why this is the answer
Good body mechanics include a wide base of support, bending at the hips and knees, keeping the load close and turning with the feet instead of twisting the spine. Lifting aids are used whenever possible.
B · Keep the load close to the body and avoid twisting
2.Infection control & patient safety
Answer: B · Immunity from hepatitis B vaccination
Why this is the answer
The vaccine contains surface antigen, so it produces anti-HBs only. A negative anti-HBc shows there has been no natural infection, and a negative HBsAg rules out current infection.
B · Immunity from hepatitis B vaccination
3.Nursing fundamentals
Answer: C · No more than 10 seconds
Why this is the answer
Rescuers look, listen and feel for normal breathing for no more than 10 seconds. If breathing is absent or not normal, they call for help and start CPR.
C · No more than 10 seconds
4.Nursing fundamentals
Answer: C · Carbon monoxide bound to haemoglobin is read by the oximeter as oxygen
Why this is the answer
Carboxyhaemoglobin absorbs light much like oxyhaemoglobin, so standard pulse oximeters overestimate oxygen saturation. Arterial blood gas with co-oximetry is needed, and high-flow oxygen is given.
C · Carbon monoxide bound to haemoglobin is read by the oximeter as oxygen
5.Microbiology
Answer: B · Their outer membrane blocks many drugs
Why this is the answer
The outer membrane of Gram-negative bacteria, with lipopolysaccharide and porins, keeps many antibiotics out and adds efflux and enzyme defences.
B · Their outer membrane blocks many drugs
6.Microbiology
Answer: A · Microorganisms come from other microorganisms, not from spontaneous generation
Why this is the answer
Boiled broth in a flask with a curved neck stayed sterile because dust and microbes were trapped in the bend. When the neck was broken, microbes entered and grew, disproving spontaneous generation.
A · Microorganisms come from other microorganisms, not from spontaneous generation