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
Why is blood glucose control important around the time of surgery?
- ALow glucose is needed around surgery so that the wound edges close more quickly
- BHigh glucose impairs white cell function and raises the risk of surgical site infection
- CGlucose levels only affect patients who have type 1 diabetes
- DHigh glucose makes anesthetic drugs work for much longer and delays waking up
2.Infection control & patient safetyHard
A patient with suspected pertussis needs to stay in a shared bay because no single room is free. What is the most appropriate arrangement while infection control is contacted?
- AUse airborne precautions with an N95 respirator for everyone
- BPlace the patient next to an immunocompromised patient
- CUse no precautions at all until a single room becomes free
- DCurtains drawn, over 1 meter (3 feet) of space, masks for close contact
3.Nursing fundamentalsMedium
A nurse posts about an "interesting patient" on social media without naming them. Why is this a problem?
- AIt is not a problem because no name was given
- BIt is not a problem if the account is private
- CThe patient may still be identifiable, which breaches confidentiality
- DIt is only a problem if the post also includes a photograph of the patient
4.Nursing fundamentalsHard
Why is lifting a patient by placing your hands under their armpits (the "drag lift") considered unsafe?
- AIt is unsafe only when the patient is wearing a gown
- BIt takes too long compared with using a hoist or slide sheet
- CIt can injure the patient's shoulders and the nurse's back
- DIt is only unsafe for children
5.MicrobiologyMedium
Tetanus and diphtheria vaccines are toxoids. What does that mean?
- AThey contain an inactivated toxin that still triggers an immune response
- BThey contain the bacterial DNA only
- CThey contain ready-made antibodies against the toxin, giving passive immunity
- DThey contain live bacteria that cannot make toxin
6.MicrobiologyHard
In the 1840s Ignaz Semmelweis lowered deaths from puerperal fever in a Vienna maternity clinic. What did he introduce?
- AVaccination of all mothers before birth
- BKeeping mothers in separate isolation rooms after delivery
- CTreating mothers with penicillin
- DHandwashing with chlorinated lime before examining women
3Solutions
1.Infection control & patient safety
Answer: B · High glucose impairs white cell function and raises the risk of surgical site infection
Why this is the answer
Hyperglycemia weakens neutrophil function and slows healing, so it increases the risk of surgical site infection. Keeping glucose in the target range is part of infection prevention for surgical patients.
B · High glucose impairs white cell function and raises the risk of surgical site infection
2.Infection control & patient safety
Answer: D · Curtains drawn, over 1 meter (3 feet) of space, masks for close contact
Why this is the answer
Droplet precautions focus on distance, masks and barriers. A single room is preferred, so infection control is contacted. Placing the patient near a vulnerable patient would be dangerous.
D · Curtains drawn, over 1 meter (3 feet) of space, masks for close contact
3.Nursing fundamentals
Answer: C · The patient may still be identifiable, which breaches confidentiality
Why this is the answer
Details such as the ward, the condition or the date can reveal who a patient is. Professional codes forbid sharing patient information on social media, even without names.
C · The patient may still be identifiable, which breaches confidentiality
4.Nursing fundamentals
Answer: C · It can injure the patient's shoulders and the nurse's back
Why this is the answer
The drag lift puts high strain on the patient's shoulder joints and skin and on the handler's spine. Patients who cannot move themselves should be moved with slide sheets, standing aids or hoists.
C · It can injure the patient's shoulders and the nurse's back
5.Microbiology
Answer: A · They contain an inactivated toxin that still triggers an immune response
Why this is the answer
A toxoid is a toxin treated (for example with formaldehyde) so it is harmless but still antigenic. The immune system makes antibodies that neutralise the real toxin.
A · They contain an inactivated toxin that still triggers an immune response
6.Microbiology
Answer: D · Handwashing with chlorinated lime before examining women
Why this is the answer
Semmelweis noticed higher mortality in the ward run by doctors who also did autopsies. Hand disinfection with chlorinated lime sharply reduced deaths, long before germ theory was accepted.
D · Handwashing with chlorinated lime before examining women