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 receiving continuous nasogastric feeding has pulled the tube partly out. What should the nurse do first?
- AIncrease the feed rate to make up for the lost time
- BStop the feeding until the tube position is checked
- CTape the tube in its new position and continue
- DPush the tube back in and restart the feed
2.Infection control & patient safetyHard
While preparing an IV medication, a nurse sees that the syringe tip touched the medication tray after the cap came off. What should the nurse do?
- ABlow on the tip to remove any dust
- BDiscard the syringe and prepare the dose again with new equipment
- CWipe the tip with an alcohol swab and give the dose
- DGive the dose anyway, because the medication tray was cleaned this morning
3.Nursing fundamentalsMedium
A patient has just finished a glass of iced water. How should this affect taking an oral temperature?
- AUse the reading but only if the patient says they feel warm
- BWait about 15–30 minutes, as the reading may be falsely low
- CTake it straight away, as cold drinks do not affect the mouth
- DAdd half a degree to the reading to correct for the drink
4.Nursing fundamentalsHard
When is a "clean" (non-sterile) technique acceptable instead of an aseptic technique?
- AFor inserting a central venous catheter
- BFor procedures that do not enter sterile body areas, such as giving an oral medicine
- CFor dressing a fresh surgical wound in theatre, provided that non-sterile gloves are worn throughout
- DFor inserting a urinary catheter
5.MicrobiologyMedium
Transfer of bacterial genes from one bacterium to another by a virus is called:
- ATransformation
- BConjugation
- CTransduction
- DTranscription
6.MicrobiologyHard
A child develops bloody diarrhoea after eating an undercooked burger, then a week later has kidney failure, anaemia and a low platelet count. Which organism is most likely?
- AShiga toxin-producing E. coli such as O157:H7
- BStaphylococcus aureus
- CClostridium perfringens
- DRotavirus
3Solutions
1.Infection control & patient safety
Answer: B · Stop the feeding until the tube position is checked
Why this is the answer
A displaced tube may now sit in the esophagus or airway. The feeding is stopped and the tube is not pushed back blindly. Its position is checked according to policy, or it is replaced.
B · Stop the feeding until the tube position is checked
2.Infection control & patient safety
Answer: B · Discard the syringe and prepare the dose again with new equipment
Why this is the answer
In aseptic non-touch technique, key parts such as syringe tips and IV hubs must not touch any non-sterile surface. A contaminated key part is not cleaned and reused. It is replaced.
B · Discard the syringe and prepare the dose again with new equipment
3.Nursing fundamentals
Answer: B · Wait about 15–30 minutes, as the reading may be falsely low
Why this is the answer
Hot or cold drinks, eating and smoking change the temperature in the mouth for a while. The nurse waits 15–30 minutes or uses another site.
B · Wait about 15–30 minutes, as the reading may be falsely low
4.Nursing fundamentals
Answer: B · For procedures that do not enter sterile body areas, such as giving an oral medicine
Why this is the answer
Aseptic technique is required when entering normally sterile sites or handling key parts of invasive devices. Routine non-invasive tasks only need standard precautions.
B · For procedures that do not enter sterile body areas, such as giving an oral medicine
5.Microbiology
Answer: C · Transduction
Why this is the answer
In transduction a bacteriophage accidentally packages bacterial DNA and delivers it to the next cell it infects. Transformation is uptake of free DNA and conjugation uses direct contact.
6.Microbiology
Answer: A · Shiga toxin-producing E. coli such as O157:H7
Why this is the answer
Shiga toxin-producing E. coli damages the bowel and the small blood vessels of the kidney, causing haemolytic uraemic syndrome. Cattle are a reservoir, so undercooked minced beef is a classic source.
A · Shiga toxin-producing E. coli such as O157:H7