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
Sterile saline is spilled on a sterile drape that lies on a non-sterile table. What does this mean?
- AThe field stays sterile, because saline is sterile
- BThe field becomes sterile again when it dries
- CThe field is contaminated, because moisture can carry organisms through the drape
- DOnly the wet part is contaminated, so items can be moved to the dry part
2.Infection control & patient safetyHard
A nurse has raised a safety concern about an order with the prescriber, who dismissed it without addressing it. What should the nurse do next?
- ARefuse to care for the patient for the rest of the shift until the prescriber apologizes
- BCarry out the order as written, because the prescriber has heard the concern
- CState the concern clearly a second time and, if still unresolved, use the chain of command
- DDiscuss the concern with the patient and let them decide
3.Nursing fundamentalsMedium
Why should reddened skin over a bony area not be massaged?
- AMassage makes the redness spread to other areas
- BMassage hides early signs of infection
- CMassage is only allowed when done by a physiotherapist
- DMassage can damage the deeper tissues further
4.Nursing fundamentalsHard
Which statement by a visitor shows a need for further teaching about contact precautions?
- A"I'll put on the gown and gloves before I go in."
- B"I'll take the gown off at home after I leave the hospital."
- C"I'll clean my hands as I leave the room."
- D"I'll take off the gown and gloves before I leave the room."
5.MicrobiologyMedium
Which virus family includes the viruses that cause cold sores and chickenpox?
- APicornaviruses
- BCoronaviruses
- CHerpesviruses
- DRetroviruses
6.MicrobiologyHard
The minimum inhibitory concentration (MIC) of an antibiotic is:
- AThe lowest concentration that kills 99.9% of the bacterial inoculum in vitro
- BThe highest dose a patient can tolerate
- CThe lowest concentration that prevents visible bacterial growth in vitro
- DThe plasma level at which side effects begin
3Solutions
1.Infection control & patient safety
Answer: C · The field is contaminated, because moisture can carry organisms through the drape
Why this is the answer
Liquid soaking through a drape can carry organisms up from the non-sterile surface below. The field is considered contaminated and is set up again.
C · The field is contaminated, because moisture can carry organisms through the drape
2.Infection control & patient safety
Answer: C · State the concern clearly a second time and, if still unresolved, use the chain of command
Why this is the answer
The two-challenge rule says the concern is voiced at least twice to make sure it was heard. If it is still not addressed, the nurse escalates through the chain of command rather than acting against the patient’s safety.
C · State the concern clearly a second time and, if still unresolved, use the chain of command
3.Nursing fundamentals
Answer: D · Massage can damage the deeper tissues further
Why this is the answer
Massaging red, pressure-damaged areas can tear small blood vessels and worsen tissue damage. Pressure is relieved by repositioning instead.
D · Massage can damage the deeper tissues further
4.Nursing fundamentals
Answer: B · "I'll take the gown off at home after I leave the hospital."
Why this is the answer
PPE is removed in or at the door of the patient's room and disposed of there, followed by hand hygiene. Wearing it out of the room spreads the organism.
B · "I'll take the gown off at home after I leave the hospital."
5.Microbiology
Answer: C · Herpesviruses
Why this is the answer
Herpes simplex (cold sores) and varicella-zoster (chickenpox, shingles) are herpesviruses that remain latent in sensory ganglia and can reactivate.
6.Microbiology
Answer: C · The lowest concentration that prevents visible bacterial growth in vitro
Why this is the answer
The MIC is the lowest concentration that inhibits visible growth. The minimum bactericidal concentration (MBC) is the lowest that kills 99.9% of the bacteria.
C · The lowest concentration that prevents visible bacterial growth in vitro