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 is admitted to an inpatient mental health unit. Why are personal belongings checked?
- ATo decide which family members may visit
- BTo make a list of valuable items for insurance
- CTo find out what the patient likes to wear during the hospital stay
- DTo remove items that could be used to harm self or others
2.Infection control & patient safetyHard
In START triage at a mass-casualty incident, a casualty cannot walk, breathes 20 times a minute, has a radial pulse and follows simple commands. Which category applies?
- AYellow (delayed)
- BRed (immediate)
- CBlack (expectant or dead)
- DGreen (minor)
3.Nursing fundamentalsMedium
Before discharge, what is most important to confirm about the patient's new medicines?
- AThat they know the chemical name of each drug
- BThat they know how and when to take them and what to report
- CThat they know which company makes each drug
- DThat they know the price of each medicine and where to buy it
4.Nursing fundamentalsHard
A patient asks for a same-sex nurse for intimate care because of their religious beliefs. What should the nurse do?
- AArrange it where possible and record the preference in the care plan
- BRefuse, as all nurses are equally qualified
- CTell the patient they must accept whoever is on duty
- DAgree, but only if the patient has a written note from a religious leader
5.MicrobiologyMedium
Which organism causes tuberculosis, and what makes it hard to stain with the Gram method?
- ALegionella pneumophila, which lives inside amoebae
- BStreptococcus pneumoniae, which has a capsule
- CMycobacterium tuberculosis, which has a waxy mycolic acid wall
- DMycoplasma pneumoniae, which has no cell wall to take up the stain
6.MicrobiologyHard
A positive blood culture shows Gram-positive cocci in clusters. Which organism is most likely?
- AStreptococcus
- BNeisseria
- CStaphylococcus
- DEnterococcus in short chains
3Solutions
1.Infection control & patient safety
Answer: D · To remove items that could be used to harm self or others
Why this is the answer
Belongings are searched with the patient, according to policy, for items such as sharp objects, cords, drugs and lighters. These are stored safely to reduce the risk of self-harm or violence.
D · To remove items that could be used to harm self or others
2.Infection control & patient safety
Answer: A · Yellow (delayed)
Why this is the answer
The casualty cannot walk, so is not green. Breathing is under 30 a minute, perfusion is adequate and they obey commands, so none of the red criteria apply. This makes them yellow, delayed.
3.Nursing fundamentals
Answer: B · That they know how and when to take them and what to report
Why this is the answer
Safe discharge needs the patient or carer to understand dose, timing, purpose and important side effects. Teach-back and written information help confirm this.
B · That they know how and when to take them and what to report
4.Nursing fundamentals
Answer: A · Arrange it where possible and record the preference in the care plan
Why this is the answer
Respecting such preferences supports dignity and trust. The nurse arranges it whenever possible, records it and explains if it cannot be met in an emergency.
A · Arrange it where possible and record the preference in the care plan
5.Microbiology
Answer: C · Mycobacterium tuberculosis, which has a waxy mycolic acid wall
Why this is the answer
M. tuberculosis has a cell wall rich in mycolic acids, so it resists Gram staining and is identified with acid-fast stains.
C · Mycobacterium tuberculosis, which has a waxy mycolic acid wall
6.Microbiology
Answer: C · Staphylococcus
Why this is the answer
Staphylococci grow in grape-like clusters; streptococci and enterococci in chains or pairs. Neisseria are Gram-negative diplococci.