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 is safe when transferring a patient from a bed to a stretcher?
- ALower the stretcher side rails during transport
- BLeave the stretcher wheels unlocked so it can move with the patient
- CLock the wheels of both the bed and the stretcher before moving the patient
- DHave the patient slide across without help or a slide sheet
2.Infection control & patient safetyHard
A patient with a common cold asks for antibiotics “to be on the safe side”. Which response is best?
- ASuggest using leftover antibiotics from a previous illness
- BExplain that antibiotics do not work on viruses and overuse breeds resistant bacteria
- CTell the patient that antibiotics will shorten the cold by several days
- DAsk the provider to prescribe antibiotics anyway so that the patient is reassured
3.Nursing fundamentalsMedium
How is a pulse deficit measured?
- AThe pulse oximeter rate is compared with the blood pressure reading
- BTwo nurses count the apical and radial pulse at the same time for one minute
- COne nurse counts the apical pulse for 15 seconds and multiplies by four
- DOne nurse counts the radial pulse twice and compares the two counts
4.Nursing fundamentalsHard
Which nursing diagnosis is written in the problem–aetiology–signs (PES) format?
- ATurn the patient every two hours to protect the skin
- BPneumonia related to a bacterial infection in the right lung
- CImpaired skin integrity related to immobility, as shown by a sacral wound
- DPain related to pain, as shown by the patient saying that it hurts a lot
5.MicrobiologyMedium
Which bacterium causes whooping cough (pertussis)?
- ABordetella pertussis
- BHaemophilus influenzae
- CCorynebacterium diphtheriae
- DMycoplasma pneumoniae
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: C · Lock the wheels of both the bed and the stretcher before moving the patient
Why this is the answer
Both surfaces are locked and at the same height before the transfer, a slide sheet is used and enough staff help. Side rails are raised on the stretcher during transport.
C · Lock the wheels of both the bed and the stretcher before moving the patient
2.Infection control & patient safety
Answer: B · Explain that antibiotics do not work on viruses and overuse breeds resistant bacteria
Why this is the answer
Colds are caused by viruses, which antibiotics do not kill. Unneeded antibiotics cause side effects and drive resistance, so the nurse explains this and offers advice on managing symptoms.
B · Explain that antibiotics do not work on viruses and overuse breeds resistant bacteria
3.Nursing fundamentals
Answer: B · Two nurses count the apical and radial pulse at the same time for one minute
Why this is the answer
A pulse deficit is the apical rate minus the radial rate, counted at the same time over a full minute. It shows that some heartbeats are too weak to reach the wrist, as in atrial fibrillation.
B · Two nurses count the apical and radial pulse at the same time for one minute
4.Nursing fundamentals
Answer: C · Impaired skin integrity related to immobility, as shown by a sacral wound
Why this is the answer
A PES statement gives the nursing problem, the related cause and the defining signs. Pneumonia is a medical diagnosis, turning is an intervention, and a cause cannot repeat the problem.
C · Impaired skin integrity related to immobility, as shown by a sacral wound
5.Microbiology
Answer: A · Bordetella pertussis
Why this is the answer
Bordetella pertussis causes long coughing fits with a "whoop". It is most dangerous for young babies, which is why vaccination in pregnancy is offered in many countries.
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