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 drugs are used as antidotes for nerve agent poisoning?
- AAtropine and pralidoxime
- BAcetylcysteine and charcoal
- CVitamin K and protamine
- DNaloxone and flumazenil
2.Infection control & patient safetyHard
Only one airborne infection isolation room (negative pressure) is free. Which newly admitted patient should be placed in it?
- AA patient with an MRSA wound infection
- BA patient with C. difficile diarrhea
- CA patient with confirmed seasonal influenza and a cough
- DA patient with suspected active pulmonary tuberculosis
3.Nursing fundamentalsMedium
Which technique is used when inserting a urinary catheter?
- AClean technique without gloves
- BNo special technique is needed
- CSterile technique only for male patients
- DAseptic technique
4.Nursing fundamentalsHard
An older patient who lives alone is ready to go home after a hip fracture but worries about washing and cooking. Which referral is most appropriate?
- APodiatry for nail care
- BDietitian for a weight-loss plan
- COccupational therapy for a home assessment
- DSpeech and language therapy for a swallowing assessment
5.MicrobiologyMedium
How is DNA transferred between bacteria during conjugation?
- ABy uptake of free DNA from the environment
- BThrough direct contact using a sex pilus
- CBy a bacteriophage carrying bacterial DNA
- DBy fusion of two bacterial cells into one
6.MicrobiologyHard
Why must a negative-sense RNA virus such as influenza carry its own RNA-dependent RNA polymerase into the host cell?
- AHost ribosomes cannot read any viral genes
- BThe polymerase is needed to integrate the genome into host DNA
- CThe polymerase protects the virus from antibodies
- DHost cells cannot make mRNA from an RNA template
3Solutions
1.Infection control & patient safety
Answer: A · Atropine and pralidoxime
Why this is the answer
Nerve agents inhibit acetylcholinesterase, causing excess acetylcholine. Atropine blocks muscarinic effects such as secretions and bradycardia, and pralidoxime helps to reactivate the enzyme.
A · Atropine and pralidoxime
2.Infection control & patient safety
Answer: D · A patient with suspected active pulmonary tuberculosis
Why this is the answer
Tuberculosis needs airborne precautions in a negative-pressure room. Influenza needs droplet precautions and MRSA and C. difficile need contact precautions, which can be given in an ordinary single room.
D · A patient with suspected active pulmonary tuberculosis
3.Nursing fundamentals
Answer: D · Aseptic technique
Why this is the answer
Urinary catheters are inserted with an aseptic technique and sterile equipment to reduce catheter-associated urinary tract infections.
4.Nursing fundamentals
Answer: C · Occupational therapy for a home assessment
Why this is the answer
Occupational therapists assess how people manage daily activities and the home, and can arrange equipment such as perching stools and raised toilet seats.
C · Occupational therapy for a home assessment
5.Microbiology
Answer: B · Through direct contact using a sex pilus
Why this is the answer
In conjugation a donor cell forms a pilus to a recipient and transfers DNA, often a plasmid. It is an important way for antibiotic resistance genes to spread.
B · Through direct contact using a sex pilus
6.Microbiology
Answer: D · Host cells cannot make mRNA from an RNA template
Why this is the answer
A negative-sense genome must first be copied into positive-sense mRNA. Human cells have no enzyme that copies RNA from RNA, so the virus brings its own polymerase.
D · Host cells cannot make mRNA from an RNA template