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
Before helping a patient from bed into a wheelchair, what should the nurse do with the wheelchair?
- ALock the brakes and place it close to the bed on the patient’s stronger side
- BPlace it on the patient’s weaker side so that side is supported
- CPlace it at the foot of the bed, facing away
- DLeave the brakes off so the chair can move along with the patient during the pivot
2.Infection control & patient safetyHard
A patient on airborne precautions needs an urgent CT scan. Which plan is correct?
- APatient masked, CT warned in advance, staff in respirators
- BThe scan is postponed until the patient is no longer infectious
- CPatient wears an N95 respirator, so staff need no protection
- DPatient goes unmasked, and the CT room is cleaned the next day
3.Nursing fundamentalsMedium
How should adhesive tape be removed from an older patient's fragile skin?
- AQuickly in one firm pull, straight upwards and away from the skin
- BAfter wetting it with alcohol rub
- CSlowly, low and close to the skin, while supporting the skin
- DBy pulling it away from the wound as hard as possible
4.Nursing fundamentalsHard
A patient reports pain of 8/10 but is chatting calmly and has normal vital signs. What should the nurse do?
- AWithhold analgesia until the vital signs change
- BRecord a lower score because the patient looks comfortable and calm
- CTell the patient they cannot be in that much pain
- DAccept the report, assess further and offer analgesia
5.MicrobiologyMedium
Which is a function of the complement system?
- APresenting antigens to T cells
- BMaking new red blood cells
- CProducing antibodies against newly encountered antigens
- DForming pores in the membranes of some bacteria
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
- CHandwashing with chlorinated lime before examining women
- DTreating mothers with penicillin
3Solutions
1.Infection control & patient safety
Answer: A · Lock the brakes and place it close to the bed on the patient’s stronger side
Why this is the answer
Locked brakes stop the chair rolling away during the transfer. Placing it close to the bed on the stronger side lets the patient lead with their strong leg.
A · Lock the brakes and place it close to the bed on the patient’s stronger side
2.Infection control & patient safety
Answer: A · Patient masked, CT warned in advance, staff in respirators
Why this is the answer
Urgent tests are not delayed, but the patient wears a surgical mask to contain particles, the route is planned, and the receiving staff are informed so they can protect themselves and other patients.
A · Patient masked, CT warned in advance, staff in respirators
3.Nursing fundamentals
Answer: C · Slowly, low and close to the skin, while supporting the skin
Why this is the answer
Peeling the tape back low and slow while holding the skin reduces the pulling force on fragile skin. Adhesive removers can also help.
C · Slowly, low and close to the skin, while supporting the skin
4.Nursing fundamentals
Answer: D · Accept the report, assess further and offer analgesia
Why this is the answer
Pain is what the patient says it is. People cope with pain in different ways, and vital signs often stay normal, especially in chronic pain, so the self-report guides care.
D · Accept the report, assess further and offer analgesia
5.Microbiology
Answer: D · Forming pores in the membranes of some bacteria
Why this is the answer
Complement proteins coat microbes for phagocytosis (opsonisation), attract immune cells and form the membrane attack complex that punches holes in some bacteria.
D · Forming pores in the membranes of some bacteria
6.Microbiology
Answer: C · 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.
C · Handwashing with chlorinated lime before examining women