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 peripheral IV site is red, warm and tender along the vein. What should the nurse do?
- AApply a warm pack and keep using the same site
- BRemove the catheter and insert a new one at another site if still needed
- CFlush the catheter harder to clear the vein and keep using the same site
- DIncrease the infusion rate to finish the bag sooner
2.Infection control & patient safetyHard
A patient weighs 180 kg and needs to be moved from bed to chair. The standard ceiling lift on the unit has a lower weight limit. What should the nurse do?
- AHave two staff lift the patient by hand
- BAsk the patient to stand and pivot without help
- CUse the standard lift, because limits include a safety margin
- DUse bariatric-rated equipment and enough trained staff
3.Nursing fundamentalsMedium
Which measure is appropriate for a patient with a fever who feels hot and uncomfortable?
- AAn ice bath until the patient shivers
- BExtra blankets to make the patient sweat it out
- CRestricting fluids so the patient sweats less during the fever
- DLight bedclothes, plenty of fluids and a prescribed antipyretic
4.Nursing fundamentalsHard
A patient needs a painful dressing change. When is it best to give the prescribed oral analgesic?
- AImmediately after the dressing change
- BEarly enough before the procedure for it to reach its peak effect
- COnly if the patient shows signs of pain or cries out during the procedure
- DThe same time the next day
5.MicrobiologyMedium
Which organism is a Gram-negative diplococcus that causes a sexually transmitted infection?
- ATrichomonas vaginalis
- BNeisseria gonorrhoeae
- CChlamydia trachomatis
- DTreponema pallidum
6.MicrobiologyHard
What is the key difference between bactericidal and bacteriostatic antibiotics?
- ABacteriostatic drugs always work faster than bactericidal drugs
- BBactericidal drugs work only on viruses; bacteriostatic drugs work on bacteria
- CBactericidal drugs kill bacteria; bacteriostatic drugs stop growth and rely on the immune system to clear them
- DBactericidal drugs work only outside the body
3Solutions
1.Infection control & patient safety
Answer: B · Remove the catheter and insert a new one at another site if still needed
Why this is the answer
Redness, warmth and tenderness along the vein indicate phlebitis, which can lead to infection. The catheter is removed and, if IV access is still needed, a new one is placed at a different site.
B · Remove the catheter and insert a new one at another site if still needed
2.Infection control & patient safety
Answer: D · Use bariatric-rated equipment and enough trained staff
Why this is the answer
Using equipment above its rated capacity can cause collapse and injury. Bariatric lifts, chairs and beds are used, with enough trained staff and a plan agreed in advance.
D · Use bariatric-rated equipment and enough trained staff
3.Nursing fundamentals
Answer: D · Light bedclothes, plenty of fluids and a prescribed antipyretic
Why this is the answer
Light clothing, fluids and antipyretics such as paracetamol (acetaminophen) increase comfort and replace fluid lost through sweating. Very cold sponging causes shivering, which produces heat.
D · Light bedclothes, plenty of fluids and a prescribed antipyretic
4.Nursing fundamentals
Answer: B · Early enough before the procedure for it to reach its peak effect
Why this is the answer
Giving analgesia in advance, timed to the drug's onset and peak, means the pain relief is working during the procedure. This is more effective than treating pain after it has started.
B · Early enough before the procedure for it to reach its peak effect
5.Microbiology
Answer: B · Neisseria gonorrhoeae
Why this is the answer
Neisseria gonorrhoeae appears as pairs of Gram-negative cocci, often inside neutrophils. Treponema is a spirochaete, Chlamydia is an intracellular bacterium and Trichomonas is a protozoan.
B · Neisseria gonorrhoeae
6.Microbiology
Answer: C · Bactericidal drugs kill bacteria; bacteriostatic drugs stop growth and rely on the immune system to clear them
Why this is the answer
Bacteriostatic drugs halt multiplication so host defences can eliminate the bacteria. Bactericidal drugs are preferred when defences are weak or hard to reach, such as in endocarditis or neutropenia.
C · Bactericidal drugs kill bacteria; bacteriostatic drugs stop growth and rely on the immune system to clear them