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 has orthostatic hypotension. Which teaching helps to prevent falls?
- AAvoid drinking fluids in the morning to reduce trips to the toilet
- BSit on the edge of the bed for a short time before standing up slowly
- CStand up straight after a hot shower to increase blood flow
- DGet out of bed quickly so the dizziness passes sooner
2.Infection control & patient safetyHard
During a power cut in a US hospital, a ventilator must stay powered. Where should it be plugged in?
- AInto the outlet that is closest to the bed, whatever its color
- BInto a red outlet connected to the emergency generator
- CInto an extension cord from the corridor
- DInto any white outlet in the room
3.Nursing fundamentalsMedium
At what angle is an intramuscular injection given?
- A90 degrees
- B15 degrees
- C30 degrees
- D45 degrees
4.Nursing fundamentalsHard
At the start of a shift, which task should the nurse do first?
- AOrder supplies for the ward store room
- BUpdate the ward whiteboard with the names of all the new patients
- CChange the bed linen of a patient who is going home
- DGive the first IV antibiotic dose to a patient with suspected sepsis
5.MicrobiologyMedium
Which virus family includes the viruses that cause cold sores and chickenpox?
- APicornaviruses
- BRetroviruses
- CCoronaviruses
- DHerpesviruses
6.MicrobiologyHard
A deep, dirty wound becomes swollen and very painful, and gas can be felt under the skin. Which organism is most likely?
- AStreptococcus pneumoniae
- BBordetella pertussis
- CClostridium perfringens
- DNeisseria gonorrhoeae
3Solutions
1.Infection control & patient safety
Answer: B · Sit on the edge of the bed for a short time before standing up slowly
Why this is the answer
Changing position slowly, dangling the legs first and getting up with help give the circulation time to adjust. Rapid standing, heat and dehydration make orthostatic hypotension worse.
B · Sit on the edge of the bed for a short time before standing up slowly
2.Infection control & patient safety
Answer: B · Into a red outlet connected to the emergency generator
Why this is the answer
In US hospitals, red outlets are usually connected to the emergency generator. Life-support equipment is plugged into them, and battery backups are checked as part of emergency planning.
B · Into a red outlet connected to the emergency generator
3.Nursing fundamentals
Answer: A · 90 degrees
Why this is the answer
Intramuscular injections are given at 90 degrees so the needle passes through the skin and fat into the muscle. Intradermal injections use about 10–15 degrees.
4.Nursing fundamentals
Answer: D · Give the first IV antibiotic dose to a patient with suspected sepsis
Why this is the answer
In sepsis antibiotics are time-critical, and every hour of delay increases the risk of death. Routine tasks are done afterwards.
D · Give the first IV antibiotic dose to a patient with suspected sepsis
5.Microbiology
Answer: D · Herpesviruses
Why this is the answer
Herpes simplex (cold sores) and varicella-zoster (chickenpox, shingles) are herpesviruses that remain latent in sensory ganglia and can reactivate.
6.Microbiology
Answer: C · Clostridium perfringens
Why this is the answer
Clostridium perfringens causes gas gangrene in poorly oxygenated wounds. Its toxins destroy muscle and its metabolism produces gas, felt as crepitus. Urgent surgery and antibiotics are needed.
C · Clostridium perfringens