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
When is a prophylactic antibiotic usually given to prevent a surgical site infection?
- AOne week before surgery
- BThe day after surgery, once the wound is closed
- COnly if a fever develops after surgery
- DWithin about 60 minutes before the incision
2.Infection control & patient safetyHard
Which action best prevents a wrong-route error with an epidural infusion?
- ATape all the lines together to keep them tidy
- BUse a free IV port if the epidural port becomes blocked
- CLabel the epidural line and keep it on its own dedicated pump
- DUse the same pump type and tubing for all of the patient’s infusions
3.Nursing fundamentalsMedium
Why must a respirator such as an FFP3 or N95 mask be fit-tested?
- AFit-testing checks whether the patient is still infectious
- BIt only protects if it seals closely to the wearer's face
- CIt must be tested to check it is the right colour
- DFit-testing makes the mask reusable for a week
4.Nursing fundamentalsHard
Why must concentrated potassium chloride never be given as a quick intravenous injection?
- AIt can cause a fatal cardiac arrest
- BIt makes the potassium inactive in the blood
- CIt makes the vein turn blue for a week
- DIt stops the kidneys from working at once
5.MicrobiologyMedium
Which type of immunity is given by breast milk antibodies?
- AArtificial passive immunity
- BNatural passive immunity
- CArtificial active immunity
- DNatural active immunity
6.MicrobiologyHard
Gram-positive cocci are found. Which test quickly separates staphylococci from streptococci?
- AThe acid-fast stain
- BGrowth on MacConkey agar
- CThe coagulase test
- DThe catalase test
3Solutions
1.Infection control & patient safety
Answer: D · Within about 60 minutes before the incision
Why this is the answer
For most drugs, prophylaxis is given within 60 minutes before the incision so tissue levels are high during surgery. Some drugs, such as vancomycin, start earlier because they are infused over longer.
D · Within about 60 minutes before the incision
2.Infection control & patient safety
Answer: C · Label the epidural line and keep it on its own dedicated pump
Why this is the answer
Labeling lines at the connection end, using distinct (non-Luer) connectors and separate, clearly marked pumps make wrong-route connections much less likely. Lines are traced from the patient to the source before connecting.
C · Label the epidural line and keep it on its own dedicated pump
3.Nursing fundamentals
Answer: B · It only protects if it seals closely to the wearer's face
Why this is the answer
A respirator filters tiny airborne particles only if air passes through the filter, not around a gap. Fit-testing and a fit-check every time it is worn make sure it seals.
B · It only protects if it seals closely to the wearer's face
4.Nursing fundamentals
Answer: A · It can cause a fatal cardiac arrest
Why this is the answer
A sudden rise in blood potassium can stop the heart. IV potassium is given diluted, by a controlled infusion and following strict policy, which is why concentrated forms are tightly controlled.
A · It can cause a fatal cardiac arrest
5.Microbiology
Answer: B · Natural passive immunity
Why this is the answer
Antibodies (mainly IgA) passed in breast milk give passive immunity acquired naturally. It is short-lived because no memory cells form.
B · Natural passive immunity
6.Microbiology
Answer: D · The catalase test
Why this is the answer
Staphylococci produce catalase, which breaks hydrogen peroxide into water and oxygen bubbles; streptococci do not. The coagulase test is then used to identify S. aureus among staphylococci.