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?
- AAcetylcysteine and charcoal
- BAtropine and pralidoxime
- CNaloxone and flumazenil
- DVitamin K and protamine
2.Infection control & patient safetyHard
A nurse teaches the daughter of a patient with moderate Alzheimer’s disease about home safety. Which statement shows a need for further teaching?
- A“I let Mom cook alone on the gas stove because she enjoys it.”
- B“We put locks high up on the outside doors.”
- C“She wears an ID bracelet in case she gets lost.”
- D“I keep her medicines locked away and give each dose to her myself.”
3.Nursing fundamentalsMedium
Why is an IV giving set primed before connecting it to the patient?
- ATo check the speed of the pump
- BTo warm the fluid to body temperature
- CTo test whether the patient is allergic to the fluid
- DTo remove air from the line
4.Nursing fundamentalsHard
A dehydrated patient is receiving IV fluids. Which finding best shows the treatment is working?
- AThe urine becomes darker and more concentrated
- BThe patient feels more thirsty than before the fluids started
- CUrine output rises and the heart rate falls towards normal
- DThe heart rate rises and the skin becomes cooler
5.MicrobiologyMedium
Which statement is one of Koch's postulates?
- AThe organism must cause the same disease when introduced into a healthy susceptible host
- BThe disease must respond to antibiotics
- CThe organism must be visible with the naked eye
- DThe organism must be found in healthy people as well
6.MicrobiologyHard
Which hepatitis viruses are mainly spread through contaminated food and water?
- AHepatitis C and E
- BHepatitis B and C
- CHepatitis A and E
- DHepatitis B and D
3Solutions
1.Infection control & patient safety
Answer: B · 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.
B · Atropine and pralidoxime
2.Infection control & patient safety
Answer: A · “I let Mom cook alone on the gas stove because she enjoys it.”
Why this is the answer
People with moderate dementia may forget a lit stove, causing fires or burns. Cooking should be supervised, or stove knobs removed or controls disabled. The other statements show good safety planning.
A · “I let Mom cook alone on the gas stove because she enjoys it.”
3.Nursing fundamentals
Answer: D · To remove air from the line
Why this is the answer
Priming fills the line with fluid and removes air, which could otherwise enter the vein and cause an air embolism.
D · To remove air from the line
4.Nursing fundamentals
Answer: C · Urine output rises and the heart rate falls towards normal
Why this is the answer
With effective fluid replacement, perfusion improves: urine output increases, the heart rate settles and the blood pressure stabilises. Watching for fluid overload is also important.
C · Urine output rises and the heart rate falls towards normal
5.Microbiology
Answer: A · The organism must cause the same disease when introduced into a healthy susceptible host
Why this is the answer
Koch's postulates say the microbe must be found in every case, grown in pure culture, cause the disease in a healthy host and be recovered again from that host. Some pathogens cannot be cultured, so the postulates have limits.
A · The organism must cause the same disease when introduced into a healthy susceptible host
6.Microbiology
Answer: C · Hepatitis A and E
Why this is the answer
Hepatitis A and E spread by the faecal–oral route. B, C and D spread through blood and body fluids and can cause chronic infection.