Infection Control and Patient Safety: cram pack

Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.

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1Formulas and methods

Infection control & patient safety

Method

  1. Start with standard precautions for every patient: hand hygiene, PPE for the expected exposure, safe sharps.
  2. Add precautions by route: contact (gown, gloves), droplet (surgical mask), airborne (N95, negative-pressure room).
  3. Keep sterile items sterile: if in doubt, it is not sterile; replace, never wipe.
  4. Prevent harm in the environment: fall measures, restraints only as a last resort, RACE and PASS for fire.
  5. 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

Sterile saline is spilled on a sterile drape that lies on a non-sterile table. What does this mean?

  1. AThe field is contaminated, because moisture can carry organisms through the drape
  2. BThe field becomes sterile again when it dries
  3. COnly the wet part is contaminated, so items can be moved to the dry part
  4. DThe field stays sterile, because saline is sterile
2.Infection control & patient safetyHard

Which patient with a suspected infection meets the qSOFA criteria that signal a higher risk of a poor outcome?

  1. ARespiratory rate 18/min, alert, systolic BP 130 mmHg, temperature 38.5 °C
  2. BRespiratory rate 16/min, alert, systolic BP 105 mmHg, WBC 13,000/mm3
  3. CRespiratory rate 24/min, new confusion, systolic BP 95 mmHg
  4. DRespiratory rate 20/min, alert, systolic BP 110 mmHg, heart rate 110/min
3.Nursing fundamentalsMedium

A patient has just died. What should the nurse find out before starting last offices?

  1. AThe family's religious and cultural wishes
  2. BWhether the patient's bills had all been paid
  3. CThe patient's blood group
  4. DThe patient's favourite food
4.Nursing fundamentalsHard

In English law, giving a treatment to a competent adult who has clearly refused it may amount to:

  1. ATheft
  2. BBreach of an employment contract
  3. CBattery (trespass to the person)
  4. DDefamation of character
5.MicrobiologyMedium

Which laboratory test separates Staphylococcus aureus from most other staphylococci?

  1. AThe Gram stain
  2. BThe catalase test
  3. CThe acid-fast stain
  4. DThe coagulase test
6.MicrobiologyHard

Joseph Lister reduced infection after surgery in the 1860s. What was his main innovation?

  1. AUsing steam autoclaves to sterilise all surgical instruments before each operation
  2. BUsing carbolic acid (phenol) as an antiseptic on wounds and instruments
  3. CGiving sulfonamide antibiotics after every operation
  4. DVaccinating surgeons against staphylococci

3Solutions

1.Infection control & patient safety

Answer: A · The field is contaminated, because moisture can carry organisms through the drape

Why this is the answer

Liquid soaking through a drape can carry organisms up from the non-sterile surface below. The field is considered contaminated and is set up again.

Answer

A · The field is contaminated, because moisture can carry organisms through the drape
2.Infection control & patient safety

Answer: C · Respiratory rate 24/min, new confusion, systolic BP 95 mmHg

Why this is the answer

qSOFA scores one point each for a respiratory rate of 22/min or more, altered mental status and a systolic BP of 100 mmHg or less. Two or more points mean higher risk, so the first patient needs urgent escalation.

Answer

C · Respiratory rate 24/min, new confusion, systolic BP 95 mmHg
3.Nursing fundamentals

Answer: A · The family's religious and cultural wishes

Why this is the answer

Some faiths have specific rules, for example about who may touch or wash the body and how soon burial should happen. Asking first respects the person and the family.

Answer

A · The family's religious and cultural wishes
4.Nursing fundamentals

Answer: C · Battery (trespass to the person)

Why this is the answer

Touching or treating a person without valid consent can be battery, even if the treatment was meant to help. This is why consent is needed before care.

Answer

C · Battery (trespass to the person)
5.Microbiology

Answer: D · The coagulase test

Why this is the answer

S. aureus produces coagulase, which converts fibrinogen to fibrin. All staphylococci are Gram-positive and catalase-positive, so those tests do not separate them.

Answer

D · The coagulase test
6.Microbiology

Answer: B · Using carbolic acid (phenol) as an antiseptic on wounds and instruments

Why this is the answer

Lister applied carbolic acid to wounds, dressings and instruments, which greatly reduced post-operative infection. This started antiseptic surgery.

Answer

B · Using carbolic acid (phenol) as an antiseptic on wounds and instruments

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