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
How should a newborn be moved through hospital corridors?
- AIn the arms of any visitor who offers to help
- BOn the mother’s lap in a wheelchair, without staff
- CIn a bassinet, not carried in the arms
- DCarried in the nurse’s arms for comfort
2.Infection control & patient safetyHard
During a sterile central line dressing change, a colleague reaches across the open sterile field to pass the nurse a roll of tape. What should the nurse do?
- ACover the field with a sterile towel and continue on top of it
- BRemove only the items nearest to where the arm passed over
- CContinue, because the colleague did not touch any sterile item
- DTreat the field as contaminated and set up a new one
3.Nursing fundamentalsMedium
What is the main purpose of a wound drain after surgery?
- ATo remove fluid or blood that could collect and delay healing
- BTo keep the wound edges apart until it heals
- CTo measure the temperature inside the wound
- DTo give antibiotics directly into the wound until it has fully healed
4.Nursing fundamentalsHard
A patient with a slow-healing leg ulcer is eating less than half of their meals. What is the most helpful nursing action?
- AGive extra salt to stimulate the appetite
- BAsk the patient to drink less to avoid swelling
- CWait until the ulcer heals before addressing nutrition
- DRefer to the dietitian and support protein and energy intake
5.MicrobiologyMedium
What is endotoxin?
- AA toxin made by fungi in damp buildings
- BA toxin produced only inside human cells
- CA protein toxin secreted by Gram-positive bacteria into the surrounding tissue
- DThe lipopolysaccharide in the outer membrane of Gram-negative bacteria
6.MicrobiologyHard
What did Pasteur's swan-neck flask experiment demonstrate?
- ABoiling cannot kill microorganisms
- BMicroorganisms need light to grow
- CAir itself produces microorganisms
- DMicroorganisms come from other microorganisms, not from spontaneous generation
3Solutions
1.Infection control & patient safety
Answer: C · In a bassinet, not carried in the arms
Why this is the answer
Infants are moved in a bassinet through corridors. This prevents drops and makes abduction easier to spot, because carrying a baby in the arms in a hallway is unusual.
C · In a bassinet, not carried in the arms
2.Infection control & patient safety
Answer: D · Treat the field as contaminated and set up a new one
Why this is the answer
Reaching across a sterile field with non-sterile arms or items contaminates it, even without touching. The field is replaced, and non-sterile items are passed around the field, not over it. When sterility is in doubt, the field is treated as contaminated.
D · Treat the field as contaminated and set up a new one
3.Nursing fundamentals
Answer: A · To remove fluid or blood that could collect and delay healing
Why this is the answer
Drains let blood, serous fluid or pus escape, preventing collections such as seromas and haematomas. The nurse records the amount and type of drainage.
A · To remove fluid or blood that could collect and delay healing
4.Nursing fundamentals
Answer: D · Refer to the dietitian and support protein and energy intake
Why this is the answer
Poor intake delays healing. Screening, dietitian referral, food charts and support with meals, including protein and energy supplements if needed, help the wound heal.
D · Refer to the dietitian and support protein and energy intake
5.Microbiology
Answer: D · The lipopolysaccharide in the outer membrane of Gram-negative bacteria
Why this is the answer
Endotoxin is lipid A of lipopolysaccharide. It triggers strong immune responses with fever and, in large amounts, septic shock.
D · The lipopolysaccharide in the outer membrane of Gram-negative bacteria
6.Microbiology
Answer: D · Microorganisms come from other microorganisms, not from spontaneous generation
Why this is the answer
Boiled broth in a flask with a curved neck stayed sterile because dust and microbes were trapped in the bend. When the neck was broken, microbes entered and grew, disproving spontaneous generation.
D · Microorganisms come from other microorganisms, not from spontaneous generation