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 parent says, “I tell my son his medicine is candy so he takes it.” What should the nurse teach?
- AIt is fine as long as the medicine is kept in the fridge
- BDo not call medicine candy, because the child may take it when no one is watching
- CIt only matters for medicines that taste bitter or are hard to swallow
- DThis is a good idea and makes giving medicine easier
2.Infection control & patient safetyHard
A nurse has just started a unit of red blood cells when a colleague asks for urgent help with another patient. What is the best action?
- ALeave to help the other patient, and check the transfusion again in about an hour
- BPause the transfusion until the nurse is free again
- CSpeed up the transfusion so it finishes sooner
- DStay with the transfusing patient for the first 15 minutes and ask another nurse to help
3.Nursing fundamentalsMedium
How should a rectal suppository be inserted?
- APast the internal sphincter, against the rectal wall
- BAfter the patient has stood up and bent forward
- CInto the middle of the stool in the rectum so it softens it
- DJust inside the anus, without passing the sphincter
4.Nursing fundamentalsHard
A nurse escalated a deteriorating patient, but the doctor has not come after 30 minutes and the patient is getting worse. What should the nurse do?
- AEscalate further, for example to a senior doctor or the rapid response team
- BTreat the patient with drugs from the cupboard without a prescription
- CWait, since the doctor has already been told
- DWrite in the notes that the doctor did not come and do nothing else
5.MicrobiologyMedium
Toxoplasma gondii is a risk in pregnancy. Which advice reduces exposure?
- AAvoid all fruit and vegetables
- BAvoid swimming pools and all other public bathing areas
- CAvoid contact with dogs
- DAvoid cleaning cat litter and avoid undercooked meat
6.MicrobiologyHard
A positive blood culture shows Gram-positive cocci in clusters. Which organism is most likely?
- ANeisseria
- BStreptococcus
- CStaphylococcus
- DEnterococcus in short chains
3Solutions
1.Infection control & patient safety
Answer: B · Do not call medicine candy, because the child may take it when no one is watching
Why this is the answer
Calling medicine candy encourages children to look for it and swallow it, which can lead to poisoning. Parents are taught to call medicine medicine and keep it locked away.
B · Do not call medicine candy, because the child may take it when no one is watching
2.Infection control & patient safety
Answer: D · Stay with the transfusing patient for the first 15 minutes and ask another nurse to help
Why this is the answer
The most serious reactions, such as acute hemolytic reactions and anaphylaxis, usually start within the first 15 minutes. The nurse stays with the patient during this time and finds another person to help elsewhere.
D · Stay with the transfusing patient for the first 15 minutes and ask another nurse to help
3.Nursing fundamentals
Answer: A · Past the internal sphincter, against the rectal wall
Why this is the answer
The suppository is pushed past the internal anal sphincter and placed against the rectal wall, usually with the patient lying on the left side. Placing it in stool stops absorption.
A · Past the internal sphincter, against the rectal wall
4.Nursing fundamentals
Answer: A · Escalate further, for example to a senior doctor or the rapid response team
Why this is the answer
If a response is delayed and the patient deteriorates, the nurse follows the escalation policy to the next level and keeps monitoring and supporting ABCDE. Each step is documented.
A · Escalate further, for example to a senior doctor or the rapid response team
5.Microbiology
Answer: D · Avoid cleaning cat litter and avoid undercooked meat
Why this is the answer
Toxoplasma oocysts are shed in cat faeces and cysts are found in undercooked meat. Infection during pregnancy can damage the fetal brain and eyes.
D · Avoid cleaning cat litter and avoid undercooked meat
6.Microbiology
Answer: C · Staphylococcus
Why this is the answer
Staphylococci grow in grape-like clusters; streptococci and enterococci in chains or pairs. Neisseria are Gram-negative diplococci.