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 PPE does a nurse wear when giving an IV chemotherapy drug?
- ATwo pairs of chemotherapy-tested gloves and a disposable impermeable gown
- BA surgical mask and no gloves
- CA reusable cloth gown and one pair of gloves
- DOne pair of standard latex gloves, changed after the infusion is started
2.Infection control & patient safetyHard
A patient in the emergency waiting room has a cough for six weeks, night sweats, weight loss and blood in the sputum. What should the nurse do first?
- APlace the patient in a shared cubicle with the curtain closed
- BStart contact precautions with a gown and gloves for staff
- CAsk the patient to wait in the waiting room until called
- DMask the patient and move them to an airborne isolation room
3.Nursing fundamentalsMedium
Why is an IV giving set primed before connecting it to the patient?
- ATo remove air from the line
- BTo check the speed of the pump
- CTo warm the fluid to body temperature
- DTo test whether the patient is allergic to the fluid
4.Nursing fundamentalsHard
A nurse develops vomiting and diarrhoea during a norovirus outbreak. When can they usually return to work (UK guidance)?
- A48 hours after the symptoms have stopped
- BAs soon as the vomiting stops
- CAfter a full week, whatever the symptoms
- DThe next shift, if they feel well enough
5.MicrobiologyMedium
How does an mRNA vaccine produce immunity?
- AThe mRNA is inserted permanently into human DNA
- BThe mRNA kills the virus directly in the blood
- CBody cells use the mRNA to make a viral protein that the immune system learns to recognise
- DThe mRNA contains weakened live virus
6.MicrobiologyHard
How do high-risk HPV types contribute to cervical cancer?
- AThe virus kills cells so quickly that they are replaced by cancer cells
- BThe virus destroys CD4 T cells in the cervix
- CViral E6 and E7 proteins inactivate the tumour suppressors p53 and Rb
- DThe virus produces an endotoxin that damages DNA
3Solutions
1.Infection control & patient safety
Answer: A · Two pairs of chemotherapy-tested gloves and a disposable impermeable gown
Why this is the answer
Hazardous drugs can be absorbed through the skin or inhaled. Staff wear double chemotherapy-tested gloves and a disposable, low-permeability gown, with eye and face protection if splashing is possible.
A · Two pairs of chemotherapy-tested gloves and a disposable impermeable gown
2.Infection control & patient safety
Answer: D · Mask the patient and move them to an airborne isolation room
Why this is the answer
Prolonged cough, night sweats, weight loss and hemoptysis suggest pulmonary tuberculosis. The patient wears a surgical mask and is moved quickly to a negative-pressure room, and staff wear respirators. Curtains do not stop airborne particles.
D · Mask the patient and move them to an airborne isolation room
3.Nursing fundamentals
Answer: A · 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.
A · To remove air from the line
4.Nursing fundamentals
Answer: A · 48 hours after the symptoms have stopped
Why this is the answer
People can still shed norovirus after symptoms settle, so staff usually stay off work until 48 hours symptom-free. This helps stop outbreaks spreading on wards.
A · 48 hours after the symptoms have stopped
5.Microbiology
Answer: C · Body cells use the mRNA to make a viral protein that the immune system learns to recognise
Why this is the answer
The mRNA is translated by cells into an antigen, such as a coronavirus spike protein. The immune system responds to it. The mRNA is broken down and does not enter the nucleus.
C · Body cells use the mRNA to make a viral protein that the immune system learns to recognise
6.Microbiology
Answer: C · Viral E6 and E7 proteins inactivate the tumour suppressors p53 and Rb
Why this is the answer
E6 promotes the breakdown of p53 and E7 binds Rb, removing controls on cell division and DNA repair. Infected cells can then accumulate mutations and become cancerous over years.
C · Viral E6 and E7 proteins inactivate the tumour suppressors p53 and Rb