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 will give a liquid antibiotic to a child at home. Which teaching is best?
- AUse any teaspoon or tablespoon from the kitchen drawer at home
- BUse a tablespoon for doses over 5 mL
- CUse the oral syringe or dosing cup that comes with the medicine
- DEstimate the dose by pouring into a cup
2.Infection control & patient safetyHard
A nurse cannot find a confused patient who was in their room 15 minutes ago. What should the nurse do first?
- AAlert staff and security at once, following the missing-patient procedure
- BDocument the absence at the end of the shift
- CWait an hour in case the patient comes back
- DCall the family to ask whether the patient has gone home on their own
3.Nursing fundamentalsMedium
At what angle is an intramuscular injection given?
- A90 degrees
- B30 degrees
- C15 degrees
- D45 degrees
4.Nursing fundamentalsHard
In a patient with sepsis, what does a raised blood lactate suggest?
- AThe kidneys are making too much urine
- BThe tissues are not getting enough oxygen
- CThe infection has been cured
- DThe patient has eaten recently
5.MicrobiologyMedium
In which phase of the bacterial growth curve do the cells divide at their fastest constant rate?
- AStationary (plateau) phase
- BDeath phase
- CLog (exponential) phase
- DLag (adaptation) phase
6.MicrobiologyHard
Which mechanism of antibiotic resistance does a bacterium use when it pumps the drug out of the cell?
- AReduced porin uptake only
- BEfflux pumps
- CTarget modification
- DEnzymatic inactivation
3Solutions
1.Infection control & patient safety
Answer: C · Use the oral syringe or dosing cup that comes with the medicine
Why this is the answer
Household spoons vary widely in size and cause dosing errors. A marked oral syringe or dosing device in mL gives an accurate dose.
C · Use the oral syringe or dosing cup that comes with the medicine
2.Infection control & patient safety
Answer: A · Alert staff and security at once, following the missing-patient procedure
Why this is the answer
A missing vulnerable patient is an emergency. The nurse immediately activates the facility’s missing-patient procedure so a search starts, and the provider and family are informed per policy.
A · Alert staff and security at once, following the missing-patient procedure
3.Nursing fundamentals
Answer: A · 90 degrees
Why this is the answer
Intramuscular injections are given at 90 degrees so the needle passes through the skin and fat into the muscle. Intradermal injections use about 10–15 degrees.
4.Nursing fundamentals
Answer: B · The tissues are not getting enough oxygen
Why this is the answer
When tissues are poorly perfused they switch to anaerobic metabolism and produce lactate. A raised lactate in sepsis signals higher risk and the need for urgent treatment.
B · The tissues are not getting enough oxygen
5.Microbiology
Answer: C · Log (exponential) phase
Why this is the answer
After the lag phase of adjustment, cells enter the log phase and grow exponentially. Growth stops in the stationary phase as nutrients run out and waste builds up.
C · Log (exponential) phase
6.Microbiology
Answer: B · Efflux pumps
Why this is the answer
Efflux pumps actively export antibiotics such as tetracyclines and fluoroquinolones, keeping the inside concentration too low to work.