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
Why does a nurse wear chemotherapy-tested gloves and a gown when emptying the urinal of a patient who recently had chemotherapy?
- AThe urine always contains infectious bacteria after chemotherapy
- BThe body fluids can contain active drug for a time after treatment
- CChemotherapy makes the urine strongly acidic and corrosive
- DThe patient is on airborne precautions after treatment
2.Infection control & patient safetyHard
A nurse arrives at the scene of a fire in a corridor and the fire is spreading. Patients are in nearby rooms. What should the nurse do after raising the alarm?
- AOpen all doors and windows to let the smoke escape
- BTake patients to the ground floor in the nearest elevator
- CTry to put out the spreading fire alone with an extinguisher
- DClose doors and move patients in danger horizontally behind fire doors
3.Nursing fundamentalsMedium
A goal states: "The patient will report pain of 3/10 or less within one hour of analgesia." After one hour the patient reports 6/10. What should the nurse do?
- AChange the goal to 6/10 or less so that it counts as met
- BRecord the goal as not met and review the plan
- CWait until the next day to evaluate again
- DRecord the goal as met, as the pain has gone down
4.Nursing fundamentalsHard
A competent adult who is a Jehovah's Witness refuses a blood transfusion that the team believes is needed. Which two ethical principles are in conflict?
- AJustice and veracity
- BFidelity and justice
- CAutonomy and beneficence
- DVeracity and non-maleficence
5.MicrobiologyMedium
Why does high vaccination coverage also protect babies too young to be vaccinated?
- ABabies are naturally immune to all vaccine-preventable diseases
- BVaccines kill the pathogen in the environment
- CFewer people can pass on the infection, so it spreads less
- DVaccinated people pass antibodies to everyone they meet
6.MicrobiologyHard
What did Pasteur's swan-neck flask experiment demonstrate?
- AMicroorganisms need light to grow
- BMicroorganisms come from other microorganisms, not from spontaneous generation
- CAir itself produces microorganisms
- DBoiling cannot kill microorganisms
3Solutions
1.Infection control & patient safety
Answer: B · The body fluids can contain active drug for a time after treatment
Why this is the answer
Many hazardous drugs are excreted in urine, stool and vomit for a period after treatment. Staff wear protective gloves and gowns when handling these fluids, according to policy.
B · The body fluids can contain active drug for a time after treatment
2.Infection control & patient safety
Answer: D · Close doors and move patients in danger horizontally behind fire doors
Why this is the answer
Closing doors slows the spread of smoke and fire. Patients in immediate danger are moved horizontally to a safe area behind fire doors, followed by further evacuation if needed. Elevators are not used, and a spreading fire is left to firefighters.
D · Close doors and move patients in danger horizontally behind fire doors
3.Nursing fundamentals
Answer: B · Record the goal as not met and review the plan
Why this is the answer
Evaluation compares the outcome with the goal. The goal was not met, so the nurse reassesses, reports and revises the plan, for example with a different analgesic.
B · Record the goal as not met and review the plan
4.Nursing fundamentals
Answer: C · Autonomy and beneficence
Why this is the answer
The patient's right to decide (autonomy) conflicts with the team's wish to do good (beneficence). A valid refusal by a competent adult is respected, and alternatives to blood are explored.
C · Autonomy and beneficence
5.Microbiology
Answer: C · Fewer people can pass on the infection, so it spreads less
Why this is the answer
When enough people are immune, chains of transmission break and the pathogen rarely reaches susceptible people, such as young babies or immunosuppressed patients.
C · Fewer people can pass on the infection, so it spreads less
6.Microbiology
Answer: B · 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.
B · Microorganisms come from other microorganisms, not from spontaneous generation