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 part of a sterile surgical gown is considered sterile once it is on?
- AThe front from the neck down to the knees
- BThe front from chest to the level of the sterile field, and the sleeves
- COnly the back of the gown, which nobody touches
- DThe whole gown, including the back, the collar and the area below the waist
2.Infection control & patient safetyHard
A confused patient in wrist restraints has cool, pale fingers on one hand and a weak radial pulse on that side. What should the nurse do first?
- ARaise the hand on a pillow, leaving the restraint as it is
- BDocument the findings carefully and recheck in two hours
- CTighten the other restraint to stop the patient pulling
- DLoosen that restraint and assess the hand’s circulation
3.Nursing fundamentalsMedium
A bedbound patient who has not opened their bowels for a week now has liquid stool leaking constantly. What should the nurse suspect?
- AFaecal impaction with overflow
- BAn infection that needs antidiarrhoeal drugs at once
- CNormal bowel function returning
- DA side effect of drinking too much water
4.Nursing fundamentalsHard
During a sterile dressing change, the nurse's sterile glove touches the bed rail. What should the nurse do?
- ARemove the gloves, perform hand hygiene and put on new sterile gloves
- BCarry on, as the bed rail was cleaned that morning
- CWipe the glove with an alcohol swab and carry on with the dressing change
- DPut a second pair of sterile gloves over the first pair
5.MicrobiologyMedium
Transfer of bacterial genes from one bacterium to another by a virus is called:
- ATransduction
- BTranscription
- CTransformation
- DConjugation
6.MicrobiologyHard
Which hepatitis viruses are mainly spread through contaminated food and water?
- AHepatitis C and E
- BHepatitis B and C
- CHepatitis B and D
- DHepatitis A and E
3Solutions
1.Infection control & patient safety
Answer: B · The front from chest to the level of the sterile field, and the sleeves
Why this is the answer
Only the front of the gown from chest to the level of the sterile field and the sleeves from above the elbow to the cuffs are sterile. The back, the neckline and anything below the sterile field are non-sterile.
B · The front from chest to the level of the sterile field, and the sleeves
2.Infection control & patient safety
Answer: D · Loosen that restraint and assess the hand’s circulation
Why this is the answer
Signs of poor circulation distal to a restraint require immediate release and assessment. The restraint is then reapplied correctly only if still needed, with the two-finger check, and the findings are reported and documented.
D · Loosen that restraint and assess the hand’s circulation
3.Nursing fundamentals
Answer: A · Faecal impaction with overflow
Why this is the answer
Overflow happens when liquid stool seeps around impacted hard faeces. Giving antidiarrhoeal drugs would make it worse; the nurse reports it for assessment and treatment.
A · Faecal impaction with overflow
4.Nursing fundamentals
Answer: A · Remove the gloves, perform hand hygiene and put on new sterile gloves
Why this is the answer
A sterile glove that touches a non-sterile surface is contaminated and must be replaced. Cleaning it or covering it does not restore sterility.
A · Remove the gloves, perform hand hygiene and put on new sterile gloves
5.Microbiology
Answer: A · Transduction
Why this is the answer
In transduction a bacteriophage accidentally packages bacterial DNA and delivers it to the next cell it infects. Transformation is uptake of free DNA and conjugation uses direct contact.
6.Microbiology
Answer: D · Hepatitis A and E
Why this is the answer
Hepatitis A and E spread by the faecal–oral route. B, C and D spread through blood and body fluids and can cause chronic infection.