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 are blood cultures usually taken from two separate venipuncture sites?
- ATo make the results come back faster from the laboratory
- BBecause each site tests a different antibiotic
- CTo reduce the total amount of blood taken
- DTo help tell a true infection from skin contamination
2.Infection control & patient safetyHard
A patient has signed a surgical consent form but tells the nurse, “I don’t really understand what they are going to do.” What should the nurse do?
- AReassure the patient that the surgeon knows best and continue with the preparation
- BGive the preoperative sedative so the patient relaxes
- CExplain the risks and benefits in place of the surgeon
- DInform the surgeon so the procedure can be explained again before any sedation
3.Nursing fundamentalsMedium
Which adverse effect is a particular risk with NSAIDs such as ibuprofen?
- AStomach irritation and bleeding
- BLow blood sugar
- CBreathing slowing down
- DSevere constipation that lasts for weeks
4.Nursing fundamentalsHard
An older woman has been lying on the floor at home all night after a fall. Which complications should the nurse look for in particular?
- AHair loss and nail damage
- BPressure damage, hypothermia and muscle breakdown
- CHigh blood sugar and a raised temperature from lying still
- DSunburn and dehydration from sweating
5.MicrobiologyMedium
How is DNA transferred between bacteria during conjugation?
- AThrough direct contact using a sex pilus
- BBy uptake of free DNA from the environment
- CBy a bacteriophage carrying bacterial DNA
- DBy fusion of two bacterial cells into one
6.MicrobiologyHard
A traveller returns from sub-Saharan Africa with fever. Malaria is suspected. Which species is most likely to cause severe and cerebral malaria?
- APlasmodium vivax
- BPlasmodium ovale
- CPlasmodium falciparum
- DPlasmodium malariae
3Solutions
1.Infection control & patient safety
Answer: D · To help tell a true infection from skin contamination
Why this is the answer
If the same organism grows from both sets, it is more likely to be a true bloodstream infection. Growth in only one set may be contamination from the skin.
D · To help tell a true infection from skin contamination
2.Infection control & patient safety
Answer: D · Inform the surgeon so the procedure can be explained again before any sedation
Why this is the answer
Informed consent is the responsibility of the person doing the procedure. If the patient does not understand, the nurse pauses the process and tells the surgeon, before any sedative drug is given.
D · Inform the surgeon so the procedure can be explained again before any sedation
3.Nursing fundamentals
Answer: A · Stomach irritation and bleeding
Why this is the answer
NSAIDs can irritate the stomach lining and cause ulcers and bleeding. They are taken with food, avoided in some patients and may also affect the kidneys.
A · Stomach irritation and bleeding
4.Nursing fundamentals
Answer: B · Pressure damage, hypothermia and muscle breakdown
Why this is the answer
A long lie causes pressure injury, hypothermia, dehydration and rhabdomyolysis, which can damage the kidneys. The patient is assessed carefully for these as well as for fractures.
B · Pressure damage, hypothermia and muscle breakdown
5.Microbiology
Answer: A · Through direct contact using a sex pilus
Why this is the answer
In conjugation a donor cell forms a pilus to a recipient and transfers DNA, often a plasmid. It is an important way for antibiotic resistance genes to spread.
A · Through direct contact using a sex pilus
6.Microbiology
Answer: C · Plasmodium falciparum
Why this is the answer
P. falciparum causes very high parasite levels and makes infected red cells stick in small vessels, including in the brain. It is common in sub-Saharan Africa and is a medical emergency.
C · Plasmodium falciparum