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 is keeping a patient warm (normothermia) during surgery part of infection prevention?
- AWarmth sterilizes the surgical site
- BLow body temperature reduces blood flow and immune function in the wound
- CCold makes bacteria grow faster in the operating room air and on the drapes
- DWarm patients do not need antibiotic prophylaxis
2.Infection control & patient safetyHard
In START triage at a mass-casualty incident, a casualty cannot walk, breathes 20 times a minute, has a radial pulse and follows simple commands. Which category applies?
- ARed (immediate)
- BGreen (minor)
- CYellow (delayed)
- DBlack (expectant or dead)
3.Nursing fundamentalsMedium
A patient's radial pulse is irregular. How should you count it?
- AOnly on the automatic blood pressure machine
- BFor 15 seconds and multiply by four
- CFor 10 seconds and multiply by six
- DFor a full 60 seconds, ideally at the apex of the heart
4.Nursing fundamentalsHard
A recently discharged patient sends the nurse a friend request on social media. What is the most appropriate response?
- AAccept it and ask how they are getting on
- BDecline it, to keep a professional boundary
- CAccept it, since the patient has gone home
- DAccept it but only post about work
5.MicrobiologyMedium
In which phase of the bacterial growth curve do the cells divide at their fastest constant rate?
- AStationary (plateau) phase
- BLag (adaptation) phase
- CLog (exponential) phase
- DDeath phase
6.MicrobiologyHard
In the 1840s Ignaz Semmelweis lowered deaths from puerperal fever in a Vienna maternity clinic. What did he introduce?
- ATreating mothers with penicillin
- BHandwashing with chlorinated lime before examining women
- CVaccination of all mothers before birth
- DKeeping mothers in separate isolation rooms after delivery
3Solutions
1.Infection control & patient safety
Answer: B · Low body temperature reduces blood flow and immune function in the wound
Why this is the answer
Hypothermia causes vasoconstriction and less oxygen in the wound, which weakens the immune defense. Keeping the patient warm is linked to fewer surgical site infections.
B · Low body temperature reduces blood flow and immune function in the wound
2.Infection control & patient safety
Answer: C · Yellow (delayed)
Why this is the answer
The casualty cannot walk, so is not green. Breathing is under 30 a minute, perfusion is adequate and they obey commands, so none of the red criteria apply. This makes them yellow, delayed.
3.Nursing fundamentals
Answer: D · For a full 60 seconds, ideally at the apex of the heart
Why this is the answer
An irregular pulse should be counted for a full minute. An apical count with a stethoscope is more accurate, as some beats may be too weak to feel at the wrist.
D · For a full 60 seconds, ideally at the apex of the heart
4.Nursing fundamentals
Answer: B · Decline it, to keep a professional boundary
Why this is the answer
Nursing codes advise keeping clear professional boundaries, and social media contact with patients can blur them. The nurse politely declines and does not share patient information online.
B · Decline it, to keep a professional boundary
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 · Handwashing with chlorinated lime before examining women
Why this is the answer
Semmelweis noticed higher mortality in the ward run by doctors who also did autopsies. Hand disinfection with chlorinated lime sharply reduced deaths, long before germ theory was accepted.
B · Handwashing with chlorinated lime before examining women