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 patient with suspected tuberculosis is in a negative-pressure room. Which practice is correct?
- AKeep the door open so staff can see the patient at all times
- BLet visitors enter without any protection
- CKeep the door closed except when entering or leaving
- DTurn off the room ventilation at night
2.Infection control & patient safetyHard
A nurse is unsure whether a sterile glove touched the edge of the sterile field. What is the correct action?
- AContinue, because the nurse is not sure
- BWipe the glove with alcohol
- CTreat the glove as contaminated and change it
- DAsk the patient whether they saw it
3.Nursing fundamentalsMedium
A patient you are walking with starts to fall. What should you do?
- ALet go quickly and call for help
- BTry to hold them upright with your arms around their chest
- CEase them gently to the floor while protecting their head
- DGrab them under the armpits and lift them
4.Nursing fundamentalsHard
A patient has had a stroke. Why must swallowing be screened before giving food, drink or oral medicine?
- AOral medicines are never used after a stroke
- BPatients after a stroke are always kept nil by mouth for at least a week
- CSwallowing checks are only needed if the patient asks
- DDysphagia is common after stroke and can cause aspiration pneumonia
5.MicrobiologyMedium
Toxoplasma gondii is a risk in pregnancy. Which advice reduces exposure?
- AAvoid contact with dogs
- BAvoid all fruit and vegetables
- CAvoid cleaning cat litter and avoid undercooked meat
- DAvoid swimming pools and all other public bathing areas
6.MicrobiologyHard
Why must a negative-sense RNA virus such as influenza carry its own RNA-dependent RNA polymerase into the host cell?
- AThe polymerase is needed to integrate the genome into host DNA
- BHost ribosomes cannot read any viral genes
- CThe polymerase protects the virus from antibodies
- DHost cells cannot make mRNA from an RNA template
3Solutions
1.Infection control & patient safety
Answer: C · Keep the door closed except when entering or leaving
Why this is the answer
The door is kept closed so that the airflow into the room is maintained. Visitors are limited and instructed about respiratory protection according to policy.
C · Keep the door closed except when entering or leaving
2.Infection control & patient safety
Answer: C · Treat the glove as contaminated and change it
Why this is the answer
The principle is “if in doubt, it is not sterile”. The edge of the field is non-sterile, so the glove is changed. Continuing on an uncertain basis puts the patient at risk of infection.
C · Treat the glove as contaminated and change it
3.Nursing fundamentals
Answer: C · Ease them gently to the floor while protecting their head
Why this is the answer
Trying to stop a fall can injure both the nurse and the patient. The nurse widens their stance, supports the patient and guides them down, protecting the head.
C · Ease them gently to the floor while protecting their head
4.Nursing fundamentals
Answer: D · Dysphagia is common after stroke and can cause aspiration pneumonia
Why this is the answer
Stroke often affects swallowing, and silent aspiration is possible. A swallow screen, with referral to a speech and language therapist if needed, guides safe food textures and routes for medicines.
D · Dysphagia is common after stroke and can cause aspiration pneumonia
5.Microbiology
Answer: C · Avoid cleaning cat litter and avoid undercooked meat
Why this is the answer
Toxoplasma oocysts are shed in cat faeces and cysts are found in undercooked meat. Infection during pregnancy can damage the fetal brain and eyes.
C · Avoid cleaning cat litter and avoid undercooked meat
6.Microbiology
Answer: D · Host cells cannot make mRNA from an RNA template
Why this is the answer
A negative-sense genome must first be copied into positive-sense mRNA. Human cells have no enzyme that copies RNA from RNA, so the virus brings its own polymerase.
D · Host cells cannot make mRNA from an RNA template