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 nurse finds a used needle in a patient’s bed linen. What should the nurse do?
- ALeave it where it is for the housekeeping staff to remove later in the day
- BFold it into the linen and send it to the laundry
- CPick it up by the hub or with forceps, put it in a sharps container and report it
- DRecap it with two hands before throwing it away
2.Infection control & patient safetyHard
A nurse calculates a child’s prescribed dose and finds it is ten times higher than the usual dose for the child’s weight. What should the nurse do?
- AHold the dose and verify it with the prescriber and pharmacist
- BGive half the dose and watch the child closely
- CGive it, because the prescriber must have a reason
- DGive one-tenth of the dose without telling anyone about it
3.Nursing fundamentalsMedium
What is the purpose of the Z-track technique for intramuscular injections?
- AIt lets the nurse give a larger volume into a small muscle
- BIt seals the drug in the muscle and stops it leaking into the tissue above
- CIt numbs the skin before the needle goes in
- DIt makes the injection go into the fatty tissue instead of the muscle
4.Nursing fundamentalsHard
A collapsed patient is unresponsive and making only occasional slow gasps. What should the nurse do?
- AGive a sip of water to clear the throat
- BWait to see whether the gasps become regular
- CTreat it as not breathing normally, call for help and start CPR
- DPlace the patient in the recovery position and keep observing them
5.MicrobiologyMedium
Which white blood cells are the main phagocytes in an acute bacterial infection and the main component of pus?
- ABasophils
- BEosinophils
- CB lymphocytes
- DNeutrophils
6.MicrobiologyHard
A child develops bloody diarrhoea after eating an undercooked burger, then a week later has kidney failure, anaemia and a low platelet count. Which organism is most likely?
- AStaphylococcus aureus
- BRotavirus
- CClostridium perfringens
- DShiga toxin-producing E. coli such as O157:H7
3Solutions
1.Infection control & patient safety
Answer: C · Pick it up by the hub or with forceps, put it in a sharps container and report it
Why this is the answer
A loose needle is a hazard to everyone who handles the linen. The nurse disposes of it safely without recapping, using an instrument if needed, and reports the incident so the cause can be addressed.
C · Pick it up by the hub or with forceps, put it in a sharps container and report it
2.Infection control & patient safety
Answer: A · Hold the dose and verify it with the prescriber and pharmacist
Why this is the answer
Tenfold errors are common in pediatrics, usually from decimal or unit mistakes. The nurse holds the dose and clarifies it, and never changes the dose on their own.
A · Hold the dose and verify it with the prescriber and pharmacist
3.Nursing fundamentals
Answer: B · It seals the drug in the muscle and stops it leaking into the tissue above
Why this is the answer
Pulling the skin sideways before injecting and releasing it afterwards makes a zigzag track that closes over the needle path, preventing leakage and skin staining.
B · It seals the drug in the muscle and stops it leaking into the tissue above
4.Nursing fundamentals
Answer: C · Treat it as not breathing normally, call for help and start CPR
Why this is the answer
Agonal gasps are common in the first minutes after cardiac arrest. They must not be mistaken for breathing; CPR is started and an AED fetched straight away.
C · Treat it as not breathing normally, call for help and start CPR
5.Microbiology
Answer: D · Neutrophils
Why this is the answer
Neutrophils arrive quickly at sites of infection and engulf bacteria. Dead neutrophils, bacteria and tissue debris form pus.
6.Microbiology
Answer: D · Shiga toxin-producing E. coli such as O157:H7
Why this is the answer
Shiga toxin-producing E. coli damages the bowel and the small blood vessels of the kidney, causing haemolytic uraemic syndrome. Cattle are a reservoir, so undercooked minced beef is a classic source.
D · Shiga toxin-producing E. coli such as O157:H7