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 cannot bear weight and cannot help with transfers. Which method is safest to move the patient from bed to chair?
- AOne nurse doing a standing pivot transfer
- BA mechanical lift used by enough trained staff
- CAsking the patient to stand and try their best
- DTwo nurses lifting the patient under the arms
2.Infection control & patient safetyHard
A nurse teaches new parents how to cope with an infant’s crying. Which statement shows a need for further teaching?
- A“If I get frustrated, I will put him safely in the crib and take a short break.”
- B“I can call a friend or family member to help when I am tired.”
- C“I will check whether he is hungry, wet or too warm.”
- D“If he won’t stop crying, a quick shake will get his attention.”
3.Nursing fundamentalsMedium
When is a sputum sample for culture best collected?
- AAt any time, using saliva from the mouth
- BIn the evening, after the patient has eaten and drunk
- CIn the morning, from a deep cough, before antibiotics start
- DAfter the first few doses of antibiotics
4.Nursing fundamentalsHard
What is the effect of deflating the blood pressure cuff too quickly?
- AThe systolic may be read too low and the diastolic too high
- BBoth the systolic and diastolic will be read too high
- COnly the pulse rate is affected, not the blood pressure
- DThe reading becomes more accurate because it is faster
5.MicrobiologyMedium
Cholera causes profuse "rice-water" diarrhoea. What is the most important treatment?
- AStopping all oral fluid intake so that the bowel can rest and recover
- BAntifungal drugs
- CAntiviral drugs
- DReplacing fluid and salts by oral or intravenous rehydration
6.MicrobiologyHard
The minimum inhibitory concentration (MIC) of an antibiotic is:
- AThe lowest concentration that kills 99.9% of the bacterial inoculum in vitro
- BThe highest dose a patient can tolerate
- CThe plasma level at which side effects begin
- DThe lowest concentration that prevents visible bacterial growth in vitro
3Solutions
1.Infection control & patient safety
Answer: B · A mechanical lift used by enough trained staff
Why this is the answer
For a patient who cannot bear weight or help, a mechanical lift prevents injury to both patient and staff. Lifting under the arms can injure the shoulders, and pivot transfers need weight bearing.
B · A mechanical lift used by enough trained staff
2.Infection control & patient safety
Answer: D · “If he won’t stop crying, a quick shake will get his attention.”
Why this is the answer
Shaking an infant can cause bleeding in the brain, permanent disability or death. Parents are taught to put the baby down safely and step away if they feel overwhelmed, and to ask for help.
D · “If he won’t stop crying, a quick shake will get his attention.”
3.Nursing fundamentals
Answer: C · In the morning, from a deep cough, before antibiotics start
Why this is the answer
An early-morning sample from deep in the chest gives the best yield. Saliva is not sputum, and antibiotics can stop organisms growing in the lab.
C · In the morning, from a deep cough, before antibiotics start
4.Nursing fundamentals
Answer: A · The systolic may be read too low and the diastolic too high
Why this is the answer
Fast deflation means the gauge drops past the first and last sounds before they are heard. The usual advice is to deflate at about 2–3 mmHg per second.
A · The systolic may be read too low and the diastolic too high
5.Microbiology
Answer: D · Replacing fluid and salts by oral or intravenous rehydration
Why this is the answer
Cholera toxin makes gut cells secrete large amounts of water and salt. Rapid rehydration saves most lives; antibiotics only shorten the illness.
D · Replacing fluid and salts by oral or intravenous rehydration
6.Microbiology
Answer: D · The lowest concentration that prevents visible bacterial growth in vitro
Why this is the answer
The MIC is the lowest concentration that inhibits visible growth. The minimum bactericidal concentration (MBC) is the lowest that kills 99.9% of the bacteria.
D · The lowest concentration that prevents visible bacterial growth in vitro