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 a fentanyl skin patch wants to use a heating pad on the area. What should the nurse teach?
- AHeat only matters if the patch is on the chest
- BAvoid heat on or near the patch, because it increases how fast the drug is absorbed
- CHeat makes the patch last longer, so fewer patches are needed each month
- DHeat is fine to use, because it helps the patch stick better to the skin
2.Infection control & patient safetyHard
A patient’s allergy band says “penicillin”, and an order has been written for amoxicillin. What should the nurse do?
- AHold the drug and contact the prescriber
- BAsk the patient whether they would like to take it anyway
- CGive the drug and watch the patient closely
- DGive an antihistamine first and then the drug
3.Nursing fundamentalsMedium
Why is early mobilisation important for older inpatients?
- ABed rest quickly causes loss of strength and independence
- BWalking makes older patients' bones grow longer
- COlder patients do not need sleep during the day
- DIt lets staff change the beds more easily while patients are up
4.Nursing fundamentalsHard
An older woman with severe arthritis has normal bladder control but wets herself because she cannot reach the toilet in time. Which type of incontinence is this?
- AUrge incontinence
- BOverflow incontinence
- CStress incontinence
- DFunctional incontinence
5.MicrobiologyMedium
How does an mRNA vaccine produce immunity?
- ABody cells use the mRNA to make a viral protein that the immune system learns to recognise
- BThe mRNA kills the virus directly in the blood
- CThe mRNA contains weakened live virus
- DThe mRNA is inserted permanently into human DNA
6.MicrobiologyHard
On MacConkey agar, pink colonies grow from a urine sample. What does this tell you?
- AThe organism is probably a Gram-negative rod that ferments lactose
- BThe organism is a Gram-positive coccus
- CThe organism is a fungus
- DThe organism does not ferment lactose, so it is probably Salmonella
3Solutions
1.Infection control & patient safety
Answer: B · Avoid heat on or near the patch, because it increases how fast the drug is absorbed
Why this is the answer
Heat from heating pads, electric blankets, hot tubs or fever increases fentanyl absorption and can cause an overdose. Patients are taught to avoid heat over the patch.
B · Avoid heat on or near the patch, because it increases how fast the drug is absorbed
2.Infection control & patient safety
Answer: A · Hold the drug and contact the prescriber
Why this is the answer
Amoxicillin is a penicillin, so it could cause a serious allergic reaction. The nurse holds the drug, clarifies the allergy and contacts the prescriber for a safe alternative.
A · Hold the drug and contact the prescriber
3.Nursing fundamentals
Answer: A · Bed rest quickly causes loss of strength and independence
Why this is the answer
Older adults lose muscle strength quickly in bed, which leads to falls and loss of independence. Getting up, dressed and moving as soon as safe helps prevent this deconditioning.
A · Bed rest quickly causes loss of strength and independence
4.Nursing fundamentals
Answer: D · Functional incontinence
Why this is the answer
Functional incontinence is caused by problems outside the urinary tract, such as poor mobility or confusion. A commode near the bed, easy clothing and regular toileting help.
D · Functional incontinence
5.Microbiology
Answer: A · Body cells use the mRNA to make a viral protein that the immune system learns to recognise
Why this is the answer
The mRNA is translated by cells into an antigen, such as a coronavirus spike protein. The immune system responds to it. The mRNA is broken down and does not enter the nucleus.
A · Body cells use the mRNA to make a viral protein that the immune system learns to recognise
6.Microbiology
Answer: A · The organism is probably a Gram-negative rod that ferments lactose
Why this is the answer
MacConkey agar contains bile salts and crystal violet that inhibit Gram-positive bacteria (selective) and lactose with a pH indicator (differential). Lactose fermenters such as E. coli produce acid and turn pink.
A · The organism is probably a Gram-negative rod that ferments lactose