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’s identification wristband is missing. A medication is due. What should the nurse do?
- AGive it, because the nurse recognizes the patient from yesterday
- BSkip the medication until the next day
- CConfirm identity with two identifiers and apply a new wristband first
- DUse the room and bed number to confirm identity
2.Infection control & patient safetyHard
A patient on contact precautions for MRSA has become withdrawn and says, “Everyone avoids me.” What is the best nursing action?
- AExplain why the precautions are needed and plan regular, unhurried time in the room
- BKeep visits short to limit the risk of spreading MRSA
- CStop the precautions for a few days so the patient feels less isolated and alone
- DAsk the provider for a sedative to help the patient cope
3.Nursing fundamentalsMedium
What makes "Risk for falls" a risk nursing diagnosis rather than an actual one?
- AThe patient has already fallen several times
- BThe fall has not happened yet, but risk factors are present
- CThe problem can never be prevented
- DThe doctor has confirmed the diagnosis with tests and a scan
4.Nursing fundamentalsHard
Which simple measure helps reduce the risk of delirium in an older inpatient?
- ALimiting visits from family members
- BMoving them to a different bed every night to vary their surroundings
- CMaking sure they have their glasses and hearing aids
- DKeeping the lights on all night
5.MicrobiologyMedium
Which organism is a common cause of infection in burns and in people with cystic fibrosis, and can produce a green pigment?
- APseudomonas aeruginosa
- BClostridium tetani
- CHelicobacter pylori
- DStreptococcus pyogenes
6.MicrobiologyHard
Why can a person get influenza many times but measles usually only once?
- AInfluenza attacks and destroys the memory cells formed after infection
- BMeasles is caused by a bacterium
- CMeasles virus has no surface antigens
- DInfluenza viruses change their surface antigens often
3Solutions
1.Infection control & patient safety
Answer: C · Confirm identity with two identifiers and apply a new wristband first
Why this is the answer
Every medication requires a confirmed identity. The nurse replaces the wristband after confirming the patient’s identity with two identifiers. Familiarity and room numbers are not acceptable identifiers.
C · Confirm identity with two identifiers and apply a new wristband first
2.Infection control & patient safety
Answer: A · Explain why the precautions are needed and plan regular, unhurried time in the room
Why this is the answer
Isolation can cause loneliness, anxiety and depression, and patients in isolation may get less contact with staff. The nurse explains the reason for the precautions, spends planned time with the patient and supports visits from people who follow the precautions.
A · Explain why the precautions are needed and plan regular, unhurried time in the room
3.Nursing fundamentals
Answer: B · The fall has not happened yet, but risk factors are present
Why this is the answer
A risk diagnosis describes a problem the patient is vulnerable to, based on risk factors, with no signs yet. Care aims to prevent the problem from occurring.
B · The fall has not happened yet, but risk factors are present
4.Nursing fundamentals
Answer: C · Making sure they have their glasses and hearing aids
Why this is the answer
Sensory aids, orientation, good sleep, hydration, mobility and family involvement all help prevent delirium. Frequent moves and poor sleep make it more likely.
C · Making sure they have their glasses and hearing aids
5.Microbiology
Answer: A · Pseudomonas aeruginosa
Why this is the answer
Pseudomonas aeruginosa is an opportunistic pathogen of burns, ventilated patients and cystic fibrosis lungs. It is naturally resistant to many antibiotics.
A · Pseudomonas aeruginosa
6.Microbiology
Answer: D · Influenza viruses change their surface antigens often
Why this is the answer
Influenza haemagglutinin and neuraminidase change through drift (small mutations) and shift (reassortment), so old antibodies may not recognise new strains. Measles is antigenically stable.
D · Influenza viruses change their surface antigens often