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
Which measure reduces errors caused by interruptions during medication preparation?
- AA quiet “no interruption” zone or signal while preparing medications
- BPreparing medications for all patients at once
- CPreparing medications at the busiest place on the ward
- DAnswering phone calls and pages while counting tablets, to save time
2.Infection control & patient safetyHard
In US nursing practice, which task should the RN not assign to an LPN/LVN?
- AGiving scheduled oral antibiotics to a stable patient
- BThe initial admission assessment of a new patient with suspected sepsis
- CReinforcing hand hygiene teaching that the RN has already given
- DA dressing change on a healing surgical wound that has no signs of infection
3.Nursing fundamentalsMedium
A nurse posts about an "interesting patient" on social media without naming them. Why is this a problem?
- AIt is not a problem if the account is private
- BThe patient may still be identifiable, which breaches confidentiality
- CIt is not a problem because no name was given
- DIt is only a problem if the post also includes a photograph of the patient
4.Nursing fundamentalsHard
A dehydrated patient is receiving IV fluids. Which finding best shows the treatment is working?
- AThe urine becomes darker and more concentrated
- BUrine output rises and the heart rate falls towards normal
- CThe heart rate rises and the skin becomes cooler
- DThe patient feels more thirsty than before the fluids started
5.MicrobiologyMedium
Which organism causes tuberculosis, and what makes it hard to stain with the Gram method?
- AStreptococcus pneumoniae, which has a capsule
- BMycoplasma pneumoniae, which has no cell wall to take up the stain
- CMycobacterium tuberculosis, which has a waxy mycolic acid wall
- DLegionella pneumophila, which lives inside amoebae
6.MicrobiologyHard
A deep, dirty wound becomes swollen and very painful, and gas can be felt under the skin. Which organism is most likely?
- ABordetella pertussis
- BStreptococcus pneumoniae
- CClostridium perfringens
- DNeisseria gonorrhoeae
3Solutions
1.Infection control & patient safety
Answer: A · A quiet “no interruption” zone or signal while preparing medications
Why this is the answer
Interruptions during medication preparation are linked to more errors. Many units use quiet zones, vests or signs to show that the nurse should not be interrupted.
A · A quiet “no interruption” zone or signal while preparing medications
2.Infection control & patient safety
Answer: B · The initial admission assessment of a new patient with suspected sepsis
Why this is the answer
The initial assessment of a new, potentially unstable patient is an RN responsibility. LPNs/LVNs can give routine medications, perform routine procedures and reinforce teaching for stable patients.
B · The initial admission assessment of a new patient with suspected sepsis
3.Nursing fundamentals
Answer: B · The patient may still be identifiable, which breaches confidentiality
Why this is the answer
Details such as the ward, the condition or the date can reveal who a patient is. Professional codes forbid sharing patient information on social media, even without names.
B · The patient may still be identifiable, which breaches confidentiality
4.Nursing fundamentals
Answer: B · Urine output rises and the heart rate falls towards normal
Why this is the answer
With effective fluid replacement, perfusion improves: urine output increases, the heart rate settles and the blood pressure stabilises. Watching for fluid overload is also important.
B · Urine output rises and the heart rate falls towards normal
5.Microbiology
Answer: C · Mycobacterium tuberculosis, which has a waxy mycolic acid wall
Why this is the answer
M. tuberculosis has a cell wall rich in mycolic acids, so it resists Gram staining and is identified with acid-fast stains.
C · Mycobacterium tuberculosis, which has a waxy mycolic acid wall
6.Microbiology
Answer: C · Clostridium perfringens
Why this is the answer
Clostridium perfringens causes gas gangrene in poorly oxygenated wounds. Its toxins destroy muscle and its metabolism produces gas, felt as crepitus. Urgent surgery and antibiotics are needed.
C · Clostridium perfringens