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 suspected tuberculosis is in a negative-pressure room. Which practice is correct?
- ALet visitors enter without any protection
- BKeep the door closed except when entering or leaving
- CTurn off the room ventilation at night
- DKeep the door open so staff can see the patient at all times
2.Infection control & patient safetyHard
In START triage at a mass-casualty incident, a casualty cannot walk, breathes 20 times a minute, has a radial pulse and follows simple commands. Which category applies?
- AGreen (minor)
- BRed (immediate)
- CBlack (expectant or dead)
- DYellow (delayed)
3.Nursing fundamentalsMedium
What is a portable bladder scanner used for?
- AMeasuring how much urine is in the bladder without a catheter
- BTaking a sterile sample of urine for culture without a catheter
- CChecking the urine for blood and protein
- DDetecting kidney stones
4.Nursing fundamentalsHard
A patient with severe anaemia has an SpO₂ of 98%. Why can this reading be misleading?
- AThe red cells present are saturated, but the blood carries little oxygen
- BAnaemia damages the light sensor of the oximeter
- CAnaemia makes the oximeter read about 10% higher than the true saturation
- DPatients with anaemia always have a low true saturation
5.MicrobiologyMedium
Which infection is a typical complication of broad-spectrum antibiotic use, causing severe diarrhoea?
- AClostridioides difficile infection
- BSalmonella infection
- CHelicobacter pylori infection
- DHepatitis A
6.MicrobiologyHard
Gram-positive cocci are found. Which test quickly separates staphylococci from streptococci?
- AThe coagulase test
- BThe catalase test
- CThe acid-fast stain
- DGrowth on MacConkey agar
3Solutions
1.Infection control & patient safety
Answer: B · Keep the door closed except when entering or leaving
Why this is the answer
The door is kept closed so that the airflow into the room is maintained. Visitors are limited and instructed about respiratory protection according to policy.
B · Keep the door closed except when entering or leaving
2.Infection control & patient safety
Answer: D · Yellow (delayed)
Why this is the answer
The casualty cannot walk, so is not green. Breathing is under 30 a minute, perfusion is adequate and they obey commands, so none of the red criteria apply. This makes them yellow, delayed.
3.Nursing fundamentals
Answer: A · Measuring how much urine is in the bladder without a catheter
Why this is the answer
A bladder scanner uses ultrasound to estimate bladder volume, for example after a patient has voided. It helps detect retention and avoids unnecessary catheterisation.
A · Measuring how much urine is in the bladder without a catheter
4.Nursing fundamentals
Answer: A · The red cells present are saturated, but the blood carries little oxygen
Why this is the answer
SpO₂ shows the percentage of haemoglobin that carries oxygen, not how much haemoglobin there is. With very little haemoglobin the oxygen content of the blood can be low despite a normal saturation.
A · The red cells present are saturated, but the blood carries little oxygen
5.Microbiology
Answer: A · Clostridioides difficile infection
Why this is the answer
Antibiotics kill normal gut bacteria, letting toxin-producing C. difficile overgrow. Its spores are not killed by alcohol gel, so soap and water handwashing is needed.
A · Clostridioides difficile infection
6.Microbiology
Answer: B · The catalase test
Why this is the answer
Staphylococci produce catalase, which breaks hydrogen peroxide into water and oxygen bubbles; streptococci do not. The coagulase test is then used to identify S. aureus among staphylococci.