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
An alcohol-based skin prep has been used before surgery with electrosurgery. What must happen before the drapes are placed?
- AThe prep must be wiped off with saline
- BThe prep must be fully dry and any pooled liquid removed
- CThe prep must be covered with the drapes while it is still wet
- DThe prep must be warmed with a hair dryer
2.Infection control & patient safetyHard
Which position is especially dangerous for a patient in physical restraints?
- ALying on the side
- BLying face down (prone)
- CLying on the back with the head raised
- DSitting upright in bed
3.Nursing fundamentalsMedium
A patient with right-sided weakness is moving from bed to chair. Where should the chair be placed?
- AAt the foot of the bed facing away
- BOn the patient's right side, close to the bed
- COn the patient's left side, close to the bed
- DAcross the room so the patient can practise walking
4.Nursing fundamentalsHard
Which simple measure helps reduce the risk of delirium in an older inpatient?
- AMaking sure they have their glasses and hearing aids
- BMoving them to a different bed every night to vary their surroundings
- CKeeping the lights on all night
- DLimiting visits from family members
5.MicrobiologyMedium
What is the main difference between innate and adaptive immunity?
- AAdaptive immunity is specific and forms memory; innate immunity does not
- BAdaptive immunity acts within minutes of infection
- CInnate immunity develops only after vaccination
- DInnate immunity uses antibodies and forms memory; adaptive immunity does not
6.MicrobiologyHard
Corynebacterium diphtheriae causes diphtheria only if it produces diphtheria toxin. When does it make this toxin?
- AWhen it carries a bacteriophage with the toxin gene
- BOnly when it is grown at high temperature
- COnly after it has conjugated with E. coli and received a plasmid
- DWhenever it is exposed to antibiotics
3Solutions
1.Infection control & patient safety
Answer: B · The prep must be fully dry and any pooled liquid removed
Why this is the answer
Wet alcohol prep and its vapors under drapes can be ignited by electrosurgery or lasers. The prep is allowed to dry fully, and pooling in skin folds or linen is prevented.
B · The prep must be fully dry and any pooled liquid removed
2.Infection control & patient safety
Answer: B · Lying face down (prone)
Why this is the answer
Restraining a person face down can restrict breathing and has caused deaths from positional asphyxia. Restrained patients are positioned to protect the airway and are watched closely.
B · Lying face down (prone)
3.Nursing fundamentals
Answer: C · On the patient's left side, close to the bed
Why this is the answer
Placing the chair on the strong side lets the patient pivot and bear weight on the stronger leg, making the transfer safer.
C · On the patient's left side, close to the bed
4.Nursing fundamentals
Answer: A · 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.
A · Making sure they have their glasses and hearing aids
5.Microbiology
Answer: A · Adaptive immunity is specific and forms memory; innate immunity does not
Why this is the answer
Innate defences (barriers, phagocytes, complement) act fast and in the same way each time. Adaptive immunity (B and T cells) takes days, is specific to each antigen and forms memory.
A · Adaptive immunity is specific and forms memory; innate immunity does not
6.Microbiology
Answer: A · When it carries a bacteriophage with the toxin gene
Why this is the answer
The tox gene is carried by a bacteriophage. When the phage is integrated as a prophage, the bacterium can produce toxin. Strains without the phage are non-toxigenic.
A · When it carries a bacteriophage with the toxin gene