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 nurse finds an unlabeled syringe of clear fluid on the medication counter. What should the nurse do?
- ADiscard it, because its contents cannot be confirmed
- BLabel it with the most likely drug name
- CAsk nearby staff and use it if someone recognizes it
- DGive it to the patient whose medication is due
2.Infection control & patient safetyHard
Which pairing of an organism with its transmission-based precautions is correct?
- AMumps – droplet
- BMeasles – contact only
- CInfluenza – airborne only
- DC. difficile – airborne
3.Nursing fundamentalsMedium
A patient's blood pressure is much higher than in all previous readings. What is the best first step?
- AIgnore it, as it must be a machine error
- BRecheck it, making sure the technique and cuff size are correct
- CTell the patient they are having a stroke
- DRecord it and give an extra dose of the blood pressure tablet
4.Nursing fundamentalsHard
Which task should a registered nurse not delegate to a healthcare assistant (nursing assistant)?
- AHelping a patient with a morning wash
- BRecording a patient's oral fluid intake
- CAssessing a patient who reports new chest pain
- DTaking routine observations on a stable patient
5.MicrobiologyMedium
Which cells does HIV mainly infect and destroy?
- APlatelets
- BRed blood cells
- CNeutrophils
- DCD4 T helper cells
6.MicrobiologyHard
Staphylococcus aureus food poisoning starts only 1–6 hours after eating. Why so fast?
- AThe bacteria made a heat-stable toxin in the food before it was eaten
- BThe immune system reacts to the bacteria within minutes
- CThe bacteria invade the bloodstream immediately
- DThe bacteria multiply very fast inside the gut and invade the intestinal wall
3Solutions
1.Infection control & patient safety
Answer: A · Discard it, because its contents cannot be confirmed
Why this is the answer
An unlabeled syringe could contain any drug or dose. It is discarded, and syringes are labeled straight away whenever they are not given immediately.
A · Discard it, because its contents cannot be confirmed
2.Infection control & patient safety
Answer: A · Mumps – droplet
Why this is the answer
Mumps spreads by respiratory droplets, so droplet precautions are used. Measles is airborne, C. difficile needs contact precautions, and influenza needs droplet precautions.
3.Nursing fundamentals
Answer: B · Recheck it, making sure the technique and cuff size are correct
Why this is the answer
Unexpected findings are validated before action. If the repeat reading is still high, the nurse assesses for symptoms and reports it.
B · Recheck it, making sure the technique and cuff size are correct
4.Nursing fundamentals
Answer: C · Assessing a patient who reports new chest pain
Why this is the answer
New symptoms in a patient need registered nurse assessment and decision-making. Routine, predictable tasks with stable patients can be delegated with clear instructions.
C · Assessing a patient who reports new chest pain
5.Microbiology
Answer: D · CD4 T helper cells
Why this is the answer
HIV binds CD4 and a co-receptor on T helper cells. Loss of these cells weakens both antibody and cell-mediated immunity, leading to AIDS.
6.Microbiology
Answer: A · The bacteria made a heat-stable toxin in the food before it was eaten
Why this is the answer
S. aureus produces enterotoxins in food left at warm temperatures. The toxin is already there when the food is eaten and survives reheating, so symptoms start quickly.
A · The bacteria made a heat-stable toxin in the food before it was eaten