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
Before giving a tablet, the patient says, “This pill looks different from my usual one.” What should the nurse do?
- AStop and recheck the order and the drug before giving it
- BGive half the pill and watch for any unusual effects
- CTell the patient that all pills look different in hospital
- DReassure the patient and give the pill
2.Infection control & patient safetyHard
A patient with active pulmonary tuberculosis asks visitors to come in. What is the best response?
- ABan all contact permanently, including phone calls
- BExplain the risk, limit visits and teach visitors to use the protection provided
- CAllow any visitor in without any precautions, to support the patient
- DAsk visitors to stand in the open doorway instead of entering the room
3.Nursing fundamentalsMedium
A patient cannot stand to be measured for the MUST screening tool. How can their height be estimated?
- ABy asking a visitor to guess
- BFrom the size of the patient's shoes
- CFrom the length of the forearm (ulna)
- DFrom the length of the bed
4.Nursing fundamentalsHard
When measuring blood pressure, the patient's arm is hanging down by their side below heart level. How does this affect the reading?
- AIt gives a falsely high reading
- BIt gives a falsely low reading
- CIt has no effect on the reading
- DIt affects only the heart rate
5.MicrobiologyMedium
Why does high vaccination coverage also protect babies too young to be vaccinated?
- AFewer people can pass on the infection, so it spreads less
- BVaccinated people pass antibodies to everyone they meet
- CVaccines kill the pathogen in the environment
- DBabies are naturally immune to all vaccine-preventable diseases
6.MicrobiologyHard
A traveller returns from sub-Saharan Africa with fever. Malaria is suspected. Which species is most likely to cause severe and cerebral malaria?
- APlasmodium malariae
- BPlasmodium vivax
- CPlasmodium ovale
- DPlasmodium falciparum
3Solutions
1.Infection control & patient safety
Answer: A · Stop and recheck the order and the drug before giving it
Why this is the answer
A patient’s concern is a safety check. The nurse stops and checks the order, the drug, the dose and the patient, and contacts the pharmacy if needed. Sometimes the reason is a different brand, but this must be confirmed first.
A · Stop and recheck the order and the drug before giving it
2.Infection control & patient safety
Answer: B · Explain the risk, limit visits and teach visitors to use the protection provided
Why this is the answer
Visits are limited and supported with education and protection according to policy, while the patient remains in a closed negative-pressure room. Visiting at an open door defeats the negative pressure.
B · Explain the risk, limit visits and teach visitors to use the protection provided
3.Nursing fundamentals
Answer: C · From the length of the forearm (ulna)
Why this is the answer
MUST includes tables that estimate height from ulna length when the patient cannot stand. Self-reported height can also be used if it is reliable.
C · From the length of the forearm (ulna)
4.Nursing fundamentals
Answer: A · It gives a falsely high reading
Why this is the answer
An arm below heart level adds hydrostatic pressure, so the reading is too high. The arm should be supported at heart level, with the patient seated and relaxed.
A · It gives a falsely high reading
5.Microbiology
Answer: A · Fewer people can pass on the infection, so it spreads less
Why this is the answer
When enough people are immune, chains of transmission break and the pathogen rarely reaches susceptible people, such as young babies or immunosuppressed patients.
A · Fewer people can pass on the infection, so it spreads less
6.Microbiology
Answer: D · Plasmodium falciparum
Why this is the answer
P. falciparum causes very high parasite levels and makes infected red cells stick in small vessels, including in the brain. It is common in sub-Saharan Africa and is a medical emergency.
D · Plasmodium falciparum