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 wants to use their own electric hair dryer in the hospital. What is correct?
- AIt is checked for electrical safety according to hospital policy before use
- BIt can be plugged into an extension lead under the bed
- CIt can be used in the bathroom near the sink if the patient is careful
- DIt can be used straight away if it looks new
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?
- ARed (immediate)
- BGreen (minor)
- CBlack (expectant or dead)
- DYellow (delayed)
3.Nursing fundamentalsMedium
Which of these is recorded as fluid intake on a fluid balance chart?
- AVomit
- BWound drainage
- CUrine output from a catheter
- DIntravenous fluids
4.Nursing fundamentalsHard
A patient has a platelet count of 40 × 10⁹/L (40,000/mm³). Which nursing measure is appropriate?
- AGive aspirin for any headaches
- BUse a soft toothbrush and avoid IM injections where possible
- CUse a firm toothbrush and floss hard to keep the gums healthy
- DEncourage contact sports to raise the count
5.MicrobiologyMedium
Which type of immunity is given by breast milk antibodies?
- AArtificial passive immunity
- BNatural passive immunity
- CNatural active immunity
- DArtificial active immunity
6.MicrobiologyHard
What does an R0 (basic reproduction number) of 3 mean?
- AThree percent of infected people die
- BThree doses of vaccine are needed
- COn average one case infects three others in a fully susceptible population
- DThe infection lasts three days
3Solutions
1.Infection control & patient safety
Answer: A · It is checked for electrical safety according to hospital policy before use
Why this is the answer
Electrical items from home can be faulty and cause shocks or fires. Policies usually require them to be inspected before use, and extension cords near patients are avoided.
A · It is checked for electrical safety according to hospital policy before use
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: D · Intravenous fluids
Why this is the answer
Intake includes oral fluids, enteral feeds and IV fluids, including drug infusions. Urine, vomit, drainage and stool are output.
4.Nursing fundamentals
Answer: B · Use a soft toothbrush and avoid IM injections where possible
Why this is the answer
A low platelet count raises the risk of bleeding. Bleeding precautions include soft toothbrushes, electric razors, avoiding IM injections and avoiding aspirin and NSAIDs.
B · Use a soft toothbrush and avoid IM injections where possible
5.Microbiology
Answer: B · Natural passive immunity
Why this is the answer
Antibodies (mainly IgA) passed in breast milk give passive immunity acquired naturally. It is short-lived because no memory cells form.
B · Natural passive immunity
6.Microbiology
Answer: C · On average one case infects three others in a fully susceptible population
Why this is the answer
R0 is the average number of secondary cases from one case when everyone is susceptible. Herd immunity needs roughly 1 − 1/R0 of the population immune: about 67% for R0 = 3.
C · On average one case infects three others in a fully susceptible population