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 has highly contagious viral conjunctivitis. Which teaching is most important?
- AWear a surgical mask whenever someone else is in the room
- BKeep using the same contact lenses to protect the eyes
- CWash hands often and do not share towels, pillows or eye drops
- DRub the eyes gently to remove the discharge
2.Infection control & patient safetyHard
A nurse often skips barcode scanning to save time, as many colleagues do. In a just culture, how is this behavior classed?
- AAcceptable behavior, because it is common on the unit
- BReckless behavior, managed by immediate dismissal and reporting to the licensing board
- CAt-risk behavior, managed by coaching and fixing the system pressures behind it
- DSimple human error, managed only by consoling the nurse and moving on
3.Nursing fundamentalsMedium
A patient with a leg injury is climbing stairs with crutches. Which leg should go up first?
- AThe injured leg
- BThe unaffected leg
- CBoth legs together
- DThe crutches always go first
4.Nursing fundamentalsHard
Under the Mental Capacity Act 2005 (England and Wales), a patient with capacity makes a decision staff think is unwise. What follows?
- AThe family must be asked to make the decision instead
- BAn unwise decision alone does not mean the person lacks capacity
- CAn unwise decision on its own proves that the person lacks capacity
- DStaff may override any decision they think is unwise
5.MicrobiologyMedium
What is the main difference between innate and adaptive immunity?
- AInnate immunity uses antibodies and forms memory; adaptive immunity does not
- BAdaptive immunity is specific and forms memory; innate immunity does not
- CAdaptive immunity acts within minutes of infection
- DInnate immunity develops only after vaccination
6.MicrobiologyHard
A healthcare worker's blood test is positive for anti-HBs (hepatitis B surface antibody) and negative for HBsAg and anti-HBc. What does this most likely mean?
- ACurrent acute hepatitis B infection
- BChronic hepatitis B infection
- CImmunity from hepatitis B vaccination
- DPast natural infection that has cleared
3Solutions
1.Infection control & patient safety
Answer: C · Wash hands often and do not share towels, pillows or eye drops
Why this is the answer
Viral conjunctivitis spreads easily by contact with eye secretions. Hand hygiene, not touching the eyes and not sharing towels, pillows or eye products reduce spread.
C · Wash hands often and do not share towels, pillows or eye drops
2.Infection control & patient safety
Answer: C · At-risk behavior, managed by coaching and fixing the system pressures behind it
Why this is the answer
At-risk behavior is a choice whose risk is not recognized or is believed to be justified, often because shortcuts have become normal. It is managed by coaching and removing the pressures behind it, while reckless behavior may need disciplinary action.
C · At-risk behavior, managed by coaching and fixing the system pressures behind it
3.Nursing fundamentals
Answer: B · The unaffected leg
Why this is the answer
Going up, the strong leg steps first and lifts the body, followed by the crutches and the injured leg. Going down, the crutches and injured leg go first.
4.Nursing fundamentals
Answer: B · An unwise decision alone does not mean the person lacks capacity
Why this is the answer
One of the Act's principles is that a person is not treated as lacking capacity just because they make an unwise decision. Staff can explain risks, but the decision is the patient's.
B · An unwise decision alone does not mean the person lacks capacity
5.Microbiology
Answer: B · 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.
B · Adaptive immunity is specific and forms memory; innate immunity does not
6.Microbiology
Answer: C · Immunity from hepatitis B vaccination
Why this is the answer
The vaccine contains HBsAg, so a vaccinated person makes anti-HBs but no anti-HBc. Past natural infection gives both anti-HBs and anti-HBc, and ongoing infection shows HBsAg.
C · Immunity from hepatitis B vaccination