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
How tight should a wrist restraint be?
- ALoose enough to fit two fingers between the restraint and the skin
- BTight enough to slow the pulse at the wrist
- CAs tight as possible so the patient cannot move the arm
- DLoose enough for the patient’s hand to slip out
2.Infection control & patient safetyHard
A hospital will introduce new infusion pumps and wants to find out how the process could fail before any harm occurs. Which method fits best?
- AA morbidity and mortality meeting
- BRoot cause analysis (RCA) of the new pumps
- CAn incident report for each new pump
- DFailure mode and effects analysis (FMEA)
3.Nursing fundamentalsMedium
Where should a urinary catheter drainage bag be kept?
- AOn the floor next to the bed
- BAbove the level of the bladder
- COn the patient's abdomen
- DBelow the level of the bladder, off the floor
4.Nursing fundamentalsHard
In early hypovolaemic shock in a young adult, which sign usually appears before blood pressure falls?
- AA very low blood pressure
- BA rising heart rate with cool peripheries
- CWarm, flushed skin
- DA slow heart rate
5.MicrobiologyMedium
Which virus family includes the viruses that cause cold sores and chickenpox?
- AHerpesviruses
- BRetroviruses
- CPicornaviruses
- DCoronaviruses
6.MicrobiologyHard
A urinary catheter has become colonised by bacteria in a biofilm. Why is the catheter usually replaced instead of just giving antibiotics?
- ABacteria in biofilms are protected and much harder for antibiotics to kill
- BBiofilms contain only viruses, so antibiotics do not work
- CAntibiotics damage the catheter material
- DBiofilm bacteria cannot cause disease
3Solutions
1.Infection control & patient safety
Answer: A · Loose enough to fit two fingers between the restraint and the skin
Why this is the answer
Being able to slip two fingers under the restraint keeps it secure without cutting off circulation or damaging the skin. Circulation, sensation and skin are checked often.
A · Loose enough to fit two fingers between the restraint and the skin
2.Infection control & patient safety
Answer: D · Failure mode and effects analysis (FMEA)
Why this is the answer
FMEA is a proactive method that looks at each step of a process, asks how it could fail and what the effect would be, and changes the process in advance. Root cause analysis is used after an event has happened.
D · Failure mode and effects analysis (FMEA)
3.Nursing fundamentals
Answer: D · Below the level of the bladder, off the floor
Why this is the answer
Keeping the bag below bladder level lets urine drain by gravity and prevents backflow. Keeping it off the floor reduces contamination and infection risk.
D · Below the level of the bladder, off the floor
4.Nursing fundamentals
Answer: B · A rising heart rate with cool peripheries
Why this is the answer
Compensation through tachycardia and vasoconstriction keeps blood pressure normal at first, so low blood pressure is a late sign. Tachycardia, cool skin and slow capillary refill should prompt action.
B · A rising heart rate with cool peripheries
5.Microbiology
Answer: A · Herpesviruses
Why this is the answer
Herpes simplex (cold sores) and varicella-zoster (chickenpox, shingles) are herpesviruses that remain latent in sensory ganglia and can reactivate.
6.Microbiology
Answer: A · Bacteria in biofilms are protected and much harder for antibiotics to kill
Why this is the answer
In a biofilm, bacteria live in a protective matrix, grow slowly and can tolerate high antibiotic levels. Removing the device removes the source of infection.
A · Bacteria in biofilms are protected and much harder for antibiotics to kill