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
Which technique is used for suctioning a tracheostomy in hospital?
- AClean technique, with the catheter rinsed in tap water
- BNo gloves at all, because the airway already contains bacteria
- CClean technique, reusing the catheter during the shift
- DSterile technique, with a sterile catheter and sterile glove
2.Infection control & patient safetyHard
During bedside handoff, the patient says, “I’m allergic to sulfa drugs,” but no allergy is recorded. What should the nurse do?
- ATell the patient that sulfa drugs are always safe
- BIgnore it, because the electronic record is more reliable than the patient’s memory
- CClarify the reaction, update the allergy record and tell the prescriber
- DWait until the patient is discharged to update the record
3.Nursing fundamentalsMedium
At what angle is a subcutaneous injection usually given?
- AAlways parallel to the skin
- BAlways exactly 15 degrees, with the skin stretched flat
- C45 to 90 degrees, depending on the amount of fat
- D90 degrees after stretching the skin flat
4.Nursing fundamentalsHard
A patient receiving chemotherapy develops a temperature of 38.3 °C. Why is this treated as an emergency?
- AThe fever means the chemotherapy has stopped working on the cancer
- BThey may have neutropenic sepsis, which can quickly become fatal
- CA fever shows the cancer has spread
- DChemotherapy always causes a fever that needs no action
5.MicrobiologyMedium
Which virus family includes the viruses that cause cold sores and chickenpox?
- ARetroviruses
- BCoronaviruses
- CPicornaviruses
- DHerpesviruses
6.MicrobiologyHard
An older adult develops a painful blistering rash in a band on one side of the chest. What explains this pattern?
- AVaricella-zoster virus reactivates from one sensory ganglion and travels along its nerve
- BA new chickenpox infection spreads through the blood to one side
- CBacteria spread along the lymphatic vessels of the chest
- DAn allergic reaction to clothing affects one dermatome
3Solutions
1.Infection control & patient safety
Answer: D · Sterile technique, with a sterile catheter and sterile glove
Why this is the answer
In hospital, tracheal suctioning uses sterile technique to avoid introducing organisms into the lower airway. Clean technique may be taught for long-term home care, according to policy.
D · Sterile technique, with a sterile catheter and sterile glove
2.Infection control & patient safety
Answer: C · Clarify the reaction, update the allergy record and tell the prescriber
Why this is the answer
Bedside handoff lets patients correct errors. The nurse asks about the reaction, updates the record and alerts the prescriber and pharmacy so current and future orders can be checked.
C · Clarify the reaction, update the allergy record and tell the prescriber
3.Nursing fundamentals
Answer: C · 45 to 90 degrees, depending on the amount of fat
Why this is the answer
The angle depends on needle length and body fat. A short needle at 90 degrees suits most adults; in thin patients a pinch of skin or a 45-degree angle avoids reaching muscle.
C · 45 to 90 degrees, depending on the amount of fat
4.Nursing fundamentals
Answer: B · They may have neutropenic sepsis, which can quickly become fatal
Why this is the answer
Patients with a low neutrophil count may have few signs of infection apart from fever and can deteriorate fast. Urgent assessment and IV antibiotics, usually within an hour, are needed.
B · They may have neutropenic sepsis, which can quickly become fatal
5.Microbiology
Answer: D · 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 · Varicella-zoster virus reactivates from one sensory ganglion and travels along its nerve
Why this is the answer
After chickenpox, VZV stays latent in a dorsal root or cranial nerve ganglion. When immunity weakens it can reactivate, travelling down that nerve to cause shingles in its dermatome.
A · Varicella-zoster virus reactivates from one sensory ganglion and travels along its nerve