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
Why are some patients screened with a nasal swab for MRSA on admission?
- ATo check whether the patient is allergic to penicillin before surgery
- BTo diagnose a sinus infection
- CTo measure the patient’s immunity to MRSA
- DTo find carriers so precautions or decolonization can be used
2.Infection control & patient safetyHard
During a procedure, a nurse sees that the team is about to start without a time-out. What should the nurse do?
- ASpeak up clearly and stop the start until the time-out is done
- BReport it to the manager at the end of the week
- CSay nothing, because the surgeon is responsible for the procedure
- DWait and raise the issue after the procedure is finished
3.Nursing fundamentalsMedium
What is the main purpose of a wound drain after surgery?
- ATo keep the wound edges apart until it heals
- BTo remove fluid or blood that could collect and delay healing
- CTo measure the temperature inside the wound
- DTo give antibiotics directly into the wound until it has fully healed
4.Nursing fundamentalsHard
A nurse uses SBAR to call a doctor about a breathless patient. Which item belongs under "Background"?
- AThe patient has COPD and was admitted two days ago with pneumonia
- B"Please come and review him within the next 10 minutes."
- C"I am calling about Mr Smith in bed 4, who is very breathless."
- DHis respiratory rate is 30 and his SpO₂ is 86% on 2 L of oxygen
5.MicrobiologyMedium
What is the main virulence factor of Streptococcus pneumoniae, and the target of its vaccines?
- AIts cholera-like toxin
- BIts polysaccharide capsule
- CIts flagella
- DIts endospores
6.MicrobiologyHard
In 1854 John Snow traced a cholera outbreak in London to the Broad Street water pump. Why is this study important?
- AIt showed that cholera spreads through "bad air" (miasma)
- BIt showed that cholera spreads through contaminated water, founding modern epidemiology
- CIt led directly to the first cholera vaccine
- DIt proved that cholera is caused by a virus
3Solutions
1.Infection control & patient safety
Answer: D · To find carriers so precautions or decolonization can be used
Why this is the answer
Screening identifies people who are colonized with MRSA, often in the nose. Precautions and, in some cases, decolonization reduce spread and the risk of the patient’s own infection after surgery.
D · To find carriers so precautions or decolonization can be used
2.Infection control & patient safety
Answer: A · Speak up clearly and stop the start until the time-out is done
Why this is the answer
The time-out is a key step to prevent wrong-patient, wrong-site and wrong-procedure errors. Any team member who sees it being skipped should speak up and halt the procedure until it is done.
A · Speak up clearly and stop the start until the time-out is done
3.Nursing fundamentals
Answer: B · To remove fluid or blood that could collect and delay healing
Why this is the answer
Drains let blood, serous fluid or pus escape, preventing collections such as seromas and haematomas. The nurse records the amount and type of drainage.
B · To remove fluid or blood that could collect and delay healing
4.Nursing fundamentals
Answer: A · The patient has COPD and was admitted two days ago with pneumonia
Why this is the answer
SBAR is Situation (why you are calling), Background (relevant history), Assessment (your findings) and Recommendation (what you need). Clear structure speeds up the response.
A · The patient has COPD and was admitted two days ago with pneumonia
5.Microbiology
Answer: B · Its polysaccharide capsule
Why this is the answer
The capsule protects S. pneumoniae from phagocytosis. There are many capsular types, and pneumococcal vaccines contain capsular polysaccharides from the most common ones.
B · Its polysaccharide capsule
6.Microbiology
Answer: B · It showed that cholera spreads through contaminated water, founding modern epidemiology
Why this is the answer
Snow mapped cases around the pump and linked them to its water. Removing the pump handle is a classic example of using epidemiology to find and stop a source, before the bacterium was identified.
B · It showed that cholera spreads through contaminated water, founding modern epidemiology