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 patient has the highest risk of a burn from a heating pad?
- AA patient with diabetic peripheral neuropathy
- BA patient with a sprained wrist who is fully alert
- CA healthy young adult with a strained muscle
- DA patient recovering from a cold
2.Infection control & patient safetyHard
A nurse is about to give IV morphine. The patient’s respiratory rate is 9/min and they are very drowsy. What should the nurse do?
- AGive the dose and recheck the respiratory rate tomorrow
- BWithhold the dose, assess the patient and inform the prescriber
- CGive half the dose
- DGive the dose because pain was reported earlier
3.Nursing fundamentalsMedium
Which stool sample is suitable for Clostridioides difficile testing?
- AA stool sample mixed with urine
- BA hard, formed stool collected first thing in the morning
- CA loose stool that takes the shape of the container
- DA dry smear of stool on a tissue
4.Nursing fundamentalsHard
A pressure ulcer shows full-thickness tissue loss with exposed bone. How is it classified?
- ACategory 4
- BCategory 3
- CSuspected deep tissue injury
- DCategory 2
5.MicrobiologyMedium
Which organism causes tuberculosis, and what makes it hard to stain with the Gram method?
- AMycoplasma pneumoniae, which has no cell wall to take up the stain
- BStreptococcus pneumoniae, which has a capsule
- CMycobacterium tuberculosis, which has a waxy mycolic acid wall
- DLegionella pneumophila, which lives inside amoebae
6.MicrobiologyHard
What did Pasteur's swan-neck flask experiment demonstrate?
- ABoiling cannot kill microorganisms
- BAir itself produces microorganisms
- CMicroorganisms need light to grow
- DMicroorganisms come from other microorganisms, not from spontaneous generation
3Solutions
1.Infection control & patient safety
Answer: A · A patient with diabetic peripheral neuropathy
Why this is the answer
Reduced sensation, as in peripheral neuropathy, prevents a person from feeling heat damage. Patients with poor sensation, poor circulation or confusion need very close monitoring if heat is used at all.
A · A patient with diabetic peripheral neuropathy
2.Infection control & patient safety
Answer: B · Withhold the dose, assess the patient and inform the prescriber
Why this is the answer
Slow breathing and sedation suggest opioid excess, so another dose could cause respiratory arrest. The nurse holds the dose, stimulates and assesses the patient, prepares naloxone per order and escalates.
B · Withhold the dose, assess the patient and inform the prescriber
3.Nursing fundamentals
Answer: C · A loose stool that takes the shape of the container
Why this is the answer
Only diarrhoeal stool (types 5–7 on the Bristol Stool Chart) is tested for C. difficile. The sample is collected in a clean pot without urine contamination.
C · A loose stool that takes the shape of the container
4.Nursing fundamentals
Answer: A · Category 4
Why this is the answer
Category 4 (Stage 4 in the US NPIAP system) involves full-thickness tissue loss with exposed bone, tendon or muscle. It carries a high risk of osteomyelitis and needs specialist input.
5.Microbiology
Answer: C · Mycobacterium tuberculosis, which has a waxy mycolic acid wall
Why this is the answer
M. tuberculosis has a cell wall rich in mycolic acids, so it resists Gram staining and is identified with acid-fast stains.
C · Mycobacterium tuberculosis, which has a waxy mycolic acid wall
6.Microbiology
Answer: D · Microorganisms come from other microorganisms, not from spontaneous generation
Why this is the answer
Boiled broth in a flask with a curved neck stayed sterile because dust and microbes were trapped in the bend. When the neck was broken, microbes entered and grew, disproving spontaneous generation.
D · Microorganisms come from other microorganisms, not from spontaneous generation