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 person in scrubs without a hospital ID badge asks to take a newborn to the nursery. What should the nurse do?
- ALet the parents decide whether to hand the baby over
- BAsk the person their name and then give them the baby
- CHand over the baby if the person seems confident
- DRefuse, keep the baby with the mother and alert security
2.Infection control & patient safetyHard
A patient on chemotherapy develops shingles over several areas on both sides of the body. Which precautions are needed?
- AContact precautions only, with gloves for dressing changes
- BStandard precautions only, with the lesions covered
- CAirborne and contact precautions until all lesions are crusted
- DDroplet precautions until the pain settles
3.Nursing fundamentalsMedium
How is body mass index (BMI) calculated?
- AHeight in centimetres divided by weight in kilograms
- BWaist size divided by hip size
- CWeight in kilograms multiplied by height in metres squared
- DWeight in kilograms divided by height in metres squared
4.Nursing fundamentalsHard
A man skips bowel cancer screening because he feels healthy and thinks cancer will not happen to him. Which Health Belief Model concept best explains this?
- AHigh self-efficacy
- BHigh perceived benefits
- CStrong cues to action
- DLow perceived susceptibility
5.MicrobiologyMedium
How is DNA transferred between bacteria during conjugation?
- ABy uptake of free DNA from the environment
- BBy fusion of two bacterial cells into one
- CThrough direct contact using a sex pilus
- DBy a bacteriophage carrying bacterial DNA
6.MicrobiologyHard
Joseph Lister reduced infection after surgery in the 1860s. What was his main innovation?
- AUsing carbolic acid (phenol) as an antiseptic on wounds and instruments
- BGiving sulfonamide antibiotics after every operation
- CVaccinating surgeons against staphylococci
- DUsing steam autoclaves to sterilise all surgical instruments before each operation
3Solutions
1.Infection control & patient safety
Answer: D · Refuse, keep the baby with the mother and alert security
Why this is the answer
Infants are only handed to staff with proper identification, as set out in the infant security policy. Suspicious behavior is reported to security at once, and parents are taught to do the same.
D · Refuse, keep the baby with the mother and alert security
2.Infection control & patient safety
Answer: C · Airborne and contact precautions until all lesions are crusted
Why this is the answer
Lesions over several areas on both sides mean disseminated zoster, which can spread through the air like chickenpox. Airborne and contact precautions are used until all lesions are dry and crusted. Localized zoster in an immunocompromised patient also needs airborne and contact precautions, but only until dissemination is ruled out.
C · Airborne and contact precautions until all lesions are crusted
3.Nursing fundamentals
Answer: D · Weight in kilograms divided by height in metres squared
Why this is the answer
BMI = weight (kg) ÷ height² (m²). For example, 70 kg and 1.75 m gives about 22.9 kg/m². It is a screening measure and does not show body composition.
D · Weight in kilograms divided by height in metres squared
4.Nursing fundamentals
Answer: D · Low perceived susceptibility
Why this is the answer
In the Health Belief Model, people act when they believe they are susceptible to a serious condition and that action will help. Low perceived susceptibility reduces the chance of screening.
D · Low perceived susceptibility
5.Microbiology
Answer: C · Through direct contact using a sex pilus
Why this is the answer
In conjugation a donor cell forms a pilus to a recipient and transfers DNA, often a plasmid. It is an important way for antibiotic resistance genes to spread.
C · Through direct contact using a sex pilus
6.Microbiology
Answer: A · Using carbolic acid (phenol) as an antiseptic on wounds and instruments
Why this is the answer
Lister applied carbolic acid to wounds, dressings and instruments, which greatly reduced post-operative infection. This started antiseptic surgery.
A · Using carbolic acid (phenol) as an antiseptic on wounds and instruments