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 safety measure is most appropriate for a patient with a latex allergy?
- AUsing latex gloves and washing hands well afterwards
- BUsing powdered latex gloves only
- CAvoiding all gloves during patient care
- DUsing latex-free equipment and documenting the allergy clearly
2.Infection control & patient safetyHard
A nurse asks a colleague to “just glance” at an insulin infusion before starting it. What makes a check truly independent?
- AThe first nurse reads the details aloud and the second agrees
- BThe second nurse looks at the bag label from the doorway
- CThe second nurse checks the order, drug, dose and pump settings separately without being told the answer
- DThe second nurse signs the record after the infusion has already been started by the first
3.Nursing fundamentalsMedium
An IV cannula site is swollen, cool and pale, and the infusion has slowed. What should the nurse do first?
- AApply a warm pack and keep the infusion running
- BStop the infusion and remove the cannula
- CIncrease the infusion rate to clear the blockage
- DFlush the cannula hard with saline
4.Nursing fundamentalsHard
A patient receiving chemotherapy develops a temperature of 38.3 °C. Why is this treated as an emergency?
- AChemotherapy always causes a fever that needs no action
- BThe fever means the chemotherapy has stopped working on the cancer
- CA fever shows the cancer has spread
- DThey may have neutropenic sepsis, which can quickly become fatal
5.MicrobiologyMedium
What does an ELISA test detect?
- AThe DNA sequence of the whole bacterial genome
- BThe shape of bacteria under the microscope
- CBacterial growth on solid agar plates
- DSpecific antigens or antibodies, using an enzyme that causes a colour change
6.MicrobiologyHard
How do retroviruses such as HIV copy their genome into the host DNA?
- AHost DNA polymerase copies the RNA without help
- BThe viral DNA is copied directly by host RNA polymerase
- CReverse transcriptase makes DNA from viral RNA, and integrase inserts it
- DThe viral RNA is translated into DNA by ribosomes
3Solutions
1.Infection control & patient safety
Answer: D · Using latex-free equipment and documenting the allergy clearly
Why this is the answer
The allergy is documented and the patient wears an allergy band. Latex-free gloves, catheters and other equipment are used, and the room may be cleared of latex products. Powdered latex gloves are especially risky because the powder carries the protein into the air.
D · Using latex-free equipment and documenting the allergy clearly
2.Infection control & patient safety
Answer: C · The second nurse checks the order, drug, dose and pump settings separately without being told the answer
Why this is the answer
In an independent double check, the second person works through each step on their own, then the two results are compared. Reading the answer aloud or glancing invites confirmation bias.
C · The second nurse checks the order, drug, dose and pump settings separately without being told the answer
3.Nursing fundamentals
Answer: B · Stop the infusion and remove the cannula
Why this is the answer
These are signs of infiltration. The infusion is stopped, the cannula removed, the limb elevated and the event documented. A new cannula is sited elsewhere if still needed.
B · Stop the infusion and remove the cannula
4.Nursing fundamentals
Answer: D · 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.
D · They may have neutropenic sepsis, which can quickly become fatal
5.Microbiology
Answer: D · Specific antigens or antibodies, using an enzyme that causes a colour change
Why this is the answer
In an enzyme-linked immunosorbent assay, antibodies linked to an enzyme bind the target. Adding the substrate produces a colour, showing whether the antigen or antibody is present.
D · Specific antigens or antibodies, using an enzyme that causes a colour change
6.Microbiology
Answer: C · Reverse transcriptase makes DNA from viral RNA, and integrase inserts it
Why this is the answer
Reverse transcriptase converts the RNA genome into DNA, which integrase inserts into the host genome as a provirus. Both enzymes are drug targets.
C · Reverse transcriptase makes DNA from viral RNA, and integrase inserts it