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 patient with active pulmonary tuberculosis must go to the radiology department. How should the patient be transported?
- AWearing a surgical mask, with radiology warned in advance
- BWearing gloves and a gown, with no mask needed
- CWithout a mask, because the corridor is well ventilated and short
- DWearing an N95 respirator that has not been fit-tested
2.Infection control & patient safetyHard
A child with fever, cough, red eyes and a spreading rash is in a clinic waiting room. Measles is suspected. What should the nurse do first?
- ASend the child home to rest without an assessment
- BGive the child an antipyretic and continue triage
- CAsk the family to wait in the main waiting room until the child is called in
- DPut a mask on the child and move them into an airborne isolation room
3.Nursing fundamentalsMedium
In the UK SSKIN care bundle for pressure ulcer prevention, what does "K" stand for?
- AKeep dry
- BKeep warm
- CKeep clean
- DKeep moving
4.Nursing fundamentalsHard
A patient standing for the first time after surgery becomes pale, sweaty and dizzy. What should the nurse do first?
- AHelp the patient sit or lie down safely
- BLeave the patient standing and fetch the blood pressure machine
- CGive the patient a sugary drink while standing
- DEncourage the patient to keep walking to build strength
5.MicrobiologyMedium
How do people usually become infected with Legionella pneumophila?
- ABy eating undercooked chicken or unpasteurised milk products
- BBy inhaling aerosols from contaminated water systems
- CBy person-to-person spread through kissing
- DBy being bitten by an infected tick
6.MicrobiologyHard
In the 1840s Ignaz Semmelweis lowered deaths from puerperal fever in a Vienna maternity clinic. What did he introduce?
- ATreating mothers with penicillin
- BKeeping mothers in separate isolation rooms after delivery
- CVaccination of all mothers before birth
- DHandwashing with chlorinated lime before examining women
3Solutions
1.Infection control & patient safety
Answer: A · Wearing a surgical mask, with radiology warned in advance
Why this is the answer
During transport, the patient wears a surgical mask to contain respiratory particles, and the receiving department is told so it can protect staff and other patients. Staff caring for the patient wear fit-tested respirators.
A · Wearing a surgical mask, with radiology warned in advance
2.Infection control & patient safety
Answer: D · Put a mask on the child and move them into an airborne isolation room
Why this is the answer
Measles is highly contagious through airborne spread. The child is masked and placed in an airborne infection isolation room, or a closed single room if none is available, and exposed people may need follow-up.
D · Put a mask on the child and move them into an airborne isolation room
3.Nursing fundamentals
Answer: D · Keep moving
Why this is the answer
SSKIN stands for Surface, Skin inspection, Keep moving, Incontinence and moisture, and Nutrition and hydration. Regular repositioning relieves pressure on the skin.
4.Nursing fundamentals
Answer: A · Help the patient sit or lie down safely
Why this is the answer
These signs suggest postural hypotension and a risk of fainting. The nurse lowers the patient safely first, then checks blood pressure and pulse and reports the finding.
A · Help the patient sit or lie down safely
5.Microbiology
Answer: B · By inhaling aerosols from contaminated water systems
Why this is the answer
Legionella grows in warm water systems. People inhale contaminated aerosols and can develop Legionnaires' disease, a severe pneumonia. It does not usually spread from person to person.
B · By inhaling aerosols from contaminated water systems
6.Microbiology
Answer: D · Handwashing with chlorinated lime before examining women
Why this is the answer
Semmelweis noticed higher mortality in the ward run by doctors who also did autopsies. Hand disinfection with chlorinated lime sharply reduced deaths, long before germ theory was accepted.
D · Handwashing with chlorinated lime before examining women