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
When is it appropriate to use the override function on an automated dispensing cabinet to take a drug before pharmacist review?
- AOnly in an urgent situation where delay would harm the patient, per policy
- BWhenever the nurse is sure of the dose
- CWhenever the pharmacist is slow to review new orders and the patient is waiting
- DAt the start of each shift to save time later
2.Infection control & patient safetyHard
A nurse who has a cold sore (herpes labialis) is assigned to the newborn nursery. What is most appropriate?
- AInform the manager, who may reassign the nurse for now
- BTell no one, and cover the lesion with makeup during shifts
- CWear gloves and carry on as usual
- DWork as usual, since cold sores are very common
3.Nursing fundamentalsMedium
Why are patients with a new ileostomy at risk of dehydration?
- AThe colon removes too much water from the stool
- BThey are not allowed to drink for several weeks after surgery
- CThe stoma absorbs water from the body
- DThe output is liquid and contains a lot of water and salt
4.Nursing fundamentalsHard
Which group of signs suggests a patient may be in the last days of life?
- ABetter mobility and more energy
- BA rising urine output and warm hands
- CRising appetite and increasing alertness
- DChanges in breathing pattern, cool mottled skin and reduced intake
5.MicrobiologyMedium
Which is a function of the complement system?
- APresenting antigens to T cells
- BProducing antibodies against newly encountered antigens
- CMaking new red blood cells
- DForming pores in the membranes of some bacteria
6.MicrobiologyHard
Why are penicillins ineffective against Mycoplasma pneumoniae?
- AIt produces large amounts of beta-lactamase
- BIt has a thick waxy mycolic acid layer that blocks entry
- CIt lives only inside red blood cells
- DIt has no cell wall for penicillin to act on
3Solutions
1.Infection control & patient safety
Answer: A · Only in an urgent situation where delay would harm the patient, per policy
Why this is the answer
Pharmacist review checks for allergies, interactions and dosing errors. Overrides are limited to true emergencies and drugs on an approved list, because bypassing review has led to serious errors.
A · Only in an urgent situation where delay would harm the patient, per policy
2.Infection control & patient safety
Answer: A · Inform the manager, who may reassign the nurse for now
Why this is the answer
Herpes simplex can cause severe infection in newborns. Staff with active lesions inform their manager and follow occupational health advice, which often means avoiding contact with newborns and other high-risk patients until the lesion has healed.
A · Inform the manager, who may reassign the nurse for now
3.Nursing fundamentals
Answer: D · The output is liquid and contains a lot of water and salt
Why this is the answer
The colon normally reabsorbs water and salt. An ileostomy bypasses it, so high output can quickly cause dehydration and low sodium; output is monitored and fluids encouraged.
D · The output is liquid and contains a lot of water and salt
4.Nursing fundamentals
Answer: D · Changes in breathing pattern, cool mottled skin and reduced intake
Why this is the answer
As death approaches, breathing may become irregular or noisy, the skin may become cool and mottled, and people eat and drink less and sleep more. Comfort, mouth care and family support become the focus.
D · Changes in breathing pattern, cool mottled skin and reduced intake
5.Microbiology
Answer: D · Forming pores in the membranes of some bacteria
Why this is the answer
Complement proteins coat microbes for phagocytosis (opsonisation), attract immune cells and form the membrane attack complex that punches holes in some bacteria.
D · Forming pores in the membranes of some bacteria
6.Microbiology
Answer: D · It has no cell wall for penicillin to act on
Why this is the answer
Mycoplasma lacks a cell wall, so beta-lactams have no target. Macrolides or tetracyclines, which act on the ribosome, are used instead.
D · It has no cell wall for penicillin to act on