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 small fire starts in a waste bin in a patient’s room while the patient is in bed. What does the nurse do first?
- AOpen the windows to clear the smoke
- BRemove the patient from immediate danger
- CGo and look for the nearest fire extinguisher
- DPhone the manager to report the fire
2.Infection control & patient safetyHard
A nurse finds an unknown liquid leaking from a container in the utility room, with a strong smell. What should the nurse do first?
- AMop it up with paper towels
- BPour water over it to dilute it
- CLeave the area, keep others out and alert the trained response team
- DMove closer and smell it carefully to identify what the substance is
3.Nursing fundamentalsMedium
What is a portable bladder scanner used for?
- AChecking the urine for blood and protein
- BDetecting kidney stones
- CMeasuring how much urine is in the bladder without a catheter
- DTaking a sterile sample of urine for culture without a catheter
4.Nursing fundamentalsHard
Eight hours after surgery a patient has not passed urine and has lower abdominal discomfort with a swelling above the pubic bone. What should the nurse do?
- AEncourage the patient to drink two litres of water quickly
- BCheck the bladder volume with a scanner and report the findings
- CRecord it and check again the next morning
- DGive a laxative to relieve the swelling
5.MicrobiologyMedium
How does an autoclave sterilise instruments?
- AWith steam under pressure at about 121 °C
- BWith dry heat at about 60 °C
- CWith ultraviolet light only
- DWith alcohol vapour at room temperature
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: B · Remove the patient from immediate danger
Why this is the answer
Rescue comes first: move the patient away from the fire. Then raise the alarm, contain the fire by closing doors, and extinguish it if safe. Opening windows feeds the fire with oxygen.
B · Remove the patient from immediate danger
2.Infection control & patient safety
Answer: C · Leave the area, keep others out and alert the trained response team
Why this is the answer
An unknown chemical spill may be toxic or flammable. The nurse moves people away, prevents entry and calls the designated hazardous materials team, who check the Safety Data Sheet and use the right equipment.
C · Leave the area, keep others out and alert the trained response team
3.Nursing fundamentals
Answer: C · Measuring how much urine is in the bladder without a catheter
Why this is the answer
A bladder scanner uses ultrasound to estimate bladder volume, for example after a patient has voided. It helps detect retention and avoids unnecessary catheterisation.
C · Measuring how much urine is in the bladder without a catheter
4.Nursing fundamentals
Answer: B · Check the bladder volume with a scanner and report the findings
Why this is the answer
These signs suggest postoperative urinary retention. A bladder scan confirms the volume, and the doctor is told so it can be relieved, often by catheterisation.
B · Check the bladder volume with a scanner and report the findings
5.Microbiology
Answer: A · With steam under pressure at about 121 °C
Why this is the answer
Pressurised steam reaches about 121 °C and kills all microorganisms, including spores, typically in about 15 minutes or more depending on the load.
A · With steam under pressure at about 121 °C
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