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 has botulism after eating contaminated food. Which precautions are needed?
- AContact precautions
- BDroplet precautions
- CStandard precautions
- DAirborne precautions
2.Infection control & patient safetyHard
In START triage at a mass-casualty incident, a casualty cannot walk, breathes 20 times a minute, has a radial pulse and follows simple commands. Which category applies?
- ARed (immediate)
- BYellow (delayed)
- CGreen (minor)
- DBlack (expectant or dead)
3.Nursing fundamentalsMedium
A student nurse is asked to carry out a procedure they have not been trained to do. What should they do?
- AAsk the patient to talk them through it
- BWatch a video and then do it alone
- CDo it anyway, carefully, to avoid upsetting the team or delaying care
- DExplain that they have not been trained and ask for supervision
4.Nursing fundamentalsHard
A patient with COPD and a target saturation of 88–92% is on oxygen. Their SpO₂ is now 97%. What should the nurse do?
- AIncrease the oxygen to keep the level high
- BReduce the oxygen to bring the saturation back into the target range
- CRemove all oxygen and stop monitoring
- DLeave it, because a higher saturation is always better for a patient with COPD
5.MicrobiologyMedium
In which phase of the bacterial growth curve do the cells divide at their fastest constant rate?
- ALog (exponential) phase
- BDeath phase
- CStationary (plateau) phase
- DLag (adaptation) phase
6.MicrobiologyHard
Which bacterial toxin causes the muscle spasms of tetanus?
- ACholera toxin, which activates adenylate cyclase
- BBotulinum toxin, which blocks acetylcholine release at the neuromuscular junction
- CEndotoxin from the outer membrane
- DTetanospasmin, which blocks inhibitory neurotransmitter release
3Solutions
1.Infection control & patient safety
Answer: C · Standard precautions
Why this is the answer
Botulism is caused by a toxin and does not spread from person to person, so standard precautions are used. Suspected cases are reported to public health at once.
2.Infection control & patient safety
Answer: B · Yellow (delayed)
Why this is the answer
The casualty cannot walk, so is not green. Breathing is under 30 a minute, perfusion is adequate and they obey commands, so none of the red criteria apply. This makes them yellow, delayed.
3.Nursing fundamentals
Answer: D · Explain that they have not been trained and ask for supervision
Why this is the answer
Nurses and students must only practise within their competence. Saying so, and asking to observe or be supervised, protects the patient and the student.
D · Explain that they have not been trained and ask for supervision
4.Nursing fundamentals
Answer: B · Reduce the oxygen to bring the saturation back into the target range
Why this is the answer
For patients at risk of hypercapnia, saturations above the target can raise CO₂ levels. The oxygen should be reduced step by step to the prescribed range, with continued monitoring.
B · Reduce the oxygen to bring the saturation back into the target range
5.Microbiology
Answer: A · Log (exponential) phase
Why this is the answer
After the lag phase of adjustment, cells enter the log phase and grow exponentially. Growth stops in the stationary phase as nutrients run out and waste builds up.
A · Log (exponential) phase
6.Microbiology
Answer: D · Tetanospasmin, which blocks inhibitory neurotransmitter release
Why this is the answer
Tetanospasmin from Clostridium tetani blocks the release of GABA and glycine from inhibitory interneurons, causing spastic paralysis. Botulinum toxin, by contrast, causes flaccid paralysis.
D · Tetanospasmin, which blocks inhibitory neurotransmitter release