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 practice makes shift handoff safer?
- AGiving handoff in a busy corridor so that the outgoing nurse can leave on time
- BLeaving written notes only, without a chance for questions
- CUsing a standard format such as SBAR or I-PASS, with time for questions
- DGiving handoff from memory without any structure
2.Infection control & patient safetyHard
A patient who speaks little English is being discharged with new medications. The patient’s 12-year-old child offers to interpret. What should the nurse do?
- ALet the child interpret, because the family prefers it
- BUse simple English and many hand gestures
- CUse a professional medical interpreter
- DGive written instructions in English only
3.Nursing fundamentalsMedium
When opening a sterile pack on a table, which flap is opened first?
- AAny flap, as long as you wear sterile gloves
- BThe flap furthest away from you
- CThe flap nearest to you
- DThe flap on your dominant side
4.Nursing fundamentalsHard
An older woman has been lying on the floor at home all night after a fall. Which complications should the nurse look for in particular?
- AHair loss and nail damage
- BSunburn and dehydration from sweating
- CPressure damage, hypothermia and muscle breakdown
- DHigh blood sugar and a raised temperature from lying still
5.MicrobiologyMedium
Transfer of bacterial genes from one bacterium to another by a virus is called:
- ATransformation
- BTransduction
- CTranscription
- DConjugation
6.MicrobiologyHard
Why is Chlamydia trachomatis usually diagnosed with nucleic acid amplification tests instead of routine culture on agar?
- AIt dies immediately in the presence of oxygen
- BIt is too large to grow on agar plates
- CIt is a virus and has no DNA
- DIt is an obligate intracellular bacterium that cannot grow on ordinary media
3Solutions
1.Infection control & patient safety
Answer: C · Using a standard format such as SBAR or I-PASS, with time for questions
Why this is the answer
Many errors happen at transitions of care. A structured handoff with an opportunity to ask questions, ideally at the bedside, reduces missed information.
C · Using a standard format such as SBAR or I-PASS, with time for questions
2.Infection control & patient safety
Answer: C · Use a professional medical interpreter
Why this is the answer
Professional medical interpreters reduce errors and protect privacy. Children and other family members may translate wrongly, leave things out or be placed in a difficult position.
C · Use a professional medical interpreter
3.Nursing fundamentals
Answer: B · The flap furthest away from you
Why this is the answer
Opening the far flap first means the nurse never reaches across the exposed sterile contents. The side flaps follow, and the nearest flap is opened last.
B · The flap furthest away from you
4.Nursing fundamentals
Answer: C · Pressure damage, hypothermia and muscle breakdown
Why this is the answer
A long lie causes pressure injury, hypothermia, dehydration and rhabdomyolysis, which can damage the kidneys. The patient is assessed carefully for these as well as for fractures.
C · Pressure damage, hypothermia and muscle breakdown
5.Microbiology
Answer: B · Transduction
Why this is the answer
In transduction a bacteriophage accidentally packages bacterial DNA and delivers it to the next cell it infects. Transformation is uptake of free DNA and conjugation uses direct contact.
6.Microbiology
Answer: D · It is an obligate intracellular bacterium that cannot grow on ordinary media
Why this is the answer
Chlamydia replicates only inside host cells, so it cannot be grown on agar. NAATs such as PCR on urine or swabs are sensitive and are the standard diagnostic test.
D · It is an obligate intracellular bacterium that cannot grow on ordinary media