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 is admitted to an inpatient mental health unit. Why are personal belongings checked?
- ATo find out what the patient likes to wear during the hospital stay
- BTo decide which family members may visit
- CTo make a list of valuable items for insurance
- DTo remove items that could be used to harm self or others
2.Infection control & patient safetyHard
A patient with active pulmonary tuberculosis asks visitors to come in. What is the best response?
- AExplain the risk, limit visits and teach visitors to use the protection provided
- BAsk visitors to stand in the open doorway instead of entering the room
- CBan all contact permanently, including phone calls
- DAllow any visitor in without any precautions, to support the patient
3.Nursing fundamentalsMedium
Why is a patient with a suspected spinal injury moved by log-rolling?
- AIt reduces the number of staff needed
- BIt lets the patient help with the turn
- CIt keeps the head, neck and spine aligned as one unit
- DIt is the fastest way to turn any patient, whatever their condition
4.Nursing fundamentalsHard
An AED is about to deliver a shock. What must the rescuer do?
- ARemove the pads and place them again
- BKeep doing chest compressions during the shock
- CHold the patient's hand to reassure them
- DMake sure no one is touching the patient
5.MicrobiologyMedium
Toxoplasma gondii is a risk in pregnancy. Which advice reduces exposure?
- AAvoid all fruit and vegetables
- BAvoid swimming pools and all other public bathing areas
- CAvoid cleaning cat litter and avoid undercooked meat
- DAvoid contact with dogs
6.MicrobiologyHard
Prions differ from all other infectious agents because they:
- AContain no nucleic acid and consist of misfolded protein
- BCan only infect bacteria
- CContain only RNA, with no protein coat surrounding the genome
- DAre killed by normal cooking and disinfection
3Solutions
1.Infection control & patient safety
Answer: D · To remove items that could be used to harm self or others
Why this is the answer
Belongings are searched with the patient, according to policy, for items such as sharp objects, cords, drugs and lighters. These are stored safely to reduce the risk of self-harm or violence.
D · To remove items that could be used to harm self or others
2.Infection control & patient safety
Answer: A · Explain the risk, limit visits and teach visitors to use the protection provided
Why this is the answer
Visits are limited and supported with education and protection according to policy, while the patient remains in a closed negative-pressure room. Visiting at an open door defeats the negative pressure.
A · Explain the risk, limit visits and teach visitors to use the protection provided
3.Nursing fundamentals
Answer: C · It keeps the head, neck and spine aligned as one unit
Why this is the answer
Log-rolling turns the body as a single unit while one person controls the head and neck, protecting a possibly unstable spine.
C · It keeps the head, neck and spine aligned as one unit
4.Nursing fundamentals
Answer: D · Make sure no one is touching the patient
Why this is the answer
Before the shock the rescuer shouts a warning and checks that everyone is clear. Compressions restart straight after the shock as the AED instructs.
D · Make sure no one is touching the patient
5.Microbiology
Answer: C · Avoid cleaning cat litter and avoid undercooked meat
Why this is the answer
Toxoplasma oocysts are shed in cat faeces and cysts are found in undercooked meat. Infection during pregnancy can damage the fetal brain and eyes.
C · Avoid cleaning cat litter and avoid undercooked meat
6.Microbiology
Answer: A · Contain no nucleic acid and consist of misfolded protein
Why this is the answer
Prions are misfolded proteins that induce normal proteins to misfold. They contain no DNA or RNA and are very resistant to standard sterilisation.
A · Contain no nucleic acid and consist of misfolded protein