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 glove-removal technique is correct?
- ARemove the second glove by pinching its outside with the bare hand, then wash
- BPeel the first off by its outside, then slide a bare finger under the second cuff
- CPull both gloves off at the same time by the fingertips
- DWash the gloved hands and reuse the gloves for the next task
2.Infection control & patient safetyHard
A child with chickenpox is admitted. Which staff member is the best choice to care for the child?
- AA nurse who is pregnant and unsure of her immunity
- BA nurse who has never had chickenpox or the vaccine
- CA nurse with documented immunity to varicella
- DA student nurse with unknown immunity
3.Nursing fundamentalsMedium
When washing a patient's eyes, how should each eye be wiped?
- AFrom the inner corner outwards, using a clean part of the cloth for each eye
- BOnly the eye that looks dirty needs cleaning
- CIn small circles over the closed eyelid of both eyes
- DFrom the outer corner inwards, using the same part of the cloth for both
4.Nursing fundamentalsHard
Which measure is most important in protecting a patient with severe neutropenia from infection?
- AKeeping the room door open for fresh air
- BTaking the temperature every hour
- CStrict hand hygiene by everyone who enters the room
- DGiving the patient a high-protein diet with extra vitamin supplements
5.MicrobiologyMedium
In which phase of the bacterial growth curve do the cells divide at their fastest constant rate?
- ALag (adaptation) phase
- BStationary (plateau) phase
- CDeath phase
- DLog (exponential) phase
6.MicrobiologyHard
What is the key difference between bactericidal and bacteriostatic antibiotics?
- ABactericidal drugs work only outside the body
- BBactericidal drugs kill bacteria; bacteriostatic drugs stop growth and rely on the immune system to clear them
- CBacteriostatic drugs always work faster than bactericidal drugs
- DBactericidal drugs work only on viruses; bacteriostatic drugs work on bacteria
3Solutions
1.Infection control & patient safety
Answer: B · Peel the first off by its outside, then slide a bare finger under the second cuff
Why this is the answer
The outside of the gloves is contaminated, so it only touches the other glove; the bare hand only touches the inside of the second glove. Hand hygiene follows. Gloves are never washed and reused.
B · Peel the first off by its outside, then slide a bare finger under the second cuff
2.Infection control & patient safety
Answer: C · A nurse with documented immunity to varicella
Why this is the answer
Staff with proven immunity, from vaccination or past infection, should care for patients with varicella. Non-immune staff, especially pregnant staff, risk infection and can spread the virus to other patients.
C · A nurse with documented immunity to varicella
3.Nursing fundamentals
Answer: A · From the inner corner outwards, using a clean part of the cloth for each eye
Why this is the answer
Wiping from the inner to the outer canthus moves debris away from the tear duct. Using a clean part of the cloth for each eye prevents spreading infection between them.
A · From the inner corner outwards, using a clean part of the cloth for each eye
4.Nursing fundamentals
Answer: C · Strict hand hygiene by everyone who enters the room
Why this is the answer
A neutropenic patient cannot fight infection well, and hand hygiene is the key protective measure. Other steps include a single room and keeping away visitors who are unwell.
C · Strict hand hygiene by everyone who enters the room
5.Microbiology
Answer: D · 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.
D · Log (exponential) phase
6.Microbiology
Answer: B · Bactericidal drugs kill bacteria; bacteriostatic drugs stop growth and rely on the immune system to clear them
Why this is the answer
Bacteriostatic drugs halt multiplication so host defences can eliminate the bacteria. Bactericidal drugs are preferred when defences are weak or hard to reach, such as in endocarditis or neutropenia.
B · Bactericidal drugs kill bacteria; bacteriostatic drugs stop growth and rely on the immune system to clear them