Infection Control and Patient Safety: cram pack

Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.

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1Formulas and methods

Infection control & patient safety

Method

  1. Start with standard precautions for every patient: hand hygiene, PPE for the expected exposure, safe sharps.
  2. Add precautions by route: contact (gown, gloves), droplet (surgical mask), airborne (N95, negative-pressure room).
  3. Keep sterile items sterile: if in doubt, it is not sterile; replace, never wipe.
  4. Prevent harm in the environment: fall measures, restraints only as a last resort, RACE and PASS for fire.
  5. 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

An infant has had a cleft lip repair. Why are elbow restraints often used?

  1. ATo prevent the infant from sucking a pacifier
  2. BTo keep the infant from rolling over in the crib
  3. CTo hold the IV line in place during feeds and stop it being pulled out
  4. DTo stop the infant’s hands reaching the mouth while still allowing arm movement
2.Infection control & patient safetyHard

A patient has a rash, and both smallpox and chickenpox are considered. Which finding suggests smallpox?

  1. ALesions all at the same stage, most dense on the face and limbs
  2. BA rash that is very itchy and starts on the trunk
  3. CSmall crops of new lesions appearing over several days in a row
  4. DLesions at different stages, most dense on the trunk
3.Nursing fundamentalsMedium

How should adhesive tape be removed from an older patient's fragile skin?

  1. ASlowly, low and close to the skin, while supporting the skin
  2. BBy pulling it away from the wound as hard as possible
  3. CQuickly in one firm pull, straight upwards and away from the skin
  4. DAfter wetting it with alcohol rub
4.Nursing fundamentalsHard

Over 24 hours a patient takes in 2400 mL and has a total measured output of 1800 mL. What is the fluid balance?

  1. APositive 4200 mL
  2. BBalanced, because both values are high
  3. CNegative 600 mL
  4. DPositive 600 mL
5.MicrobiologyMedium

Which bacterium causes whooping cough (pertussis)?

  1. ABordetella pertussis
  2. BCorynebacterium diphtheriae
  3. CHaemophilus influenzae
  4. DMycoplasma pneumoniae
6.MicrobiologyHard

Which process can produce a completely new influenza A subtype that causes a pandemic?

  1. AAntigenic shift through reassortment of gene segments
  2. BAntigenic drift through gradual accumulation of point mutations
  3. CTransformation with free DNA
  4. DLysogenic conversion by a bacteriophage

3Solutions

1.Infection control & patient safety

Answer: D · To stop the infant’s hands reaching the mouth while still allowing arm movement

Why this is the answer

Elbow restraints keep the elbows straight so the infant cannot touch the suture line. They are removed regularly, one at a time, for skin checks and movement under supervision.

Answer

D · To stop the infant’s hands reaching the mouth while still allowing arm movement
2.Infection control & patient safety

Answer: A · Lesions all at the same stage, most dense on the face and limbs

Why this is the answer

In smallpox, lesions develop at the same stage in any one area and are densest on the face and extremities. In chickenpox, crops appear at different stages and are densest on the trunk.

Answer

A · Lesions all at the same stage, most dense on the face and limbs
3.Nursing fundamentals

Answer: A · Slowly, low and close to the skin, while supporting the skin

Why this is the answer

Peeling the tape back low and slow while holding the skin reduces the pulling force on fragile skin. Adhesive removers can also help.

Answer

A · Slowly, low and close to the skin, while supporting the skin
4.Nursing fundamentals

Answer: D · Positive 600 mL

Why this is the answer

2400 − 1800 = +600 mL, a positive balance. Insensible losses such as sweat and breathing are not measured, so true balance is lower than the chart shows.

Answer

D · Positive 600 mL
5.Microbiology

Answer: A · Bordetella pertussis

Why this is the answer

Bordetella pertussis causes long coughing fits with a "whoop". It is most dangerous for young babies, which is why vaccination in pregnancy is offered in many countries.

Answer

A · Bordetella pertussis
6.Microbiology

Answer: A · Antigenic shift through reassortment of gene segments

Why this is the answer

When two different influenza A viruses infect the same cell, their segments can mix, giving new haemagglutinin or neuraminidase combinations. Few people are immune, so pandemics can follow. Drift causes the smaller yearly changes.

Answer

A · Antigenic shift through reassortment of gene segments

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