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 remove items that could be used to harm self or others
- BTo decide which family members may visit
- CTo find out what the patient likes to wear during the hospital stay
- DTo make a list of valuable items for insurance
2.Infection control & patient safetyHard
A nurse notices that the wrong drug was drawn up, but realizes it before giving it. What should the nurse do?
- ASay nothing, because the patient was not harmed
- BGive the drug anyway, since it is already drawn up
- CReport it only if the same mistake happens again on the unit
- DDiscard it, prepare the correct drug and report a near miss
3.Nursing fundamentalsMedium
Why should enteric-coated tablets not be crushed?
- ACrushing makes the drug inactive in water
- BCrushing makes the dose roughly twice as strong as the whole tablet
- CCrushing removes the coating that protects the stomach or drug
- DCrushing makes the tablet taste so bitter that patients refuse it
4.Nursing fundamentalsHard
What is the best way to check that a patient has learned to use an inhaler correctly?
- AAsk them to repeat the drug's name
- BAsk whether they have any questions
- CAsk the patient to show how they use it
- DAsk whether they have read the leaflet
5.MicrobiologyMedium
Transfer of bacterial genes from one bacterium to another by a virus is called:
- AConjugation
- BTranscription
- CTransduction
- DTransformation
6.MicrobiologyHard
Why must a negative-sense RNA virus such as influenza carry its own RNA-dependent RNA polymerase into the host cell?
- AHost cells cannot make mRNA from an RNA template
- BThe polymerase protects the virus from antibodies
- CHost ribosomes cannot read any viral genes
- DThe polymerase is needed to integrate the genome into host DNA
3Solutions
1.Infection control & patient safety
Answer: A · 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.
A · To remove items that could be used to harm self or others
2.Infection control & patient safety
Answer: D · Discard it, prepare the correct drug and report a near miss
Why this is the answer
A near miss shows a weakness in the system, such as similar packaging or storage. Reporting allows the risk to be fixed before a patient is harmed. A just culture supports such reporting.
D · Discard it, prepare the correct drug and report a near miss
3.Nursing fundamentals
Answer: C · Crushing removes the coating that protects the stomach or drug
Why this is the answer
Enteric coatings stop the tablet dissolving until it reaches the small intestine, protecting the stomach lining or the drug from stomach acid. Crushing destroys this protection.
C · Crushing removes the coating that protects the stomach or drug
4.Nursing fundamentals
Answer: C · Ask the patient to show how they use it
Why this is the answer
A return demonstration shows whether a psychomotor skill has been learned and lets the nurse correct mistakes. Saying "yes, I understand" does not prove the technique is right.
C · Ask the patient to show how they use it
5.Microbiology
Answer: C · 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: A · Host cells cannot make mRNA from an RNA template
Why this is the answer
A negative-sense genome must first be copied into positive-sense mRNA. Human cells have no enzyme that copies RNA from RNA, so the virus brings its own polymerase.
A · Host cells cannot make mRNA from an RNA template