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 on nasal cannula oxygen has dry lips. Which product should the nurse offer?
- AA scented petroleum ointment
- BAn oil-based lip balm
- CA water-based lip lubricant
- DPetroleum jelly
2.Infection control & patient safetyHard
Ten minutes into a red blood cell transfusion, the patient reports chills and low back pain and has a new fever. What should the nurse do first?
- ASlow the transfusion and recheck vital signs in 15 minutes
- BGive an antipyretic and continue the transfusion
- CCall the blood bank and let the transfusion continue
- DStop the transfusion
3.Nursing fundamentalsMedium
Why should a tourniquet not be left on for a long time before taking blood?
- AIt can change the results, for example by concentrating the blood
- BIt makes the blood turn blue in the tube
- CIt stops the needle from entering the vein because the vein is too hard
- DIt makes the patient's arm grow stronger
4.Nursing fundamentalsHard
When measuring blood pressure, the patient's arm is hanging down by their side below heart level. How does this affect the reading?
- AIt gives a falsely low reading
- BIt has no effect on the reading
- CIt affects only the heart rate
- DIt gives a falsely high reading
5.MicrobiologyMedium
Which organism causes tuberculosis, and what makes it hard to stain with the Gram method?
- AStreptococcus pneumoniae, which has a capsule
- BMycoplasma pneumoniae, which has no cell wall to take up the stain
- CMycobacterium tuberculosis, which has a waxy mycolic acid wall
- DLegionella pneumophila, which lives inside amoebae
6.MicrobiologyHard
Staphylococcus aureus food poisoning starts only 1–6 hours after eating. Why so fast?
- AThe immune system reacts to the bacteria within minutes
- BThe bacteria made a heat-stable toxin in the food before it was eaten
- CThe bacteria multiply very fast inside the gut and invade the intestinal wall
- DThe bacteria invade the bloodstream immediately
3Solutions
1.Infection control & patient safety
Answer: C · A water-based lip lubricant
Why this is the answer
Petroleum- and oil-based products can increase the risk of burns or fire in an oxygen-rich setting. A water-based lubricant is used instead.
C · A water-based lip lubricant
2.Infection control & patient safety
Answer: D · Stop the transfusion
Why this is the answer
These signs suggest an acute transfusion reaction, possibly hemolytic. The nurse stops the transfusion at once, keeps the IV open with normal saline through new tubing, assesses the patient and notifies the provider and blood bank.
3.Nursing fundamentals
Answer: A · It can change the results, for example by concentrating the blood
Why this is the answer
Prolonged tourniquet time causes fluid to leave the vessel and can alter results such as potassium and protein. It is applied only as long as needed.
A · It can change the results, for example by concentrating the blood
4.Nursing fundamentals
Answer: D · It gives a falsely high reading
Why this is the answer
An arm below heart level adds hydrostatic pressure, so the reading is too high. The arm should be supported at heart level, with the patient seated and relaxed.
D · It gives a falsely high reading
5.Microbiology
Answer: C · Mycobacterium tuberculosis, which has a waxy mycolic acid wall
Why this is the answer
M. tuberculosis has a cell wall rich in mycolic acids, so it resists Gram staining and is identified with acid-fast stains.
C · Mycobacterium tuberculosis, which has a waxy mycolic acid wall
6.Microbiology
Answer: B · The bacteria made a heat-stable toxin in the food before it was eaten
Why this is the answer
S. aureus produces enterotoxins in food left at warm temperatures. The toxin is already there when the food is eaten and survives reheating, so symptoms start quickly.
B · The bacteria made a heat-stable toxin in the food before it was eaten