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 with suspected tuberculosis is in a negative-pressure room. Which practice is correct?
- AKeep the door open so staff can see the patient at all times
- BKeep the door closed except when entering or leaving
- CLet visitors enter without any protection
- DTurn off the room ventilation at night
2.Infection control & patient safetyHard
A patient with a common cold asks for antibiotics “to be on the safe side”. Which response is best?
- ASuggest using leftover antibiotics from a previous illness
- BTell the patient that antibiotics will shorten the cold by several days
- CExplain that antibiotics do not work on viruses and overuse breeds resistant bacteria
- DAsk the provider to prescribe antibiotics anyway so that the patient is reassured
3.Nursing fundamentalsMedium
In the UK SSKIN care bundle for pressure ulcer prevention, what does "K" stand for?
- AKeep warm
- BKeep clean
- CKeep moving
- DKeep dry
4.Nursing fundamentalsHard
A patient with capacity tells the nurse they do not want the operation their family keeps pushing for. What is the nurse's best action?
- ASupport the patient to tell the team their wishes
- BSay nothing to avoid a conflict with the family
- CTell the patient to follow the family's advice
- DLet the family decide, as they know the patient best
5.MicrobiologyMedium
In the lysogenic cycle of a bacteriophage, what happens to the phage DNA?
- AIt is destroyed by the bacterium
- BIt is integrated into the bacterial chromosome as a prophage
- CIt leaves the cell through the pilus
- DIt is immediately used to make new phages that burst the cell
6.MicrobiologyHard
The minimum inhibitory concentration (MIC) of an antibiotic is:
- AThe lowest concentration that kills 99.9% of the bacterial inoculum in vitro
- BThe plasma level at which side effects begin
- CThe lowest concentration that prevents visible bacterial growth in vitro
- DThe highest dose a patient can tolerate
3Solutions
1.Infection control & patient safety
Answer: B · Keep the door closed except when entering or leaving
Why this is the answer
The door is kept closed so that the airflow into the room is maintained. Visitors are limited and instructed about respiratory protection according to policy.
B · Keep the door closed except when entering or leaving
2.Infection control & patient safety
Answer: C · Explain that antibiotics do not work on viruses and overuse breeds resistant bacteria
Why this is the answer
Colds are caused by viruses, which antibiotics do not kill. Unneeded antibiotics cause side effects and drive resistance, so the nurse explains this and offers advice on managing symptoms.
C · Explain that antibiotics do not work on viruses and overuse breeds resistant bacteria
3.Nursing fundamentals
Answer: C · Keep moving
Why this is the answer
SSKIN stands for Surface, Skin inspection, Keep moving, Incontinence and moisture, and Nutrition and hydration. Regular repositioning relieves pressure on the skin.
4.Nursing fundamentals
Answer: A · Support the patient to tell the team their wishes
Why this is the answer
As an advocate the nurse makes sure the patient's own wishes are heard. A competent adult decides about their treatment, and the family's views do not override this.
A · Support the patient to tell the team their wishes
5.Microbiology
Answer: B · It is integrated into the bacterial chromosome as a prophage
Why this is the answer
In lysogeny the phage genome integrates into the host chromosome and is copied with it. Later it may switch to the lytic cycle, making new phages and lysing the cell.
B · It is integrated into the bacterial chromosome as a prophage
6.Microbiology
Answer: C · The lowest concentration that prevents visible bacterial growth in vitro
Why this is the answer
The MIC is the lowest concentration that inhibits visible growth. The minimum bactericidal concentration (MBC) is the lowest that kills 99.9% of the bacteria.
C · The lowest concentration that prevents visible bacterial growth in vitro