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 diabetes will use lancets and insulin needles at home. Which teaching about disposal is correct?
- APut them in a puncture-resistant container with a lid and follow local disposal rules
- BPut them loose in the household trash bag, as long as the bag is tied shut
- CFlush the used lancets and needles down the toilet
- DRecap each needle with two hands before putting it in the kitchen trash
2.Infection control & patient safetyHard
A handwritten order reads “10U regular insulin subcut now”. What is the nurse’s best action?
- AGive 100 units, as the order seems to say
- BGive 10 units without question, as written
- CAsk a nursing assistant to interpret the handwriting
- DClarify the order, because “U” can be misread
3.Nursing fundamentalsMedium
What is the correct order of techniques when assessing the abdomen?
- AAuscultation, palpation, inspection, percussion
- BPalpation, inspection, auscultation, percussion
- CInspection, palpation, percussion, auscultation
- DInspection, auscultation, percussion, palpation
4.Nursing fundamentalsHard
A patient with a valid DNACPR (DNR) decision, whose death was expected, stops breathing. What should the nurse do?
- AStart CPR and call the cardiac arrest team
- BStart CPR but stop after five minutes
- CNot start CPR, note the time, inform the team and support the family
- DLeave the patient and ask the family to wait outside until the doctor comes
5.MicrobiologyMedium
Which is a function of the complement system?
- AProducing antibodies against newly encountered antigens
- BMaking new red blood cells
- CPresenting antigens to T cells
- DForming pores in the membranes of some bacteria
6.MicrobiologyHard
Gram-positive cocci are found. Which test quickly separates staphylococci from streptococci?
- AThe acid-fast stain
- BThe catalase test
- CGrowth on MacConkey agar
- DThe coagulase test
3Solutions
1.Infection control & patient safety
Answer: A · Put them in a puncture-resistant container with a lid and follow local disposal rules
Why this is the answer
Home sharps go into a puncture-resistant container, such as an approved sharps container or a rigid plastic bottle if local rules allow, which is closed and disposed of according to local guidance.
A · Put them in a puncture-resistant container with a lid and follow local disposal rules
2.Infection control & patient safety
Answer: D · Clarify the order, because “U” can be misread
Why this is the answer
“10U” can be read as 100 or 104 units, a potentially fatal overdose. The nurse clarifies the order and asks for “units” to be written in full. Guessing is never acceptable for insulin.
D · Clarify the order, because “U” can be misread
3.Nursing fundamentals
Answer: D · Inspection, auscultation, percussion, palpation
Why this is the answer
In the abdomen the nurse listens before touching, because percussion and palpation can change bowel sounds. In other body systems palpation and percussion come before auscultation.
D · Inspection, auscultation, percussion, palpation
4.Nursing fundamentals
Answer: C · Not start CPR, note the time, inform the team and support the family
Why this is the answer
CPR is not attempted when a valid DNACPR decision applies. The nurse notes the time, follows local policy for verifying death, informs the medical team and supports the family.
C · Not start CPR, note the time, inform the team and support the family
5.Microbiology
Answer: D · Forming pores in the membranes of some bacteria
Why this is the answer
Complement proteins coat microbes for phagocytosis (opsonisation), attract immune cells and form the membrane attack complex that punches holes in some bacteria.
D · Forming pores in the membranes of some bacteria
6.Microbiology
Answer: B · The catalase test
Why this is the answer
Staphylococci produce catalase, which breaks hydrogen peroxide into water and oxygen bubbles; streptococci do not. The coagulase test is then used to identify S. aureus among staphylococci.