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 water-based lip lubricant
- BA scented petroleum ointment
- CAn oil-based lip balm
- DPetroleum jelly
2.Infection control & patient safetyHard
Which patient with a suspected infection meets at least two SIRS criteria?
- ARespiratory rate 16/min and WBC 8,000/mm3
- BTemperature 38.6 °C and heart rate 112/min
- CTemperature 36.8 °C and respiratory rate 18/min
- DTemperature 37.2 °C and heart rate 80/min
3.Nursing fundamentalsMedium
A bedbound patient who has not opened their bowels for a week now has liquid stool leaking constantly. What should the nurse suspect?
- ANormal bowel function returning
- BAn infection that needs antidiarrhoeal drugs at once
- CA side effect of drinking too much water
- DFaecal impaction with overflow
4.Nursing fundamentalsHard
Four patients need you at the same time. Who should you see first?
- AA patient who has developed noisy, high-pitched breathing (stridor)
- BA patient asking about their discharge time
- CA patient with pain of 6/10 who was given oral analgesia 20 minutes ago
- DA patient due for a routine oral medicine
5.MicrobiologyMedium
What is the incubation period?
- AThe time an antibiotic takes to work
- BThe time during which a patient remains infectious to others
- CThe time a culture needs in the laboratory
- DThe time between infection and the first symptoms
6.MicrobiologyHard
Corynebacterium diphtheriae causes diphtheria only if it produces diphtheria toxin. When does it make this toxin?
- AWhenever it is exposed to antibiotics
- BOnly after it has conjugated with E. coli and received a plasmid
- CWhen it carries a bacteriophage with the toxin gene
- DOnly when it is grown at high temperature
3Solutions
1.Infection control & patient safety
Answer: A · 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.
A · A water-based lip lubricant
2.Infection control & patient safety
Answer: B · Temperature 38.6 °C and heart rate 112/min
Why this is the answer
SIRS criteria include a temperature above 38 °C or below 36 °C, heart rate above 90/min, respiratory rate above 20/min and a WBC above 12,000 or below 4,000/mm3. Only the first patient meets two.
B · Temperature 38.6 °C and heart rate 112/min
3.Nursing fundamentals
Answer: D · Faecal impaction with overflow
Why this is the answer
Overflow happens when liquid stool seeps around impacted hard faeces. Giving antidiarrhoeal drugs would make it worse; the nurse reports it for assessment and treatment.
D · Faecal impaction with overflow
4.Nursing fundamentals
Answer: A · A patient who has developed noisy, high-pitched breathing (stridor)
Why this is the answer
Stridor signals a partly blocked upper airway, which can quickly become life-threatening. Airway problems come before breathing, circulation and other needs.
A · A patient who has developed noisy, high-pitched breathing (stridor)
5.Microbiology
Answer: D · The time between infection and the first symptoms
Why this is the answer
The incubation period runs from exposure to the onset of symptoms. People can sometimes already transmit the infection during it.
D · The time between infection and the first symptoms
6.Microbiology
Answer: C · When it carries a bacteriophage with the toxin gene
Why this is the answer
The tox gene is carried by a bacteriophage. When the phage is integrated as a prophage, the bacterium can produce toxin. Strains without the phage are non-toxigenic.
C · When it carries a bacteriophage with the toxin gene