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
Why are some patients screened with a nasal swab for MRSA on admission?
- ATo check whether the patient is allergic to penicillin before surgery
- BTo measure the patient’s immunity to MRSA
- CTo diagnose a sinus infection
- DTo find carriers so precautions or decolonization can be used
2.Infection control & patient safetyHard
An 80-year-old patient took a sleeping tablet an hour ago and now wants to go to the bathroom. What should the nurse do?
- ATell the patient to wait until the morning
- BRaise all four side rails so the patient stays in bed
- CTell the patient to go alone and use the call light if needed
- DWalk with the patient to the bathroom and stay close by
3.Nursing fundamentalsMedium
While being helped to eat, a patient with dysphagia coughs and their voice sounds wet and gurgly. What should the nurse do?
- AStop feeding and report for a swallowing assessment
- BGive a drink of water to wash the food down
- CLie the patient flat to rest
- DFeed more quickly so the meal is finished before they tire
4.Nursing fundamentalsHard
A patient going home on warfarin has been taught about the drug. Which statement shows a need for further teaching?
- A"I'll try to keep the amount of green vegetables I eat steady."
- B"I'll stop eating all green vegetables from now on."
- C"I'll report any blood in my urine or black stools."
- D"I'll keep my appointments for blood tests."
5.MicrobiologyMedium
How is DNA transferred between bacteria during conjugation?
- ABy uptake of free DNA from the environment
- BBy a bacteriophage carrying bacterial DNA
- CBy fusion of two bacterial cells into one
- DThrough direct contact using a sex pilus
6.MicrobiologyHard
Joseph Lister reduced infection after surgery in the 1860s. What was his main innovation?
- AUsing carbolic acid (phenol) as an antiseptic on wounds and instruments
- BVaccinating surgeons against staphylococci
- CGiving sulfonamide antibiotics after every operation
- DUsing steam autoclaves to sterilise all surgical instruments before each operation
3Solutions
1.Infection control & patient safety
Answer: D · To find carriers so precautions or decolonization can be used
Why this is the answer
Screening identifies people who are colonized with MRSA, often in the nose. Precautions and, in some cases, decolonization reduce spread and the risk of the patient’s own infection after surgery.
D · To find carriers so precautions or decolonization can be used
2.Infection control & patient safety
Answer: D · Walk with the patient to the bathroom and stay close by
Why this is the answer
Hypnotics cause drowsiness and unsteadiness, especially in older adults, and many falls happen on the way to the toilet at night. The nurse assists the patient rather than restricting them or leaving them alone.
D · Walk with the patient to the bathroom and stay close by
3.Nursing fundamentals
Answer: A · Stop feeding and report for a swallowing assessment
Why this is the answer
Coughing, choking and a wet voice during meals suggest food or drink is entering the airway. Feeding stops, the patient sits upright and a speech and language therapist assesses them.
A · Stop feeding and report for a swallowing assessment
4.Nursing fundamentals
Answer: B · "I'll stop eating all green vegetables from now on."
Why this is the answer
Vitamin K in green vegetables opposes warfarin, so a stable intake keeps the INR steady. Cutting them out suddenly can make the INR rise; bleeding signs and blood tests are correct points.
B · "I'll stop eating all green vegetables from now on."
5.Microbiology
Answer: D · Through direct contact using a sex pilus
Why this is the answer
In conjugation a donor cell forms a pilus to a recipient and transfers DNA, often a plasmid. It is an important way for antibiotic resistance genes to spread.
D · Through direct contact using a sex pilus
6.Microbiology
Answer: A · Using carbolic acid (phenol) as an antiseptic on wounds and instruments
Why this is the answer
Lister applied carbolic acid to wounds, dressings and instruments, which greatly reduced post-operative infection. This started antiseptic surgery.
A · Using carbolic acid (phenol) as an antiseptic on wounds and instruments