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 blood cultures usually taken from two separate venipuncture sites?
- ABecause each site tests a different antibiotic
- BTo make the results come back faster from the laboratory
- CTo reduce the total amount of blood taken
- DTo help tell a true infection from skin contamination
2.Infection control & patient safetyHard
During an oral drug round, a patient asks to take a tablet later. The nurse leaves it on the bedside table. What is the main safety problem?
- AThe nurse cannot confirm it was taken, and another person could take it
- BThe tablet may lose its color and become hard to identify later
- CThere is no safety problem if the patient is alert
- DTablets dissolve quickly when left in the open air
3.Nursing fundamentalsMedium
Why does long-term immobility increase the risk of kidney stones?
- ACalcium released from bone raises the calcium in the urine
- BThe kidneys stop producing urine during bed rest
- CPatients on bed rest drink too much fluid
- DLying flat makes the kidneys produce extra uric acid
4.Nursing fundamentalsHard
A nurse escalated a deteriorating patient, but the doctor has not come after 30 minutes and the patient is getting worse. What should the nurse do?
- ATreat the patient with drugs from the cupboard without a prescription
- BWait, since the doctor has already been told
- CEscalate further, for example to a senior doctor or the rapid response team
- DWrite in the notes that the doctor did not come and do nothing else
5.MicrobiologyMedium
Which laboratory test separates Staphylococcus aureus from most other staphylococci?
- AThe acid-fast stain
- BThe catalase test
- CThe Gram stain
- DThe coagulase test
6.MicrobiologyHard
Gram-positive cocci are found. Which test quickly separates staphylococci from streptococci?
- AThe catalase test
- BGrowth on MacConkey agar
- CThe acid-fast stain
- DThe coagulase test
3Solutions
1.Infection control & patient safety
Answer: D · To help tell a true infection from skin contamination
Why this is the answer
If the same organism grows from both sets, it is more likely to be a true bloodstream infection. Growth in only one set may be contamination from the skin.
D · To help tell a true infection from skin contamination
2.Infection control & patient safety
Answer: A · The nurse cannot confirm it was taken, and another person could take it
Why this is the answer
Medicines are not left at the bedside unless there is an agreed self-administration plan. The nurse must see the medication taken to document it correctly, and unattended tablets can be taken by another patient or lost.
A · The nurse cannot confirm it was taken, and another person could take it
3.Nursing fundamentals
Answer: A · Calcium released from bone raises the calcium in the urine
Why this is the answer
Without weight-bearing, bone releases calcium, and urine also drains less well when lying flat. Mobilisation and adequate fluids reduce the risk.
A · Calcium released from bone raises the calcium in the urine
4.Nursing fundamentals
Answer: C · Escalate further, for example to a senior doctor or the rapid response team
Why this is the answer
If a response is delayed and the patient deteriorates, the nurse follows the escalation policy to the next level and keeps monitoring and supporting ABCDE. Each step is documented.
C · Escalate further, for example to a senior doctor or the rapid response team
5.Microbiology
Answer: D · The coagulase test
Why this is the answer
S. aureus produces coagulase, which converts fibrinogen to fibrin. All staphylococci are Gram-positive and catalase-positive, so those tests do not separate them.
6.Microbiology
Answer: A · 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.