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 nurse who wears prescription glasses must irrigate a wound where splashing is likely. Which eye protection is suitable?
- AThe prescription glasses alone
- BGoggles or a face shield worn over the glasses
- CThe glasses with a surgical mask
- DNo eye protection, if the nurse stands to one side
2.Infection control & patient safetyHard
A nurse teaches parents about using an infant car seat. Which statement shows a need for further teaching?
- A“We will put the rear-facing seat in the front so we can see the baby.”
- B“We will make sure the harness straps are snug against the baby’s chest.”
- C“We will use the car seat for every trip, even short ones.”
- D“We will install the seat in the back seat, facing the rear.”
3.Nursing fundamentalsMedium
In which direction should a female patient's perineum be cleaned?
- AFrom front to back
- BFrom back to front
- CIn circles starting at the anus
- DEither way, as long as soap is used
4.Nursing fundamentalsHard
Before giving a PRN dose of oral morphine, which assessment is most important?
- AThe patient's weight and height, recorded on admission
- BThe patient's blood glucose level
- CThe patient's last bowel movement
- DThe respiratory rate and level of sedation
5.MicrobiologyMedium
What does an ELISA test detect?
- ASpecific antigens or antibodies, using an enzyme that causes a colour change
- BThe shape of bacteria under the microscope
- CThe DNA sequence of the whole bacterial genome
- DBacterial growth on solid agar plates
6.MicrobiologyHard
A urinary catheter has become colonised by bacteria in a biofilm. Why is the catheter usually replaced instead of just giving antibiotics?
- ABiofilm bacteria cannot cause disease
- BAntibiotics damage the catheter material
- CBiofilms contain only viruses, so antibiotics do not work
- DBacteria in biofilms are protected and much harder for antibiotics to kill
3Solutions
1.Infection control & patient safety
Answer: B · Goggles or a face shield worn over the glasses
Why this is the answer
Prescription glasses do not protect against splashes from the sides, top or bottom. Goggles or a face shield that fit over them are worn when splashes are likely.
B · Goggles or a face shield worn over the glasses
2.Infection control & patient safety
Answer: A · “We will put the rear-facing seat in the front so we can see the baby.”
Why this is the answer
A rear-facing car seat must never be placed in front of an active airbag, which can strike the seat with great force. Infants ride rear-facing in the back seat, with a snug harness, on every trip.
A · “We will put the rear-facing seat in the front so we can see the baby.”
3.Nursing fundamentals
Answer: A · From front to back
Why this is the answer
Cleaning from the urethra towards the anus moves bacteria away from the urinary tract and lowers the risk of urinary tract infection.
4.Nursing fundamentals
Answer: D · The respiratory rate and level of sedation
Why this is the answer
Opioids can cause sedation and respiratory depression. Checking breathing and alertness before each dose, as well as the pain score, keeps the patient safe.
D · The respiratory rate and level of sedation
5.Microbiology
Answer: A · Specific antigens or antibodies, using an enzyme that causes a colour change
Why this is the answer
In an enzyme-linked immunosorbent assay, antibodies linked to an enzyme bind the target. Adding the substrate produces a colour, showing whether the antigen or antibody is present.
A · Specific antigens or antibodies, using an enzyme that causes a colour change
6.Microbiology
Answer: D · Bacteria in biofilms are protected and much harder for antibiotics to kill
Why this is the answer
In a biofilm, bacteria live in a protective matrix, grow slowly and can tolerate high antibiotic levels. Removing the device removes the source of infection.
D · Bacteria in biofilms are protected and much harder for antibiotics to kill