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
Which assessment is most important while a patient is in wrist restraints?
- AThe patient’s height and weight
- BThe patient’s hearing in both ears with a watch test
- CCirculation, sensation and skin beyond the restraint
- DThe patient’s food and drink preferences for the day
2.Infection control & patient safetyHard
A patient is admitted with acute diarrhea, and C. difficile is suspected. The test result is pending. When should contact precautions start?
- AOnly when the test result comes back positive
- BOnly if the patient develops a fever
- CAfter three days of diarrhea
- DStraight away, without waiting for the test result
3.Nursing fundamentalsMedium
Why does long-term immobility increase the risk of kidney stones?
- APatients on bed rest drink too much fluid
- BThe kidneys stop producing urine during bed rest
- CLying flat makes the kidneys produce extra uric acid
- DCalcium released from bone raises the calcium in the urine
4.Nursing fundamentalsHard
Why is the level of sedation a useful early warning in a patient on opioids?
- ASedation means the opioid dose is too low
- BSedation only occurs after the breathing has stopped
- CSedation shows that the pain has completely gone and the dose is right
- DIncreasing sedation usually comes before respiratory depression
5.MicrobiologyMedium
How does an autoclave sterilise instruments?
- AWith dry heat at about 60 °C
- BWith steam under pressure at about 121 °C
- CWith alcohol vapour at room temperature
- DWith ultraviolet light only
6.MicrobiologyHard
A patient with suspected infectious pulmonary tuberculosis is admitted. Which precautions are needed?
- ADroplet precautions with a surgical mask, and only within one metre
- BAirborne precautions, ideally a negative-pressure room and respirator masks for staff
- CNo special precautions, because TB spreads only by blood
- DContact precautions only, with gloves and an apron
3Solutions
1.Infection control & patient safety
Answer: C · Circulation, sensation and skin beyond the restraint
Why this is the answer
Restrained patients are checked often for circulation, sensation, skin condition, comfort, fluids and toileting, and the restraint is released at regular intervals for movement according to policy.
C · Circulation, sensation and skin beyond the restraint
2.Infection control & patient safety
Answer: D · Straight away, without waiting for the test result
Why this is the answer
Precautions start on suspicion, because the patient can spread spores while the test is pending. The patient is placed in a single room with contact precautions, and soap-and-water hand washing is used.
D · Straight away, without waiting for the test result
3.Nursing fundamentals
Answer: D · 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.
D · Calcium released from bone raises the calcium in the urine
4.Nursing fundamentals
Answer: D · Increasing sedation usually comes before respiratory depression
Why this is the answer
Patients usually become drowsy before their breathing slows dangerously. Checking sedation with a simple scale alongside respiratory rate allows early action.
D · Increasing sedation usually comes before respiratory depression
5.Microbiology
Answer: B · With steam under pressure at about 121 °C
Why this is the answer
Pressurised steam reaches about 121 °C and kills all microorganisms, including spores, typically in about 15 minutes or more depending on the load.
B · With steam under pressure at about 121 °C
6.Microbiology
Answer: B · Airborne precautions, ideally a negative-pressure room and respirator masks for staff
Why this is the answer
M. tuberculosis spreads in airborne droplet nuclei that can stay suspended for long periods. Patients need a single room with negative pressure where possible, and staff wear FFP2/FFP3 or N95 respirators.
B · Airborne precautions, ideally a negative-pressure room and respirator masks for staff