Infection Control and Patient Safety: cram pack

Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.

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1Formulas and methods

Infection control & patient safety

Method

  1. Start with standard precautions for every patient: hand hygiene, PPE for the expected exposure, safe sharps.
  2. Add precautions by route: contact (gown, gloves), droplet (surgical mask), airborne (N95, negative-pressure room).
  3. Keep sterile items sterile: if in doubt, it is not sterile; replace, never wipe.
  4. Prevent harm in the environment: fall measures, restraints only as a last resort, RACE and PASS for fire.
  5. 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 instruction about using a standard walker is correct?

  1. ACarry the walker and use it only when tired
  2. BPush up from the walker to stand from a chair
  3. CMove the walker forward, then step into it
  4. DWalk well ahead of the walker for balance
2.Infection control & patient safetyHard

Which position is especially dangerous for a patient in physical restraints?

  1. ALying on the side
  2. BLying on the back with the head raised
  3. CLying face down (prone)
  4. DSitting upright in bed
3.Nursing fundamentalsMedium

Why do nurses often count the respiratory rate while still appearing to take the pulse?

  1. ACounting breaths is only accurate when the wrist is held
  2. BPatients who know their breathing is watched tend to change it
  3. CThe pulse and breathing rates are always the same number
  4. DIt is not allowed to tell patients that breathing is measured
4.Nursing fundamentalsHard

A patient's NEWS2 score suddenly rises from 1 to 7. What is the appropriate response?

  1. AUrgent or emergency response with immediate senior clinical review
  2. BContinue four-hourly observations
  3. CDocument it, repeat the observations and inform the doctor at the next ward round
  4. DRecheck the observations tomorrow morning
5.MicrobiologyMedium

In which phase of the bacterial growth curve do the cells divide at their fastest constant rate?

  1. ALag (adaptation) phase
  2. BStationary (plateau) phase
  3. CLog (exponential) phase
  4. DDeath phase
6.MicrobiologyHard

Which process can produce a completely new influenza A subtype that causes a pandemic?

  1. AAntigenic drift through gradual accumulation of point mutations
  2. BAntigenic shift through reassortment of gene segments
  3. CLysogenic conversion by a bacteriophage
  4. DTransformation with free DNA

3Solutions

1.Infection control & patient safety

Answer: C · Move the walker forward, then step into it

Why this is the answer

The patient moves the walker forward, sets it down with all legs on the floor and then steps into it. To stand, they push up from the chair arms, because a walker can tip if used to pull up.

Answer

C · Move the walker forward, then step into it
2.Infection control & patient safety

Answer: C · Lying face down (prone)

Why this is the answer

Restraining a person face down can restrict breathing and has caused deaths from positional asphyxia. Restrained patients are positioned to protect the airway and are watched closely.

Answer

C · Lying face down (prone)
3.Nursing fundamentals

Answer: B · Patients who know their breathing is watched tend to change it

Why this is the answer

Breathing can be changed on purpose, so a patient who is aware of being watched may breathe differently. Counting unobtrusively for a full minute gives a more accurate rate.

Answer

B · Patients who know their breathing is watched tend to change it
4.Nursing fundamentals

Answer: A · Urgent or emergency response with immediate senior clinical review

Why this is the answer

A NEWS2 of 7 or more calls for an emergency response: continuous monitoring and immediate assessment by a clinician with critical care skills.

Answer

A · Urgent or emergency response with immediate senior clinical review
5.Microbiology

Answer: C · Log (exponential) phase

Why this is the answer

After the lag phase of adjustment, cells enter the log phase and grow exponentially. Growth stops in the stationary phase as nutrients run out and waste builds up.

Answer

C · Log (exponential) phase
6.Microbiology

Answer: B · Antigenic shift through reassortment of gene segments

Why this is the answer

When two different influenza A viruses infect the same cell, their segments can mix, giving new haemagglutinin or neuraminidase combinations. Few people are immune, so pandemics can follow. Drift causes the smaller yearly changes.

Answer

B · Antigenic shift through reassortment of gene segments

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