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
An adult with hepatitis A is incontinent of stool. Which precautions are used?
- AA protective environment with filtered air
- BAirborne precautions in a negative-pressure room with the door closed
- CContact precautions in addition to standard precautions
- DDroplet precautions with a surgical mask
2.Infection control & patient safetyHard
A nurse asks a colleague to “just glance” at an insulin infusion before starting it. What makes a check truly independent?
- AThe second nurse checks the order, drug, dose and pump settings separately without being told the answer
- BThe first nurse reads the details aloud and the second agrees
- CThe second nurse signs the record after the infusion has already been started by the first
- DThe second nurse looks at the bag label from the doorway
3.Nursing fundamentalsMedium
What does the Malnutrition Universal Screening Tool (MUST) assess?
- AThe risk of malnutrition
- BThe level of pain
- CThe risk of falling
- DSwallowing ability
4.Nursing fundamentalsHard
In a patient with sepsis, what does a raised blood lactate suggest?
- AThe tissues are not getting enough oxygen
- BThe patient has eaten recently
- CThe infection has been cured
- DThe kidneys are making too much urine
5.MicrobiologyMedium
Which organism causes tuberculosis, and what makes it hard to stain with the Gram method?
- AStreptococcus pneumoniae, which has a capsule
- BMycobacterium tuberculosis, which has a waxy mycolic acid wall
- CLegionella pneumophila, which lives inside amoebae
- DMycoplasma pneumoniae, which has no cell wall to take up the stain
6.MicrobiologyHard
Which hepatitis viruses are mainly spread through contaminated food and water?
- AHepatitis C and E
- BHepatitis A and E
- CHepatitis B and C
- DHepatitis B and D
3Solutions
1.Infection control & patient safety
Answer: C · Contact precautions in addition to standard precautions
Why this is the answer
Hepatitis A spreads through fecal contamination. For a patient who is incontinent or in diapers, contact precautions are added to standard precautions to prevent spread on hands and surfaces.
C · Contact precautions in addition to standard precautions
2.Infection control & patient safety
Answer: A · The second nurse checks the order, drug, dose and pump settings separately without being told the answer
Why this is the answer
In an independent double check, the second person works through each step on their own, then the two results are compared. Reading the answer aloud or glancing invites confirmation bias.
A · The second nurse checks the order, drug, dose and pump settings separately without being told the answer
3.Nursing fundamentals
Answer: A · The risk of malnutrition
Why this is the answer
MUST combines body mass index, unplanned weight loss and acute disease effect into a score that shows the risk of malnutrition and guides nutritional care.
A · The risk of malnutrition
4.Nursing fundamentals
Answer: A · The tissues are not getting enough oxygen
Why this is the answer
When tissues are poorly perfused they switch to anaerobic metabolism and produce lactate. A raised lactate in sepsis signals higher risk and the need for urgent treatment.
A · The tissues are not getting enough oxygen
5.Microbiology
Answer: B · Mycobacterium tuberculosis, which has a waxy mycolic acid wall
Why this is the answer
M. tuberculosis has a cell wall rich in mycolic acids, so it resists Gram staining and is identified with acid-fast stains.
B · Mycobacterium tuberculosis, which has a waxy mycolic acid wall
6.Microbiology
Answer: B · Hepatitis A and E
Why this is the answer
Hepatitis A and E spread by the faecal–oral route. B, C and D spread through blood and body fluids and can cause chronic infection.