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 has just given an intramuscular injection with a safety needle. What should the nurse do next with the needle?
- AActivate the safety device and drop it into a sharps container at once
- BLay it on the medication tray and discard it later
- CRecap it carefully with both hands and dispose of it after the drug round
- DBend the needle to make it unusable, then discard it
2.Infection control & patient safetyHard
A patient in a vest restraint has slid down in bed, and the vest is pressing against the neck. What should the nurse do first?
- AWrite a note about the event in the chart
- BRelease the restraint at once and reposition the patient
- CTighten the vest so the patient cannot slide down again
- DCall the provider to ask about a different restraint
3.Nursing fundamentalsMedium
When measuring blood pressure manually, which sound marks the systolic pressure?
- AThe point at which all sounds disappear as the cuff deflates
- BThe first clear tapping sound as the cuff deflates
- CThe sound heard before the cuff is inflated
- DThe loudest sound heard
4.Nursing fundamentalsHard
Four patients need you at the same time. Who should you see first?
- AA patient who has developed noisy, high-pitched breathing (stridor)
- BA patient due for a routine oral medicine
- CA patient asking about their discharge time
- DA patient with pain of 6/10 who was given oral analgesia 20 minutes ago
5.MicrobiologyMedium
What does PCR do in a diagnostic laboratory?
- AIt stains bacteria so they can be seen
- BIt grows bacteria faster on agar plates
- CIt measures the level of specific antibodies in a patient's serum sample
- DIt makes many copies of a specific DNA sequence so it can be detected
6.MicrobiologyHard
How do retroviruses such as HIV copy their genome into the host DNA?
- AReverse transcriptase makes DNA from viral RNA, and integrase inserts it
- BHost DNA polymerase copies the RNA without help
- CThe viral RNA is translated into DNA by ribosomes
- DThe viral DNA is copied directly by host RNA polymerase
3Solutions
1.Infection control & patient safety
Answer: A · Activate the safety device and drop it into a sharps container at once
Why this is the answer
Used needles are never recapped with two hands, bent or left lying around. The safety feature is activated straight away and the needle goes into a puncture-resistant sharps container at the point of use.
A · Activate the safety device and drop it into a sharps container at once
2.Infection control & patient safety
Answer: B · Release the restraint at once and reposition the patient
Why this is the answer
Patients have died from strangulation when vest restraints moved up to the neck. The nurse frees the patient immediately, checks breathing and repositions them, then reassesses whether the restraint is needed at all.
B · Release the restraint at once and reposition the patient
3.Nursing fundamentals
Answer: B · The first clear tapping sound as the cuff deflates
Why this is the answer
Systolic pressure is the first clear Korotkoff sound as blood starts to pass the cuff. Diastolic pressure is usually taken where the sounds disappear.
B · The first clear tapping sound as the cuff deflates
4.Nursing fundamentals
Answer: A · A patient who has developed noisy, high-pitched breathing (stridor)
Why this is the answer
Stridor signals a partly blocked upper airway, which can quickly become life-threatening. Airway problems come before breathing, circulation and other needs.
A · A patient who has developed noisy, high-pitched breathing (stridor)
5.Microbiology
Answer: D · It makes many copies of a specific DNA sequence so it can be detected
Why this is the answer
The polymerase chain reaction amplifies a target sequence millions of times. It can detect pathogens that are hard to culture; RNA viruses are first converted to DNA (RT-PCR).
D · It makes many copies of a specific DNA sequence so it can be detected
6.Microbiology
Answer: A · Reverse transcriptase makes DNA from viral RNA, and integrase inserts it
Why this is the answer
Reverse transcriptase converts the RNA genome into DNA, which integrase inserts into the host genome as a provirus. Both enzymes are drug targets.
A · Reverse transcriptase makes DNA from viral RNA, and integrase inserts it