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 person in scrubs without a hospital ID badge asks to take a newborn to the nursery. What should the nurse do?
- AHand over the baby if the person seems confident
- BAsk the person their name and then give them the baby
- CRefuse, keep the baby with the mother and alert security
- DLet the parents decide whether to hand the baby over
2.Infection control & patient safetyHard
While preparing an IV medication, a nurse sees that the syringe tip touched the medication tray after the cap came off. What should the nurse do?
- ADiscard the syringe and prepare the dose again with new equipment
- BWipe the tip with an alcohol swab and give the dose
- CGive the dose anyway, because the medication tray was cleaned this morning
- DBlow on the tip to remove any dust
3.Nursing fundamentalsMedium
When are non-sterile gloves needed?
- AOnly when handling medicines
- BFor every patient contact, including taking a pulse or blood pressure
- COnly when the patient is known to have an infection
- DWhen contact with blood, body fluids or broken skin is expected
4.Nursing fundamentalsHard
A severely malnourished patient is about to start feeding. Which complication is a particular risk?
- AVery high blood sodium in the first hour
- BSudden weight gain of several kilograms of fat in the first week
- CImmediate allergic reaction to the feed
- DRefeeding syndrome with low phosphate, potassium and magnesium
5.MicrobiologyMedium
In the chain of infection, what is the "reservoir"?
- AThe place where the pathogen normally lives and multiplies
- BThe way the pathogen enters a new host
- CThe route by which the pathogen leaves the infected host's body
- DThe person who is most at risk of infection
6.MicrobiologyHard
A healthcare worker's blood test is positive for anti-HBs (hepatitis B surface antibody) and negative for HBsAg and anti-HBc. What does this most likely mean?
- AChronic hepatitis B infection
- BCurrent acute hepatitis B infection
- CImmunity from hepatitis B vaccination
- DPast natural infection that has cleared
3Solutions
1.Infection control & patient safety
Answer: C · Refuse, keep the baby with the mother and alert security
Why this is the answer
Infants are only handed to staff with proper identification, as set out in the infant security policy. Suspicious behavior is reported to security at once, and parents are taught to do the same.
C · Refuse, keep the baby with the mother and alert security
2.Infection control & patient safety
Answer: A · Discard the syringe and prepare the dose again with new equipment
Why this is the answer
In aseptic non-touch technique, key parts such as syringe tips and IV hubs must not touch any non-sterile surface. A contaminated key part is not cleaned and reused. It is replaced.
A · Discard the syringe and prepare the dose again with new equipment
3.Nursing fundamentals
Answer: D · When contact with blood, body fluids or broken skin is expected
Why this is the answer
Under standard precautions, gloves are worn when exposure to blood or body fluids is likely. Wearing them for all contact gives false security and can spread germs if not changed.
D · When contact with blood, body fluids or broken skin is expected
4.Nursing fundamentals
Answer: D · Refeeding syndrome with low phosphate, potassium and magnesium
Why this is the answer
When feeding restarts after starvation, insulin release drives phosphate, potassium and magnesium into the cells. Low levels can cause heart failure and arrhythmias, so feeding starts slowly and bloods are monitored.
D · Refeeding syndrome with low phosphate, potassium and magnesium
5.Microbiology
Answer: A · The place where the pathogen normally lives and multiplies
Why this is the answer
The chain of infection links the agent, reservoir, portal of exit, mode of transmission, portal of entry and susceptible host. Breaking any link stops transmission.
A · The place where the pathogen normally lives and multiplies
6.Microbiology
Answer: C · Immunity from hepatitis B vaccination
Why this is the answer
The vaccine contains HBsAg, so a vaccinated person makes anti-HBs but no anti-HBc. Past natural infection gives both anti-HBs and anti-HBc, and ongoing infection shows HBsAg.
C · Immunity from hepatitis B vaccination