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
During a norovirus outbreak on a ward, which hand hygiene method should staff use after patient care?
- ANo hand hygiene if gloves were worn
- BWiping hands on a paper towel only
- CAlcohol hand rub only
- DWashing with soap and water
2.Infection control & patient safetyHard
Which patient most needs fall precautions?
- AAn alert patient on bed rest who follows instructions
- BA young adult with a broken finger who walks steadily and safely unaided
- CAn older patient, newly confused, on a sedative, with an unsteady gait
- DA patient awaiting discharge who walks independently
3.Nursing fundamentalsMedium
How should an unconscious patient be positioned for mouth care?
- ASitting fully upright with the head bent forwards
- BOn their side with the head turned, with suction ready
- CProne with the face in the pillow
- DFlat on their back with the head tilted back
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
- BIncreasing sedation usually comes before respiratory depression
- CSedation shows that the pain has completely gone and the dose is right
- DSedation only occurs after the breathing has stopped
5.MicrobiologyMedium
What is the incubation period?
- AThe time a culture needs in the laboratory
- BThe time between infection and the first symptoms
- CThe time during which a patient remains infectious to others
- DThe time an antibiotic takes to work
6.MicrobiologyHard
Several people vomit within a few hours of eating fried rice that was cooked the day before and kept at room temperature. Which organism is the classic cause?
- AClostridium botulinum
- BBacillus cereus
- CListeria monocytogenes
- DSalmonella Typhi
3Solutions
1.Infection control & patient safety
Answer: D · Washing with soap and water
Why this is the answer
Norovirus is not reliably killed by alcohol hand rub, so hands are washed with soap and water, which removes it mechanically. Contact precautions and thorough environmental cleaning are also used.
D · Washing with soap and water
2.Infection control & patient safety
Answer: C · An older patient, newly confused, on a sedative, with an unsteady gait
Why this is the answer
New confusion, a sedative and an unsteady gait are major fall risk factors. The patient needs measures such as a low bed, scheduled toileting, close observation and a medication review.
C · An older patient, newly confused, on a sedative, with an unsteady gait
3.Nursing fundamentals
Answer: B · On their side with the head turned, with suction ready
Why this is the answer
Side-lying lets fluid drain from the mouth instead of into the airway. Only small amounts of fluid are used, and suction is kept at hand to reduce the risk of aspiration.
B · On their side with the head turned, with suction ready
4.Nursing fundamentals
Answer: B · 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.
B · Increasing sedation usually comes before respiratory depression
5.Microbiology
Answer: B · The time between infection and the first symptoms
Why this is the answer
The incubation period runs from exposure to the onset of symptoms. People can sometimes already transmit the infection during it.
B · The time between infection and the first symptoms
6.Microbiology
Answer: B · Bacillus cereus
Why this is the answer
Bacillus cereus spores survive boiling. If cooked rice is left warm, the bacteria grow and make a heat-stable emetic toxin, so reheating does not make the rice safe.