NMC - Nursing Midwifery Council Infection Prevention and Control Questions and Answers 1 — Questions and Answers
Question 1: A nurse is providing care for a patient with suspected influenza who is coughing frequently. To adhere to droplet precautions, what is the minimum Personal Protective Equipment (PPE) the nurse should wear when working within one meter of the patient?
- Gloves and a disposable apron.
- A fluid-resistant surgical mask (FRSM), eye protection, gloves, and a disposable apron. (Correct answer)
- An FFP3 respirator mask, gloves, and a long-sleeved gown.
- A fluid-resistant surgical mask (FRSM) only.
Correct answer: A fluid-resistant surgical mask (FRSM), eye protection, gloves, and a disposable apron.
Influenza is transmitted via droplets. Standard droplet precautions require a fluid-resistant surgical mask (FRSM) and eye protection to protect the nurse's mucous membranes from infectious respiratory secretions. Gloves and an apron are also required as part of standard precautions to protect hands and uniform from contamination. An FFP3 mask is for airborne precautions, which are not typically required for influenza unless an aerosol-generating procedure is being performed.
Question 2: According to the World Health Organization's '5 Moments for Hand Hygiene', which of the following scenarios represents a critical moment requiring hand hygiene?
- After documenting patient care in the nursing station.
- Before entering the patient's room from the corridor.
- After touching a patient's bed rail, having not touched the patient. (Correct answer)
- Before preparing medications in the treatment room.
Correct answer: After touching a patient's bed rail, having not touched the patient.
The WHO's 5 Moments for Hand Hygiene are: 1) before touching a patient, 2) before a clean/aseptic procedure, 3) after body fluid exposure risk, 4) after touching a patient, and 5) after touching patient surroundings. Touching the patient's bed rail falls under 'after touching patient surroundings' and requires hand hygiene to prevent the transmission of germs from the environment to the healthcare worker and then to other patients or surfaces.
Question 3: Which of the following nursing actions is the most effective way to break the 'portal of entry' link in the chain of infection?
- Placing a patient with a respiratory infection in a single-occupancy room.
- Performing hand hygiene before and after patient contact.
- Administering a prescribed antibiotic to a patient with a bacterial infection.
- Applying a sterile, occlusive dressing to a patient's post-operative wound. (Correct answer)
Correct answer: Applying a sterile, occlusive dressing to a patient's post-operative wound.
The 'portal of entry' is the path through which a pathogen enters a susceptible host. Applying a sterile, occlusive dressing creates a physical barrier over broken skin (the wound), directly blocking microorganisms from entering the body. Isolating a patient targets the 'mode of transmission', hand hygiene breaks the 'mode of transmission', and antibiotics target the 'infectious agent'.
Question 4: A nurse sustains a puncture wound from a sterile, unused needle while opening a suture pack. What is the correct immediate first aid action?
- Immediately complete an incident report and inform the line manager.
- Do nothing, as the needle was sterile and posed no risk of infection.
- Encourage the wound to bleed gently under running water, wash with soap, and cover with a waterproof dressing. (Correct answer)
- Squeeze the wound firmly to express any potential contaminants and then apply an antiseptic wipe.
Correct answer: Encourage the wound to bleed gently under running water, wash with soap, and cover with a waterproof dressing.
UK health and safety guidance mandates that for any sharps injury, the wound should be encouraged to bleed gently (without sucking or vigorous squeezing), washed thoroughly with soap and running water, and covered with a waterproof dressing. Even if the needle is unused and sterile, the skin barrier has been breached, and this first aid procedure must be followed before reporting the incident. Squeezing can cause further tissue damage and is not recommended.
Question 5: When preparing to insert a peripheral intravenous cannula, which action is a core principle of the Aseptic Non-Touch Technique (ANTT)?
- Cleaning the patient's skin with an alcohol wipe for at least 30 seconds and allowing it to dry.
- Wearing sterile gloves for the entire duration of the procedure.
- Ensuring only 'key parts' make contact with other 'key parts' or the 'key site'. (Correct answer)
- Establishing a large sterile field using a drape for all cannulation procedures.
Correct answer: Ensuring only 'key parts' make contact with other 'key parts' or the 'key site'.
The fundamental principle of ANTT is identifying and protecting 'key parts' and 'key sites'. Key parts (e.g., the cannula, the tip of the saline flush syringe) must only come into contact with other key parts or the patient's prepared key site (the insertion point) to maintain asepsis and prevent infection. While cleaning the skin and using gloves are parts of the process, the core concept that defines ANTT is the protection of these specific components from any non-sterile contact.
Question 6: A nurse has just administered an intramuscular injection containing a medicinal product. According to UK waste segregation guidelines, what is the correct container for the immediate disposal of the used needle and syringe?
- An orange-lidded sharps container.
- A yellow clinical waste bag.
- A yellow-lidded sharps container. (Correct answer)
- A purple-lidded sharps container.
Correct answer: A yellow-lidded sharps container.
In the UK, sharps must be disposed of at the point of use in a designated sharps container. A yellow-lidded container is used for sharps contaminated with medicines or anaesthetics, other than those that are cytotoxic or cytostatic. An orange lid is for sharps not contaminated with medicines. A purple lid is for cytotoxic and cytostatic waste. A yellow bag is for soft infectious waste and is not puncture-proof.
NMC - Nursing Midwifery Council Infection Prevention and Control Questions and Answers 1
A nurse is providing care for a patient with suspected influenza who is coughing frequently.
To adhere to droplet precautions, what is the minimum Personal Protective Equipment (PPE) the nurse should wear when working within one meter of the patient?