Infection control, asepsis and biomedical waste

20 Kerala PSC Staff Nurse Gr II practice questions on Infection control, asepsis and biomedical waste, part of Fundamentals of Nursing and First Aid. The first 20 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

1. Question 1 · Medium

   An elderly resident has crusted (Norwegian) scabies. Which precautions does the nurse use?

   1. AAirborne precautions
   2. BContact precautions
   3. CProtective isolation
   4. DDroplet precautions

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   Answer: B · Contact precautions

   Scabies mites spread by direct skin contact and through bedding and clothing, and crusted scabies carries huge numbers of mites. Contact precautions with gloves and gown for all contact, dedicated equipment and careful linen handling are needed. Linen is washed hot or bagged. Contacts are treated at the same time to prevent re-infestation.

   • A: Scabies is not spread through the air, so airborne precautions are not needed.
   • C: Protective isolation shields an immunocompromised patient, not others.
   • D: Droplet precautions are for organisms spread by coughing within close range.

2. Question 2 · Hard

   A surgical ward has three new MRSA wound infections in one week. Which single measure will most reduce further spread?

   1. AAntibiotic prophylaxis for all ward patients
   2. BFormalin fumigation of the ward each week
   3. CStrict hand hygiene before and after every patient
   4. DNasal swabs taken from every visitor

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   Answer: C · Strict hand hygiene before and after every patient

   MRSA spreads mainly on the hands of staff moving from one patient to the next. Strict hand hygiene at every WHO moment, with contact precautions for the infected patients, breaks this route. Blanket antibiotics breed more resistance, and fumigation does nothing about hands. Staff screening is done only if hand hygiene and isolation fail.

   • A: Prophylactic antibiotics for everyone select for more resistant organisms.
   • B: Fumigation does not clean hands, the main route of spread.
   • D: Visitors are not the main source; staff hands are.

3. Question 3 · Easy

   After autoclaving and shredding, red-category plastic waste under the BMW Rules 2016 is finally:

   1. ASent to registered recyclers
   2. BBurnt in the incinerator
   3. CDumped in a municipal landfill
   4. DBuried in a deep burial pit

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   Answer: A · Sent to registered recyclers

   Red-category waste such as tubing, catheters, gloves and urine bags is disinfected by autoclaving, microwaving or hydroclaving and then shredded or mutilated. The treated plastic goes to authorised recyclers. It is never incinerated, because burning plastics releases toxic gases such as dioxins. Shredding stops reuse of items such as syringes.

   • B: Incineration of plastics releases dioxins, so red waste is not burnt.
   • C: Treated plastic is recycled, not sent to a landfill.
   • D: Deep burial is only for some yellow-category waste in remote areas.

4. Question 4 · Medium

   A patient after chemotherapy has an absolute neutrophil count of 400/µL. Which isolation is most suitable?

   1. AProtective (reverse) isolation
   2. BContact isolation
   3. CAirborne isolation
   4. DEnteric isolation

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   Answer: A · Protective (reverse) isolation

   A neutrophil count below 500/µL is severe neutropenia, and the patient cannot fight even common organisms. Protective or reverse isolation keeps organisms away from the patient: a single room, strict hand hygiene, no visitors with infections and no fresh flowers. The other isolations protect others from an infected patient. Fever in this patient is an emergency.

   • B: Contact isolation stops organisms on an infected patient from reaching others.
   • C: Airborne isolation keeps an infected patient's droplet nuclei from spreading to others.
   • D: Enteric isolation contains faecal-oral infection from the patient.

5. Question 5 · Medium

   Medical asepsis differs from surgical asepsis in that medical asepsis aims to:

   1. ARemove all organisms including spores
   2. BKeep an area free of every pathogen
   3. CReduce the number and spread of organisms
   4. DSterilise the skin before an incision

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   Answer: C · Reduce the number and spread of organisms

   Medical asepsis, or clean technique, lowers the number of organisms and stops their spread, for example by hand washing and clean gloves. Surgical asepsis, or sterile technique, keeps an area or object free of all organisms, including spores. Sterile technique is used for wounds, catheterisation and invasive procedures. Skin cannot be sterilised, only disinfected.

   • A: Removing all organisms including spores is sterilisation, the aim of surgical asepsis.
   • B: Freedom from every organism is the goal of sterile technique, not clean technique.
   • D: Living skin cannot be made sterile; antiseptics only reduce its flora.

6. Question 6 · Easy

   Autoclave indicator tape on a linen pack has turned dark after a cycle. This shows that the pack:

   1. AWas packed by trained staff
   2. BIs proved free of all spores
   3. CWas exposed to steam heat
   4. DCan be stored for six months

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7. Question 7 · Medium

   Why are the hands held higher than the elbows during a surgical hand scrub?

   1. AWater flows from the cleanest area down
   2. BIt lowers blood flow to the fingers
   3. CIt keeps the gown sleeves dry
   4. DIt helps the antiseptic dry faster

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8. Question 8 · Medium

   A large spill of blood on the ward floor is best disinfected with:

   1. APlain soap and water
   2. B1% sodium hypochlorite
   3. C70% ethyl alcohol
   4. D2% glutaraldehyde

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9. Question 9 · Hard

   While setting up a sterile dressing tray, a nurse wearing sterile gloves adjusts her mask with one hand. What should she do next?

   1. AChange to a new pair of sterile gloves
   2. BCarry on, since the mask was clean
   3. CWipe the gloves with spirit and carry on
   4. DDiscard the whole tray and start again

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10. Question 10 · Medium

    A 4-month-old is admitted with paroxysms of cough ending in a whoop and vomiting. Which transmission-based precautions are needed?

    1. AStandard precautions only
    2. BContact precautions
    3. CAirborne precautions
    4. DDroplet precautions

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11. Question 11 · Hard

    A man on a general ward has had a cough for 6 weeks, fever and weight loss; his sputum is sent for testing for TB. What is the nurse's first action?

    1. AMask the patient and move him to an isolation room
    2. BStart antitubercular drugs to stop transmission
    3. CWait for the sputum result before isolating him
    4. DGive the patient an N95 and keep him on the ward

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12. Question 12 · Easy

    Broken glass ampoules and empty medicine vials are discarded in which container?

    1. ARed non-chlorinated bag
    2. BYellow non-chlorinated bag
    3. CBlue-marked cardboard box
    4. DWhite puncture-proof box

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13. Question 13 · Easy

    Used disposable gloves are segregated under the BMW Rules 2016 into the:

    1. ABlue box
    2. BRed bag
    3. CYellow bag
    4. DBlack bag

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14. Question 14 · Hard

    Which pairing of waste and container is NOT correct under the BMW Rules 2016?

    1. ABroken ampoule - blue box
    2. BPlacenta - yellow bag
    3. CExpired tablets - red bag
    4. DUsed urine bag - red bag

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15. Question 15 · Medium

    2% glutaraldehyde is mainly used in hospitals for:

    1. ADisinfection of large blood spills
    2. BHigh-level disinfection of endoscopes
    3. CSterilisation of wrapped linen packs
    4. DAntiseptic preparation of the skin

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16. Question 16 · Easy

    An infection is termed hospital-acquired when it appears after admission by at least:

    1. A48 hours
    2. B24 hours
    3. C12 hours
    4. D7 days

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17. Question 17 · Easy

    Under the BMW Rules 2016, a placenta from the labour room is discarded in a:

    1. AYellow bag
    2. BWhite container
    3. CRed bag
    4. DBlue box

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18. Question 18 · Medium

    Which statement is a correct principle of surgical asepsis?

    1. AA wet sterile pack on a dry tray stays sterile
    2. BReaching across a sterile field is safe in gloves
    3. CSterile items held below the waist stay sterile
    4. DA 2.5 cm border of a sterile drape is unsterile

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19. Question 19 · Easy

    A newly built airborne isolation room for a patient with sputum-positive pulmonary tuberculosis should have at least how many air changes per hour?

    1. A12
    2. B4
    3. C40
    4. D2

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20. Question 20 · Easy

    Teaching a coughing patient to cover the mouth and nose with a tissue breaks the chain of infection at which link?

    1. AReservoir
    2. BPortal of entry
    3. CPortal of exit
    4. DSusceptible host

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