Safety and Infection Control
What this domain tests
Two threads: keeping clients physically safe and interrupting the chain of infection. For safety, know fall precautions (bed low, call light in reach, non-skid footwear, hourly rounding, bed/chair alarms), seizure precautions (padded side rails, suction and oxygen at bedside, never force objects into the mouth), restraint rules (last resort, provider order with time limits, frequent circulation and skin checks, never PRN), fire response (RACE - rescue, alarm, contain, extinguish; PASS for the extinguisher), and poisoning or home-safety teaching.
Infection control
Standard precautions apply to every client. Transmission-based precautions add to, not replace, standard precautions:
- Airborne: N95 respirator, negative-pressure room (tuberculosis, measles, varicella).
- Droplet: surgical mask, private room, door may stay open (influenza, pertussis, mumps, rubella, meningococcal disease).
- Contact: gown and gloves, dedicated equipment (MRSA, VRE, C. difficile, scabies).
PPE donning: gown, mask, goggles, gloves. Removal: gloves first, then goggles, gown, mask; hand hygiene after. C. difficile requires soap and water, not alcohol rub, because spores resist alcohol.
Traps
Varicella is both airborne and contact; students pick only one. Items that let you enter an airborne room without an N95. Sterile-field items where the nurse turns her back or reaches over the field. Needlestick items - wash with soap and water, report, source testing; do not squeeze or scrub.
Worked rule
When two precautions could apply, choose the more protective one and add the second set as required.