MRCPsych Safety and Infection Control 2 — Questions and Answers
Question 1: A psychiatric inpatient with known MRSA is prescribed oral antibiotics. Which additional infection control measure is MOST important in an acute ward setting?
- Isolate the patient in a side room with contact precautions (Correct answer)
- Administer IV vancomycin regardless of severity
- Restrict all staff from entering the room
- Transfer immediately to a medical ward
Correct answer: Isolate the patient in a side room with contact precautions
MRSA-positive patients should be cohort nursed or isolated in a single room with contact precautions including gloves and aprons.
Question 2: During a ward round, a clinician accidentally needlestick-injures themselves while drawing blood from an HIV-positive patient. What is the FIRST immediate action?
- Start post-exposure prophylaxis within 1 hour
- Encourage bleeding by squeezing the wound and wash thoroughly with soap and water (Correct answer)
- Notify the occupational health department
- Test the clinician's baseline HIV status
Correct answer: Encourage bleeding by squeezing the wound and wash thoroughly with soap and water
The immediate first action is to encourage bleeding and wash the wound thoroughly with soap and water; PEP and reporting follow.
Question 3: Which of the following best describes the purpose of a 'ligature risk assessment' in psychiatric settings?
- To assess the risk of patients tying staff members
- To identify environmental anchor points that could be used for self-strangulation (Correct answer)
- To evaluate patients' risk of running away from the ward
- To document fire safety hazards
Correct answer: To identify environmental anchor points that could be used for self-strangulation
Ligature risk assessments identify environmental features (e.g., door hinges, curtain rails) that could be used as anchor points for self-harm by hanging.
Question 4: A community psychiatric nurse visits a patient at home and notices signs of domestic violence. Under what framework should the nurse act to safeguard the patient?
- Mental Health Act 1983
- Safeguarding Adults framework under the Care Act 2014 (Correct answer)
- Infection Control Act
- Public Health (Control of Disease) Act 1984
Correct answer: Safeguarding Adults framework under the Care Act 2014
Domestic violence concerns in adults at risk are addressed under the Safeguarding Adults framework established by the Care Act 2014.
Question 5: Clostridium difficile (C. diff) diarrhoea is suspected in a psychiatric inpatient who has recently completed a course of broad-spectrum antibiotics. Which infection control measure is UNIQUELY important for C. diff compared to standard precautions?
- Use of alcohol hand gel after patient contact
- Use of soap and water hand hygiene (not alcohol gel) (Correct answer)
- Wearing a full-body protective suit
- Negative pressure isolation room
Correct answer: Use of soap and water hand hygiene (not alcohol gel)
Alcohol-based gels do not kill C. diff spores; soap and water hand washing is mandatory for C. diff infection control.
Question 6: A patient with schizophrenia refuses a tuberculin skin test despite a history of possible TB exposure. Which legal provision is MOST relevant to managing this public health risk in England?
- Section 2 of the Mental Health Act 1983
- Public Health (Control of Disease) Act 1984 and Health Protection Regulations 2010 (Correct answer)
- Mental Capacity Act 2005 best interests decision
- Deprivation of Liberty Safeguards
Correct answer: Public Health (Control of Disease) Act 1984 and Health Protection Regulations 2010
The Public Health (Control of Disease) Act 1984, amended by the Health Protection Regulations 2010, allows compulsory examination and isolation for notifiable diseases including TB.
Question 7: Which of the following is the correct personal protective equipment (PPE) sequence when entering the room of a patient in contact isolation for a multidrug-resistant organism?
- Gloves → apron → mask → eye protection (Correct answer)
- Apron → gloves → mask → eye protection
- Mask → apron → gloves → eye protection
- Eye protection → mask → apron → gloves
Correct answer: Gloves → apron → mask → eye protection
The recommended donning sequence for contact isolation PPE is gloves first, then apron, then mask and eye protection if splash risk exists.
MRCPsych Safety and Infection Control 2
A psychiatric inpatient with known MRSA is prescribed oral antibiotics.
Which additional infection control measure is MOST important in an acute ward setting?