NMC OSCE Infection Prevention and Control — Questions and Answers
Question 1: According to WHO guidelines, what are the 5 moments for hand hygiene?
- Before touching a patient, before a clean/aseptic procedure, after body fluid exposure, after touching a patient, after touching patient surroundings (Correct answer)
- Before and after each shift only
- Before meals and after using the toilet
- Before touching a patient and after touching a patient only
Correct answer: Before touching a patient, before a clean/aseptic procedure, after body fluid exposure, after touching a patient, after touching patient surroundings
The WHO 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. These moments capture all situations where hand hygiene prevents transmission of healthcare-associated infections.
Question 2: A patient has been diagnosed with Clostridioides difficile infection. What specific hand hygiene method must be used and why?
- Soap and water handwashing, because alcohol gel does not kill C. difficile spores (Correct answer)
- Alcohol hand gel is sufficient
- No special hand hygiene is needed beyond standard precautions
- Surgical scrubbing with iodine solution
Correct answer: Soap and water handwashing, because alcohol gel does not kill C. difficile spores
C. difficile produces spores that are resistant to alcohol-based hand rubs. Effective decontamination requires physical removal of spores through handwashing with soap and water for at least 15-20 seconds. This is a critical infection control measure — using alcohol gel alone will not remove spores and allows ongoing transmission.
Question 3: What is the correct order for donning (putting on) personal protective equipment when preparing to enter a patient room requiring full contact precautions?
- Gown/apron first, then mask/respirator, then eye protection, then gloves last (Correct answer)
- Gloves first, then gown, then mask
- Mask first, then gloves, then gown
- Any order is acceptable
Correct answer: Gown/apron first, then mask/respirator, then eye protection, then gloves last
The correct donning sequence is: (1) gown/apron, (2) mask or respirator, (3) eye protection/face shield, (4) gloves last (so they cover the gown cuffs). This sequence ensures all areas are covered and minimises self-contamination. The doffing (removal) sequence is the reverse, with gloves removed first as they are the most contaminated.
Question 4: What type of isolation precautions are required for a patient with suspected pulmonary tuberculosis?
- Airborne precautions in a negative-pressure single room with FFP3 respirator masks for staff (Correct answer)
- Standard precautions only
- Contact precautions with apron and gloves
- Droplet precautions with a surgical mask
Correct answer: Airborne precautions in a negative-pressure single room with FFP3 respirator masks for staff
Pulmonary TB is transmitted via airborne nuclei (<5 micrometres) that remain suspended in air for prolonged periods. Patients require a single room with negative pressure ventilation. Staff must wear FFP3 respirator masks (not standard surgical masks). Visitors should be limited, and the door must remain closed. These precautions continue until the patient is non-infectious.
Question 5: When performing an aseptic non-touch technique (ANTT) for a wound dressing, what is the key principle?
- Identify and protect key parts (parts that if contaminated cause infection) and key sites (wounds, insertion sites) by ensuring they are not touched or contaminated (Correct answer)
- Wear sterile gloves for all wound dressings regardless of wound type
- Work as quickly as possible to reduce air exposure time
- Use the largest possible sterile field for all procedures
Correct answer: Identify and protect key parts (parts that if contaminated cause infection) and key sites (wounds, insertion sites) by ensuring they are not touched or contaminated
ANTT is based on identifying key parts (parts of equipment that come into contact with the patient's key site or connect with key parts of other equipment) and key sites (wounds, device insertion sites). The fundamental principle is that key parts and key sites must not be touched or exposed to contamination. This applies to both surgical-ANTT (complex procedures) and standard-ANTT (simpler procedures).
Question 6: A sharps injury occurs when a nurse accidentally pricks their finger with a used insulin needle. What are the immediate first aid actions?
- Encourage bleeding by gently squeezing (do not suck), wash under running water with soap, apply a waterproof dressing, and report immediately via occupational health/A&E (Correct answer)
- Apply a tourniquet above the injury
- Suck the wound to remove blood
- Apply antiseptic cream and continue working
Correct answer: Encourage bleeding by gently squeezing (do not suck), wash under running water with soap, apply a waterproof dressing, and report immediately via occupational health/A&E
Immediate first aid for sharps injuries: encourage the wound to bleed freely (gentle squeezing, never suck the wound), wash thoroughly under running water with soap, dry and apply a waterproof dressing. Report immediately to the line manager and occupational health department. A risk assessment for blood-borne viruses (HIV, hepatitis B, hepatitis C) must be performed, and PEP may be required within 1 hour for HIV risk.
NMC OSCE Infection Prevention and Control
According to WHO guidelines, what are the 5 moments for hand hygiene?