NMC OSCE Infection Prevention & Control 1 — Questions and Answers
Question 1: What are the five moments for hand hygiene according to the WHO?
- Before patient contact, after patient contact, before a procedure, after a procedure, after touching the patient's environment (Correct answer)
- Before entering the ward, after using the toilet, before meals, after patient contact, after removing gloves
- Before contact, after contact, before meals, after toileting, after removing PPE
- Before and after every clinical procedure only
Correct answer: Before patient contact, after patient contact, before a procedure, after a procedure, after touching the patient's environment
The WHO Five Moments for Hand Hygiene are: (1) before patient contact, (2) before a clean/aseptic procedure, (3) after body fluid exposure risk, (4) after patient contact, and (5) after contact with patient surroundings. These moments form the framework for hand hygiene compliance.
Question 2: Which hand hygiene method is most effective against Clostridioides difficile (C. diff) spores?
- Alcohol-based hand rub
- Soap and water handwashing (Correct answer)
- Chlorhexidine hand wipes
- Either soap or alcohol — both equally effective
Correct answer: Soap and water handwashing
Alcohol-based hand rubs are ineffective against C. difficile spores. Soap and water handwashing physically removes the spores from hands. For this reason, soap and water must be used when caring for patients with confirmed or suspected C. diff infection.
Question 3: Standard precautions apply to which patients?
- Only patients with known infectious disease
- Only immunocompromised patients
- All patients at all times regardless of diagnosis (Correct answer)
- Only patients in isolation rooms
Correct answer: All patients at all times regardless of diagnosis
Standard precautions (formerly universal precautions) apply to all patients, all the time, regardless of known infection status. This approach assumes all blood, body fluids, secretions, and non-intact skin may be infectious.
Question 4: A patient is diagnosed with pulmonary tuberculosis. What type of isolation is required?
- Contact precautions in a side room
- Droplet precautions only
- Airborne precautions in a negative pressure room (Correct answer)
- No isolation required if on treatment for more than 48 hours
Correct answer: Airborne precautions in a negative pressure room
Active pulmonary tuberculosis requires airborne precautions because M. tuberculosis is transmitted via droplet nuclei that remain suspended in air. A negative pressure room prevents the pathogen from escaping into the general ward environment.
Question 5: What is the correct order for donning (putting on) PPE before entering an isolation room?
- Gloves, apron, mask, eye protection
- Apron, mask, eye protection, gloves (Correct answer)
- Mask, eye protection, apron, gloves
- Eye protection, apron, mask, gloves
Correct answer: Apron, mask, eye protection, gloves
The correct donning sequence is: apron/gown first, then mask/respirator, then eye protection/face shield, then gloves. Gloves are last as they protect against hand contamination during other PPE donning steps.
Question 6: What is the minimum time recommended for hand hygiene using the WHO six-step technique with soap and water?
- 10–15 seconds
- 20–30 seconds
- 40–60 seconds (Correct answer)
- 90 seconds
Correct answer: 40–60 seconds
The WHO recommends that hand hygiene using soap and water using the six-step technique takes 40–60 seconds, including wetting, application of soap, rubbing (six steps), rinsing, and drying. Alcohol hand rub takes 20–30 seconds.
NMC OSCE Infection Prevention & Control 1
What are the five moments for hand hygiene according to the WHO?