Deck 28: Safety

Question 1

A female 36-year-old bank executive was recently promoted to vice president.She and her husband have two school-age children.The patient is being seen at the clinic and reports severe abdominal pain with diarrhea.During the assessment,the patient explains to the health care worker that she and her family will be moving to another state because of her promotion.Her children are upset about leaving their friends.The health care worker recognizes that which of the following information is a priority for patient teaching?

A) Providing growth and development information about the school-age child
B) Recommending a gastroenterologist
C) Offering to call a moving company
D) Discussing how a high level of stress can cause illness

Answer 1

Discussing how a high level of stress can cause illness

Question 2

The nurse is concerned because a 77-year-old patient is weak after abdominal surgery.Which of the following should be done to ensure that one of the preventable conditions identified by the Centers for Medicare and Medicaid does not occur?

A) Use the "rights" of medication administration.
B) Provide frequent opportunities to use the bathroom.
C) Document thoroughly.
D) Complete discharge teaching as quickly as possible.

Answer 2

Provide frequent opportunities to use the bathroom.

Question 3

A registered nurse works in a small rural health clinic.During a routine well baby visit,a new mother questions the need to have her infant immunized.Which of the following is the best explanation for why it is recommended that her child receive immunizations?

A) "Immunization increases resistance to an infectious disease."
B) "It provides a small amount of a live, strong organism to protect against disease."
C) "Immunization will definitely keep your child well."
D) "It will provide active immunity by providing antibodies to your child."

Answer 3

"Immunization increases resistance to an infectious disease."

Question 4

In an outpatient surgery center,the preoperative nurse has the responsibility of starting IVs prior to the patients' surgeries.One of the surgeons who works at the center orders a different type of IV fluid than the rest of the surgeons.Which of the following should the nurse be most concerned about in this situation?

A) Procedure-related accident
B) Patient-inherent accident
C) Patient confusion from medications
D) Potential electrolyte imbalance

Question 5

A patient is confused and has been restrained to prevent injury.Which of the following is a priority as the nurse plans care for the shift?

A) Calling the physician for an order for a chemical restraint
B) Applying the most restrictive restraint to prevent injury
C) Removing the restraints on the patient at least every 2 hours
D) Checking on the restrained patient last

Question 6

A nursing student is undergoing a community health clinical rotation.One of the patients is a 53-year-old grandmother who has recently assumed custody of her daughter's two young children,ages 3 and 5 years old.Regarding the children's welfare,which of the following is most important for the nursing student to assess on this visit?

A) The patient's financial ability to care for two young children
B) The patient's knowledge of safety precautions for young children
C) The patient's emotional stability
D) The patient's feelings regarding taking on this responsibility

Question 7

The nurse identifies that one of the IV pumps has been malfunctioning and was placed outside a patient room until it could be repaired.To prevent an equipment-related accident from occurring,which action should the nurse take first?

A) Tag the pump and remove it from the area.
B) Initiate a work order on the pump.
C) Clean the pump and put it in the equipment closet.
D) Call the pump manufacturer.

Question 8

All hospital employees are concerned about the safety of patients in the hospital,especially regarding the transmission of pathogens.What is the most common means of transmission of pathogens in this environment?

A) Contaminated blood products
B) Enteric transmission
C) Insufficient hand hygiene
D) Aerosols

Question 9

A nurse is giving anticipatory guidance to the mother of a 10-month-old child.The nurse is focusing on providing a safe environment for the child.Which of the following is the best statement regarding childhood safety?

A) "The car seat should be placed in a forward-facing position."
B) "The majority of deaths in children between the ages of 1 and 3 years old are caused by contagious diseases."
C) "Injuries are a major cause of death during infancy, especially for children 6 to 12 months old."
D) "Measles causes more deaths in children younger than 5 years old than all other diseases combined."

Question 10

The registered nurse from the home health agency is performing an initial assessment on a 72-year-old patient who was released from a nursing home.The patient had been admitted to the nursing home for therapy after surgery for repair of a fractured left hip.During a survey of the home environment,which finding would cause the nurse to intervene?

A) Bedside lamp plugged into the wall outlet behind the bed
B) Handrail on one side of the stairs only
C) Throw rugs in the bedroom
D) No handrail near the toilet

Question 11

A patient who underwent surgery for a bowel obstruction yesterday has become confused and has made several attempts to climb out of bed.The nurse is considering options to prevent the patient from harm.Which of the following actions could be delegated to assistive nursing personnel working with the nurse?

A) Assessing the patient for appropriateness of restraints
B) Calling the physician for an order for a restraint alternative
C) Discussing the need for restraints with the patient's family
D) Applying restraints after orders received by the nurse

Question 12

Of the following,who is most at risk for accidental poisoning?

A) Supervised 16-month-old toddler eating dry cereal in the highchair
B) Unsupervised 2-month-old infant left near a closed bottle of prescription medication
C) Unsupervised 4-year-old child playing dress-up with mother's makeup
D) Supervised 6-year-old child playing with watercolor paints

Question 13

A student nurse has been asked by the registered nurse with whom the student nurse is working to apply wrist restraints to a patient who is confused and is trying to remove the endotracheal tube.The student nurse knows that it is important to tie the restraints to which part of the bed?

A) Side rails
B) Part of bed frame that moves up and down with the patient
C) Footboard
D) Headboard

Question 14

An 85-year-old retired man with arthritis has recently been prescribed a new medication by his health care provider for pain management.The health care provider identifies that the patient is currently taking 13 different medications on a daily basis.The health care provider is concerned about the patient's safety in the home.Which of the following is most important to assess?

A) Marital status
B) Potential for falls
C) Skin breakdown
D) Cultural beliefs

Question 15

A 16-year-old patient is being seen in the emergency department (ED)after being involved in a minor motor vehicle accident.The guardian has voiced that the patient has been spending more time in his or her room,has difficulties getting along with friends,and has declining grades over the past 3 months.The patient seems distant and angry all the time.Which of the following topics is most important for the nurse to discuss with the guardian?

A) Accident prevention measures
B) Enrolling the patient in a defensive driving course
C) The possibility of substance abuse
D) The importance of automobile insurance

Question 16

The parent of a 13-year-old boy is concerned because the teenager wants to hang out with friends all the time and has stated that he wants to get his ear pierced because all his friends have piercings.What is the best response from the nurse?

A) "I think you need to seek counseling for your son."
B) "I think this is just a phase that will quickly pass."
C) "Your son needs to find new friends."
D) "Your son's behavior is normal; he is trying to assert his independence."

Question 17

A nursing student is volunteering with a local agency to help prepare the community for a potential bioterrorist attack.On which of the following threats would be the nursing student's primary focus?

A) Hurricane
B) Earthquake
C) Anthrax
D) Tornado

Question 18

A 5-year-old child was admitted to the pediatric unit of the hospital with the diagnosis of fever of unknown origin.Currently the patient's temperature is 105° F.Which of the following is the best way to prevent a patient-inherent accident from occurring?

A) Keep all electric receptacles covered in the patient's room.
B) Clean up patient spills as they occur.
C) Pad all bed side rails.
D) Do not allow the child in the playroom.

Question 19

The patient has recently moved into a newly renovated home in the inner city.The patient is being seen in the clinic for complaints of ongoing headaches,nausea,dizziness and fatigue.The symptoms started shortly after moving into the new home.As the nurse gathers information,which of the following questions would be most appropriate to ask the patient?

A) "Have you changed the battery in your smoke alarm recently?"
B) "Have you changed your diet since moving?"
C) "What type of furnace do you have?"
D) "When was the last time your house was painted?"

Question 20

A 75-year-old patient in an acute care hospital who underwent surgery for an abdominal aneurysm developed a urinary tract infection 3 days after placement of a Foley catheter.The nurse believes that this is a reportable incident,and which of the following will happen as a result?

A) Medicare will be denied to the patient.
B) Medicare will take the hospital to court.
C) Nothing; it is not a reportable incident.
D) Medicare will not reimburse the hospital for this infection.

Question 21

A pediatric nurse is assessing a patient for a routine physical.The nurse identifies that the parents need additional safety teaching when the parents mentions which of the following?

A) A 2-year-old child can safely sit in the front seat of a car.
B) Teenagers need to practice safe sex.
C) Children need to wear a helmet and safety pads when in-line skating.
D) Children need to learn to swim even if parents do not have a swimming pool.

Question 22

A patient has just undergone an abdominal aortic aneurysm repair.The patient is pulling at the Foley catheter,nasogastric tube,central line,and abdominal dressing and a wrist restraint is applied after an order is received.Later,the patient reports tingling and numbness in the fingers and hand.Which actions should the nurse take? (Select all that apply.)

A) Remove the restraint immediately.
B) Remind the patient this will decrease with time.
C) Notify the health care provider.
D) Medicate the patient for pain.
E) Stay with the patient.

Question 23

A toddler is ready to be discharged home after outpatient surgery.When conducting a home safety assessment the child's guardian states,"I keep the cleaning supplies under the sink for easy access,and how soon can the child resume swimming in the local pond?" Based on this statement,what is the most important safety issue for the nurse to identify?

A) Standing water in the neighborhood
B) Reasons for outbursts in behavior
C) Storage of cleaning supplies in the house
D) Child's use of safety equipment when riding or skating

Question 24

A nurse is working in a health facility that creates a culture of safety.Which behavior will the nurse use in this type of facility?

A) Find blame when problems occur.
B) Reprimand co-workers when a mistake is made.
C) Maximize adverse events.
D) Focus on performance improvement efforts.

Question 25

A health care provider orders that a confused and disoriented patient be placed in a full hand restraint because of excessive scratching of skin.The nurse acknowledges which of the following?

A) Restraints are used on an as-needed basis.
B) No orders or patient consents are needed.
C) Restraints must be removed every 2 hours to allow for skin assessment, toileting, and nutrition.
D) An order for restraints may be used indefinitely until the patient no longer needs to be restrained.

Question 26

A patient in the intensive care unit requires mechanical ventilation,a wound VAC system,patient-controlled analgesia,and an intravenous infusion device.Which safety precaution should the nurse implement in the health care setting?

A) Using two-pronged plugs
B) Never operating equipment without previous instruction
C) Using an extension cord to accommodate plugs for all the equipment
D) Never using equipment without having another nurse assist

Question 27

A fire erupts in a hospital waste receptacle in the hallway.What is the nurse's first response?

A) Report the fire.
B) Attempt to extinguish the fire.
C) Assist any patients to a safe area.
D) Close the door to contain the fire.

Question 28

A nurse working on the medical unit mistakenly administers the wrong medication to a patient.This type of error would be classified as which of the following?

A) Poisoning accident
B) Equipment-related accident
C) Procedure-related accident
D) Accident related to time management

Question 29

A confused patient was found wandering in the hallways several times during the shift.What is the most appropriate nursing intervention to prevent a fall by this patient?

A) Reassigning the patient to a room closer to the nursing station
B) Using an electronic monitor that sounds an alarm when the patient reaches a near-vertical position
C) Raising two or four side rails
D) Placing wrist restraint on the patient during the nighttime hours of sleep

Question 30

A group of teenagers are attending a preparation class for babysitters.Which statements by the teenagers indicate a correct understanding of the teaching about safety issues? (Select all that apply.)

A) "Home fires are a major cause of death and injury."
B) "Bacterial food contamination cannot be controlled."
C) "There should be working batteries in the smoke detector."
D) "Temperature changes do not affect the child's safety."
E) "Toddlers are very curious and like to put objects in their mouths."