Chapter 27: Safety, Security, and Emergency Preparedness

Which topics should be included in an education plan for preventing falls in the home? (select all that apply) A. use a nightlight B. avoid climbing a chair or table to reach items that are high C. consider the use of an electronic personal alarm D. consider the use of a raised toilet seat E. keep electrical and phone cords against the wall and out of walkways F. remove clutter from walkways

A, B, E, and F

A nurse is assessing the following children. Which child would the nurse identify as having the greatest risk for choking and suffocating? A. a toddler playing with his older brothers construction set B. a 4 year old eating yogurt for lunch C. an infant covered with a small blanket in the crib D. a 3 year old drinking a glass of juice

A.

A nurse responds to the call bell and finds another nurse evacuating a client from the room, which has caught fire. Which action should the nurse take? A. pull the fire alarm lever B. contain the fire C. evacuate the unit D. extinguish the fire

A.

Which statement should the nurse include in the teaching plan for a family learning about fire safety? A. most people who die in home fires die from inhalation and not burns B. cigarette smoking is no longer a major cause of home fires because most people smoke outside C. electronic heaters are safer and do not usually increase the risk of fire in the home D. most fires occur outside of the home when grilling or camping

A.

A nurse is preparing to file a safety event report after a client experienced a fall. Which statement is correct regarding the filing of a safety event report? A. the nurse should record the incident in the patients medical record and fill out a safety report separately B. the nurse should make a copy of the event repot and place it in the clients medical record C. the nurse should await the results of the X-ray before filing the report D. the nurse should include a note on the clients chart that mentions the report

A. Rationale: the safety report would be completed immediately after an unintentional injury and should be recorded in the medical record, the safety event repot is not a part of the medical record and should not be mentioned

A 17 year old is brought to the ER with a head injury. The nurse knows that adolescents are vulnerable to injuries related to: A. automobile accidents B. falls from beds C. play-related injuries D. falls from staircases

A. auto accidents

A home care nurse provides health education to parents regarding the care of their toddler. Which of the following precautions should the nurse suggest the parents take to protect the toddler from drowning? A. avoid unattended baths for the toddler B. allow the child to swim with friends C. instruct the child not to go near the pool D. monitor activities of the toddler

A. avoid unattended baths

A school nurse is providing info to older adults during fire prevention week. Which statement is correct regarding fires in the home? A. most people who die, die of smoke inhalation rather than burns B. about 10% of house fire deaths occur in a home without a smoke detector C. most home fires are caused by kids playing with matches D. most fatal home fires occur while people are cooking

A. most die of smoke inhalation rather than boring

A nurse finds that a fire has broken out in a clients room at the healthcare facility. Which of the following interventions is of the highest priority? A. rescue the client B. confine the fire C. raise the alarm D. extinguish the fire

A. rescue the client

The nurse caring for patients in a long term care facility knows that there are factors that place certain patients at a higher risk for falls. Which patient would the nurse consider to be in this category? (select all that apply) A. a pt who is older than 50 B. a pt who has already fallen twice C. a pt who is taking antibiotics D. a pt who experiences postural hypotension E. a pt who is experiencing nausea from chemotherapy F. a 70 year old pt who is transferred to long term care

B, D, and F

A nurse is making a home visit for. a client living in a high-crime area and observes the apartment doesn't have outside lighting. The nurse understands this is an important assessment for which reason? A. nurses in home healthcare are not concerned with safety B. assessment includes risk factors in the home including individual risk and unsafe environment C. although important, this assessment is irrelevant to care D. this assessment findings with make the client less able to go to social gatherings

B.

A nurse is preparing discharge education for a client with a newborn baby. What is the highest priority item that must be included in the education plan? A. give warm bottles of formula to the baby B. restrain the baby in a car seat C. keep all pots and pans in lower cabinets D. lock all cabinets containing cleaning supplies

B.

The Joint Commission issues guidelines regarding the use of restraints. In which case is a restraint properly used? A. the nurse positions a patient in a supine position before applying restraints B. the nurse ensures that two fingers can be inserted between the restraint and the patient's ankle C. the nurse applies a cloth restraint to the left hand of a patient with an IV catheter in the right wrist D. the nurse ties an elbow restraint to the raised side rail of a patients bed

B.

A nurse is caring for older adult clients. Which is the most important safety issue in older clients? A. electrical injury B. accidental falls C. poisoning D. drowning

B. accidental falls

A child is learning to ride a bicycle. He should be instructed to use a(an) A. knee pads B. helmet C. light D. wrist guard

B. helmet Rationale: the helmet is the most important safety because it protects the childs head

During a course on terrorism, a group of ER nurses learns about terrorists who use bombs or other explosives to inflict injury on numerous people and cause multiple fatalities. This is an example of: A. bioterrorism B. mass trauma terrorism C. chemical terrorism D. nuclear terrorism

B. mass trauma terrorism

A nurse smells smoke and subsequently discovers a fire in a garbage can in a common area on the hospital unit. What is the nurse's priority action in this situation? A. attempt to extinguish the fire B. rescue anyone who is in immediate danger C. evaluate the clients and staff D. activate the fire alarm on the unit

B. rescue anyone in immediate danger Rationale: RACE; rescue is the first response

A nurse is caring for a client who is receiving an intravenous therapy through an IV pump. Which intervention should the nurse implement to ensure electrical safety? A. tape the electrical cord of the pump to the floor B. use an extension cord to provide freedom of movement C. obtain a 3 prong grounded plug adapter D. run an electrical cord of the pump under the carpet

C.

A school nurse is aware of poisoning risks in the adolescent population. Poisoning in this age group is mostly caused by: A. exposure to toxic fumes in the home B. malfunction of carbon monoxide monitor in the home C. experimentation with drugs and inhalants D. ingestion of substances in the home that contain lead

C.

What is the rationale for health care personnel to orient clients to rooms and equipment when they are admitted to the hospital? A. it is hospital policy B. it allows time for the health care provider to write admission orders C. orientating clients to the surroundings decreases the potential for injury D. it is part of the routine and is included on the admission checklist

C.

What generalization can be made about safety in client care? A. although safety is a basic human need, it is provided by self-care B. health care providers exclude safety as a client need C. safety is a paramount concern underlying all nursing care D. safety is an important need, but not as important as self-actualization

C. Rationale: safety and security are more important than all other needs except for the basic needs like air and water and food

In the acronym RACE, the A stands for; A. answer the phone calls and call lights B. alert the fire department C. activate the fire alarm and notify the appropriate person D. attempt to extinguish the fire

C. Rationale: RACE is rescue, alarm, contain, and extinguish

A nurse is educating the family caregiver of an older adult client about measures to promote client safety in the home. What would be most appropriate to include? A. avoid the use of nightlights in the bedroom B. keep all medications in the clients reach C. clear the clutter from stariways and walkways D. get the client immunized against whooping cough

C. clear the clutter in walkways

Health care worker may be exposed to a common occupational injury such as: A. intimate parter violence B. sensory deprivation C. inadvertent needle-stick D. carbon monoxide exposure

C. inadvertent needle-stick

A client in a long-term care facility has become increasingly unsteady. The nurses are worried that the client will climb out of bed and fall. Which of the following measures would be a high priority recommendation for this client? A. raising all of the side rails on the bed B. using restraints on the client to prevent a fall C. providing a bed that is elevated from the floor D. placing the client in a bed with a bed alarm

D.

A nurse is providing instructions to the mother of a toddler regarding prevention of burn injuries. Which instruction is the priority to provide to the mother? A. instruct the toddler about consequences of burns B. teach the toddler about fire safety C. cool hot liquids before giving them to the child D. keep coffee cups on the counter above the child's reach

D.

A team of inner city school nurses attends a community conference on child safety during the summer months. Which of the following would be the priority health outcome that these nurses would expect to achieve in summer school? A. the students will read 400 pages from the summer book list B. the students will sign up for fall after-school programs C. the students will only swim in the pool when it hasn't rained for 2 days D. the students will demonstrate proper use of safety equipment when playing sports

D.

The nurse is teaching the parents of a teenager about safety. Which teaching will the nurse include? A. keep away from bodies of water B. climbing can increase the risk of injury C. household cleaners should be placed out of reach D. be alert for signs of peer pressure

D.

An older resident who is disoriented likes to wander the halls of his long-term care facility. Which action would be most appropriate for the nurse to use as an alternative to restraints? A. Sitting him in a geriatric chair near the nurses' station B. Using the sheets to secure him snugly in his bed C. Keeping the bed in the high position D. Identifying his door with his picture and a balloon

D. Rationale: this allows the patient to wander around and be aware which room is his when he wants to go back

Which topic should a public health nurse emphasize when educating older adults on reducing their risk of poisoning? A. alternatives to chemical based cleaning supplies B. hidden source of lead in household environment C. avoiding the use of alternative and complementary therapies D. keeping medications in clearly labeled containers

D. Rationale: medication overdose are the more common sources of poisoning in older adults and can be reduced by ensuring medication stays properly labeled

An older adult client is planning to move with her son and daughter-in-law into a bigger apartment. The son asks the nurse for some tips to keep his mother safe. What would the nurse most likely include? A. keep the home green by planting tomato greens B. place household cleaners on open shelves C. keep all medicines in easily accessible shelves D. put a small night light in the hall and stair

D. Rationale: the elderly are at a high risk for falls so having a light can help them see better at night

The nurse is caring for an adult client on prescribed bed rest who repeatedly attempts to get out of bed, despite instructions to remain there. Which initial prevention is appropriate? A. contact the physician for an order to apply waist restraint B. administer a prescribed dose of lorazepam C. raise the side rails D. assess for the need to urinate

D. Rationale: the nurse should assess before considering any other type of restraint

A nurse working in a pediatrician's office receives calls from parents whose children have ingested toxins. What would be the nurses best response? A. administer activated charcoal in tablet from and take the child to the ED B. administer syrup of ipecac and take the child to the ED C. bring the child into the primary care provider for gastric lavage D. call the PCC immediately before attempting any home remedy

D. call the poison control center immediately

A nurse orients an older patient to the safety features in her hospital room. What is a priority component of this admission routine? a. Explain how to use the telephone. b. Introduce the patient to her roommate. c. Review the hospital policy on visiting hours. d. Explain how to operate the call bell.

D. explain how to operate the call bell Rationale: knowing how to use the call bell is a safety priority. none of the other answer choices are

Based on the statistics for the leading cause of hospital admission for trauma in older adults, what would be the nurse's priority intervention to prevent trauma when caring for older patients in a nursing home? A. checking to make sure fire alarms are working properly B. preventing exposure to temperature extremes C. screening for partner elder abuse D. making sure patient rooms are decluttered

D. making sure the rooms are decluttered Rationale: the elderly are at the greatest risk for injury due to falls so keeping the patients room clean would be helpful in preventing trauma to the elderly

Evaluation of effectiveness

debris and evaluate what we did right and wrong, and explore and work through different emotions; always promote environmental safety, prevent injury, and promote emergency preparedness

Safety from danger, harm, or risk

developmental considerations (infants put things in their mouths), lifestyle (job can be dangerous), environment (cities are at risk for pollution), mobility, sensory perception (hearing and seeing), knowledge, ability to communicate, and physical and psychosocial health

Emergency management

evacuation plans, know what to do in case of a fire or other emergency, and biologic agents of concern

Specific risk factor assessments

falls (leaf on the door means pt is a high fall risk), fires (extinguisher- PASS- pull, aim, swish, and sweep), poisoning (prevention of poisoning is KEY), and suffocation and choking

Factors that contribute to falls

lower body weakness, poor vision, gait and/or balance issues, problems with feet or shoes, use of psychoactive medications (meds that affect the CNS), postural drowsiness (when standing BP and HR drop), and hazards in the home and community

Restraints

physical devices used to limit a patient's movement, chemical restraints are drugs that control behavior and aren't used in normal medication regimens, side rails are not appropriate restraints

RACE (in a fire)

rescue (rescue anyone you can), alarm (sound a fire alarm), confine (confine the fire if possible), and extinguish (try and put out the fire if you can)

What are the two components of a safety assessment?

the nursing history and the physical assessment; we focus on the individual, the environment, and specific risk factors to the patient