Ch. 19 - Safety

An anxious son asks the nurse how he can keep his older adult father safe in his home. He tells the nurse that his father lives alone, has chronic illnesses, and also has sensory-perceptual alterations. What is the best statement by the nurse?

"A good idea is to get a weekly medicine tray at the pharmacy. This will keep him from missing medication doses or taking the wrong pill by accident."

A large health care organization has committed to promoting a just culture when adverse events and near misses take place. Which question will guide the organization's response when a nurse commits an error?

"How did the nurse's actions contribute to this error?"

Which item would alert the home care nurse to a safety hazard threatening a young child?

Dangling blind cords

The clinical nurse educator at a long-term care facility is responsible for organizing and carrying out staff education sessions. Which topic for staff education is most likely to benefit the greatest number of residents?

Educating nurses on how to prevent falls

A nurse finds that a fire has broken out in a client's room at the health care facility. Place the steps the nurse should take in the correct sequence, from first to last. (4)

Evacuate the client. Raise an alarm. Confine the fire. Extinguish the fire.

A client has presented to the emergency department after splashing a chemical in the eyes. When managing the injury, what should be included in the plan of care?

Flush eyes with water for 10 minutes

The nurse is providing discharge teaching to the family of an older adult client. Which teaching will the nurse include to decrease the risk for electric shock?

Refrain from using extension cords.

The nurse is working at a local elementary school. A mother arrives to pick up her 6-year-old son and has her 2-year-old daughter in tow. Based on the nurse's developmental knowledge of toddlers, which behavior would most concern the nurse?

The 2-year-old leaning against the screen of a window in a classroom.

The nurse is on a radiologic emergency response team. There was a limited nuclear accident at a nearby laboratory. Employees at the laboratory who were exposed to the radiation are being transported to the hospital. What nursing actions would protect the clients and nurse? (4)

Wear a radiation detection device. Don gear that would protect the nurse from radiation exposure. Ask the client how long he or she was exposed to radiation. Determine the client's distance from the radiation source at the time of exposure.

A staff development nurse is providing an in-service to a group of nurses on the use of restraints in health care facilities. What is an example of a chemical restraint?

a dose of an antipsychotic

The nurse is caring for a client who has been repetitively pulled at IV lines and the urinary catheter. After other methods of diverting the client's behaviors fail, the healthcare provider orders chemical restraints. Which treatment does the nurse anticipate?

administration of an antipsychotic agent to alter the client's behavior

The nurse recognizes that assessment for sensory-perceptual alterations is a priority for which client?

an 84-year-old male with four recent driving violations

he nurse is reviewing a healthcare provider's orders in the electronic health record (EHR) and notices several abbreviations. What is the appropriate nursing action?

contact healthcare provider to clarify order

The nurse is preparing to administer medication to a client. Which validation of client information is appropriate?

full name and date of birth

A nurse finds a client in his room asphyxiated with carbon monoxide (CO) inhalation. Which activity should be the priority for the nurse?

get the victim out of the present environment

The nurse is conducting a home care visit for a new mother who delivered a baby 3 days ago. Which finding within the home requires immediate nursing intervention?

hot water heater thermostat set at 130 degrees F

A fire has erupted in the trash can on the unit and the nurse implements the protocol for fire safety for the facility. Another nurse obtains the fire extinguisher and is preparing to use it. What would the nurse do first?

pull the pin

True or False? The goal of evidence-based practice related to restraints is to avoid the use of restraints.

true

The school nurse is educating 7th grade children about safety. Which recommendation is most appropriate for this age group?

use protective sporting equipment

A group of girls is camping in the woods with camp counselors. They should be instructed to:

use the buddy system

Owen is a 15-year-old client who is waking up postoperatively. He became combative and tried to strangle one of the nurses. A support team was called and 4-point restraints were applied in this emergent situation. How soon does a licensed provider need to assess the client and place the restraint order?

1 hour

The nurse is caring for a client with a latex allergy. When ordering lunch for the client, which food does the nurse cross off of the menu that should not be consumed?

1 medium banana

An acronym RACE is commonly taught as a means for remembering priorities for action during a fire. The "A" in this acronym stands for which of the following?

Activate the fire alarm and notify the appropriate person.

A school nurse is providing information to a group of older adults during Fire Prevention Week. Which statement is correct regarding fires in the home?

Most people who die in house fires die of smoke inhalation, rather than burns.

What generalization can be made about safety in client care?

Safety is a paramount concern underlying all nursing care

A client who is enrolled in Medicare and who has been recovering in the hospital from a stroke has developed a pressure ulcer on his coccyx, an event that the Centers for Medicare & Medicaid Services (CMS) has identified as a "never event." The nurse should recognize what implication of this CMS designation?

The hospital must bear any costs incurred for treating the client's ulcer.

A nurse is completing an intake assessment. The nurse notes that an older adult male client appears to have bruises in varying stages of healing. Which action by the nurse indicates an understanding of her responsibilities?

The nurse should question the client about the source of the bruises.

The nurse is teaching a nursing student about proper latex glove use. Which teaching will the nurse include?

Wash hands thoroughly after removing gloves with a pH balanced soap.

The nurse instructs the family of an older adult client with a visual impairment and decreased mobility that the most common problem for these clients is related to:

falls

When educating families on fire safety, it is important to:

have a meeting place outside the home.

When educating parents of preschoolers, what is most important for the nurse to include in the presentation?

keep chemicals in a locked cabinet

Which reason best explains why adolescents behave in an unsafe manner despite knowledge of a particular activity's risk?

social pressure

The nurse is teaching the caregiver of a 1-year old about safety. Which teaching will the nurse include?

supervise your child on the changing table

Which level of health care provider may make the decision to apply physical restraints to a client?

nurse practitioner

Which agent has the potential to affect the integrity of latex gloves?

oil-based lotions

The nurse educator has just completed a lecture regarding older adults and hazards in the home. The nurse educator recognizes that the education was effective when the students state that common dangers in the home setting of an older adult include:

polypharmacy and use of multiple extension cords.

There is a fire in the neurology unit of a health care facility. What would be most appropriate to avoid in this situation?

use of elevators

The poison control nurse receives a call from the parent of a 2-year-old child. The parent states, "I just took a quick shower, and when I finished, I walked into the kitchen and found my child with an open bottle of household cleaner." What is the poison control nurse's appropriate response?

"Is your child breathing at this time?"

One of the leading causes of death in the United States, particularly in southwestern states, is drowning. How can the nurse assist in lowering this statistic?

Implement drowning-prevention strategies.

The community health nurse is talking with four clients. Who does the nurse identify that would most benefit from teaching about alcohol and drug abuse?

19-year-old male college student majoring in physics

A nurse is assessing fire safety in a home in which a single mother and young children live. What information would the nurse include in teaching the mother on how to prevent injury from fires and burns? (4)

Cook on back burners on the stove, and keep handles turned toward the back. Practice with the children what to do if there is a fire in the home. Set the temperature of the water heater to 120°F (49°C) or less. Teach your children to stop, drop, and roll if clothing catches on fire.

The nurses on a critical care unit can utilize the safety strategy of redundancy by:

having two nurses independently check the dosage of high-risk medications.

A nurse was injured when a client with Alzheimer's disease struck the nurse on the side of the head during a transfer. The nurse has completed an incident report. Which statement about an incident report is most accurate?

The report provides a detailed and objective account of the circumstances before, during, and after the event.

A caregiver of a toddler has called the poison control nurse to report that the child licked a small amount of petroleum jelly. The caregiver states that the toddler is sitting on the floor, watching a cartoon, and playing with a toy. Which information will the poison control nurse provide?

dilute with water or milk

A school nurse is aware of poisoning risks in the adolescent population. Poisoning in this age group is most often related to:

experimentation with drugs and inhalants

Which topic should a public health nurse emphasize when educating older adults on reducing their risk of poisoning?

keeping medications in clearly labeled containers

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?

put a small nightlight in the hall and stair

Over the past few weeks, 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 measure does not comply with a least restraint policy?

raising all side rails while the client is in bed

The nurse has received a medication order over the telephone from a provider. What is the next appropriate nursing action?

repeat or read back the order

The nurse is admitting a client to a medical-surgical unit who states, "If someone brings balloons to me, I might have trouble breathing." What is the appropriate nursing action?

replace common healthcare items with latex-free equipment

A nurse is caring for a stable toddler diagnosed with accidental poisoning due to the ingestion of medication. Which measure would be most effective at protecting a toddler from accidental poisoning with medication?

request childproof caps on all prescription medications

A nurse is caring for an 18 month-old boy status post a tracheostomy. He is recovering well and wanting to be more active. The nurse selects a toy from the playroom for him to play with. Which toy is most developmentally appropriate?

rocking horse

An 18-year-old boy is brought to the emergency department with a head injury. The nurse knows that adolescents are vulnerable to injuries related to:

sports-related activities

The nurse is reading another nurse's notes that were recorded in the electronic health record (EHR) during the previous shift. What is the appropriate nursing action when numerous unapproved abbreviations are noticed in the previous nurse's notes?

suggest to the nurse manager that are in-service on abbreviation use would be helpful

The staff at a day-surgery clinic are meeting because there have been two significant medication errors committed over the past few weeks. In order to prevent future medication errors, what is the priority action for the nurse's to take?

take measures to ensure that nurses are not disturbed when obtaining and administering medicaitons

A male client with early-stage Alzheimer disease is being discharged home after a hospital admission and his wife will be his sole caregiver. What action should the nurse encourage the wife to take in order to reduce her husband's risk of experiencing a fall in the home?

teach the wife to remove loose rugs from the floors in the home

The nurse is caring for a client who has been repetitively pulled at IV lines and the urinary catheter. After other methods of diverting the client's behaviors fail to prevent this behavior, and chemical restraints fail, which treatment does the nurse anticipate will be ordered?

temporary application of devices that reduce the client's ability to move arms