CH 27: Safety, Security, and Emergency Preparedness
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 9-year-old brother's construction set B) A 4-year-old eating yogurt for lunch C) An infant covered with a small blanket and asleep in the crib D) A 3-year-old drinking a glass of juice
a
A nurse is conducting a prenatal class for expectant parents. What is one topic that should be addressed to promote safety in the developing fetus? A) alcohol consumption and smoking B) infant hygiene and feeding C) the stages of labor with possible complications D) the role of the father in proper prenatal care
a
A nurse is teaching parents in a parenting class about the use of car seats and restraints for infants and children. Which information is accurate and should be included in the teaching plan? A) Booster seats should be used for children until they are 4′9″ tall and weigh between 80 and 100 lb. B) Most U.S. states mandate the use of infant car seats and carriers when transporting a child in a motor vehicle. C) Infants and toddlers up to 2 years of age (or up to the maximum height and weight for the seat) should be in a front-facing safety seat. D) Children older than 6 years may be restrained using a car seat belt in the back seat.
a
A patient arrives at the Emergency Department with nausea, hematemesis, fever, abdominal pain, and severe diarrhea. There is a suspicion the patient has been exposed to the anthrax bacillus. What category of medications will be administered? A) antimicrobials B) narcotics C) antihistamines D) antacids
a
A patient with type 1 diabetes has impaired sensation in her lower extremities. What teaching would be necessary to reduce her risk of injury? A) Always test the temperature of bath water before stepping in. B) Take your insulin twice a day as we have discussed. C) Remember to follow your diet so you lose weight this month. D) Rub lotion on the skin of your legs and feet twice a day.
a
An elderly woman in a long-term care facility has fallen and sustained several injuries. Which of her injuries would be the most serious fall-related injury? A) fractured hip B) fractured ulna C) lacerated lip D) thigh contusion
a
The nurse is following the Joint Commissions national patient safety goals when giving medications. Based on these goals, how can the nurse improve the accuracy of patient identification? A) Use two patient identifiers (neither to be the room number). B) Use two patient identifiers (one may be the room number). C) Check the patients armband three times. D) Say to the patient are you Mrs. Jones?
a
What age group is most vulnerable to toxic fumes or asphyxiation? A) young children B) adolescents C) young adults D) middle adults
a
When a fire occurs in a patient's room, what would be the nurse's priority action? A) Rescue the patient. B) Extinguish the fire. C) Sound the alarm. D) Run for help.
a
Which of the following are examples of developmental risk factors? Select all that apply. A) A toddler is allowed to crawl in a house that has not been childproofed .B) A machinist works in an environment that exposes him to loud noises. C) A sales executive worries that he wont make his yearly sales quota. D) An elderly woman in a long-term healthcare facility is at high risk for falls. E) A 42-year-old woman is unable to move her left side following a stroke. F) A teenager has difficulty ambulating following multiple fractures from a MVA.
a,d
A grade school nurse is addressing parents at a PTA meeting regarding car safety. Which of the following is a recommended safety guideline for this age group? A) All school-aged children need to be secured in safety seats. B) Booster seats should be used for children until they are 4-feet 9-inches tall or at least 8 years of age. C) Children under 8 years old should ride in the back seat. D) All school-aged children need to be secured in lap seat belts.
b
A nurse is assessing a patient who recently had a stroke. What is one area of assessment necessary to promote safety? A) skin integrity B) neuromuscular status C) hygiene D) abdominal integrity
b
A nurse making a home visit for a patient living in a high-crime area observes that the apartment building does not have outside lighting. Why is this an important assessment? A) It will make the patient less able to go to social gatherings. B) Assessment includes risk factors in the home. C) Although important, this assessment is irrelevant to care. D) Nurses in home healthcare are not concerned with safety.
b
An adolescent has recently had a ring inserted into her navel. What is the adolescent at risk for developing? A) a scar over the navel B) a local and/or systemic infection C) a greater acceptance by peers D) a strained relationship with parents
b
If an individual has smallpox, how would it most likely be spread? A) fecal-oral route B) direct contact C) contaminated items D) by birds
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 prior to applying wrist restraints. B) The nurse ensures that two fingers can be inserted between the restraint and 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 patient's bed.
b
What safety device for children is mandated by law in all 50 states? A) bumper pads in baby cribs B) infant car seats and carriers C) automatic hot water heater controls D) parental controls for Internet access
b
Which of the following nursing diagnoses would be appropriate for teaching interventions for a single mother who leaves her toddler unattended in the bathtub? A) Noncompliance B) Risk for Suffocation C) Risk for Falls D) Risk for Imbalanced Body Temperature
b
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 patients would the nurse consider to be in this category? Select all that apply. A) A patient who is older than 50 B) A patient who has already fallen twice C) A patient who is taking antibiotics D) A patient who experiences postural hypotension E) A patient who is experiencing nausea from chemotherapy F) A 70-year-old patient who is transferred to long-term care
b,d,f
A nurse is teaching parents about Internet safety for their children. Which of the following are recommended guidelines for Internet use? Select all that apply. A) Keep identifying information posted on the Web sites. B) Use filtering software to block objectionable information. C) Investigate any public chat rooms used by the children. D) Emphasize that everything read online is usually true. E) Be alert for downloaded files with suffixes that indicate images or pictures. F) Consider locating the computer in a central location in the house.
b,e,f
A nurse has conducted a timed get up and go test to assess an older adults risk for a fall. The patient completes the test in 30 seconds. Based on the finding, what will the nurse do? A) Continue with the plan of care for this fully mobile patient. B) Document the time of the test and observe the patient. C) Develop a care plan for Impaired Physical Mobility. D) Maintain the patient on bedrest to prevent falling.
c
A nurse makes a medication error and fills out an incident report. What will the nurse do with the incident report once it is filled out? A) Place it in the patients medical record. B) Take it home and keep it locked up. C) Maintain it according to agency policy. D) Include it with documentation of the error.
c
Bioterrorism has become a commonly used term. What is the definition of bioterrorism? A) a verbal threat by those wishing to harm specific individuals B) a written threat calculated to produce terror in a family C) the deliberate spread of pathogens into a community D) a worldwide plan to produce illness and injury
c
What statement by a patient would indicate that a nurse had successfully implemented a teaching/learning strategy to prevent injury in the home? A) I will turn off the outside lights and lock the doors every night. B) Do you think it would be best for me to buy a gun? C) I am going to remove all those throw rugs on the floor. D) Well, I always let the boys play in the bathtub; they love it.
c
Which set of terms best describes first-aid care? A) long-term, chronic illness B) professional, hospital C) immediate, temporary D) skilled, complex
c
While discussing home safety with the nurse, a patient admits that she always smokes a cigarette in bed before falling asleep at night. Which nursing diagnosis would be the priority for this patient? A) Impaired gas exchange related to cigarette smoking B) Anxiety related to inability to stop smoking C) Risk for suffocation related to unfamiliarity with fire prevention guidelines D) Deficient knowledge related to lack of follow-through of recommendation to stop smoking
c
A school nurse is teaching parents about home safety and fires. What information would be accurate to include in the teaching plan? Select all that apply. C) Most people who die in fires die of smoke inhalation. D) Fire-related injury and death have declined due to the availability and use of smoke alarms. E) Fires are more likely to occur in homes without electricity or gas.
c,d,e
A confused elderly woman who keeps attempting to remove tubes from her surgical incision is placed in wrist restraints. Which of the following diagnoses would be appropriate for this patient? A) Risk for Contamination B) Risk for Trauma C) Risk for Falls D) Risk for Disuse Syndrome
d
A nurse is filing a safety event report for a confused patient who fell when getting out of bed. What action is performed appropriately? A) The nurse includes suggestions on how to prevent the incident from recurring. B) The nurse provides minimal information about the incident. C) The nurse discusses the details with the patient before documenting them. D) The nurse records the circumstances and effect on the patient in the medical record.
d
A nurse orients an older adult 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
A nurse working in a pediatrician's office receives calls from parents whose children have ingested toxins. What would be the nurse's best response? A) Administer activated charcoal in tablet form and take child to the ED. B) Administer syrup of ipecac and take child to the ED. C) Bring the child in to the primary care provider for gastric lavage. D) Call the PCC immediately before attempting any home remedy.
d
A patient is very anxious and states, I am so stressed. Why do these factors affect the patients safety? A) stress increases retention of information B) stress affects interpersonal relationships C) stress increases concern about hazards D) stress tends to narrow the attention span
d
An emergency room nurse is assessing a toddler with multiple bruises and burns. The nurse suspects the toddler has been abused. What is legally required of the nurse? A) Nothing; the nurse has no control over the toddlers home. B) Refer the caregivers of the toddler to a home health nurse. C) Verbally confront the caregivers about the suspicions. D) Report suspicions about the abuse to proper authorities.
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
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 adults in a nursing home? A) Checking to make sure fire alarms are working properly. B) Preventing exposure to temperature extremes. C) Screening for partner or elder abuse. D) Making sure patient rooms are decluttered.
d
In what situation would the use of side rails not be considered a restraint? A) The nurse keeps them raised at all times. B) The institutions policies mandate using side rails. C) A visitor requests their use. D) A patient requests they be up at night.
d
Nurses provide many interventions to prevent falls in healthcare settings. Which of the following would be an appropriate fall-prevention intervention? A) Keep bed in the high position. B) Keep side rails up at all times. C) Apply restraints to all confused patients. D) Lock wheels on beds and wheelchairs.
d
What consideration should the nurse keep in mind regarding the use of side rails for a patient who is confused? A) They prevent confused patients from wandering. B) A history of a previous fall from a bed with raised side rails is insignificant. C) Alternative measures are ineffective to prevent wandering. D) A person of small stature is at increased risk for injury from entrapment.
d
What generalization can be made about safety in patient care? A) Healthcare providers exclude safety as a patient need. B) Although safety is a basic human need, it is provided by self-care. C) Safety is an important need, but not as important as self-actualization. D) Safety is a paramount concern underlying all nursing care.
d
When discussing emergency preparedness with a group of first responders, what information would be important to include about preparation for a terrorist attack? Posttraumatic stress disorders can be expected in most survivors of a terrorist attack. The FDA has collaborated with drug companies to create stockpiles of emergency drugs. Even small doses of radiation result in bone marrow depression and cancer. BLI is a serious consequence following detonation of an explosive device.
d
When should a healthcare facility determine how to deliver care if an emergency or disaster occurs? A) as soon as the disaster is announced publicly B) when it is officially informed that a disaster has occurred C) after the first disaster has been experienced D) in advance of a possible emergency or disaster
d
Which of the following is an example of a natural disaster? A) toxic spill B) war C) terrorist event D) earthquake
d
Which of the following people is at greater risk for accidental injury? A) an infant just learning to crawl B) an older adult who walks 2 miles a day C) an athlete who exercises on a regular basis D) a worker who operates industrial machines
d