class 4 - chapter 28: safety, security, and emergency preparedness

A public health nurse is providing community education to older adults regarding their risk of poisoning. Which information does the nurse include in the teaching?

keeping medications in clearly labeled containers

The nurse manager is reviewing the QSEN quality and safety competencies for nurses. Which competencies are included in this initiative? Select all that apply.

Client-centered care Teamwork and collaboration Quality improvement (QI)

The community health nurse is performing a home visit to a family with a toddler. Which observation should prompt the nurse to perform safety education?

Dangling blind cords

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

nurse practitioner

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?

The nurse should record the incident in the client's medical record and fill out a safety event report separately.

Which safety tip could the nurse give to parents to help decrease the risk of the leading cause of injury or death in children 1 to 4 years of age?

"Always provide close supervision for young children when they are in or around pools and bathtubs."

The poison control nurse receives a call from the caregiver of a young school-age child who may have ingested a poisonous substance. Which is the priority response by the nurse?

"Check breathing and heart rate."

The nurse is teaching an unlicensed assistive personnel (UAP) about fire safety. Which UAP statement requires immediate nursing intervention?

"Only certain members of the health care team can extinguish a fire."

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

19-year-old male college student majoring in physics

Which nurse would be at the highest risk of causing a hazardous situation?

A nurse who has worked 32 hours of overtime this week

The nurse overhears an older adult client's son talking to her in a very aggressive and violent way. When the nurse walks into the room, the son changes and speaks kindly to his mother and the health care providers. What should the nurse do about this observation?

Ask to examine the client alone in order to speak to her privately.

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

Implement drowning prevention strategies.

A child is playing soccer and is involved in a head-to-head collision with another player. Which assessment findings should the nurse be alert to that may indicate a concussion? Select all that apply.

Drowsiness Headache Vomiting

The nurse is providing education to a group of healthy older adults. Which nursing recommendation best promotes client safety in an independent living environment?

Encourage exercise that improves balance and muscle strength

A health care provider orders extremity restraints for a confused client who is at risk for injury by pulling out her central venous catheter. What is the nurse's most appropriate action when carrying out this order?

Ensure that two fingers can be inserted between the restraint and the client's extremity.

What teaching will the community health nurse include for parents of toddlers?

Household cleaners must be kept out of reach.

The unlicensed assistive personnel (UAP) tells the nurse that a client is very confused and trying to get out of bed without assistance. What is the appropriate action by the nurse?

Initiate use of a bed alarm

A nurse working in a long-term care facility is instituting interventions to prevent falls. Which intervention is an appropriate alternative to the use of restraints for ensuring client safety and preventing falls?

Involve family members in the client's care.

The nurse is performing an assessment on an older adult. From which data does the nurse deduce that the client is at high risk for falls in the home? Select all that apply.

Takes furosemide daily Admits to drinking wine through the evening Has history of diabetic neuropathy

The school nurse is preparing a presentation about safety promotion for middle school-aged students. Which topic will the nurse plan to include?

consistently using seat belts

The nurse is teaching an unlicensed assistive personnel (UAP) about fire safety. Which UAP statement demonstrates that teaching has been effective?

"I will rescue clients from harm before doing anything else."

Which client will the nurse assess for sensory-perceptual alterations?

84-year-old client with four recent driving violations

A nurse is performing safety assessments in a health care facility. Which statements reflect considerations a nurse should keep in mind when assessing a client for safety? Select all that apply.

A person with a history of falls is likely to fall again. Some people are more at risk for accidents than others. A medication regimen that includes diuretics or analgesics places an individual at risk for falls.

What is the primary role of the nurse in the care of clients who experience domestic violence?

Providing prompt recognition of the potential or actual threat to safety

A nurse is filing a safety event report for an older adult client who tripped and fell when getting out of bed. Which action exemplifies an accurate step of this process?

The nurse details the client's response and the examination and treatment of the client after the incident.

The nurse performs discharge teaching for the family of an older adult client with a visual impairment and decreased mobility. Which instruction would the nurse give to help prevent falls in the client's home?

Use night-lights in bedrooms and bathrooms.

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

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

A 17-year-old is brought to the emergency department with a head injury. The nurse knows that adolescents are vulnerable to injuries related to:

automobile accidents

A nurse is caring for an older adult client who has expressed concern regarding their decreased level of mobility, particularly walking around the house. Which question by the nurse is most appropriate to gain more information related to the client's safety at home?

correct answer: "Have you fallen down at all in the last few months?" your answer: "Do you have any throw rugs in the home?"

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?

correct answer: "Is your child breathing at this time?" your answer: "Induce vomiting and call 911 right away."

The nurse is evaluating risk factors for a developmentally diverse group of clients. Which client(s) is at risk for safety? Select all that apply.

correct answer: A toddler allowed to crawl in a house that has not been childproofed An older adult client with a shuffling gait your answer: A toddler allowed to crawl in a house that has not been childproofed A machinist working in an environment with exposure to loud noises An older adult client with a shuffling gait A 42-year-old client with left-side paralysis following a stroke

A home care nurse provides health education to parents regarding the care of their toddler. Which precaution should the nurse suggest the parents take to protect the toddler from drowning?

correct answer: Avoid unattended baths for the toddler. your answer: Monitor the activities of the toddler.

The nurse is teaching the caregiver of a school-age child (5-9 years old) about safety. Which teaching will the nurse include?

correct answer: Buy protective sporting equipment. your answer: Place all household cleaners out of reach.

The nurse is able to help promote safety and prevent injury by identifying which factors that have a direct impact on client safety? Select all that apply.

correct answer: Communication ability Developmental level Mobility

A confused client is pulling at the IV line. When considering alternatives to restraints, which nursing intervention would be used first?

correct answer: Conceal IV tubing with gauze wrap your answer: Ask visiting family member to stay

The nurse is preparing to apply prescribed extremity restraints to a client's ankles. Place in order the steps of the procedure the nurse should perform. Use all options.

correct answer: Ensure rationale for use to the client and family. Pad bony prominences. Wrap the restraint around the client's ankle and secure it with hook-and-loop fastener straps. Ensure that two fingers fit between the restraint and the client's skin. Position limbs in normal anatomic position. Secure restraints to bed frame with quick-release knots. your answer: Explain rationale for use to the client and family. Position limbs in normal anatomic position. Pad bony prominences. Wrap the restraint around the client's ankle and secure it with hook-and-loop fastener straps. Ensure that two fingers fit between the restraint and the client's skin. Secure restraints to the bed frame with quick-release knots.

A resident of a nursing home keeps trying to get out of bed to use the bathroom, despite having a urinary catheter in place. Which intervention will best preserve this client's safety and could be used as an alternative to restraints?

correct answer: Investigate the possibility of discontinuing his or her catheter. your answer: Increase the resident's physical activity to reduce evening restlessness.

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?

correct answer: Most people who die in house fires die of smoke inhalation rather than burns. your answer: About 10% of home fire deaths occur in a home without a smoke detector.

A nurse responds to the call bell and finds another nurse evacuating the client from the room, which has caught fire. Which action should the nurse take?

correct answer: Pull the fire alarm lever. your answer: Confine the fire

A nurse is completing an intake assessment. The nurse notes that an older adult client appears to have bruises in varying stages of healing. Which is the nurse's most appropriate initial action?

correct answer: Question the client about the source of the bruises. your answer: Notify the primary care provider about the bruises.

The nurse is caring for an 80-year-old client who was admitted to the hospital in a confused and dehydrated state. After the client got out of bed and fell, restraints were applied. She began to fight and was rapidly becoming exhausted. She has black-and-blue marks on her wrists from the restraints. What would be the most appropriate nursing intervention for this client?

correct answer: Take the restraints off, stay with her, and talk gently to her. your answer: Leave the restraints on and talk with her, explaining that she must calm down.

The nurse is caring for a client who has been prescribed extremity restraints. Which action must be documented by the nurse?

correct answer: The alternative measures attempted before applying the restraints your answer: A detailed description of the restraint application process

A client who is enrolled in Medicare and who has been recovering in the hospital from a stroke has developed a pressure injury on the 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?

correct answer: The hospital must bear any costs incurred for treating the client's injury. your answer: The hospital will be fined by CMS because the client developed a pressure injury.

The home care nurse observes that a child has recently learned to ride a bicycle and is now riding independently. Which would the nurse teach the child about bicycle safety?

correct answer: The importance of being visible at night your answer: The importance of wearing a helmet or a sturdy headcovering

Which Knowledge, Skills, and Attitudes (KSAs) are nursing actions based on the QSEN competency of quality improvement? Select all that apply.

correct answer: The nurse manager schedules a meeting of staff to review client outcomes on the hospital ward. The nurse schedules a meeting with the nurse manager to review and update the policies for client admissions. The nurse administrator sets up a committee to review the procedure manual and recommend any needed changes. your answer: The nurse manager schedules a meeting of staff to review client outcomes on the hospital ward. The nurse schedules a meeting with the nurse manager to review and update the policies for client admissions. The nurse administrator sets up a committee to review the procedure manual and recommend any needed changes. The nurse coordinator calls a meeting of all the health care professionals involved in the care of a client. The nurse listens to a client who is having trouble adjusting to a long-term care facility and treats the client with compassion and respect.

A nurse is preparing to implement an order for the use of restraints to ensure a client's safety. Which statement accurately describes a guideline to follow?

correct answer: Time-limit the use of restraints and release the client from the restraint as soon as he or she is no longer a risk to self or others. your answer: Respond to the past history of the client (including previous falls) to determine the need for restraints.

The school nurse is providing education on poisoning risks to adolescent students. Which topic does the nurse include in the teaching?

correct answer: experimentation with drugs and inhalants your answer: ingestion of substances in the home that contain lead

The nurse has completed a comprehensive assessment of a client who has been admitted to the hospital experiencing acute withdrawal from alcohol. What identified nursing concern provides the clearest justification for the use of physical restraints during this client's care?

injury risk related to agitation

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