Safety NCLEX Practice questions

The nurse is educating a group of clients about risks for food poisoning. Which statement made by a client indicates understanding? 1. "I should not consume raw cookie dough." 2. "It is fine to eat raw sushi in a restaurant." 3. "I sometimes drink milk straight from the cow." 4. "I can leave food out for three hours before consumption."

Answer: 1 Rationales Option 1: Raw cookie dough contains raw eggs which can lead to food poisoning. This statement indicates understanding. Option 2: Raw or undercooked foods can lead to foodborne illnesses or food poisoning. Option 3: Milk straight from the cow is unpasteurized and can cause foodborne illnesses. Option 4: The client should be instructed that food should not be left out for several hours as this can lead to foodborne illnesses. [Page reference: 672]

Which factor most decreases adverse outcomes in a healthcare facility? 1. Quality nursing care 2. Good insurance coverage 3. Adequate psychosocial support 4. Knowledgeable healthcare providers

Answer: 1 Rationales Option 1: Research has shown that the availability of quality nursing care decreases adverse outcomes. Option 2: It can alleviate a client's stress to know that healthcare costs are covered, but this does not necessarily decrease adverse outcomes. Option 3: Psychosocial support can help a client meet specific mental health outcomes, but it does not always prevent physiological adverse outcomes from occurring. Option 4: The client needs Knowledgeable healthcare providers; however, this does not alter client outcomes as much as quality nursing care can. [Page reference: 673]

A client informs the healthcare provider of increased fatigue upon return from a camping trip last weekend. For what should the nurse assess the client? 1. Skin for bug bites 2. Contact with lead paint 3. Ingestion of raw meats 4. Carbon monoxide exposure

Answer: 1 Rationales Option 1: The nurse should assess the client's skin for bug bites. The client reports feeling tired after returning from camping. Many vector-borne illnesses such may be passed on to hosts from bugs in outdoors settings. Option 2: Lead paint exposure is not applicable to a client who went camping. Option 3: The client did not report any ingestion of raw meat, which would cause food poisoning. Nausea and vomiting would be indicative of foodborne illness. Option 4: Carbon monoxide poisoning would cause fatigue, but it is unlikely to occur in outdoors open spaces. [Page reference: 672]

The nurse is caring for a violent client. The nurse contacts the healthcare provider and receives an order for restraints. Which actions should the nurse include in the plan of care for this client? Select All That Apply. 1. Removing the restraints every two hours 2. Renewing the prescription every 24 hours 3. Administering medications as needed to restrain a client 4. Using the most restrictive restraint in the beginning 5. Obtaining standing orders for the use of restraints for a client

Answer: 1, 2 Rationales Option 1: The nurse should assess circulation and remove the restraints every two hours to maintain skin integrity and allow for toileting and meals. Option 2: The nurse and healthcare provider should reevaluate the need for restraints every 24 hours. Option 3: Medications such as sedatives and antipsychotics are considered chemical restraints. These should not be used without the healthcare provider's orders. Option 4: The nurse should incorporate the least restrictive restraint possible to start. Option 5: Standing orders are not acceptable for restraints. [Page reference: 697]

Which criteria must be present for an occurrence to be labeled a never event? Select All That Apply. 1. Serious 2. Preventable 3. Measurable 4. Documentable 5. Manageable outcomes

Answer: 1, 2, 3 Rationales Option 1: For the incident to be considered a never event, it must be a serious occurrence. Option 2: A never occurrence must be preventable. Option 3: Never occurrences should be identifiable and measurable. Option 4: A never event should be documented in an incident form; however, other events must be documented as well. Option 5: Never events can lead to death. Such an event is not manageable. [Page reference: 674]

Which factors related to the healthcare system can lead to safety issues? Select All That Apply. 1. Lack of staffing 2. Malfunctioning equipment 3. Bullying and intimidation practices 4. Availability policy and procedure manuals 5. Thorough orientation sessions for new employees

Answer: 1, 2, 3 Rationales Option 1: Inadequate numbers of nurses can lead to safety issues. Client needs are not as easily met, and medications and procedures can be late. Nurses may not be able to answer call lights promptly and clients may try to get out of bed alone, leading to falls. Option 2: Equipment failures can place clients at risk for injury. Option 3: Bullies exist in every work environment; this can intimidate coworkers and clients and put people at risk for injuries. Option 4: When policy and procedure manuals are available, this provides a resource for nurses to ensure client and staff safety. Option 5: New employees should receive a thorough orientation. This promotes a safe work environment. [Page reference: 673]

Which instructions should the nurse give to the parents of a 5-month-old infant to prevent hazards? Select All That Apply. 1. Get rid of all pillows from the crib. 2. Remove any long ribbons hanging from items. 3. Eliminate the string holding the infant's pacifier. 4. Use gas ovens to keep the house warm for the infant during winter time. 5. Be careful when bathing the child as drownings are the leading cause of death in infants.

Answer: 1, 2, 3 Rationales Option 1: The nurse should instruct the parents to remove all pillows from the crib to prevent accidental suffocation. Option 2: Long ribbons on toys or window blind cords should be removed because these create a strangulation hazard. Option 3: The string that holds the infant's pacifier can become tangled around the neck. This can cause a strangulation hazard. Option 4: Gas ovens can emit carbon monoxide which can lead to death. The nurse would instead suggest carbon monoxide detectors. Option 5: Drownings are more prevalent in children from 1-18 years, not in infants. [Page reference: 671]

The home health nurse is instructing the family of an elderly client about safety precautions that should be taken in the bathroom. Which information should the nurse provide? Select All That Apply. 1. Use raised toilet seats. 2. Set up grab bars in the shower. 3. Purchase a sturdy shower chair for the client. 4. Place a throw rug on the floor to dry wet feet. 5. Install a fixed shower head on the wall for the client.

Answer: 1, 2, 3 Rationales Option 1: Toilet seats that are too low can make it difficult for the client to sit down and get up, which can lead to injuries. Option 2: Grab bars in the shower provide support for the client. Option 3: A sturdy shower chair should be purchased to allow the client to sit if needed during a shower. Option 4: The nurse should not instruct the family to place a throw rug on the floor as this can slip and lead to falls. Option 5: The nurse would instruct the family to install a movable shower head to allow the client to sit down on a shower chair and still get the water at a comfortable angle. [Page reference: 685]

Which are measures that should be taken by health-care workers to decrease radiation exposure for a client with a radioactive implant? Select all that apply. 1. Limit the amount of time spent with the client. 2. Perform care near the client only when necessary. 3. Stand at an angle from the client to minimize radiation exposure. 4. Wear a lead apron. 5. Change clothes after x-ray exposure.

Answer: 1, 2, 4 Rationales Option 1: Organize nursing care to limit the amount of time spent in a radiated area. Option 2: Minimize radiation exposure by only providing care that is necessary in an exposed area. Option 3: Radiation scatters, and the angle of the health-care worker will not provide protection. Option 4: Wearing protective shielding, such as a lead apron, will provide a degree of protection. Option 5: Changing clothes will not have an effect on the amount of radiation exposure. [Page reference: 678] Test Taking Tip: Some clients will have a radioactive implant. Exposure to these clients should be limited in time and distance to client. Protection can be increased through the use of shielding devices.

Which are components of an effective culture of safety on a nursing unit? Select all that apply. 1. Transparency 2. Accountability 3. Punitive response to errors 4. Performing all activities the same way every time 5. Team empowerment

Answer: 1, 2, 5 Rationales Option 1: Team members are united in goals, and communicate openly about identified problems. Option 2: Staff claim ownership of human error and are willing to disclose the error. Option 3: Errors should not have a punitive response; the most frequent cause is process-related. Option 4: Performing all activities the same way is descriptive of a high reliability organization. Option 5: Every individual is a valued member of the team, sharing common goals. [Page reference: 675] Test Taking Tip: In a culture of safety environment, all nurses practice together to create a safe unit, disclose errors without fear, and address any safety concerns as a team.

Which falls prevention measures can a nurse delegate to nursing assistive personnel? Select All That Apply. 1. Provide nonskid slippers. 2. Lock beds and wheelchairs. 3. Initiate restraints. 4. Prepare medications as ordered. 5. Discharge planning. 6. Keep room free of clutter.

Answer: 1, 2, 6 Rationales Option 1: A nursing assistive provider can provide nonskid slippers for clients at risk of falling. Option 2: Locking beds and wheelchairs should be an expectation of all members of the care team. Option 3: Nursing assistive personnel cannot initiate restraints. This is also not a falls prevention measure. Option 4: Nursing assistive personnel are not permitted to prepare or administer medications. Option 5: The discharge plan is part of the care plan and is the responsibility of the nurse. Option 6: All members of the care team should work together to keep the client room free of clutter and debris. [Page reference: 694]

Which factors lead to increased numbers of injuries in children and younger adults related to motor vehicle accidents? Select All That Apply. 1. Driver distraction 2. Poor driving patterns 3. Failure to use seat belts 4. Decreased reaction time 5. Improperly placed car seats

Answer: 1, 3, 5 Rationales Option 1: Driver distraction with mobile phones and texting has led to an increase in injuries to teenagers and younger adults. Option 2: Poor driving patterns are not typically a factor in injuries to children and young adults. Option 3: Failure to use seat belts is a major contributing factor to injuries in children and young adults. Option 4: Older adults have decreased reaction time. This is not an issue in younger adults. Option 5: Car seats placed in the front seat have led to injuries in infants and children when air bags are deployed. [Page reference: 672]

Which are examples of never events, or Serious Reportable Events? Select all that apply. 1. Foreign object left in client after surgery 2. Medication errors 3. Delays in discharge 4. Catheter-associated urinary tract infection 5. Stage IV pressure ulcer that develops during hospitalization

Answer: 1, 4, 5 Rationales Option 1: A foreign object left in a client is a serious complication that is potentially fatal and should never happen in a hospital. Option 2: Medication errors, although potentially serious, are not considered reportable safety events. Option 3: Delays in discharge should be avoided but are not considered never events. Option 4: A urinary tract infection that occurs from Foley catheter insertion is a never event. Option 5: Severe pressure ulcers are serious reportable events. [Page reference: 674] Test Taking Tip: Serious Reportable Events, or never events, are serious complications that occur during hospitalization. These events should never occur in a hospital.

Which are contributing factors for escalation of violent behavior? Select all that apply. 1. Under the influence of drugs or alcohol 2. Age between 18 and 25 3. Long-term illness 4. Chaotic environment 5. History of violent behavior

Answer: 1, 4, 5 Rationales Option 1: Clients who are under the influence of drugs or alcohol have increased risk of not being able to control their actions. Option 2: Age is not a factor that contributes to violent behavior. Option 3: Long term illness does not contribute to violent behavior. Option 4: A chaotic environment can increase confusion and anxiety, escalating violent behavior. Option 5: A client who has a history of violent behavior is at risk for escalation of that behavior again. [Page reference: 693] Test Taking Tip: The impact of violence against health-care workers is widespread, and it results in injuries, staff turnover, and stress-related illnesses. Some behaviors or characteristics of clients can indicate a risk for violent behavior.

A client is being discharged on home oxygen. Which is an important part of discharge teaching? 1. Do not cook with the oxygen in place. 2. Do not smoke at all in the home. 3. Oxygen should be increased at night. 4. Oxygen should be removed before smoking.

Answer: 2 Rationales Option 1: Cooking may need to be modified for a client who is on home oxygen, but this is not the most important safety factor. Option 2: A client on home oxygen should be taught that no smoking is permitted in the home. Option 3: Oxygen increases are not part of oxygen therapy safety considerations. Option 4: Smoking should not occur in a home with oxygen in use. [Page reference: 684] Test Taking Tip: Oxygen is highly flammable.

Which is an effective nursing intervention for preventing falls? 1. Requiring family to remain with the client 2. Use of bed alarms 3. Application of restraints 4. Administration of sedation

Answer: 2 Rationales Option 1: Family presence is not a guarantee of decreased risk for falls. Option 2: Bed alarms will alert the nurse when the client is getting out of bed, and they are useful in preventing falls. Option 3: Restraints should only be used as a last resort; a client is more likely to fall and be injured while in restraints. Option 4: Administration of sedating medication will increase the client's risk for falls. [Page reference: 692] Test Taking Tip: Identification of those at risk for falls is one of the most important ways to prevent falls, and interventions are effective.

Which is considered a restraint? 1. Holding a client for a procedure 2. Soft wrist holders 3. Siderails up X 2 4. Closing the door to the room

Answer: 2 Rationales Option 1: Holding a client for a procedure is not considered a restraint. Option 2: Soft wrist holders, or wrist restraints, are considered a restraint. Option 3: If the client is able to maneuver out of bed without limitation, siderails up X 2 is not a restraint. Option 4: Closing the room door is not a restraint. Locking a client in a room is seclusion, and it is only permitted at certain types of facilities. [Page reference: 699] Test Taking Tip: Any device that restricts a client's movement or freedom is a restraint. If the client cannot remove the device, it is considered a restraint and is ordered and documented as such.

The nurse is caring for an unsteady client who keeps getting out of his or her chair due to confusion. What is the best intervention for this client? 1. Keep the client in bed with the side rails up. 2. Place a chair alarm under the client's chair. 3. Apply restraints to the client to keep the client in place. 4. Provide the client with some distraction activities.

Answer: 2 Rationales Option 1: Keeping a client in bed with the side rails up is not the best nursing intervention because mobile clients should keep moving to prevent complications. Option 2: A chair alarm would be most beneficial for this client; it allows the client to stay sitting up and out of bed but will alert the nurse if the client gets up. Option 3: The nurse should not apply restraints. This is unethical for a client who is not violent and should not be done without orders from a healthcare provider. Option 4: The nurse can provide distraction activities; however, this does not necessarily prevent a client from getting up and falling. [Page reference: 698]

Which action made by the parent of a 4-month-old infant indicates a need for further education? 1. Use of sunscreen prior to going outside 2. Warming formula in the microwave 3. Placing all firearms in a locked gun safe 4. Applying child-proof locks on cabinets and drawers

Answer: 2 Rationales Option 1: Sunburns can be prevented by applying sunscreen to babies. This is a correct action by the parent. Option 2: Warming formula in the microwave can cause burns. This action indicates a need for further teaching. Option 3: Guns and firearms should be placed out of reach and inside of a locked gun safe to prevent gunshot injuries. Option 4: Children love to explore, and if there are cleaning supplies or other chemicals on ground level, the parents should apply child-proof locks on cabinets and drawers. [Page reference: 684]

An 82-year-old client is admitted with a fractured hip from a fall at home. The initial assessment reveals that the client is incontinent at times, suffers from dizziness when standing, and is on multiple medications. Which is the primary safety risk for this client? 1. Infection 2. Falls 3. Violence 4. Poisoning

Answer: 2 Rationales Option 1: The client is not at increased risk for infection at the time of admission. Option 2: The history of falls, incontinence, dizziness, and multiple medications increase the client's risk of falling. Option 3: The client does not have any identified risk factors for violence. Option 4: The client does not have any identified increased risk for poisoning. [Page reference: 697] Test Taking Tip: This client's intrinsic risk factors that increase risk include a history of falls, incontinence, multiple medications, dizziness, and functional impairment.

Which safety precaution should the nurse take when preparing to administer an injection to a client? 1. Recapping the needle after administering the injection 2. Disposing of the needle immediately in the sharps container 3. Setting the needle aside after the injection until bleeding has stopped 4. Inserting the needle into a full sharps container for disposal

Answer: 2 Rationales Option 1: The nurse should never recap the needle after giving the injection. This can lead to use of contaminated needles. Option 2: The nurse should immediately dispose of the contaminated needle in the sharps container to prevent accidental injury. Option 3: The nurse should activate the safety mechanism prior to setting the needle aside if needed to care for bleeding. Option 4: The nurse should not overfill the sharps container as it can cause needles to stick out and accidentally stick someone. [Page reference: 696]

Which development-related safety issue should the nurse include when educating the parents of a 6-month-old infant? 1. Supervision when in the pool 2. Objects being placed in the mouth 3. Unsecured front-facing child car seats 4. Protection from playground-related injuries

Answer: 2 Rationales Option 1: Toddlers and preschool-age children are at higher risk for drowning and other outside related injuries. This is not applicable to infants who are unable to walk. Option 2: As infants begin to crawl and explore, infants may put many objects in the mouth, creating a choking hazard. Option 3: A 6-month-old infant would be in a rear-facing car seat, not a front-facing car seat. Option 4: Playground-related injuries are more likely to affect older children. [Page reference: 668]

Which scenarios support the use of restraints in a hospital? Select all that apply. 1. A client refusing to take medications 2. A confused client who continuously pulls out his or her IV line 3. An alert client who is ventilator dependent who is pulling at the endotracheal tube 4. A client who is threatening to leave the hospital against medical advice 5. A confused client who has fallen multiple times

Answer: 2, 3 Rationales Option 1: A client has the right to refuse treatment. Application of restraints is not appropriate Option 2: A confused client is not able to follow instructions, and continuously pulling such medical devices could be an indication for restraint use. Option 3: If a client is unwilling to follow instructions not to pull at necessary equipment, restraints may be indicated. Option 4: Clients should never be restrained for refusal of treatment or threatening to leave. Option 5: Application of restraints should not be used to prevent falls. A client is more likely to fall while in restraints than not. [Page reference: 699-702] Test Taking Tip: Restraints must be medically prescribed and only used as a last resort. Clients are more likely to be injured while in restraints. Alternative measures should be exhausted before restraints are applied.

The nurse is educating the parents of a toddler about medication safety in the home. What should the nurse include in the teaching plan? Select All That Apply. 1. Keep old medications on hand for future use. 2. Refrain from calling medications candy. 3. Avoid taking medications in front of children. 4. Store all medications in child-resistant containers. 5. Transfer all medications into different bottles.

Answer: 2, 3, 4 Rationales Option 1: The nurse should instruct the parents to properly dispose of old medications to prevent children from getting ahold of them. Option 2: The nurse should teach the parents to explain to the child that pills are not candy, which can make children want to try them on their own. Option 3: Children imitate adults, so the parent should try to avoid taking medications in front of children. Option 4: All medications should be stored in child-resistant containers. Option 5: The nurse should instruct the parents to keep all medications in the original bottles and packaging to avoid confusion. [Page reference: 683]

The nurse in a long-term care facility is caring for a 70-year-old client who has a history of type 2 diabetes mellitus, hypertension, and Parkinson disease. The client takes antihypertensive medications, insulin, and carbodopa/levodopa. The client has functional incontinence due to a shuffling gait and uses a wheeled walker for ambulation. Which factors place the client at risk for falls? Select All That Apply. 1. Insulin injections 2. Parkinson disease 3. Wheeled walker use 4. Functional incontinence 5. Type 2 diabetes mellitus 6. Antihypertensive medications

Answer: 2, 3, 4, 6 Rationales Option 1: Insulin is not a medication that can lead to falls. If a client has too low of a glucose level, this can lead to an unsteady gait and confusion, but the medication itself does not place a client at risk for falls. Option 2: Parkinson disease can cause difficulty with balance due to the shuffling gait it produces. Option 3: The use of assistive devices indicates the client has an unsteady gait and is at higher risk for falls. Option 4: Functional incontinence can place a client at risk for falls if he/she rushes to get to a bathroom. Option 5: Having type 2 diabetes mellitus does not place a client at risk for falls unless complications such as impaired vision or amputations occur. Option 6: Antihypertensive medications can lower the client's blood pressure and lead to orthostatic blood pressure changes and dizziness. [Page reference: 678-679]

Which are possible consequences of alarm fatigue? Select All That Apply. 1. Alarm goes off and is noticed by staff 2. Alarm device does not detect alarm condition 3. Alarm is activated without the condition occurring 4. Alarm device does not communicate to the nurse the problem 5. Alarm device sounds like other alarms and is not noticed by the nurse

Answer: 2, 4, 5 Rationales Option 1: The purpose of an alarm is to notify the nurse of a situation that needs to be addressed immediately. Alarm fatigue results in missed alarms. Option 2: Alarm fatigue occurs when nurses are desensitized to the sounds of multiple alarms. Missed alarms can happen due to the alarm not detecting the condition that is supposed to trigger the alarm. Option 3: It is better for the alarm to alert without the situation occurring than to not alarm when there is a problem. Option 4: An alarm can malfunction and not communicate the problem to the nurse. This can cause a missed alarm. Option 5: Alarm fatigue can lead to a nurse missing alarms because they sound like other alarms. [Page reference: 675]

What is the correct procedure for responding to small fires? 1. Confine the fire. 2. Rescue the clients. 3. Activate the alarm. 4. Extinguish the fire.

Answer: 2,3,1,4 Rationale When a fire occurs, the nurse should put client safety first. The nurse would rescue the clients then activate the fire alarm. The third step is to confine the fire by closing doors and windows. If the fire is small enough, the nurse may attempt to extinguish the fire. [Page reference: 692]

Which describes the universal symbol for choking? 1. A raised hand 2. Hands on the stomach 3. Hands clutching the neck 4. Opening mouth and pointing at throat

Answer: 3 Rationales Option 1: A raised hand is not the universal symbol for choking. Option 2: Hands on stomach is not likely to be noticed, and it is not the universal symbol for choking. Option 3: The choking person will bring both hands to the neck to signal that he or she is choking. Option 4: The choking person will not open his or her mouth and point when in distress. [Page reference: 686]

An oxygen tank in the home explodes and results in serious burns to a client. According to The Joint Commission (TJC), which process would the durable medical equipment company apply to investigate the occurrence? 1. Sentinel event 2. Incident report 3. Root cause analysis 4. Insurance company notification

Answer: 3 Rationales Option 1: A sentinel event has occurred, but this does not describe the process of investigation. Option 2: An incident report would be created, but this is not a TJC process. Option 3: TJC mandates that when a sentinel event occurs, the agency does a root cause analysis to determine where the problem originated. Option 4: The nurse would need to notify the insurance company, but this is not part of a TJC investigation. [Page reference: 674]

Correct body mechanics should be utilized by nurses to prevent which type of injury? 1. Falls 2. Burns 3. Back injury 4. Head injury

Answer: 3 Rationales Option 1: Correct body mechanics are not implemented to prevent unintentional falls. Option 2: Correct body mechanics are not a measure to prevent burns. Option 3: Repetitive strain from lifting or moving can result in back injury. Correct body mechanics can prevent this. Option 4: Body mechanics are not used to prevent head injury. [Page reference: 677]

A nurse works night shift in and intensive care unit. After a night of multiple clients developing abnormal heart rhythms, and alarms going off continuously, the nurse does not notice that a client has developed a potentially lethal rhythm and the alarm is sounding. What does this describe? 1. High reliability 2. Root cause 3. Alarm fatigue 4. Alarm inertia

Answer: 3 Rationales Option 1: High reliability describes an organization that has a culture in place to prevent errors in processes. Option 2: Root cause is the identified underlying cause of a safety event. Option 3: Alarm fatigue occurs when caregivers become desensitized to hearing alarms and begin to ignore or silence them. Option 4: Alarm inertia is a lack of action in response to an alarm, but it is not a failure to hear or acknowledge the alarm. [Page reference: 675] Test Taking Tip: Nurses can become so overwhelmed by the number of alarm signals that they begin to ignore or even silence alarms. Missed alarms can result in serious events, even client deaths.

Which is the appropriate initial action if a client has a possible poisoning? 1. Induce vomiting immediately. 2. Give a full glass of water and observe. 3. Contact the nearest poison control center. 4. Have the client lie still.

Answer: 3 Rationales Option 1: Inducing vomiting is not indicated for all types of poisoning. Option 2: Giving a full glass of water is not indicated for most instances of poisoning. Option 3: Calling the poison control center is the appropriate first action when confronted with possible poisoning. Option 4: Lying still is not an intervention in poisoning. [Page reference: 682]

Which is the leading cause of unintentional deaths in the United States? 1. Motor vehicle crashes 2. Firearms 3. Poisoning 4. Drowning

Answer: 3 Rationales Option 1: Motor vehicle crashes is one of the top causes of unintentional deaths, but it is not the leading cause. Option 2: Firearms contribute to a large number of accidental deaths every year, often in young children, but it is not the leading cause. Option 3: The rate of poisoning has quadrupled in the past 20 years, with all ages and developmental levels affected. Option 4: Drowning is a cause of many deaths in the United States every year, but it is not the leading cause. [Page reference: 683]

Which interventions should the nurse include in the plan of care for a client who is violent? Select All That Apply. 1. Work in the client's room on a 1:1 basis. 2. Be aggressive and assertive with the client. 3. Refrain from wearing stethoscope around the neck. 4. Remove objects from the environment that can be harmful. 5. Obtain permission from the client before using touch.

Answer: 3, 4, 5 Rationales Option 1: The nurse should never go in an angry or violent client's room alone. This can place the nurse at risk for injury. Option 2: The nurse should never be aggressive with an angry or violent client. This can worsen the situation. Option 3: The nurse should never wear a stethoscope around his or her neck. This can be used to strangle the nurse. Option 4: The nurse should remove objects that the client could use to inflict harm. Option 5: The nurse should always obtain permission from a violent client to use touch. [Page reference: 693]

Which fire extinguisher classification is approved for use with combustible metals? 1. Class A 2. Class B 3. Class C 4. Class D

Answer: 4 Rationales Option 1: Class A fire extinguishers are approved for use with wood, paper, rubber, textiles, and plastic. Option 2: Class B fire extinguishers are approved for use with flammable liquids, gases, oils, solvents, or greases. Option 3: Class C fire extinguishers are approved for use with live electrical wires or equipment. Option 4: Class D fire extinguishers are approved for use with combustible metals. [Page reference: 692] Test Taking Tip: Fire extinguishers are classified according to the type of fire they extinguish. Most health-care facilities have multipurpose extinguishers, such as Class A, B, or C.

The home health nurse is discussing fire safety with a family. The family asks about how to handle different types of fires. Which type of fire extinguisher is used to extinguish grease fires? 1. Class A 2. Class B 3. Class D 4. Class K

Answer: 4 Rationales Option 1: Class A fire extinguishers put out fires caused by paper and wood products. Option 2: Class B fire extinguishers extinguish fires from flammable liquids. Option 3: Class D fire extinguishers are not usually used in private homes; they extinguish fires caused by combustible metals. Option 4: Class K fire extinguishers put out grease fires. [Page reference: 692]

In 2015, how many deaths were estimated to occur per year related to medical errors? 1. 98,000 2. 200,000 3. 300,000 4. 400,000

Answer: 4 Rationales Option 1: In 1999, the Institutes of Medicine estimated that 98,000 people die per year related to medical errors. The number has increased since then. Option 2: There are more than 200,000 deaths per year related to medical errors. Option 3: There are more than 300,000 medical error-related deaths per year. Option 4: It was estimated in 2015 that there are over 400,000 deaths per year related to medical errors. [Page reference: 673]

Which describes the process in which a safety event is analyzed to determine the underlying cause and to prevent the event from occurring again? 1. Reporting 2. Trending 3. Clinical analysis 4. Root cause analysis

Answer: 4 Rationales Option 1: Reporting internally should always be done on any safety events. Some events require mandatory reporting to external agencies, such as state departments of health. Option 2: Trending should be done on safety events to determine if there is a risk that should be mitigated. Option 3: Clinical analysis refers to reviewing the illness and care the client is receiving. Option 4: Root cause analysis is done to determine the underlying cause of an event and work to prevent it from occurring again. [Page reference: 674]

A client is brought by ambulance to a hospital after being found in a closed garage with the car running. The physician orders 100% humidified oxygen. Which type of poisoning does this client have? 1. Food poisoning 2. Exposure to caustic chemicals 3. Gasoline ingestion 4. Carbon monoxide inhalation

Answer: 4 Rationales Option 1: The client does not have any symptoms or a treatment plan for food poisoning. Option 2: There is a known exposure to chemicals, but this is not a contact-related caustic chemical. Option 3: There is nothing in the client's presentation related to gasoline ingestion. Option 4: The client most likely has carbon monoxide inhalation poisoning, which is treated with 100% humidified oxygen. [Page reference: 684]

Which nursing interventions are important for the home health nurse to perform to promote safety when caring for elderly clients? Select All That Apply. 1. Removing throw rugs 2. Moving electrical cords 3. Changing positions slowly 4. Using visual and hearing aids 5. Taking pain medication prior to movement

Answers: 1, 2, 3, 4 Rationales Option 1: Throw rugs should be removed to prevent accidental slipping and falling. Option 2: The nurse should move electrical cords out of the way to prevent tripping. Option 3: Elderly clients should be instructed to change positions slowly to prevent dizziness from orthostatic blood pressure changes. Option 4: The nurse should instruct the client to use visual and hearing aids to be able to better detect safety issues. Option 5: Although pain medication may make it easier for an elderly client to walk due to arthritic changes, it can cause drowsiness and sedation, which can lead to falls. [Page reference: 679]