Prep-U for Chapter 27 - Safety, Security, and Emergency Preparedness

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? (A) Ask to examine the client alone in order to speak to her privately. (B) Document the observed behaviors in the client's chart. (C) Nothing, as it is none of the nurse's concern. (D) Report the suspicions to the authorities.

(A) Ask to examine the client alone in order to speak to her privately. Reference: p. 755

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? (A) Most people who die in house fires die of smoke inhalation rather than burns. (B) Most fatal home fires occur while people are cooking. (C) About 10% of home fire deaths occur in a home without a smoke detector. (D) Most home fires are caused by children playing with matches.

(A) Most people who die in house fires die of smoke inhalation rather than burns. Reference: p. 758

The telehealth nurse receives a call stating that upon entering a family member's home, two people have been found semi-conscious with a bright cherry red skin color. They are reporting nausea and headache, and are unable to move. Which initial direction will the nurse provide? (A) Open doors and windows. (B) Wait inside until emergency personnel arrive. (C) Recommend that carbon monoxide detectors be installed in the home. (D) Allow emergency personnel to apply oxygen.

(A) Open doors and windows. Reference: p. 762

What is the primary role of the nurse in the care of clients who experience domestic violence? (A) Providing prompt recognition of the potential or actual threat to safety (B) Identifying health education and counseling measures for the family (C) Serving as a witness in court (D) Calling the police

(A) Providing prompt recognition of the potential or actual threat to safety Reference: p. 771

Which reason best explains why adolescents behave in an unsafe manner despite knowledge of a particular activity's risk? (A) Social pressure (B) Normal rebellion (C) Past experience (D) Poor judgment

(A) Social pressure Reference: p. 754

The nurse is teaching the caregiver of a 8-month-old infant about safety. Which teaching will the nurse include? (A) Supervise your child on the changing table. (B) Keep medications out of reach. (C) Peer pressure causes children of this age to take risks. (D) Buy protective sporting equipment.

(A) Supervise your child on the changing table. Reference: p. 765

The nurse is caring for a client that is agitated and combative. What action can the nurse take other than the use of physical restraints? Select all that apply. (A) Use a large plant or piece of furniture as a barrier to limit wandering from the designated area. (B) Provide a safe environment. (C) Distract and redirect in a commanding voice. (D) Place all four side rails up. (E) Use simple, clear explanations and directions. (F) Reduce stimulation, noise, and light.

(A) Use a large plant or piece of furniture as a barrier to limit wandering from the designated area. (B) Provide a safe environment. (E) Use simple, clear explanations and directions. (F) Reduce stimulation, noise, and light. Reference: p. 775

During a course on terrorism, a group of emergency room 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) mass trauma terrorism. (B) chemical terrorism. (C) bioterrorism. (D) nuclear terrorism.

(A) mass trauma terrorism. Reference: p. 780

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? (A) the 2-year-old leaning against the screen of a window in a classroom (B) the 6-year-old riding a bike on the playground with his friend (C) the 2-year-old helping mom to open the front door of the school (D) the 2-year-old and 6-year-old each holding the mother's hand

(A) the 2-year-old leaning against the screen of a window in a classroom Reference: p. 767

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? (A) 34-year-old male who does not use a seat belt (B) 19-year-old male college student majoring in physics (C) 25-year-old female who just accepted her first job (D) 40-year-old female who is working two jobs

(B) 19-year-old male college student majoring in physics Reference: p. 769

When educating families on fire safety in the home, which information is important for the nurse to emphasize? (A) Use extension cords to prevent shock. (B) Have a meeting place outside the home in case of fire. (C) Keep a fire extinguisher in a closet. (D) Account for all members and then exit together.

(B) Have a meeting place outside the home in case of fire. Reference: p. 760

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? (A) Contact the physician for a restraint order. (B) Initiate use of a bed alarm. (C) Administer the client's sedative as ordered. (D) Put up all four side rails on the bed.

(B) Initiate use of a bed alarm. Reference: p. 775

A nurse finds that a fire has broken out in a client's room at the health care facility. Which intervention is of the highest priority? (A) Raise an alarm. (B) Rescue the client. (C) Extinguish the fire. (D) Confine the fire.

(B) Rescue the client. Reference: p. 776

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? (A) CMS may choose to divert clients to other health care facilities in the future. (B) The hospital must bear any costs incurred for treating the client's injury. (C) The hospital will be fined by CMS because the client developed a pressure injury. (D) CMS will bear the hospital's costs if the client chooses to sue the hospital.

(B) The hospital must bear any costs incurred for treating the client's injury. Reference: p. 772

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 include a note on the client's chart that mentions the report. (B) The nurse should record the incident in the client's medical record and fill out a safety event report separately. (C) The nurse should make a copy of the safety event report and place it in the client's medical record. (D) The nurse should await results of the x-ray before filing the report.

(B) The nurse should record the incident in the client's medical record and fill out a safety event report separately. Reference: p. 778

Which actions should the nurse perform to help prevent occupational safety hazards? Select all that apply. (A) Twist or bend electric cords to make sure the cords are not dragging on the floor. (B) Use equipment only for the use for which it was intended. (C) Clean all equipment with soap and water after use. (D) Only operate equipment the nurse is familiar with. (E) Use three-pronged electric plugs whenever possible.

(B) Use equipment only for the use for which it was intended. (D) Only operate equipment the nurse is familiar with. (E) Use three-pronged electric plugs whenever possible. Reference: p. 777

The school nurse is educating 7th grade children about safety. Which recommendation is most appropriate for this age group? (A) Be cautious of electrical outlets. (B) Use protective sporting equipment. (C) Do not text while driving. (D) Use caution when descending stairs.

(B) Use protective sporting equipment. Reference: p. 765

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. (A) Increased thirst (B) Vomiting (C) Headache (D) Drowsiness (E) Fever

(B) Vomiting (C) Headache (D) Drowsiness Reference: p. 768

Which level of health care provider may make the decision to apply physical restraints to a client? (A) senior personal care assistant (B) nurse practitioner (C) LPN team leader (D) RN nurse manager

(B) nurse practitioner Reference: p. 776

Which statement indicates that a family understands the teaching that has been provided by the nurse related to car seat safety for a 9-month-old infant? (A) "We place our baby in a front-facing car seat in the front of the car so that he doesn't cry." (B) "We place our baby in a front-facing car seat in the middle of the back seat of the car." (C) "We place our baby in a rear-facing car seat in the back seat of the car." (D) "We place our baby in a rear-facing car seat in the front of the car so that we can see him in case he chokes."

(C) "We place our baby in a rear-facing car seat in the back seat of the car." Reference: p. 765

The nurse is caring for an older adult client who states the need to use the restroom. Which safety intervention must the nurse perform first? (A) Arrange furniture so that the client has something to hold on to. (B) Put the client's bedside rails up. (C) Assess the need for assistance with ambulation. (D) Apply socks to the client's feet.

(C) Assess the need for assistance with ambulation. Reference: p. 778

One of the leading causes of death in the United States is drowning. How can the nurse assist in lowering this statistic? (A) Require fencing around all pools. (B) Begin swim lessons with toddlers. (C) Implement drowning prevention strategies. (D) Educate children in cardiopulmonary resuscitation.

(C) Implement drowning prevention strategies. Reference: p. 766

The nurse is creating a plan of care for the older adult who has multiple medications and a difficult time reading medication labels due to poor eyesight. What is the most appropriate nursing diagnosis to include in this client's plan of care? (A) Risk for Injury related to substance use (B) Risk for Falls related to immobility (C) Risk for Poisoning related to poor eyesight and the inability to read medication labels (D) Altered Sensory Perception related to decreased visual acuity

(C) Risk for Poisoning related to poor eyesight and the inability to read medication labels Reference: p. 772

A nurse is caring for an 18-month-old client after a tracheostomy. The client is recovering well and noted a desire to be more active. The nurse selects a toy from the playroom for the client to play with. Which toy is most developmentally appropriate? (A) dominos (B) a beaded bracelet (C) a rocking horse (D) marbles

(C) a rocking horse Reference: pp. 788-789

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

(C) experimentation with drugs and inhalants. Reference: pp. 761-762

A client went missing from a long-term care facility and an emergency code was called. After a search of 1 hour, the client was discovered in a utility room that should have been inaccessible. When responding to this event, staff should: (A) document strategies in the client's health record for preventing future incidents. (B) complete an incident report to determine who was primarily responsible for the event. (C) fill out an incident report, with the goal of preventing a similar event in the future. (D) hold a facility-wide meeting to identify strategies for making improvements to the safety of residents.

(C) fill out an incident report, with the goal of preventing a similar event in the future. Reference: p. 778

Which item would alert the home care nurse to a safety hazard threatening a young child? (A) Three blankets in a crib (B) A gated stairway (C) Padded child safety seat (D) Dangling blind cords

(D) Dangling blind cords Reference: pp. 760-778

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? (A) Apply restraints to the hands or wrists, never to the ankles. (B) Use a quick-release knot to tie the restraint to the side rail. (C) Remove the restraint at least every 4 hours, or according to facility policy. (D) Ensure that two fingers can be inserted between the restraint and the client's extremity.

(D) Ensure that two fingers can be inserted between the restraint and the client's extremity. Reference: pp. 786-789

What best describes the nurse's role in disaster preparedness? (A) Performance of all of the skills such as IV insertion and wound care (B) Administration of all of the medications (C) Counseling the victims and families (D) Multiple roles, including triage and the distribution of resources

(D) Multiple roles, including triage and the distribution of resources Reference: p. 783

The nurse begins a shift and finds that the wrong medication has been administered to a client. After completing a safety event report, what should the nurse do next? (A) File the safety event report in the appropriate file and document in the nurse's notes the date and time that it was filed. (B) Make a copy of the safety event report for the client. (C) Place the safety event report in the client's medical record for future reference. (D) Submit the safety report to the appropriate department within the facility so that it can be reviewed.

(D) Submit the safety report to the appropriate department within the facility so that it can be reviewed. Reference: p. 778

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? (A) Sedate her with sleeping pills and leave the restraints on. (B) Talk with the client's family about taking her home because she is out of control. (C) Leave the restraints on and talk with her, explaining that she must calm down. (D) Take the restraints off, stay with her, and talk gently to her.

(D) Take the restraints off, stay with her, and talk gently to her. Reference: pp. 774-775