Chapter 27: Patient Safety and Quality

The nurse enters the patient's room and notices a small fire in the headlight above the patient's bed. In which order will the nurse perform the steps, beginning with the first one? 1. Pull the alarm. 2. Remove the patient. 3. Use the fire extinguisher. 4. Close doors and windows. a. 2, 1, 4, 3 b. 1, 2, 4, 3 c. 1, 2, 3, 4 d. 2, 1, 3, 4

a. 2, 1, 4, 3

A nurse is teaching a community group of school-aged parents about safety. The proper fitting of which safety item is most important for the nurse to include in the teaching session? a. A bicycle helmet b. Soccer shin guards c. Swimming goggles d. Baseball sliding shorts

a. A bicycle helmet

The nurse is caring for a patient who suddenly becomes confused and tries to remove an intravenous (IV) infusion. Which priority action will the nurse take to minimize the patient's risk for injury? a. Assess the patient. b. Gather restraint supplies. c. Try alternatives to restraint. d. Call the health care provider for a restraint order.

a. Assess the patient.

A nurse is teaching the patient and family about wound care. Which technique will the nurse teach to best prevent transmission of pathogens? a. Effective hand hygiene b. Saline wound irrigation c. Appropriate use of gloves d. When eye protection is needed

a. Effective hand hygiene

The nurse is presenting an educational session on safety for parents of adolescents. Which information will the nurse include in the teaching session? a. Frequent injuries related to poor psychomotor coordination b. Recognizing common signs and symptoms of the schizophrenia c. Failing grades and changes in dress may indicate substance abuse d. The importance of the use seat belts whenever riding in the backseat of a car

a. Frequent injuries related to poor psychomotor coordination

A home health nurse is assessing a family's home after the birth of an infant. A toddler also lives in the home. Which finding will cause the nurse to follow up? a. Plastic grocery bags are neatly stored under the counter. b. Electric outlets are covered in all rooms. c. No bumper pads are in the crib. d. Crib slats are 5 cm apart.

a. Plastic grocery bags are neatly stored under the counter.

A patient has an ankle restraint applied. Upon assessment the nurse finds the toes a light blue color. Which action will the nurse take next? a. Remove the restraint. b. Place a blanket over the feet. c. Immediately do a complete head-to-toe neurological assessment. d. Take the patient's blood pressure, pulse, temperature, and respiratory rate.

a. Remove the restraint.

A confused patient is restless and continues to try to remove the oxygen cannula and urinary catheter. What is the priority nursing diagnosis and intervention to implement for this patient? a. Risk for injury: Check on patient every 15 minutes. b. Risk for suffocation: Place ―Oxygen in Use‖ sign on door. c. Disturbed body image: Encourage patient to express concerns about body. d. Deficient knowledge: Explain the purpose of oxygen therapy and the urinary catheter.

a. Risk for injury: Check on patient every 15 minutes.

The nurse is caring for an older-adult patient admitted with nausea, vomiting, and diarrhea due to food poisoning. The nurse completes the health history. Which priority concern will require collaboration with social services to address the patient's health care needs? a. The electricity was turned off 3 days ago. b. The water comes from the county water supply. c. A son and family recently moved into the home. d. This home is not furnished with a microwave oven.

a. The electricity was turned off 3 days ago.

Which activity will increase the need for the nurse to monitor for equipment-related accidents? a. Using a patient-controlled analgesic pump b. Making an entry in a computer-based documentation record c. Using a plastic measuring device to accurately measure urine d. Removing medications from a manual medication-dispensing device

a. Using a patient-controlled analgesic pump

The nurse is teaching a group of older adults at an assisted-living facility about age-related physiological changes affecting safety. Which question would be most important for the nurse to ask this group? a. ―Are you able to hear the tornado sirens in your area?‖ b. ―Are you able to read your favorite book?‖ c. ―Are you able to taste spices like before?‖ d. ―Are you able to open a jar of pickles?‖

a. ―Are you able to hear the tornado sirens in your area?‖

The nurse is discussing threats to adult safety with a college group. Which statement by a group member indicates understanding of the topic? a. ―Smoking just to control stress is not good for my body.‖ b. ―Our campus is safe; we leave our dorms unlocked all the time.‖ c. ―As long as I have only two drinks, I can still be the designated driver.‖ d. ―I am young, so I can work nights and go to school with 2 hours' sleep.‖

a. ―Smoking just to control stress is not good for my body.‖

Which patient will the nurse see first? a. A 56-year-old patient with oxygen with a lighter on the bedside table b. A 56-year-old patient with oxygen using an electric razor for grooming c. A 1-month-old infant looking at a shiny, round battery just out of arm's reach d. A 1-month-old infant with a pacifier that has no string around the baby's neck

b. A 56-year-old patient with oxygen using an electric razor for grooming

The nurse is monitoring for Never Events. Which finding indicates the nurse will report a Never Event? a. Lack of blood incompatibility with a blood transfusion b. A surgical sponge is left in the patient's incision c. Pulmonary embolism after lung surgery d. Stage II pressure ulcer

b. A surgical sponge is left in the patient's incision

The nurse is assessing a patient for possible lead poisoning. Which patient is the nurse most likely assessing? a. A teenager b. A toddler c. A young adult d. An adolescent

b. A toddler

When making rounds the nurse observes a purple wristband on a patient's wrist. What information about the patient does this provide the nurse? a. They are allergic to certain medications or foods. b. A ―Do not resuscitate‖ order is in effect. c. The patient has a high risk for falls. d. The patient is at risk for seizures.

b. A ―Do not resuscitate‖ order is in effect.

An older-adult patient is using a wheelchair to attend a physical therapy session. Which action by the nurse indicates safe transport of the patient? a. Positions patient's buttocks close to the front of wheelchair seat. b. Backs wheelchair into elevator, leading with large rear wheels first. c. Places locked wheelchair on same side of bed as patient's weaker side. d. Unlocks wheelchair for easy maneuverability when patient is transferring.

b. Backs wheelchair into elevator, leading with large rear wheels first.

The patient applies sequential compression devices after going to the bathroom. The nurse checks the patient's application of the devices and finds that they have been put on upside down. Which nursing diagnosis will the nurse add to the patient's plan of care? a. Risk for falls b. Deficient knowledge c. Risk for suffocation d. Impaired physical mobility

b. Deficient knowledge

A home health nurse is teaching a family to prevent electrical shock. Which information will the nurse include in the teaching session? a. Run wires under the carpet. b. Disconnect items before cleaning. c. Grasp the cord when unplugging items. d. Use masking tape to secure cords to the floor.

b. Disconnect items before cleaning.

An adult patient presents to the emergency department and is treated for hypothermia. What risk factor should the patient be assessed for? a. Tobacco use b. Homelessness c. High carbohydrate diet d. History of chronic respiratory disorder

b. Homelessness

The emergency department has been notified of a potential bioterrorism attack. Which action by the nurse is priority? a. Monitor for specific symptoms. b. Manage all patients using standard precautions. c. Transport patients quickly and efficiently through the elevators. d. Prepare for posttraumatic stress associated with this bioterrorism attack.

b. Manage all patients using standard precautions.

A nurse is attempting to minimize the risk of future infection for a post-surgical patient about to be discharged. Which technique will the nurse teach the patient to best achieve this goal? a. Sanitizing of eating utensils b. Medical asepsis handwashing c. Wound care using surgical asepsis d. Limiting visitors during flu season

b. Medical asepsis handwashing

When the nurse discovers a patient on the floor, the patient states, ―I fell out of bed‖. The nurse assesses the patient and then places the patient back in bed. Which action should the nurse take next? a. Do nothing, no harm has occurred. b. Notify the health care provider. c. Complete an incident report. d. Re-assess the patient.

b. Notify the health care provider.

The nurse is caring for a hospitalized patient. Which behavior alerts the nurse to consider the temporary need for a restraint? a. The patient refuses to call for help to go to the bathroom. b. The patient continues to remove the nasogastric tube. c. The patient gets confused regarding the time at night. d. The patient does not sleep and continues to ask for items.

b. The patient continues to remove the nasogastric tube.

During the admission assessment, the nurse assesses the patient for fall risk. Which finding will alert the nurse to an increased risk for falls? a. The patient is oriented. b. The patient takes a hypnotic. c. The patient walks only 2 miles a day. d. The patient recently became widowed.

b. The patient takes a hypnotic.

The nurse has placed a yellow armband on a 70-year-old patient. Which observation by the nurse will indicate the patient has an understanding of this action? a. The patient removes the armband to bathe. b. The patient wears the red nonslip footwear. c. The patient insists on taking a ―water‖ pill in the evening. d. The patient who is allergic to penicillin asks the name of a new medicine.

b. The patient wears the red nonslip footwear.

The nurse is admitting an older adult to the surgical unit. What intervention is necessary when determining the safe use of side rails for this patient? a. Explain to the patient the need to call for assistance when side rails are up. b. Discuss whether the patient is accepting of having the side rails up. c. Assess the patient's ability to effectively follow instructions. d. Always keeping the bed in its lowest position to the floor.

c. Assess the patient's ability to effectively follow instructions.

A nurse is providing care to a patient. Which action indicates the nurse is following the National Patient Safety Goals? a. Identifies patient with one identifier before transporting to x-ray department. b. Initiates an intravenous (IV) catheter using clean technique on the first try. c. Uses medication bar coding when administering medications. d. Obtains vital signs to place on a surgical patient's chart.

c. Uses medication bar coding when administering medications.

The nurse is providing information regarding safety and accidental poisoning to a grandparent who will be taking custody of a 1-year-old grandchild. Which comment by the grandparent will cause the nurse to intervene? a. ―The number for poison control is 800-222-1222.‖ b. ―Never induce vomiting if my grandchild drinks bleach.‖ c. ―I should call 911 if my grandchild loses consciousness.‖ d. ―If my grandchild eats a plant, I should provide syrup of ipecac.‖

d. ―If my grandchild eats a plant, I should provide syrup of ipecac.‖

A home health nurse is performing a home assessment for safety. Which comment by the patient will cause the nurse to follow up? a. ―Every December is the time to change batteries on the carbon monoxide detector.‖ b. ―I will schedule an appointment with a chimney inspector next week.‖ c. ―If I feel dizzy when using the heater, I need to have it inspected.‖ d. ―When it is cold outside in the winter, I will use a non-vented heater.‖

d. ―When it is cold outside in the winter, I will use a non-vented heater.‖

What statement by the nurse demonstrates an understanding of food safety to be provided for a patient living alone? a. ―It's acceptable to eat unwashed fruits and vegetables if they are organically grown.‖ b. ―It's best to allow cooked foods to thoroughly cool off before putting them into the refrigerator.‖ c. ―You can use the same cutting board for meats and for vegetables if it is washed between uses.‖ d. ―Your perishable left-over food should be stored in a refrigerator at below 40F.‖

d. ―Your perishable left-over food should be stored in a refrigerator at below 40F.‖

A patient may need restraints. Which task can the nurse delegate to a nursing assistive personnel? a. Determining the need for restraints b. Assessing the patient's orientation c. Obtaining an order for a restraint d. Applying the restraint

d. Applying the restraint

A patient is admitted and is placed on fall precautions. The nurse teaches the patient and family about fall precautions. Which action will the nurse take in accordance with hospital policy? a. Check on the patient once a shift. b. Encourage visitors in the early evening. c. Place all four side rails in the ―up‖ position. d. Keep the patient on fall risk until discharge.

d. Keep the patient on fall risk until discharge.

A nurse reviews the history of a newly admitted patient. Which finding will alert the nurse that the patient is at risk for falls? a. 55 years old b. 20/20 vision c. Urinary continence d. Orthostatic hypotension

d. Orthostatic hypotension

The patient is confused, is trying to get out of bed, and is pulling at the intravenous infusion tubing. Which nursing diagnosis will the nurse add to the care plan? a. Impaired home maintenance b. Deficient knowledge c. Risk for poisoning d. Risk for injury

d. Risk for injury

The nurse is monitoring for risks for injury identified in the health care environment. Which finding will alert the nurse that these safety risks are occurring? a. Tile floors, cold food, scratchy linen, and noisy alarms b. Dirty floors, hallways blocked, medication room locked, and alarms set c. Carpeted floors, ice machine empty, unlocked supply cabinet, and nurse call system in reach d. Wet floors unmarked, failure to use lift for patient, and alarms not functioning properly

d. Wet floors unmarked, failure to use lift for patient, and alarms not functioning properly