Foundations patient safety and security

The nurse is discussing car safety with the mother of a 6-year-old child. The child's mother questions the need for the use of special car seats for her child. What information can be provided to her? "Car seats are only recommended until children are 3 years old." "At the age of 6 your child should be using a booster seat." "Car seats are recommended until children are at least 10 years old." "Your child will be safe in the car using the provided shoulder harness and lap belts."

"At the age of 6 your child should be using a booster seat."

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." "What do you think that the child might have ingested?" "At what time did the child ingest the substance?" "Induce vomiting while you wait for emergency personnel to arrive."

"Check breathing and heart rate."

The nurse is conducting a community education program on bike helmet safety. The nurse determines additional information is needed when a participant states: "I should be able to fit two fingers between my chin and the chin strap." "The helmet should rest 1 in (2.5 cm) above the eyebrows." "My child needs a helmet if in a secured passenger bike seat." "My child should wear a helmet every time he rides a bike."

"I should be able to fit two fingers between my chin and the chin strap."

he 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? "Did you leave the household chemical in reach of your child?" "Is your child breathing at this time?" "You should not have left your child alone while you showered." "Induce vomiting and call 911 right away."

"Is your child breathing at this time?"

A school nurse is conducting a safety seminar with students in 6th grade. Which teaching point is most important? "Make sure that you have smoke detectors in your house and that they're in working order." "If your clothes should catch on fire, go to an open area as quickly as possible." "Make sure that your family's microwave oven was made after 1999; otherwise, it may be a fire risk." "A wood-burning fireplace is a major fire risk, and it shouldn't be used unless necessary."

"Make sure that you have smoke detectors in your house and that they're in working order."

Which statement indicates that a family understands the teaching that has been provided by the nurse related to car seat safety for their 3-year-old child who weighs 31 lb (14 kg)? "We place our child in a front-facing car seat in the back seat of the car." "We place our child in a front-facing car seat in the front of the car." "We place our child in a rear-facing car seat in the back seat of the car." "We place our child in a rear-facing car seat in the front of the car."

"We place our child in a rear-facing car seat in the back seat of the car."

A new mother inquires about the use of a car seat for her infant. Which information provided by the nurse is most accurate regarding the use of a rear-facing safety seat for an infant? A rear-facing safety seat should be used for infants and toddlers younger than 2 years old or up to the maximum weight for the seat. A rear-facing safety seat should be used for infants and toddlers younger than 2 years old and weighing less than 20 lb (9 kg). A rear-facing safety seat should be used for infants younger than 1 year old or up to the maximum weight for the seat. A rear-facing safety seat should be used for infants younger than 1 year old and weighing more than 20 lb (9 kg).

A rear-facing safety seat should be used for infants and toddlers younger than 2 years old or up to the maximum weight for the seat.

A client has frequent readmissions for fall-related injuries. Which is the most appropriate intervention by the nurse? Perform a vision test with Snellen chart Arrange an audiology consult to evaluate hearing Assess the client for signs and symptoms of osteoporosis Arrange for a skilled home care assessment

Arrange for a skilled home care assessment

The nurse is assessing a client's mental health competence and decision-making ability. Which activity will best provide the needed information to the nurse? Ask the client to read and discuss a passage from a pamphlet. Ask the client "what if" questions to determine level of thought organization. Ask the client to review his medical health history to assess for the level of organization of his thought processes. Discuss with the client's family any concerns about his mental stability.

Ask the client "what if" questions to determine level of thought organization.

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. Document the observed behaviors in the client's chart. Nothing, as it is none of the nurse's concern. Report the suspicions to the authorities.

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

A confused client is pulling at the IV line. When considering alternatives to restraints, which nursing intervention would be used first? Request a sedative from health care provider Conceal IV tubing with gauze wrap Ask visiting family member to stay Assure bed alarms are activated

Conceal IV tubing with gauze wrap

A client has presented to the emergency department after splashing a chemical in the eyes. When managing the injury, what should be included in the plan of care? Wash the eyes with a hypertonic solution for at least 30 minutes. Advise the client to avoid blinking until after the eyes are irrigated. Flush the eyes with water for 10 minutes. Flush the eyes with a cool saline solution for a 10-minute period.

Flush the eyes with water for 10 minutes.

What teaching will the community health nurse include for parents of toddlers? Place the child securely on a changing table. Household cleaners must be kept out of reach. Purchase protective sporting equipment. Peer pressure can contribute to risk-taking.

Household cleaners must be kept out of reach.

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? Investigate the possibility of discontinuing his or her catheter. Limit the resident's fluid intake in order to reduce his or her urge to void. Collaborate with the resident's health care provider to have his or her diuretics discontinued. Increase the resident's physical activity to reduce evening restlessness.

Investigate the possibility of discontinuing his or her catheter.

A hospital is introducing a program that has the goal of aligning practices more closely with the Quality and Safety Education for Nurses (QSEN) project. What initiative best exemplifies QSEN competencies? New systems are introduced to increase communication between nurses and the members of other health disciplines. Systems are reviewed with the goal of achieving the best client outcomes at the lowest cost. Hiring practices are reviewed to maximize the proportion of nurses who possess baccalaureate or graduate degrees. New partnerships are established between the hospital and local schools of nursing.

New systems are introduced to increase communication between nurses and the members of other health disciplines.

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? Open doors and windows. Wait inside until emergency personnel arrive. Allow emergency personnel to apply oxygen. Recommend that carbon monoxide detectors be installed in the home.

Open doors and windows.

The nurse is teaching the caregiver of an adolescent child about safety. Which teaching will the nurse include? Supervise your child on the changing table. Place all household cleaners out of reach. Buy protective sporting equipment. Peer pressure causes children of this age to take risks.

Peer pressure causes children of this age to take risks.

he nurse is teaching the caregiver of an adolescent child about safety. Which teaching will the nurse include? Supervise your child on the changing table. Place all household cleaners out of reach. Buy protective sporting equipment. Peer pressure causes children of this age to take risks.

Peer pressure causes children of this age to take risks.

An older adult client with an unsteady gait has been experiencing urinary urgency after being diagnosed with a urinary tract infection. What is the nurse's best action for reducing the client's risk of falls? Provide a bedside commode and ensure adequate lighting. Obtain an order for insertion of an indwelling urinary catheter. Limit the client's fluid intake during the evening. Accompany the client to the bathroom every 4 hours around the clock.

Provide a bedside commode and ensure adequate lighting.

The nurse has completed a comprehensive assessment of a client who has been admitted to the hospital experiencing acute withdrawal from alcohol. What nursing diagnosis would provide the clearest justification for the use of physical restraints during this client's care? Impaired Bed Mobility Related to Muscle Wasting Noncompliance Related to Medication Regimen Risk for Injury Related to Agitation Chronic Confusion Related to Long-Standing Alcohol Use

Risk for Injury Related to Agitation

The nurse is teaching the caregiver of an infant about safety. Which teaching will the nurse include? Supervise your child on the changing table. Place all household cleaners out of reach. Buy protective sporting equipment. Peer pressure causes children of this age to take risks.

Supervise your child on the changing table.

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 acute care nurse is caring for a client who is at risk for falling. Which desired outcome is most appropriate for this client? The client will not experience a fall and remains free of injury. The client will stay in bed. The client will wear nonskid footwear The client will not ambulate without assistance.

The client will not experience a fall and remains free of injury.

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 adds the information in the safety event report to the client health record. The nurse calls the primary health care provider to fill out and sign the safety event report. The nurse provides an opinion of the physical and mental condition of the client that may have precipitated the incident. The nurse details the client's response and the examination and treatment of the client after the incident.

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

Which factor is related to the highest proportion of falls in long-term care settings? Toileting Agitation Polypharmacy Impaired sleep patterns

Toileting

The nurse is preparing to discuss safety with a group of parents of infants. When planning the program, which topic would be most important to include? the use of skid-proof mats for the bath tub safety of guns in the home correct placement of booster seats for the car Use of blankets, pillows, and stuffed animals in the crib

Use of blankets, pillows, and stuffed animals in the crib

A group of children is preparing for a camping trip in the woods with camp counselors. The children are learning about health promotion activities to use on their upcoming camping trip. Which principle is most important for the nurse to teach to promote a safe camping experience? Wearing sturdy shoes for hiking Using the buddy system during the trip Avoiding poison ivy Running on smooth surfaces

Using the buddy system during the trip

A program has been introduced at a hospital with the goal of improving client safety. The nurses participating in the program should recognize what event as posing the most significant threat to a client's safety? transferring the client from one location in the hospital to another electronically reporting the results of diagnostic testing to the client's primary care provider administering medications to the client admitting the client to the health care facility

administering medications to the client

The school nurse is providing education on poisoning risks to adolescent students. Which topic does the nurse include in the teaching? experimentation with drugs and inhalants ingestion of substances in the home that contain lead poisoning from polypharmacy ingestion of laundry cleaning agents

experimentation with drugs and inhalants

A near miss has taken place on a medical unit in which a client nearly received a unit of packed red blood cells of an incompatible blood type. In the follow up to this event, which action should be prioritized? identifying systemic factors on the unit that may have contributed to the event reinforcing the standards for nursing care to staff members who were involved ensuring that the client's nurse is held accountable and educated about best practice communicating the potential consequences of the near miss to the client involved

identifying systemic factors on the unit that may have contributed to the event

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: mass trauma terrorism. chemical terrorism. bioterrorism. nuclear terrorism.

mass terrorism

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:

mass trauma terrorism.

The nurse is caring for a client that is disoriented. The nurse places the client in soft wrist restraints to discourage pulling at a nasogastric tube. Which nursing action(s) is appropriate? Select all that apply. Obtain order from a licensed provider within minutes of restraint application. Withhold information from family regarding restraints due to HIPAA. Check circulation and skin condition every 2 hours. Offer regular, frequent opportunities for toileting. Maintain restraints until discharge.

obtain order from a licensed provider within minutes of restraint application check circulation and skin every 2 hours offer regular, frequent opportunities for toileting

An older adult is admitted to the hospital with a fractured hip. The client suddenly develops acute onset of confusion and hallucinations. Which action should the nurse implement first? Leave to notify the health care provider concerning a change in client status Apply limb restraints to ensure client safety Promptly document the change in client status Reduce distressing environmental stimuli to maximize client safety

reduce distressing environment stimuli to maximize client safety

The nurse cares for a client who is postoperative after an abdominal surgery. Which is the most important statement for the nurse to use in teaching this client? "It is important to us that you remain free from injury." "You will mostly stay in bed while you are hospitalized." "Use the call bell for any needs and wear nonslip footwear." "Do not get up without assistance for any reason."

use the call bell for any needs and wear nonslip footwear

A nurse is applying restraints to a confused client who has threatened the safety of a roommate. Which actions would the nurse perform when properly applying restraints to a client? Select all that apply. Check agency policy for the application of restraints and secure a physician's order. Choose the most restrictive type of device that allows the least amount of mobility. Pad bony prominences. For a restraint applied to an extremity, ensure that the restraint is tight enough that a finger cannot be inserted between the restraint and the client's wrist or ankle. Fasten the restraint to the side rail. Remove the restraint at least every 2 hours or according to agency policy and client need.

Check agency policy for the application of restraints and secure a physician's order. Pad bony prominences. Remove the restraint at least every 2 hours or according to agency policy and client need.

A nurse is making a home visit for a client with several home safety concerns. On which safety concept(s) would the nurse advise the client? Select all that apply. Remove extension cords from open spaces. Check the batteries in all smoke detectors. Store prescription medications on the counter. Ensure appropriate lighting in hallways and entrances to the home. Remove throw rugs from high traffic areas.

Remove extension cords from open spaces. Check the batteries in all smoke detectors. Ensure appropriate lighting in hallways and entrances to the home. Remove throw rugs from high traffic areas.

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. Fires are responsible for most hospital incidents. Between 15% and 25% of falls result in fractures or soft tissue injury. A medication regimen that includes diuretics or analgesics places an individual at risk for falls. A nurse whose behavior is reasonable and prudent, and similar to what would be expected of another nurse in a similar circumstance, is still likely to be found liable if a client falls, especially if an injury results.

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.

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. The nurse should include a note on the client's chart that mentions the report. The nurse should await results of the x-ray before filing the report. The nurse should make a copy of the safety event report and place it in the client's medical record.

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

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 Establishment of clinical career ladders Revamping the licensing requirements for foreign-educated nurses Quality improvement (QI)

client-centered care teamwork and collaboration quality improvement

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." "Never smoke in the bed in the house when young children are present." "Store medications in a locked area to prevent children from getting into them." "Never keep firearms in the home with young children."

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

A nurse failed to document the administration of a client's warfarin and the nurse on the next shift administered the drug again, believing that it had been overlooked. When performing root cause analysis, what question should be asked first? "Has this, or something very similar, ever happened on the unit before?" "Why did the second nurse administer this drug to the client?" "What could the two nurses have done to ensure this did not happen?" "What were the possible adverse outcomes that could have resulted from this error?"

"What could the two nurses have done to ensure this did not happen?"