PrepU safety chapter 26

Trying to balance too many activities can result in sleep deprivation.

A 14-year-old boy is in the clinic for his well-child exam. When the client asks his mother if she has any questions for the practitioner, she states "He sleeps so much. I am worried about how lazy he is." What does the nurse know to be true about sleep in adolescents?

"How did the nurse's actions contribute to this error?"

A large health care organization has committed to promoting a just culture when adverse events and near misses take place. Which question will guide the organization's response when a nurse commits an error?

involve family members in the client's care

A nurse working in a long-term care facility institutes interventions to prevent falls in the older adult population. Which intervention would be an appropriate alternative to the use of restraints for ensuring client safety and preventing falls?

Draw up the medication in a location that has minimal distractions.

A nursing student is tired and is struggling to keep up with necessary tasks during a shift. The student is preparing to draw up a patient's prescribed dose of hydromorphone (Dilaudid), an opioid analgesic. What is the student's most appropriate action?

Experimentation with drugs and inhalants.

A school nurse is aware of poisoning risks in the adolescent population. Poisoning in this age group is most often related to:

automobile accidents

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

"It is important to monitor frequently for headache, vomiting, visual disturbances, and changes in alertness."

An 8-year-old boy fell off his bicycle. He was not wearing a helmet and has sustained a concussion. What information should the nurse teach the parents about concussions?

Carpal tunnel syndrome

An administrative assistant of a large factory visits the medical unit and tells the nurse she is having pain in the right wrist, numbness in the index finger, and decreased mobility of the right hand. The nurse suspects the client has what?

Put a small nightlight in the hall and stair.

An older adult client is planning to move with her son and daughter-in-law into a bigger apartment. The son asks the nurse for some tips to keep his mother safe. What would the nurse most likely include?

1 hour

Owen is a 15-year-old client who is waking up postoperatively. He became combative and tried to strangle one of the nurses. A support team was called and 4-point restraints were applied in this emergent situation. How soon does a licensed provider need to assess the client and place the restraint order?

RACE (rescue; alarm; confine; evacuate).

The acronym health care workers use to remember the safety procedures in the event of fire is:

Using pesticides for mosquitoes

The health department is reviewing community health initiatives for the year. During the summer, the health department focuses infection control activities on which program?

polypharmacy and multiple use of extension cords

The nurse educator has just completed a lecture regarding older adults and hazards in the home. The nurse educator recognizes that the education was effective when the students state that common dangers in the home setting of an older adult include:

Remove the client from the room.

The nurse on a medical-surgical unit notices smoke from a client's room. Upon entering, the nurse notes that the curtain in the room is on fire. What should be the nurse's first action?

Use protective sporting equipment.

The school nurse is educating 7th grade children about safety. Which recommendation is most appropriate for this age group?

Doors of classrooms and offices are open. Elevators are used to increase speed of vacating the building.

The school nurse is evaluating a school's response to a fire drill. Which action requires the school nurse to provide teaching to the schoolteachers, staff, and students? (Select all that apply.)

Fifth.

Unintentional injuries are a major cause of disability and death in the United States. For adults, where do unintentional injuries fall on the list of leading causes of death?

Multiple roles, including triage and the distribution of resources

What best describes the nurse's role in disaster preparedness?

Avoid climbing on a chair or table to reach items that are too high. Use a nightlight. Remove clutter from walkways. Keep electrical and telephone cords against the wall and out of walkways. Consider the use of a raised toilet seat.

Which topics should be included in an education plan for preventing falls in the home? Select all that apply.

Replace common healthcare items with latex-free equipment.

the nurse is admitting a client to a medical-surgical unit who states, "If someone brings balloons to me, I might have trouble breathing." What is the appropriate nursing action?

having two nurses independently check the dosage of high-risk medications.

the nurses on a critical care unit can utilize the safety strategy of redundancy by:

Heatstroke

the older adult will have an increased risk for developing which of the following?

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

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?

The nurse includes the client as a member of the health care team.

A nurse follows the universal client compact principles for partnership when providing care for clients. Which nursing action reflects this philosophy?

The nurse makes health care decisions for a patient who is uncooperative.

A nurse follows the universal patient compact principles for partnership when providing care for patients. Which nursing action does not reflect this philosophy?

Call for assistance to remove the client from the area

A nurse in a psychiatric care unit finds that a client with psychosis has become violent and is actively trying to harm another client in the unit. What action should the nurse take?

Obtain a three-prong grounded plug adapter.

A nurse is caring for a client who is receiving an intravenous therapy through an IV pump. Which intervention should the nurse implement to ensure electrical safety?

Childproofing the house

A nurse is educating parents of preschoolers on appropriate safety measures for this age group. What might be a focus of the education plan?

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

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?

-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. -Between 15% and 25% of falls result in fractures or soft tissue injury. -Some people are more prone to have accidents than others. -A person with a history of falls is likely to fall again. -A medication regimen that includes diuretics or analgesics places an individual at risk for falls.

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.

Restrain the baby in a car seat

A nurse is preparing discharge education for a client with a newborn baby. What is the highest priority item that must be included in the education plan?

Dilute with milk or water.

A nurse is treating an adolescent who swallowed drain cleaner on a dare from his classmates. Which interventions would the nurse perform related to this situation?

The nurse researches best current practices for prevention of the spread of infection in physician offices.

A nurse is using the QSEN competency of evidence-based practice when caring for clients. What is an example of this competency?

Obtain order from a licensed provider within minutes of restraint application. Offer regular, frequent opportunities for toileting. Check circulation and skin condition every 2 hours.

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.

black debris in nasal passages impaired judgement mild cough

The nurse is caring for a client that was brought to the emergency department after a building fire. Which assessment finding alerts the nurse to possible smoke inhalation? (Select all that apply.)

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

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

Call Nutrition Services for a plain hamburger. (tomato contains chitinase, a latex protein)

The nurse is caring for a client with a latex allergy. When the dietary tray arrives, the nurse notes that it contains a hamburger with lettuce and tomato, baked potato, apple, chocolate chip cookie, and small serving of milk. What is the appropriate nursing action?

Flag the chart and room door. Apply an allergy-alert identification bracelet on the client. Communicate to the interdisciplinary healthcare team to use nonlatex equipment. Teach client to wear Medic-Alert bracelet.

The nurse is caring for a client with a latex allergy. Which nursing interventions are appropriate? (Select all that apply.)

Take the restraints off, stay with her, and talk gently to her.

The nurse is caring for an 80-year-old patient who was admitted to the hospital in a confused and dehydrated state. After the patient 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 patient?

27-year old who cannot eat avocados

The nurse is caring for four clients. Which client does the nurse anticipate is at highest risk for latex sensitivity?

21 year old who cannot eat bananas

The nurse is caring for four clients. Which does the nurse anticipate may have a latex sensitivity?

Risk for Poisoning related to poor eyesight and the inability to read medication labels

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?

Supervise the child closely to prevent injury. Childproof the house to ensure that poisonous products and small objects are out of reach. Do not leave the child alone in the bathtub or near water.

The nurse is educating parents of toddlers on how to prevent injuries and promote safety for their children. What are age-appropriate safety interventions for this age group? Select all that apply.

The child's feet touch the floor of the car when belted in with the lap and shoulder belt.

The nurse is performing a safety belt fit test for a young client at a well-child check-up. What criteria confirms that the child may sit in the back seat of a vehicle with a lap and shoulder belt in place?

Refrain from using extension cords.

The nurse is providing discharge teaching to the family of an older adult client. Which teaching will the nurse include to decrease the risk for electric shock?

Hair dryer is placed next to the sink.

The nurse is providing safety teaching to the family of an older adult client. Which finding in the client's home will the nurse teach the family to address?

Suggest to the nurse manager that an in-service on abbreviation use would be helpful.

The nurse is reading another nurse's notes that were recorded in the electronic health record (EHR) during the previous shift. What is the appropriate nursing action when numerous unapproved abbreviations are noticed in the previous nurse's notes?

Wash hands thoroughly after removing gloves with a pH balanced soap.

The nurse is teaching a nursing student about proper latex glove use. Which teaching will the nurse include?

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

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

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

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

class A

The nurse is teaching fire safety to members of a community. When a community member asks which type of fire extinguisher would be appropriate to put out a bonfire, what will the nurse identify?

class B

The nurse is teaching fire safety to members of a community. When a community member asks which type of fire extinguisher would be appropriate to put out a gasoline fire, what will the nurse identify?

class C

The nurse is teaching fire safety to members of a community. When a community member asks which type of fire extinguisher would be appropriate to put out an electrical fire, what will the nurse identify?

Supervise your child on the changing table.

The nurse is teaching the caregiver of an infant about safety. Which teaching will the nurse include?

"Is your child breathing at this time?"

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?

The client will demonstrate safety measures to prevent falls.

What is the most appropriate outcome for the client that has a nursing diagnosis of "Risk for injury related to the use of assistive mobility devices in an unfamiliar environment?"

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

What statement indicates that a family understands the teaching that has been provided by the nurse related to car seat safety for their 9-month-old infant?

A hospital has set ambitious targets for reducing the incidence of catheter-related urinary tract infections.

Which action directly addresses one of the Joint Commission 2015 Hospital National Safety Goals?

Dangling blind cords

Which item would alert the home care nurse to a safety hazard threatening a young child?

Nurse Practitioner

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

A nurse who has worked 32 hours of overtime this week

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

The mother loves to drink coffee all day.

Which nursing assessment finding while screening a family with an 11-month-old infant who is beginning to pull to stand should be most concerning?

social pressure

Which reason best explains why adolescents behave in an unsafe manner despite knowledge of a particular activity's risk?

Keeping medications in clearly labeled containers

Which topic should a public health nurse emphasize when educating older adults on reducing their risk of poisoning?

trial and error

A nurse instructs a group of parents of preschool-age children that the rules of safe social interaction for this age group are often learned by:

experimentation with drugs and inhalants.

A school nurse is aware of poisoning risks in the adolescent population. Poisoning in this age group is most often related to:

Mass trauma 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:

The nurse administrator sets up a committee to review the procedure manual and recommend any needed changes. The nurse schedules a meeting with the nurse manager to review and update the policies for client admissions. The nurse manager schedules a meeting of staff to review client outcomes on the hospital ward.

Nurses are expected to have the knowledge, skills, and attitudes (KSAs) necessary to continually improve the quality and safety of the health care system within which they work. Which KSAs are examples of nursing actions based on the QSEN competency of quality improvement? Select all that apply.

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

The acute care nurse is caring for a client who is at risk for falling. Which desired outcome is most appropriate for this client?

importance of consistent seat belt use

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

Open doors and windows

The telehealth nurse receives a call from a caller who states that upon entering the home, two confused family members have been found 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?

Initiate use of a bed alarm.

The unlicensed personnel 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?

Avoid stuffed animals and blankets in the crib.

What is the most important safety concept that a nurse should include in the teaching plan for a family with a newborn infant in the household?

Providing prompt recognition of the potential or actual threat to safety

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

CDC

What national organization determined that unintentional injuries were the fifth-leading cause of all deaths in the United States?

drowsiness vomiting headache

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.

the amount of money the hospital receives from the Centers for Medicare & Medicaid Services.

A client has been discharged from the hospital after being treated for a myocardial infarction. The client has been asked to evaluate the care received by completing the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The results of this survey may affect:

Flush the eyes with water for 10 minutes.

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?

Placing the client in a bed with a bed alarm

A client in a long-term care facility has become increasingly unsteady. The nurses are worried that the client will climb out of bed and fall. Which measure would be a priority recommendation for this client?

Report this sentinel event to the Joint Commission and to relevant state agencies

A client on a hospital unit has been infected with hepatitis C virus (HCV) because a nurse mistakenly connected an HCV-positive client's intravenous pump and tubing. What is an appropriate response by the hospital to this incident?

fill out an incident report, with the goal of preventing a similar event in the future.

A client went missing from a long-term care facility and an emergency code was called. After a search of one hour, the client was discovered in a utility room that should have been inaccessible. When responding to this event, staff should:

The hospital must bear any costs incurred for treating the client's injury.

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

Report the event to the Joint Commission.

A client who was receiving care on a psychiatric unit committed suicide at a time when nurses are known to be handing off to nurses on the next shift. What is a responsibility of the organization when responding to this sentinel event?

She may be the victim of cyber-bullying.

A father asks the nurse who is caring for his 13-year-old daughter why his daughter could be performing poorly in school lately, and why she is distancing herself from friends and family. Which of these possibilities would the nurse consider as the priority risk?

Avoid unattended baths for the toddler.

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?

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

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?

Keep coffee cups on the counter above the child's reach.

A nurse is providing instructions to the mother of a toddler regarding the prevention of burn injuries in the toddler. Which instruction is the priority to provide to the mother?

Limit the number of other adolescents in the car. Never text while driving. Always wear a seat belt. Obey the speed limit.

A school nurse is teaching a group of adolescents about safe driving. What behaviors should the nurse encourage in order to help prevent motor vehicle accidents? Select all that apply.

Assessment of vital signs and respiratory status

A school-age child is admitted to the emergency room with the diagnosis of a concussion following a collision when playing football. After the collision, the parents state that he was "knocked out" for a few minutes before recognizing his surroundings. What is the priority assessment when the nurse first sees the client?

a dose of an antipsychotic

A staff development nurse is providing an in-service to a group of nurses on the use of restraints in health care facilities. What is an example of a chemical restraint?

Apply an allergy-alert identification bracelet on the client.

The nurse has just admitted a client with a latex allergy to the medical-surgical nursing floor. Which is the priority nursing intervention?

Mobility Communication ability Developmental level

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

"These could be signs of substance use. Open communication and seeing a counselor who specializes in substance use would be beneficial."

The nurse is assessing an adolescent with an annual physical. The parent reports noticing a change in the child's behavior lately, including mood swings, withdrawal from the family, and failing school grades. The parent does not know what to do and asks the nurse for guidance. What is the most appropriate guidance from the nurse?

"I should be able to fit two fingers under the chin strap."

The nurse is conducting a community education program on bike helmet safety. The nurse determines additional information is needed when a participant states:

The 2-year-old leaning against the screen of a window in a classroom.

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?

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

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

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

The nurse overhears an older 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?

The client will identify behaviors that would decrease the risk for injury.

What is the best positive short-term outcome for a client with the nursing diagnosis of Risk for injury related to risk taking behaviors?

Have a meeting place outside the home in case of fire.

When educating families on fire safety in the home, which information is important for the nurse to emphasize?

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

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?

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

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?