PrepU Safety, Security, Emergency Preparedness

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

a. Toileting

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. 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

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. Drowsiness c. Fever d. Vomiting e. Headache

b. Drowsiness d. Vomiting e. Headache

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? a. Lock all cabinets that contain cleaning supplies. b. Restrain the baby in a car seat. c. Give warm bottles of formula to the baby. d. Keep all pots and pans in lower cabinets.

b. Restrain the baby in a car seat.

The nurse is evaluating risk factors for a developmentally diverse group of clients. Which client(s) is at risk for safety? Select all that apply. a. A machinist working in an environment with exposure to loud noises b. A 42-year-old client with left-side paralysis following a stroke c. An older adult client with a shuffling gait d. A toddler allowed to crawl in a house that has not been childproofed e. A sales executive worried about making the yearly sales quota

c. An older adult client with a shuffling gait d. A toddler allowed to crawl in a house that has not been childproofed

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? a. Providing a bed that is elevated from the floor b. Using restraints on the client to prevent a fall c. Raising all the side rails of the bed d. Placing the client in a bed with a bed alarm

d. Placing the client in a bed with a bed alarm

What is the primary role of the nurse in the care of clients who experience domestic violence? a. Serving as a witness in court b. Calling the police c. Identifying health education and counseling measures for the family d. Providing prompt recognition of the potential or actual threat to safety

d. Providing prompt recognition of the potential or actual threat to safety

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? a. "At what time did the child ingest the substance?" b. "Induce vomiting while you wait for emergency personnel to arrive." c. "What do you think that the child might have ingested?" d. "Check breathing and heart rate."

d. "Check breathing and heart rate."

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

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

Which nurse would be at the highest risk of causing a hazardous situation? a. A nurse who is administering medications to four clients b. A nurse who is transferred to another unit to assist with care c. A nurse who has placed a client in the bed with three side rails up d. A nurse who has worked 32 hours of overtime this week

d. A nurse who has worked 32 hours of overtime this week

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? a. Tenth b. Eighth c. First d. Fifth

d. Fifth

A 17-year-old is brought to the emergency department with a head injury. The nurse knows that adolescents are vulnerable to injuries related to: a. falls from beds. b. play-related injuries. c. falls from staircases. d. automobile accidents.

d. automobile accidents.

What is the leading cause of injury-related deaths in adults 65 and older? a. motor vehicle accidents b. alcoholism c. violence d. falls

d. falls

Which topic should a public health nurse emphasize when educating older adults on reducing their risk of poisoning? a. keeping medications in clearly labeled containers b. hidden sources of lead in the household environment c. avoiding the use of alternative and complementary therapies d. alternatives to chemical-based cleaning supplies

a. keeping medications in clearly labeled containers

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. a. Check the batteries in all smoke detectors. b. Remove extension cords from open spaces. c. Remove throw rugs from high traffic areas. d. Store prescription medications on the counter. e. Ensure appropriate lighting in hallways and entrances to the home.

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

The nurse is providing education to a group of healthy older adults. Which nursing recommendation best promotes client safety in an independent living environment? a. Encourage exercise that improves balance and muscle strength b. Suggest a high-fiber, low-fat diet c. Provide a pamphlet on maintaining healthy sleep habits d. Restrict consumption of liquids before bedtime

a. Encourage exercise that improves balance and muscle strength

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

a. Ensure that two fingers can be inserted between the restraint and the client's extremity. Explanation Restraints should be sufficiently loose for two fingers to be inserted between the restraint and the extremity. Restraints can be placed on ankles; quick-release knots should be tied to the bed frame, not the side rail. Restraints should be removed every 2 hours

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? a. Flush the eyes with water for 10 minutes. b. Advise the client to avoid blinking until after the eyes are irrigated. c. Flush the eyes with a cool saline solution for a 10-minute period. d. Wash the eyes with a hypertonic solution for at least 30 minutes.

a. Flush the eyes with water for 10 minutes.

A nurse makes a medication error and reports it to the nurse manager, requesting assistance filling out the incident report. What should the nurse manager educate the nurse about regarding the incident report? Select all that apply. a. It should provide a clear, concise recording of the situation b. It should include factual information about the incident. c. The incident report should be placed with the client's health records. d. Completion of the incident report should be noted in the nurse's notes. e. The nurse should include a personal perception about the cause of the incident

a. It should provide a clear, concise recording of the situation b. It should include factual information about the incident.

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. a. Mobility b. Developmental level c. Communication ability d. Community population e. Type of health care facility

a. Mobility b. Developmental level c. Communication ability

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. a. Offer regular, frequent opportunities for toileting. b. Obtain order from a licensed provider within minutes of restraint application. c. Maintain restraints until discharge. d. Check circulation and skin condition every 2 hours. e. Withhold information from family regarding restraints due to HIPAA.

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

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

a. Peer pressure causes children of this age to take risks.

The nurse manager is reviewing the QSEN quality and safety competencies for nurses. Which competencies are included in this initiative? Select all that apply. a. Quality improvement (QI) b. Client-centered care c. Teamwork and collaboration d. Revamping the licensing requirements for foreign-educated nurses Establishment of clinical career ladders

a. Quality improvement (QI) b. Client-centered care c. Teamwork and collaboration

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? a. Reduce distressing environmental stimuli to maximize client safety b. Apply limb restraints to ensure client safety c. Promptly document the change in client status d. Leave to notify the health care provider concerning a change in client status

a. Reduce distressing environmental stimuli to maximize client safety

An older adult client has developed diabetic neuropathy. What would be the most important education intervention for the client and family? a. Reduce the temperature on the water heater. b. Increase the amount of ventilation in the house. c. Obtain a carbon monoxide detector in the home. d. Keep the environment warmer in winter.

a. Reduce the temperature on the water heater.

The home care nurse observes that a child is learning to ride a bicycle. Which would the nurse teach the child about bicycle safety? a. The importance of wearing a helmet b. The importance of using wrist guards c. The importance of wearing knee pads d. The importance of using the buddy system

a. The importance of wearing a helmet

The nurse performs discharge teaching for the family of an older adult client with a visual impairment and decreased mobility. Which instruction would the nurse give to help prevent falls in the client's home? a. Use night-lights in bedrooms and bathrooms. b. Use ladders and step stools to reach high items. c. Place throw rugs in high traffic areas. d. Install 60 watt light bulbs in stairways.

a. Use night-lights in bedrooms and bathrooms.

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? a. "Store medications in a locked area to prevent children from getting into them." b. "Always provide close supervision for young children when they are in or around pools and bathtubs." c. "Never keep firearms in the home with young children." d. "Never smoke in the bed in the house when young children are present."

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

Which item would alert the home care nurse to a safety hazard threatening a young child? a. A gated stairway b. Padded child safety seat c. Dangling blind cords d. Three blankets in a crib

c. Dangling blind cords

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

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

The nurse is teaching an unlicensed assistive personnel (UAP) about fire safety. Which UAP statement demonstrates that teaching has been effective? a. "I will sound the alarm before I start moving a patient from a room." b. "I will rescue clients from harm before doing anything else." c. "I will leave all doors open after rescuing patients." d. "I know that nurses are the only ones who can extinguish a fire."

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

A nurse is teaching a community group about bicycle safety. Which statement should be included when creating a teaching plan regarding bicycle safety? a. "Young children secured in a bicycle passenger seat do not have to wear a helmet." b. "Parents are effective role models for children when they also wear helmets while riding." c. "Any helmet is appropriate for bicycle riding because all children should wear helmets when riding." d. "The chin strap on the helmet should be adjusted to fit loosely so that it does not choke the child."

b. "Parents are effective role models for children when they also wear helmets while riding."

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. Between 15% and 25% of falls result in fractures or soft tissue injury. b. A person with a history of falls is likely to fall again. c. A medication regimen that includes diuretics or analgesics places an individual at risk for falls. d. Some people are more at risk for accidents than others. e. Fires are responsible for most hospital incidents.

b. A person with a history of falls is likely to fall again. c. A medication regimen that includes diuretics or analgesics places an individual at risk for falls. d. Some people are more at risk for accidents than others.

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. a. Shares a one floor living space with a spouse b. Admits to drinking wine through the evening c. Has history of diabetic neuropathy d. Takes furosemide daily e. Participates in a walking club

b. Admits to drinking wine through the evening c. Has history of diabetic neuropathy d. Takes furosemide daily

A nurse making a home visit for a client living in a high-crime area observes that the apartment building does not have outside lighting. The nurse understands this is an important assessment for which reason? a. This assessment finding will make the client less able to go to social gatherings. b. Assessment includes risk factors in the home such as individual risk and unsafe environment. c. Nurses in home health care are not concerned with safety. d. Although important, this assessment is irrelevant to care.

b. Assessment includes risk factors in the home such as individual risk and unsafe environment.

The older adult client is confused and wanders at night at home. The caregiver is seeking assistance with this problem. The caregiver states, "I am so worried about my family member. What can I do and still get some rest at night?" What instruction(s) would the nurse provide to the caregiver? Select all that apply. a. Have the client exercise in the evening to ensure the client is tired at hours of sleep. b. Place locks on any doors to the outside that the client would be able to open. c. Provide low lights in the rooms in which the client may wander. d. Encourage the client to toilet prior to bedtime. e. Reduce stimulation, noise, and light a few hours prior to bedtime.

b. Place locks on any doors to the outside that the client would be able to open. c. Provide low lights in the rooms in which the client may wander. d. Encourage the client to toilet prior to bedtime. e. Reduce stimulation, noise, and light a few hours prior to bedtime.

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? a. All machines that are used infrequently are to remain plugged in. b. Refrain from using extension cords. c. Remove the plug from the wall by pulling the electric cord. d. Leave outlets and switches open so air circulates through them.

b. Refrain from using extension cords.

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? a. Impaired Bed Mobility Related to Muscle Wasting b. Risk for Injury Related to Agitation c. Noncompliance Related to Medication Regimen d. Chronic Confusion Related to Long-Standing Alcohol Use

b. Risk for Injury Related to Agitation

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? a. She may be beginning her menses. b. She may be the victim of cyber-bullying. c. She may be developing nutritional deficiencies from poor dietary habits. d. She has lost interest in academics because she has a boyfriend now.

b. She may be the victim of cyber-bullying.

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? a. correct placement of booster seats for the car b. Use of blankets, pillows, and stuffed animals in the crib c. the use of skid-proof mats for the bath tub d. safety of guns in the home

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

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? a. transferring the client from one location in the hospital to another b. administering medications to the client c. electronically reporting the results of diagnostic testing to the client's primary care provider d. admitting the client to the health care facility

b. administering medications to the client

The nurse has delegated several parts of basic care for a client who is a fall risk to an unlicensed assistive personnel (UAP) member. Which UAP action requires nursing intervention? a. assuring that there is a clear path between the bathroom and bed b. assisting the client to put on slippers prior to ambulation c. placing the bed into the lowest setting e. reminding the client to sit on the bed for a few moments before standing

b. assisting the client to put on slippers prior to ambulation

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? a. communicating the potential consequences of the near miss to the client involved b. identifying systemic factors on the unit that may have contributed to the event c. reinforcing the standards for nursing care to staff members who were involved d. ensuring that the client's nurse is held accountable and educated about best practice

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

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? a. "Concussions happen often in children of this age group, and they always bounce back fine." b. "Wearing bicycle helmets will keep your child safe from head injuries." c. "It is important to monitor frequently for headache, vomiting, visual disturbances, and changes in alertness." d. "Try to keep him resting for a few days at home using the television and his video games."

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

The nurse is assessing an adolescent with an annual physical. The parent reports a marked 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? a. "Parenting adolescents is challenging. Sometimes allowing natural consequences for behavior can result in positive change." b. "Before drawing conclusions, let's arrange inpatient assessment at an acute care facility to better understand what is going on with your child." c. "These could be signs of substance use. Open communication and seeing a counselor who specializes in substance use may be beneficial." d. "This is typical adolescent behavior. If you can maintain open lines of communication and get through it, it is likely to change."

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

A nurse is educating parents of preschoolers on appropriate safety measures for this age group. What might be a focus of the education plan? a. Smoking cessation b. Safety equipment for playing sports c. Childproofing the house d. Back to sleep guidelines

c. Childproofing the house

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

c. Investigate the possibility of discontinuing his or her catheter. Explanation Discontinuing the catheter, if medically prudent, would eliminate the risks associated with the resident's behavior. Limiting fluid intake or reducing diuretics would be unsafe and ineffective. Similarly, increasing the resident's activity is unlikely to reduce restlessness.

An individual calls the telehealth nurse and reports that a family member was just found on the floor of an enclosed garage while a car was still running. The family member is unconscious and cherry red in color. What direction will the telehealth nurse provide? a. Instruct the caller to quickly administer oral fluids. b. Direct the caller to search for a carbon monoxide detector in the garage. c. Open garage doors and windows, and call 911. d. Turn the car's air conditioner on to circulate flow of air.

c. Open garage doors and windows, and call 911.

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? a. Accompany the client to the bathroom every 4 hours around the clock. b. Limit the client's fluid intake during the evening. c. Provide a bedside commode and ensure adequate lighting. d. Obtain an order for insertion of an indwelling urinary catheter.

c. Provide a bedside commode and ensure adequate lighting. Explanation The use of a commode can often reduce the risk of falls that is associated with ambulating to the bathroom. Falls reduction is not considered a justifiable rationale for catheter insertion. Toileting every 4 hours may or may not be adequate for the client's needs. Fluid intake should never be reduced for the sole purpose of reducing urine output.

A nurse responds to the call bell and finds another nurse evacuating the client from the room, which has caught fire. Which action should the nurse take? a. Extinguish the fire. b. Confine the fire. c. Pull the fire alarm lever. d. Evacuate the unit.

c. Pull the fire alarm lever.

The school nurse is preparing a presentation about safety promotion for middle school students. Which topic should the nurse plan to include? a. Avoiding workplace injury b. Identification of hazards associated with falls c. The importance of consistent seat belt use d. The importance of practicing moderation when consuming alcohol

c. The importance of consistent seat belt use

The nurse is caring for an adult who requires IV fluids but continues to pull at the IV site and tubing. The adult child tries to calm the client, without success. Which short-term restraints should the nurse use to control the adult's movement during the procedure? a. Mummy restraint b. Elbow restraint c. Waist restraint d. Extremity restraint

d. Extremity restraint

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? a. Maintain a high bed position so the client will not attempt to get out unassisted. b. Keep the client sedated with tranquilizers. c. Allow the client to use the bathroom independently. d. Involve family members in the client's care.

d. Involve family members in the client's care.

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? a. New partnerships are established between the hospital and local schools of nursing. b. Hiring practices are reviewed to maximize the proportion of nurses who possess baccalaureate or graduate degrees. c. Systems are reviewed with the goal of achieving the best client outcomes at the lowest cost. d. New systems are introduced to increase communication between nurses and the members of other health disciplines.

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

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. Place the safety event report in the client's medical record for future reference. b. Make a copy of the safety event report for the client. c. File the safety event report in the appropriate file and document in the nurse's notes the date and time that it was filed. 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.

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

d. Supervise your child on the changing table.

The nurse is caring for a client who has been prescribed extremity restraints. Which action must be documented by the nurse? a. The type of personal protective equipment used by the nurse during restraint application b. A verbal prescription for the restraints, renewed every 48 hours c. A detailed description of the restraint application process d. The alternative measures attempted before applying the restraints

d. The alternative measures attempted before applying the restraints

he nurse is caring for a client who has been prescribed extremity restraints. Which action must be documented by the nurse? a. A detailed description of the restraint application process b. A verbal prescription for the restraints, renewed every 48 hours c. The type of personal protective equipment used by the nurse during restraint application d. The alternative measures attempted before applying the restraints

d. The alternative measures attempted before applying the restraints

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

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

Which level of health care provider may make the decision to apply physical restraints to a client? a. senior personal care assistant b. RN nurse manager c. LPN team leader d. nurse practitioner

d. nurse practitioner

Which action by the unlicensed assistive personnel (UAP) requires intervention from the nurse when providing care to an older adult client who is at risk for falls? a. has client sit in bed for a few moments before standing b. places bed at lowest setting c. clears a path from bed to bathroom d. provides slippers for ambulation

d. provides slippers for ambulation