Chapter 28: 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? 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.
Ask to examine the client alone in order to speak to her privately.
The nurse is caring for a new older adult client who states the need to use the restroom. Which safety intervention must the nurse perform first? Assess the need for assistance with ambulation. Arrange furniture securely so that the client has something to hold on to. Apply socks to the client's feet. Apply a lap belt to assist with transfer
Assess the need for assistance with ambulation.
A nurse is educating parents of preschoolers on appropriate safety measures for this age group. What might be a focus of the education plan? Smoking cessation Childproofing the house Back to sleep guidelines Safety equipment for playing sports
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? Childproofing the house Smoking cessation Back to sleep guidelines Safety equipment for playing sports
Childproofing the house
The nurse manager is reviewing the QSEN quality and safety competencies for nurses. Which competencies are included in this initiative? Select all that apply. Establishment of clinical career ladders Client-centered care Teamwork and collaboration Quality improvement (QI) Revamping the licensing requirements for foreign-educated nurses
Client-centered care Teamwork and collaboration Quality improvement (QI)
The community health nurse is performing a home visit to a family with a toddler. Which observation should prompt the nurse to perform safety education? Absence of pads on the stairs Use of an electric heater in the house Three blankets in the child's crib Dangling blind cords
Dangling blind cords
Which level of health care provider may make the decision to apply physical restraints to a client? LPN team leader RN nurse manager senior personal care assistant nurse practitioner
nurse practitioner
A confused client is pulling at the IV line. When considering alternatives to restraints, which nursing intervention would be used first? Conceal IV tubing with gauze wrap Assure bed alarms are activated Request a sedative from health care provider Ask visiting family member to stay
Conceal IV tubing with gauze wrap
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? "Never keep firearms in the home with young children." "Store medications in a locked area to prevent children from getting into them." "Never smoke in the bed in the house when young children are present." "Always provide close supervision for young children when they are in or around pools and bathtubs."
"Always provide close supervision for young children when they are in or around pools and bathtubs."
The nurse is teaching an unlicensed assistive personnel (UAP) about fire safety. Which UAP statement demonstrates that teaching has been effective? "I know that nurses are the only ones who can extinguish a fire." "I will rescue clients from harm before doing anything else." "I will leave all doors open after rescuing clients." "I will sound the alarm before I start moving a client from a room."
"I will rescue clients from harm before doing anything else."
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? "Is your child breathing at this time?" "You should not have left your child alone while you showered." "Did you leave the household chemical in reach of your child?" "Induce vomiting and call 911 right away."
"Is your child breathing at this time?"
A nurse is teaching a community group about bicycle safety. Which statement should be included when creating a teaching plan regarding bicycle safety? "The chin strap on the helmet should be adjusted to fit loosely so that it does not choke the child." "Young children secured in a bicycle passenger seat do not have to wear a helmet." "Any helmet is appropriate for bicycle riding because all children should wear helmets when riding." "Parents are effective role models for children when they also wear helmets while riding."
"Parents are effective role models for children when they also wear helmets while riding."
The nurse is presenting content on fire safety to a family. One of the family members tells the nurse that they have designated a meeting spot in their front yard in case of fire and that they practice using escape routes. Which is the nurse's best response? "It's preferable to have a meeting place that's at least 100 yards from your home." "That's an important part of an overall fire safety plan." "It's preferable to focus on fire extinguisher safety because most people can't follow escape routes in a fire." "Make sure your escape route passes through each family member's bedroom."
"That's an important part of an overall fire safety plan."
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? 19-year-old male college student majoring in physics 25-year-old female who just accepted her first job 34-year-old male who does not use a seat belt 40-year-old female who is working two jobs
19-year-old male college student majoring in physics
Which client will the nurse assess for sensory-perceptual alterations? 12-year-old client who sprained their wrist skateboarding 16-year-old pregnant client who has morning sickness 42-year-old client who is a single parent with a sick child home from school 84-year-old client with four recent driving violations
84-year-old client with four recent driving violations
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 prioritize what action? Document strategies in the client's health record for preventing future incidents. Complete an incident report to determine who was primarily responsible for the event. Fill out an incident report, with the goal of preventing a similar event in the future. Hold a facility-wide meeting to identify strategies for making improvements to the safety of residents.
Fill out an incident report, with the goal of preventing a similar event in the future.
When educating families on fire safety in the home, which information is important for the nurse to emphasize? Have a meeting place outside the home in case of fire. Use extension cords to prevent shock. Keep a fire extinguisher in a closet. Account for all members and then exit together.
Have a meeting place outside the home in case of fire.
What teaching will the community health nurse include for parents of toddlers? Purchase protective sporting equipment. Place the child securely on a changing table. Peer pressure can contribute to risk-taking. Household cleaners must be kept out of reach.
Household cleaners must be kept out of reach.
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? 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 Reinforcing the standards for nursing care to staff members who were involved Identifying systemic factors on the unit that may have contributed to the event
Identifying systemic factors on the unit that may have contributed to the event
One of the leading causes of death in the United States is drowning. How can the nurse assist in lowering this statistic? Educate children in cardiopulmonary resuscitation. Implement drowning prevention strategies. Require fencing around all pools. Begin swim lessons with toddlers.
Implement drowning prevention strategies.
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? About 10% of home fire deaths occur in a home without a smoke detector. Most home fires are caused by children playing with matches. Most people who die in house fires die of smoke inhalation rather than burns. Most fatal home fires occur while people are cooking.
Most people who die in house fires die of smoke inhalation rather than burns.
What is the rationale for health care personnel to orient clients to rooms and equipment when they are admitted to the hospital? It is hospital policy. It allows time for the health care provider to write admission orders. It is part of the routine and is included on the admission checklist. Orienting clients to the surroundings decreases the potential for injury.
Orienting clients to the surroundings decreases the potential for injury.
What is the primary role of the nurse in the care of clients who experience domestic violence? Identifying health education and counseling measures for the family Providing prompt recognition of the potential or actual threat to safety Serving as a witness in court Calling the police
Providing prompt recognition of the potential or actual threat to safety
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? Evacuate the unit. Extinguish the fire. Pull the fire alarm lever. Confine the fire.
Pull the fire alarm lever.
A nurse is completing an intake assessment. The nurse notes that an older adult client appears to have bruises in varying stages of healing. Which is the nurse's most appropriate initial action? Notify the primary care provider about the bruises. Question the client about the source of the bruises. Contact the facility's social work department. Request permission from the client to photograph the bruises.
Question the client about the source of the bruises.
A nurse is completing an intake assessment. The nurse notes that an older adult client appears to have bruises in varying stages of healing. Which is the nurse's most appropriate initial action? Question the client about the source of the bruises. Contact the facility's social work department. Request permission from the client to photograph the bruises. Notify the primary care provider about the bruises.
Question the client about the source of the bruises.
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? Reduce distressing environmental stimuli to maximize client safety Apply limb restraints to ensure client safety Leave to notify the health care provider concerning a change in client status Promptly document the change in client status
Reduce distressing environmental stimuli to maximize client safety
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? Leave outlets and switches open so air circulates through them. All machines that are used infrequently are to remain plugged in. Refrain from using extension cords. Remove the plug from the wall by pulling the electric cord.
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? Refrain from using extension cords. All machines that are used infrequently are to remain plugged in. Remove the plug from the wall by pulling the electric cord. Leave outlets and switches open so air circulates through them.
Refrain from using extension cords.
A nurse smells smoke and subsequently discovers a fire in a garbage can in a common area on the hospital unit. What is the nurse's priority action in this situation? Rescue anyone who is in immediate danger. Activate the fire alarm on the unit. Evacuate clients and staff. Attempt to extinguish the fire.
Rescue anyone who is in immediate danger.
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? Sedate her with sleeping pills and leave the restraints on. Leave the restraints on and talk with her, explaining that she must calm down. Take the restraints off, stay with her, and talk gently to her. Talk with the client's family about taking her home because she is out of control.
Take the restraints off, stay with her, and talk gently to her.
A health care provider has ordered restraints for an older adult client who is delirious from the pain medication she was administered. Which guideline is appropriate for utilizing restraints? The client's order for restraints must be renewed by the health care provider every 4 hours. The restraints can be ordered by the nursing supervisor in emergency situations. The client's vital signs must be assessed every hour. Chemical restraints should be tried before using physical restraints.
The client's vital signs must be assessed every hour.
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? CMS will bear the hospital's costs if the client chooses to sue the hospital. The hospital will be fined by CMS because the client developed a pressure injury. The hospital must bear any costs incurred for treating the client's injury. CMS may choose to divert clients to other health care facilities in the future.
The hospital must bear any costs incurred for treating the client's 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 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 adds the information in the safety event report to the client health record.
The nurse details the client's response and the examination and treatment of the client after the incident.
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 await results of the x-ray before filing the 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 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 is providing safety education to a group of adolescents. What teaching point should the nurse prioritize? Infection control and strategies for breaking the chain of infection Fire prevention and fire safety The obligation to report any unsafe actions to authorities The value of not giving into social pressure to perform unsafe acts
The value of not giving into social pressure to perform unsafe acts
A nurse is preparing to implement an order for the use of restraints to ensure a client's safety. Which statement accurately describes a guideline to follow? Alert the health care provider and the client's family if restraints are ordered by the client's primary nurse. Respond to the past history of the client (including previous falls) to determine the need for restraints. Time-limit the use of restraints and release the client from the restraint as soon as he or she is no longer a risk to self or others. Individualize the use of restraints and choose the most easily used device.
Time-limit the use of restraints and release the client from the restraint as soon as he or she is no longer a risk to self or others.
A nurse is teaching parents about Internet safety for children. Which action(s) is a recommended guideline for Internet use? Select all that apply. Emphasize that everything read online is usually true. Use filtering software to block objectionable information. Be alert for downloaded files with suffixes that indicate images or pictures. Keep identifying information posted on the web sites. Investigate any public chat rooms used by the children.
Use filtering software to block objectionable information. Investigate any public chat rooms used by the children. Be alert for downloaded files with suffixes that indicate images or pictures.
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. Increased thirst Headache Fever Drowsiness Vomiting
Vomiting Drowsiness Headache
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? a geriatric chair with a tray a dose of an analgesic a dose of an antipsychotic side rails
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? a geriatric chair with a tray a dose of an antipsychotic side rails a dose of an analgesic
a dose of an antipsychotic
The nurse is caring for a client who has been repetitively pulling at IV lines and the urinary catheter. After other methods of diverting the client's behaviors fail, the health care provider orders chemical restraints. Which treatment does the nurse anticipate? administration of an antipsychotic agent to alter the client's behavior asking the unlicensed assistive personnel (UAP) to sit with the client application of devices that reduce the client's ability to move arms articulating the reason for use of a physical restrictive device to the client's spouse
administration of an antipsychotic agent to alter the client's behavior
The nurse is caring for a client who has been repetitively pulling at IV lines and the urinary catheter. After other methods of diverting the client's behaviors fail, the health care provider orders chemical restraints. Which treatment does the nurse anticipate? asking the unlicensed assistive personnel (UAP) to sit with the client application of devices that reduce the client's ability to move arms articulating the reason for use of a physical restrictive device to the client's spouse administration of an antipsychotic agent to alter the client's behavior
administration of an antipsychotic agent to alter the client's behavior
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: play-related injuries. automobile accidents. falls from beds. falls from staircases.
automobile accidents.
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: play-related injuries. automobile accidents. falls from staircases. falls from beds.
automobile accidents.
The school nurse is preparing a presentation about safety promotion for middle school-aged students. Which topic will the nurse plan to include? avoiding workplace injury consistently using seat belts practicing moderation when consuming alcohol identifying hazards associated with falls
consistently using seat belts
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. bioterrorism. chemical terrorism. nuclear terrorism.
mass trauma terrorism.
Health care workers may be exposed to a common occupational injury such as: Intimate Partner Violence (IPV). sensory deprivation. carbon monoxide exposure. inadvertent needlestick.
inadvertent needlestick.
The nurse has completed a comprehensive assessment of a client who has been admitted to the hospital experiencing acute withdrawal from alcohol. What identified nursing concern provides the clearest justification for the use of physical restraints during this client's care? altered bed mobility caused by muscle wasting noncompliance with medication regimen chronic confusion related to long-term use of alcohol injury risk related to agitation
injury risk related to agitation
The nurse has completed a comprehensive assessment of a client who has been admitted to the hospital experiencing acute withdrawal from alcohol. What identified nursing concern provides the clearest justification for the use of physical restraints during this client's care? chronic confusion related to long-term use of alcohol injury risk related to agitation altered bed mobility caused by muscle wasting noncompliance with medication regimen
injury risk related to agitation
A public health nurse is providing community education to older adults regarding their risk of poisoning. Which information does the nurse include in the teaching? avoiding the use of alternative and complementary therapies keeping medications in clearly labeled containers reviewing hidden sources of lead in the household environment using alternatives to chemical-based cleaning supplies
keeping medications in clearly labeled containers
