PrepU Ch. 28: Safety, Security, and Emergency Preparedness

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

"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? -"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?"

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

Restraints should be removed every __ hours.

2

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 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 -Safety equipment for playing sports -Back to sleep guidelines

Childproofing the house

RACE

rescue, alarm, confine, and extinguish

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?

1 hour

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? -Instruct the toddler not to go near the pool. -Avoid unattended baths for the toddler. -Monitor the activities of the toddler. -Allow the child to swim with friends.

Avoid unattended baths for the toddler.

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

Dangling blind cords

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

Encourage exercise that improves balance and muscle strength

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? -Obtain a three-prong grounded plug adapter. -Use an extension cord to provide freedom of movement. -Tape the electrical cord of the pump to the floor. -Run the electrical cord of the pump under the carpet.

Obtain a three-prong grounded plug adapter.

Which reason best explains why adolescents behave in an unsafe manner despite knowledge of a particular activity's risk? -Past experience -Poor judgment -Social pressure -Normal rebellion

Social pressure

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

The alternative measures attempted before applying the restraints

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

Toileting

True or false: An incident report remains confidential and is not part of the client's medical record.

True

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: -falls from beds. -automobile accidents. -play-related injuries. -falls from staircases.

automobile accidents.

Restraints can be placed on ankles; quick-release knots should be tied to the _______ ________, not the side rail.

bed frame

The school nurse is preparing a presentation about safety promotion for middle school-aged students. Which topic will the nurse plan to include? -consistently using seat belts -practicing moderation when consuming alcohol -avoiding workplace injury -identifying hazards associated with falls

consistently using seat belts

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

nurse practitioner

Teaching about protective sporting gear is appropriate for ____________ _______________ who are physically active.

school-age children

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 nurse visits an older adult client at home and assesses the safety of the client's environment. Multiple small rugs are located in the home. Which statement by the nurse is appropriate when addressing the client's safety? -"Your home needs to be a safe environment as older adults have a tendency to fall." -"I think you should replace your small rugs with skid-resistant rugs on the floor." -"I am concerned that the small rugs in your home can be a tripping hazard." -"You need to remove the small rugs from your house or you will fall."

"I am concerned that the small rugs in your home can be a tripping hazard."

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 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. -The incident report should be placed with the client's health records. -It should provide a clear, concise recording of the situation -It should include factual information about the incident. -The nurse should include a personal perception about the cause of the incident -Completion of the incident report should be noted in the nurse's notes.

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

A school nurse is teaching a group of adolescents about safe driving. What behavior(s) should the nurse encourage to promote safe driving? Select all that apply. -Always wear a seat belt. -Drive at night when fewer people are on the road. -Limit the number of other adolescents in the car. -Never text while driving. -Obey the speed limit.

-Limit the number of other adolescents in the car. -Never text while driving. -Obey the speed limit.

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 -Shares a one floor living space with a spouse -Has history of diabetic neuropathy -Participates in a walking club

-Takes furosemide daily -Admits to drinking wine through the evening -Has history of diabetic neuropathy

According to the American Academy of Pediatrics' 2020 Car Seat Guidelines, infants and toddlers should ride in a rear-facing car safety seat as long as possible, until they reach the highest weight or height allowed by their seat. Most convertible seats have limits that will allow children to ride rear-facing for 2 years or more with weight limits averaging ____ to _____ (15.5 to 18 kg).

35 to 40 lb

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? -Outlets and switches have cover plates. -Machines used infrequently are unplugged. -A hair dryer is placed next to the sink. -No extension cords are being used.

A hair dryer is placed next to the sink.

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) 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. b) 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). c) A rear-facing safety seat should be used for infants younger than 1 year old or up to the maximum weight for the seat. d) 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.

The nurse is caring for an 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. -Put the client's bedside rails up. -Apply socks to the client's feet. -Arrange furniture so that the client has something to hold on to.

Assess the need for assistance with ambulation.

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

Ensure that two fingers can be inserted between the restraint and the client's extremity.

The unlicensed assistive personnel (UAP) 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? -Contact the health care provider for a restraint order. -Administer the client's sedative as ordered. -Put up all four side rails on the bed. -Initiate use of a bed alarm.

Initiate use of a bed alarm.

A nurse working in a long-term care facility is instituting interventions to prevent falls. Which intervention is an appropriate alternative to the use of restraints for ensuring client safety and preventing falls? -Involve family members in the client's care. -Allow the client to use the bathroom independently. -Keep the client sedated with tranquilizers. -Maintain a high bed position so the client will not attempt to get out unassisted.

Involve family members in the client's care.

_______________ _________________ are among the more common sources of poisoning in older adults

Medication overdoses

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.

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

Placing the client in a bed with a bed alarm

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?

Pull the fire alarm lever.

A nurse is preparing discharge education for a client with a newborn infant. What is the highest priority item that must be included in the education plan? -Lock all cabinets that contain cleaning supplies. -Keep all pots and pans in lower cabinets. -Give warm bottles of formula to the infant. -Restrain the infant in a car seat.

Restrain the infant in a car seat.

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.

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? -Respond to the past history of the client (including previous falls) to determine the need for restraints. -Alert the health care provider and the client's family if restraints are ordered by the client's primary nurse. -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.

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 preparing to implement an order for the use of restraints to ensure a client's safety. Which statement accurately describes a guideline to follow? a) Respond to the past history of the client (including previous falls) to determine the need for restraints. b) Alert the health care provider and the client's family if restraints are ordered by the client's primary nurse. c) Individualize the use of restraints and choose the most easily used device. d)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.

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 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 dose of an antipsychotic -side rails -a geriatric chair with a tray -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? -application of devices that reduce the client's ability to move arms -administration of an antipsychotic agent to alter the client's behavior -asking the unlicensed assistive personnel (UAP) to sit with the client -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

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: -complete an incident report to determine who was primarily responsible for the event. -document strategies in the client's health record for preventing future incidents. -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.

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 -injury risk related to agitation -chronic confusion related to long-term use of alcohol

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? -keeping medications in clearly labeled containers -using alternatives to chemical-based cleaning supplies -reviewing hidden sources of lead in the household environment -avoiding the use of alternative and complementary therapies

keeping medications in clearly labeled containers

The nurse is creating a plan of care for an older adult client who takes multiple medications and a has difficult time reading medication labels due to poor eyesight. What is the most appropriate nursing concern to include in this client's plan of care? a) falls risk related to immobility injury b) risk related to medication use c) poisoning risk related to poor eyesight and the inability to read medication labels d) sensory perception related to decreased visual acuity

poisoning risk related to poor eyesight and the inability to read medication labels

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? -the 2-year-old leaning against the screen of a window in a classroom -the 2-year-old and 6-year-old each holding the mother's hand -the 2-year-old helping mom to open the front door of the school -the 6-year-old riding a bike on the playground with his friend

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