Safety & Infect Control Quiz 2 : Study Plan B

Which basic professional certification is most desirable in the nurse who wants to join a team sent to care for earthquake victims? A)Certification in Emergency Care B)Certification in Basic Life Support C)Certification in Advanced Cardiac Life Support D)Certification in Pediatric Advanced Life Support

A)Certification in Emergency Care The Certified Emergency Nurse possesses a certification in core emergency nursing knowledge, which is useful at an emergency disaster site. To perform cardiopulmonary resuscitation in clients with cardiac arrest, the nurse would possess a Certification in Basic Life Support. If the nurse has to perform any invasive airway management, pharmacology, or electrical therapies, an Advanced Cardiac Life Support certification is desired. If the nurse has to perform any neonatal and pediatric resuscitation, the nurse would possess a Pediatric Advanced Life Support certification.

Which parental education would the nurse include when discussing how to terminate exposure to a poisonous substance? Select all that apply. One, some, or all responses may be correct. A)Empty mouth of substances. B)Remove contaminated clothing. C)Administer oxygen for inhalation poisoning. D)Flush skin or eyes with large amounts of warm water or saline. E)Place child side-lying, sitting, or kneeling with head below the chest.

A)Empty mouth of substances. B)Remove contaminated clothing. D)Flush skin or eyes with large amounts of warm water or saline. Emptying the mouth of substances, removing contaminated clothing, and flushing the skin and eyes with large amounts of warm water or saline are methods used to terminate the exposure to a poisonous substance. A victim of inhalation poison should be brought into the fresh air; oxygen is not indicated. Placing a child side-lying, sitting, or kneeling with the head below the chest is done to prevent aspiration.

Which would the nurse state is an example of a natural disaster? A)Floods B)Terrorism C)Fire explosion D)Building collapse

A)Floods External disasters can be natural, such as floods, earthquakes, or tornadoes. Acts of terrorism are external disasters that use technology such as explosive devices or a malfunction of a nuclear reactor. A fire explosion is an internal disaster. A building collapse is a consequence of internal or external disaster.

Which personal protective equipment would the nurse use when giving a bath to a client with acquired immunodeficiency syndrome (AIDS), pneumonia, and AIDS wasting syndrome with fecal incontinence? Select all that apply. One, some, or all responses may be correct. A)Goggles B)Surgical mask C)Shoe covers D)Gown E)Gloves F)N95 hepa mask

A)Goggles B)Surgical mask D)Gown E)Gloves Evidence-based guidelines indicate the need to use standard and contact precautions (consisting of a gown and gloves) in clients who have fecal incontinence to avoid possible transmission of gastrointestinal infection. Standard precautions are used for clients with AIDS, but the client's pneumonia diagnosis indicates the need for droplet precautions with eye protection and a surgical mask, because the client may be coughing during the bath. Shoe covers are designed for protecting a sterile environment such as a surgery suite and are not necessary for giving patient care at the bedside. An N95 hepa mask would be necessary if the client had tuberculosis, but not for pneumonia.

For which condition would an infant born with exstrophy of the bladder be at risk? A)Infection B)Dehydration C)Urine retention D)Intestinal obstruction

A)Infection The greatest problem facing this infant is infection of the bladder mucosa and excoriation of the surrounding tissue; meticulous hygiene is necessary both before and after surgery. Dehydration is not a problem, because fluid intake and the amount of urine output are not affected. Urine retention is not a problem, because the urine drains continuously. The congenital abnormality involves the genitourinary system, not the intestines.

Which assessment will the nurse perform to determine complications in clients exposed to phosgene? A)Lung sounds B)Skin integrity C)Level of orientation D)Bleeding and bruising

A)Lung sounds The nurse will assess lung sounds in victims of phosgene exposure because the chemical agent can cause respiratory distress and pulmonary edema. Skin integrity would be assessed in victims of cutaneous anthrax. Level of orientation would be assessed in clients with shock. Bleeding and bruising would be noted in victims of the Ebola virus.

Which intervention would the nurse use for a client with full-thickness burns to the chest and anterior right arm? Select all that apply. One, some, or all responses may be correct. A)Monitoring vital signs B)Cutting off the clothing C)Inserting a urinary catheter D)Removing the client's jewelry E)Establishing an intravenous line

A)Monitoring vital signs B)Cutting off the clothing C)Inserting a urinary catheter D)Removing the client's jewelry E)Establishing an intravenous line According to the Rule of Nines, the client has full-thickness burns to 22.5% of the body (18% chest and 4.5% right arm). The nurse would monitor vital signs (including oxygen saturation), remove the client's clothing and jewelry, insert a urinary catheter to maintain intake and output, and insert an intravenous line to administer fluids. Test-Taking Tip: Read every word of each question and option before responding to the item. Glossing over the questions just to get through the exam quickly can cause you to misread or misinterpret the real intent of the question.

A child with meningitis suddenly assumes an opisthotonic position. In which position would the nurse position the child? A)Side-lying B)Knee-chest C)High-Fowler D)Trendelenburg

A)Side-lying Maximal safety and comfort are ensured with the side-lying position because the child's neck and back are hyperextended. The knee-chest position is impossible because the child is in a rigid opisthotonic position, with the neck and back hyperextended. The high-Fowler is impossible because the child is in a rigid position with the neck and back hyperextended. The Trendelenburg position increases intracranial pressure and is contraindicated in meningitis.

Which would the nurse emphasize when teaching insulin self-administration to a child with recently diagnosed diabetes? A)The need to wash the hands before preparing the insulin injection B)The need to shake the bottle of insulin thoroughly before drawing up the dose C)The need to alternate the sites of the insulin injections among the four extremities D)The need to rub the injection site briskly for half a minute after giving the injection

A)The need to wash the hands before preparing the insulin injection Thorough hand washing is the best infection-prevention technique and should always precede preparation of an injection. Shaking insulin causes air bubbles, which can interfere with preparation of an accurate dose; the bottle should be rolled gently between the palms. Although injection sites should be rotated, the abdomen, not the extremities, is the preferred site for self-administration of insulin. The injection site should not be rubbed, because this will affect absorption of the insulin and cause a reaction at the site.

Which would the nurse determine before preparing a child with cerebral palsy (CP) for crutch-walking? A)Weight-bearing ability of the child's four extremities B)The power in the child's trunk to drag the legs forward when the child is erect C)Whether the child's circulation can tolerate the body being placed in an erect position D)The ability of the child's shoulder girdle to support the body's weight when it leaves the floor

A)Weight-bearing ability of the child's four extremities The choice of gait is based on the weight-bearing capabilities of each of the four extremities. Assessment of the extremities takes priority over assessment of the trunk. The child with CP uses upper extremity strength for crutch control and lower extremity strength to facilitate some movement. The child with CP is unlikely to have orthostatic circulatory impairment. Because of decreased muscle control, it is unlikely that the child is able to use a gait involving complete support of body weight off the floor.

Which school-age children require close supervision when using a skateboard? Select all that apply. One, some, or all responses may be correct. A) 5 year old B) 6 year old C) 7 year old D) 8 year old E) 9 year old

B) 6 year old C) 7 year old D) 8 year old E) 9 year old School-age children who are 6 years, 7 years, 8 years, or 9 years all require close supervision when using a skateboard. The 5-year-old school-age client should not be allowed to ride a skateboard due to the high risk for injury. Children ages 6 to 10 years should use skateboards only with close adult supervision.

Which disaster triage tag would the nurse apply to the group of clients who have extensive full-thickness body burns and severe head trauma after an apartment building fire and clients who require mechanical ventilation for survival? A)Red B)Black C)Green D)Yellow

B)Black Clients with extensive full-thickness body burns, severe head trauma, and high cervical spinal cord injury requiring mechanical ventilation are given black tags because they are expected to die. Clients with airway obstruction or shock are given red tags because they require immediate attention. Clients with open fractures with a distal pulse and large wounds that need treatment within 30 minutes to 2 hours are given yellow tags. Green tags are issued to clients with minor injuries. Test-Taking Tip: Read the question carefully before looking at the answers: (1) Determine what the question is really asking; look for key words; (2) Read each answer thoroughly and see if it completely covers the material asked by the question; (3) Narrow the choices by immediately eliminating answers you know are incorrect.

Which would be included in the plan of care for an obstetrical client who has been taking carbamazepine throughout the first trimester of pregnancy? A)Evaluation for fetal hydramnios B)Evaluation for a neural tube defect C)Evaluation for cardiac malformation D)Chromosomal assessment for Down syndrome

B)Evaluation for a neural tube defect Carbamazepine is associated with neural tube defects. Fetal hydramnios, cardiac malformation, and Down syndrome are not related to the use of carbamazepine.

A client with hyperthyroidism has been treated with radioactive iodine (131I) to destroy overactive thyroid gland cells. To reduce radiation exposure, which would the nurse consider when providing care? A)Wearing a lead-shield apron at all times B)Limiting time with and increasing distance from the client C)Wearing a radiation meter to measure exposure D)Remaining at least 6 feet (1.8 m) away from the client at all times

B)Limiting time with and increasing distance from the client When caring for clients who are radioactive, the three most important concepts for reducing radiation exposure are to limit exposure time, increase distance, and use shielding. In this situation, time and distance provide the best reduction in radiation exposure. Wearing a lead-shield apron will help prevent radiation exposure, but time and distance are the first priorities. A radiation meter measures exposure, but does nothing to protect caretakers. Remaining at least 6 feet (1.8 m) away from the client at all times is not a practical approach.

Which would the nurse include information on during maintenance health visits to prevent more frequent accidental poisonings of toddler-age children? A)Iron B)Plants C)Aspirin D)Corrosives

B)Plants Plants are the number one cause of accidental poisonings for the toddler-age client; therefore, the nurse would provide education related to this type of accidental poisoning at each health maintenance visit. Iron, aspirin, and corrosives also lead to accidental poisoning; however, these are not as common as plant poisoning.

Which disaster triage tag would the nurse find on victims of a mass causality event with minor injuries who arrived to a hospital in a private vehicle? A)Red B)Black C)Green D)Yellow

C)Green The green-tagged victims have minor injuries, can move themselves to the hospital from a mass causality scene in a private vehicle, and are also called "walking-wounded" victims. Red-tagged victims can't ambulate themselves because they are severely injured. The black-tagged victims are dead or expected to die and require ambulances to transfer them. The yellow-tagged victims can have large wounds that require assistance to ambulate.

A newly pregnant client reports that she is taking isotretinoin. Which statement applies to the care of this client? A)Isotretinoin is used to suppress hunger in individuals trying to lose weight, so the client should stop taking the medication. B)Isotretinoin is often used to treat migraines associated with hormonal changes and should be safe for continued use as needed. C)Isotretinoin is teratogenic and is associated with major fetal malformations, so the client should stop the medication immediately. D)Isotretinoin is an atypical antipsychotic, and the woman needs to make an immediate appointment with her mental health care provider to discuss alternative medications.

C)Isotretinoin is teratogenic and is associated with major fetal malformations, so the client should stop the medication immediately. Isotretinoin is used to treat severe acne that has not responded to other forms of treatment. It is teratogenic, and pregnancy should be avoided by female clients taking the medication. Isotretinoin is not used in a weight-loss program, is not used to treat migraines, and is not an antipsychotic.

During an acquired immunodeficiency syndrome (AIDS) education class a client states, "Petroleum jelly works great when I use condoms." Which conclusion about the client's knowledge of condom use would the nurse draw from this statement? A)An understanding of safer sex through proper use of condoms B)An ability to assume self-responsibility and protection of others C)Lack of knowledge related to correct condom application and use D)Ignorance regarding transmission of human immunodeficiency virus (HIV)

C)Lack of knowledge related to correct condom application and use Petroleum jelly breaks down condom integrity and will increase the risk for condom failure. Using petroleum jelly instead of a water-soluble lubricant shows a lack of knowledge about condom use, a form of safer sex. Although the person is attempting to be responsible, there is a lack of knowledge and the behavior is unsafe. Condom use shows the client has some understanding about the transmission of HIV.

Which clinical findings would the nurse recognize as indicative of possible neglect of a 5-year-old child? Select all that apply. One, some, or all responses may be correct. A)Enuresis B)Lacerations C)Malnutrition D)Poor hygiene E)Sleep disturbances

C)Malnutrition D)Poor hygiene

Which personnel would the nurse state are responsible for deciding the number, acuity, and resources needed for clients during a disaster? A)Triage officer B)Community relations officer C)Medical command physician D)Hospital incident commander

C)Medical command physician Medical command physicians have the authority to decide the number, acuity, and resources needed for clients during a disaster. Triage officers are the primary health care providers or nurses who are responsible for evaluating the clients rapidly and determining the priority of treatment. The community relations officer serves as a liaison between the health care facility and the media. Hospital incident commanders act as leaders and are responsible for implementing the emergency plan.

To ensure accuracy when assessing a client's blood pressure, how would the nurse prevent a parallax error? A)Elevate the head of the bed. B)Use the appropriate-sized cuff. C)Read the manometer at eye level. D)Place the cuff at the level of the heart.

C)Read the manometer at eye level. A parallax error is the apparent displacement of an observed object, such as the indicators on the manometer, because of the position of the observer. Elevating the head of the bed is not associated with a parallax error. If the appropriate-sized cuff is not used, an inaccurate reading will result, but it will not be caused by a parallax error. If the cuff is not placed at the level of the heart, an inaccurate reading will result, but it will not be caused by a parallax error.

When evaluating the white blood cell count differential, which statement indicates the meaning of "a shift to the left"? A)Heightened phagocytosis B)Functioning bone marrow C)Infection is being contained D)Increased immature neutrophils

D)Increased immature neutrophils A "shift to the left" in the white blood cell count differential indicates immature neutrophils are being released into the blood. The immature neutrophils are not capable of phagocytizing. The bone marrow is unable to produce mature neutrophils, and the infection is continuing, not being contained.

Which would the nurse conclude about isolation for the child admitted to the pediatric unit with a diagnosis of meningococcal meningitis? A)It is unnecessary during the incubation period. B)It is required for 7 to 10 days until the fever subsides. C)It will be unnecessary after the diagnosis is confirmed. D)It will be necessary for 24 to 72 hours after the initiation of antibiotic

D)It will be necessary for 24 to 72 hours after the initiation of antibiotic The meningococcal organism is rendered inactive after 24 to 72 hours of antibiotic therapy; isolation is not required after this time. Meningitis is not evident during the incubation period. The presence of a fever is not the influencing factor indicating the need for isolation. After the diagnosis of meningitis is confirmed, isolation is required for 24 to 72 hours after the institution of antibiotic therapy.

When preparing to assess a client with active tuberculosis, which piece of protective equipment is necessary for the nurse before entering the client room? A)Isolation gown B)Surgical mask C)Shoe covers D)N95 respiratory mask

D)N95 respiratory mask Active tuberculosis places a client on airborne precautions where the nurse must wear an N95 respiratory mask to prevent personal respiratory exposure to the infectious droplets. An isolation gown, surgical mask, or shoe covers are not necessary protective devices in the assessment of a client with active tuberculosis.Test-Taking Tip: Never leave a question unanswered. Even if answering is no more than an educated guess on your part, go ahead and mark an answer. You might be right, but if you leave it blank, you will certainly be wrong and lose precious points.

Which assessment technique will the nurse avoid in a client with a suspected hematological disease? A)Auscultating heart sounds B)Palpating inguinal lymph nodes C)Percussing the costovertebral angle D)Palpating the abdominal left upper quadrant

D)Palpating the abdominal left upper quadrant Splenomegaly and risk for rupture of the spleen may occur with hematological diseases. Palpation of the left upper quadrant of the abdomen would be avoided in the client with hematological disease because of the risk of rupturing an enlarged spleen. Heart sounds are auscultated for regularity and abnormal sounds. Checking for costovertebral angle tenderness would not increase risk for splenic rupture. Inguinal lymph node palpation would not increase pressure on the spleen.