Week 1 - Chapter 27: Safety, Security, and Emergency Preparedness

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

Which statement indicates that a family understands the teaching that has been provided by the nurse related to car seat safety for a 9-month-old infant? "We place our baby in a front-facing car seat in the front of the car so that he doesn't cry." "We place our baby in a front-facing car seat in the middle of the back seat of the car." "We place our baby in a rear-facing car seat in the back seat of the car." "We place our baby in a rear-facing car seat in the front of the car so that we can see him in case he chokes."

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

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. Remove the plug from the wall by pulling the electric cord. Refrain from using extension cords. All machines that are used infrequently are to remain plugged in.

Refrain from using extension cords.

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 vital signs must be assessed every hour.

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.

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. hold a facility-wide meeting to identify strategies for making improvements to the safety of residents. 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.

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

A child is learning to ride a bicycle. He should be instructed to use which of the following protective devices? Helmet Wrist guard Knee pads Light

Helmet

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 physician for a restraint order. Initiate use of a bed alarm. Administer the client's sedative as ordered. Put up all four side rails on the bed.

Initiate use of a bed alarm.

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?" "Induce vomiting and call 911 right away." "Is your child breathing at this time?" "You should not have left your child alone while you showered."

"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?

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

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 34-year-old male who does not use a seat belt 25-year-old female who just accepted her first job 40-year-old female who is working two jobs

19-year-old male college student majoring in physics

A school nurse is aware of poisoning risks in the adolescent population. Poisoning in this age group is most often related to: A. exposure to toxic fumes in the home. B. the ingestion of substances in the home that contain lead C. experimentation with drugs and inhalants. D. malfunction of a carbon monoxide monitor in the home.

c

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? a. "Did you leave the household chemical in reach of your child?" b. "Induce vomiting and call 911 right away." c. "Is your child breathing at this time?" d. "You should not have left your child alone while you showered."

c

A nurse is caring for an 18-month-old client after a tracheostomy. She is recovering well and noted a desire to be more active. The nurse selects a toy from the playroom for the client to play with. Which toy is most developmentally appropriate? a. marbles b. dominos c. a beaded bracelet d. a rocking horse

d

What is the most important safety concept that a nurse should include in the teaching plan for a family with a newborn infant in the household? a. Include safeguards to prevent falls in the home. b. Educate about, and be aware of, signs of risky behaviors. c. Teach seat belt safety. d. Avoid stuffed animals and blankets in the crib.

d

A nurse is assessing a client who was exposed to botulism from contaminated food supplies. Which symptom would the nurse expect to find in this client? Petechial hemorrhages Flu-like symptoms Skeletal muscle paralysis that progresses symmetrically and in a descending manner Skin lesion with local edema that progresses, enlarges, ulcerates, and becomes necrotic

Skeletal muscle paralysis that progresses symmetrically and in a descending manner

The nurse is discussing car safety with the mother of a 6-year-old child. The child's mother questions the need for the use of special car seats for her child. What information can be provided to her? "At the age of 6 your child should be using a booster seat." "Your child will be safe in the car using the provided shoulder harness and lap belts." "Car seats are only recommended until children are 3 years old." "Car seats are recommended until children are at least 10 years old."

"At the age of 6 your child should be using a booster seat."

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

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

The nurse is conducting discharge teaching for a caregiver and a toddler. Which statement by the caregiver indicates the need for additional teaching? "I will check my text messages while my child is in the tub." "I will take a CPR course in the near future." "I will ensure that all balls and toys are not smaller than a tennis ball." "I will ensure that my child will use a three-point seatbelt on all car trips."

"I will check my text messages while my child is in the tub."

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 patient from a room." "I will leave all doors open after rescuing patients." "I know that nurses are the only ones who can extinguish a fire."

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

The nurse is assessing an adolescent with an annual physical. The parent reports noticing a change in the child's behavior lately, including mood swings, withdrawal from the family, and failing school grades. The parent does not know what to do and asks the nurse for guidance. What is the most appropriate guidance from the nurse? "Let's admit your child to an acute care facility so that we can run more tests." "Adolescents are generally difficult children. Sometimes punishment is necessary to make them change their attitudes." "These could be signs of substance use. Open communication and seeing a counselor who specializes in substance use would be beneficial." "This is typical adolescent behavior. Ignore it and it will improve."

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

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

A hair dryer is placed next to the sink.

A client arrives at the emergency department after an industrial explosion involving an unknown chemical contaminant. What is the nurse's priority action? Assess client's respiratory depth and effort Identify chemical agent before treating Flush skin while rinsing with sterile saline Activate external disaster protocol

Activate external disaster protocol

The acronym RACE is commonly taught as a means for remembering priorities for action during a fire. The "A" in this acronym stands for which of the following?

Activate the fire alarm and notify the appropriate person.

A school nurse is teaching a group of adolescents about safe driving. What behaviors should the nurse encourage in order to help prevent motor vehicle accidents? Select all that apply. Never text while driving. Drive at night when fewer people are on the road. Limit the number of other adolescents in the car. Always wear a seat belt. Obey the speed limit.

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

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 to the authorities.

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

A school-age child is admitted to the emergency room with the diagnosis of a concussion following a collision when playing football. After the collision, the parents state that he was "knocked out" for a few minutes before recognizing his surroundings. What is the priority assessment when the nurse first sees the client? Initiation of a peripheral intravenous (IV) line for fluid administration Assessment of head circumference Assessment of vital signs and respiratory status Evaluation of all of his cranial nerves

Assessment of vital signs and respiratory status

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. Allow the child to swim with friends. Monitor the activities of the toddler. Avoid unattended baths for the toddler.

Avoid unattended baths for the toddler.

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

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

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

Dangling blind cords

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. Fever Headache Vomiting Increased thirst Drowsiness

Drowsiness Headache Vomiting

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

Encourage exercise that improves balance and muscle strength

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

Flush the eyes with water for 10 minutes.

One of the leading causes of death in the United States is drowning. How can the nurse assist in lowering this statistic? a. Educate children in cardiopulmonary resuscitation. b. Require fencing around all pools. c. Begin swim lessons with toddlers. d. Implement drowning prevention strategies.

Implement drowning prevention strategies.

What best describes the nurse's role in disaster preparedness? Performance of all of the skills such as IV insertion and wound care Multiple roles, including triage and the distribution of resources Counseling the victims and families Administration of all of the medications

Multiple roles, including triage and the distribution of resources

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

Obtain a three-prong grounded plug adapter.

The nurse is providing care for an older adult client with a hip fracture utilizing a walker. Which action by the nurse would be the priority? Place a falls risk bracelet on client Provide 1:1 companionship at bedside Monitor neurological status Assess the mobility of the client

Place a falls risk bracelet on client

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

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?

Providing prompt recognition of the potential or actual threat to safety

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

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? Pull the fire alarm lever. Extinguish the fire. Confine the fire. Evacuate the unit.

Pull the fire alarm lever.

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

Restrain the baby in a car seat.

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

Risk for Injury Related to Agitation

The nurse is caring for a young child in the hospital who is being discharged home with his grandmother, who has guardianship. When performing a risk assessment, the nurse identifies that his grandmother has one other adult living with her to help with the child, because the grandmother has congestive heart failure and diabetes mellitus. In addition, the financial situation is poor and she cannot afford to buy safety devices to safety-proof the house. What nursing diagnosis is most appropriate for this child based on these findings?

Risk for Poisoning related to medications in unlocked cabinets

The nurse is creating a plan of care for the older adult who has multiple medications and a difficult time reading medication labels due to poor eyesight. What is the most appropriate nursing diagnosis to include in this client's plan of care? Risk for Falls related to immobility Altered Sensory Perception related to decreased visual acuity Risk for Poisoning related to poor eyesight and the inability to read medication labels Risk for Injury related to substance use

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

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

Social pressure

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? Talk with the client's family about taking her home because she is out of control. 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. Sedate her with sleeping pills and leave the restraints on.

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

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?

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

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 may choose to divert clients to other health care facilities in the future. 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 will bear the hospital's costs if the client chooses to sue the hospital.

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

A nurse is completing an intake assessment. The nurse notes that an older adult male client appears to have bruises in varying stages of healing. Which action by the nurse indicates an understanding of her responsibilities? The nurse should contact the facility's social services department. The nurse should notify the primary care physician about the bruises. The nurse should question the client about the source of the bruises. The nurse should request permission from the client to photograph the bruises.

The nurse should question the client about the source of the bruises.

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 make a copy of the safety event report and place it in the client's medical record. The nurse should include a note on the client's chart that mentions the report.

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

The school nurse is educating 7th grade children about safety. Which recommendation is most appropriate for this age group? Do not text while driving. Use caution when descending stairs. Use protective sporting equipment. Be cautious of electrical outlets.

Use protective sporting equipment.

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? a. 19-year-old male college student majoring in physics b. 40-year-old female who is working two jobs c. 34-year-old male who does not use a seat belt d. 25-year-old female who just accepted her first job

a

The nurse educator has just completed a lecture regarding older adults and hazards in the home. The nurse educator recognizes that the education was effective when the students state that common dangers in the home setting of an older adult include: a. polypharmacy and use of multiple extension cords. b. household cleaners stored under the sink and hanging cords on window blinds. c. risky behaviors and cyberbullying. d. peeling paint and easy access to the backyard pool.

a

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? a. administration of an antipsychotic agent to alter the client's behavior b. articulating the reason for use of a physical restrictive device to the client's spouse c. application of devices that reduce the client's ability to move arms d. asking the unlicensed assistive personnel (UAP) to sit with the client

a

The nurse on a medical-surgical unit notices smoke from a client's room. Upon entering, the nurse notes that the curtain in the room is on fire. What should be the nurse's first action? a. Remove the client from the room. b. Activate the fire alarm. c. Close the client's door. d. Obtain the fire extinguisher.

a

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

a

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

a

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 making the initial assessment of a client following a surgical procedure with sedation. Place in order the nurse's assessment actions. Use all options. a. airway, breathing, and circulation b. level of consciousness and orientation c. wounds and tubes d. intravenous access and IV fluids e. items within the client's reach

a, b, d, c, e

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

automobile accidents.

A nurse was injured when a client with Alzheimer disease struck the nurse on the side of the head during a transfer. The nurse has completed an incident report. Which statement about an incident report is most accurate? a. The incident report is reviewed by state agencies and the Occupational Safety and Health Administration rather than by hospital administration. b. The report provides a detailed and objective account of the circumstances before, during, and after the event. c. The client and the client's family will be required to sign the report, acknowledging that they read it before it was filed. d. The report becomes a confidential part of the client's health record once it is reviewed by hospital administration.

b

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? A. About 10% of home fire deaths occur in a home without a smoke detector. B. Most people who die in house fires die of smoke inhalation rather than burns. C. Most home fires are caused by children playing with matches. D. Most fatal home fires occur while people are cooking.

b

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. side rails b. a dose of an antipsychotic c. a dose of an analgesic d. a geriatric chair with a tray

b

A 5-year-old is admitted to the ICU after a head trauma from a bike injury. The child is awake but confused, and continues to pull at IV tubing and a catheter. When the provider orders a restraint, what options would be least restrictive? Select all that apply. a. four-point soft restraints b. administration of sedation c. having a parent stay with the child d. isolation e. four side rails up

b, c, e

A nurse is completing an intake assessment. The nurse notes that an older adult male client appears to have bruises in varying stages of healing. Which action by the nurse indicates an understanding of her responsibilities? a. The nurse should request permission from the client to photograph the bruises. b. The nurse should notify the primary care physician about the bruises. c. The nurse should contact the facility's social services department. d. The nurse should question the client about the source of the bruises.

d

When educating families on fire safety, it is important to: keep a fire extinguisher in a closet. have a meeting place outside the home. account for all members and then exit. use extension cords to prevent shock.

have a meeting place outside the home.

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

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 6-year-old riding a bike on the playground with his friend 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 2-year-old leaning against the screen of a window in a classroom