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1. When educating families on fire safety, it is important to:
A) have a meeting place outside the home.
B) account for all members and then exit.
C) use extension cords to prevent shock.
D) keep a fire extinguisher in a closet.
Ans: A
Feedback:
The whole family should regularly practice crawling on the floor, using escape routes, and having a meeting place outside the home in case of fire. Attempting to account for all family members before exiting the burning structure is dangerous and may result in the loss of life. Shock is possible with extension cords. Having a fire extinguisher is important, but it should be kept in an area with access and not a closet.
15. 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) Client-centered care
B) Teamwork and collaboration
C) Clinical career ladders
D) Licensure revamping
E) Quality improvement (QI)
Ans: A, B, E
Feedback:
The Quality and Safety Education for Nurses (QSEN) project has been designed to provide a framework for the knowledge, skills, and attitudes necessary for future nurses. The six competencies include client-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. Requirements for foreign-educated nurses and the establishment of clinical career ladders are not explicit focuses of the QSEN competencies.
17. 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 his or her responsibilities?
A) The nurse should notify the primary care provider about the bruises.
B) The nurse should contact the facility’s social services department.
C) The nurse should question the client about the source of the bruises.
D) The nurse should request permission from the client to photograph the bruises.
Ans: C
Feedback:
The initial action by the nurse would be to determine the source of the bruises. If suspicion remains, the nurse should question the client. If the nurse feels there is potential abuse, the nurse is obligated to report it.
23. The occupational health nurse is planning a safety in-service for a group of clerical workers. Which topic would be most beneficial?
A) Principles of body alignment
B) The use of protective clothing
C) The use of ear plugs
D) Appropriate storage of combustible cleaning solutions
Ans: A
Feedback:
The clerical worker is primarily sedentary. The greatest concern would relate to body alignment and positioning. Ear plugs would be most appropriate for the factory worker. The use of protective clothing and the storage of hazardous materials would be topics best suited for janitorial workers.
3. A group of girls is camping in the woods with camp counselors. They should be instructed to:
A) get adequate amounts of sleep.
B) use the buddy system.
C) eat nutritious foods.
D) run on smooth surfaces.
Ans: B
Feedback:
The buddy system, a prearranged agreement between two or more people to provide mutual companionship and to monitor each other’s whereabouts and well-being during certain high-risk activities, is an important outdoor and water safety strategy.
16. 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) The use of skid-proof mats for the bathtub
B) The use of safety gates at stairwells
C) Correct placement of booster seats for the car
D) The use of flame-retardant pajamas
Ans: D
Feedback:
Infant safety education should include car seats, the use of electrical outlet covers, and flame-retardant clothing. The use of skid-proof mats in the bathtub, safety gates, and booster seats are topics more suited to the parents of preschool children.
21. 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?
A) "Car seats are only recommended until children are 3 years old."
B) "At the age of 6, your child should be using a booster seat."
C) "Car seats are recommended until children are at least 10 years old."
D) "Your child will be safe in the car using the provided shoulder harness and lap belts."
Ans: B
Feedback:
When children outgrow standard car seats, parents and caregivers should use booster seats, preferably those that use combination shoulder and lap belts, until the car seat belt fits appropriately (typically when they have reached 4 feet, 9 inches in height and are between 8 and 12 years of age).
14. A nurse is completing an incident report. Which information would the nurse include? Select all that apply.
A) The events surrounding how the injury occurred
B) The effects of the injury on the client
C) Measures initiated for the client
D) The client’s condition
E) Documentation of the report in the medical record
Ans: A, B, C
Feedback:
In an incident report, the nurse describes how an injury occurred, what the effects were on the client, and what was done for the client. In addition to filing an incident report, the nurse must enter on the client’s medical record a description of the incident and its effects on the client. The nurse also notifies the client’s healthcare provider of the incident, and the healthcare provider will document the client’s condition. The nurse does not make note of the incident report on the medical record because it is used internally for risk management and quality improvement purposes.
5. Which statement should the nurse include in the education plan regarding safety issues for a group of adult clients?
A)In most age groups, motor vehicle accidents are major causes of death.
B) Suicide is the leading cause of death in adults and adolescents.
C) Occupational safety practices can eliminate all workplace hazards.
D) Environmental lead exposure is a primary cause of death in adult clients.
Ans: A
Feedback:
Motor vehicles continue to be the major cause of deaths related to unintentional injuries for all age groups up to 80 years. Suicide is not the leading cause of death in adolescents and adults. Safety practices can reduce, but not completely eliminate, workplace risks. Lead exposure is significant but is not a primary cause of death.
20. After identifying a medication error, the nurse completes an incident report. The nurse correctly recognizes which statement as true about the use of these documents? Select all that apply.
A) The incident report should be placed with the client’s medical records.
B) Incident reports provide a clear, concise recording of the situation that can be
provided to the client’s legal representative in the event of a lawsuit.
C) The incident report should include factual information about the incident.
D) The nurse should include his or her own personal perception about the cause of the incident in the report.
E) Completion of the incident report should be noted in the nurse’s notes.
Ans: B, C
Feedback:
An accident, or injury, occurring in the hospital necessitates the filing of an incident report. The document remains confidential and is not part of the client’s medical record. It completely describes all the aspects of the event that occurred. Specifically, the report should include the accident, client assessment, and interventions provided for the client. The report is used for internal review to improve the system to prevent similar errors and cannot be subpoenaed by a court of law.
7. An older adult client has developed diabetic neuropathy. What would be the most important education intervention for the client and family?
A) Provide a stable temperature in the home.
B) Reduce the temperature on the water heater.
C) Keep the environment warmer in winter.
D) Increase the amount of ventilation in the house.
Ans: B
Feedback:
The principles of a safe environment for older adults follow the same general guidelines as those for all ages: comfortable temperature range; adequate clothing; bath water of the right temperature (the setting on the hot water heater may need to be reduced); adequate ventilation; and lighting that allows for safe navigation throughout the house at all times of day. Clients with neuropathy will definitely need the hot water heater temperature reduced.
9. The nurse instructs the family of an older adult client with a visual impairment and decreased mobility that the most common problem for these clients is related to:
A) electrical cords
B) medication errors
C) falls
D) aspiration
Ans: C
Feedback:
The risk of falls increases when a person of advanced age, impaired mobility, or both encounters these hazards.
2. A child is learning to ride a bicycle and should be instructed to use which protective device?
A) Helmet
B) Wrist guard
C) Knee pads
D) Light
Ans: A
Feedback:
Children should wear properly fitted helmets when cycling, riding, or playing contact sports. Helmets will help to protect against head injury. Knee pads and wrist guards will protect children but not with the same degree of importance as a helmet.
19. The nurse is assessing the client’s sensory input. Which assessments should be
included? Select all that apply.
A) Sensitivity to touch
B) Sensitivity of sharp to dull stimulation
C) Ability to maintain balance
D) Pupil sensitivity to light changes
E) Ability to recall information
Ans: A, B, C
Feedback:
Examination of sensory function allows the nurse to verify the accuracy and quality of sensory input. Testing should include ability to balance, sensitivity to sharp versus dull stimulation, and sensitivity to light touch of the extremities.
11. The health department is reviewing community health initiatives for the year. During the summer, the health department focuses infection control activities on which program?
A) Administering influenza immunizations
B) Administering free antibiotics
C) Using pesticides for mosquitoes
D) Delivering fans to older adult residents
Ans: C
Feedback:
Community problems such as water supply contaminated with sewage or tick infestations near residential areas also can result in infection. Influenza immunization is concentrated in the fall and winter. Antibiotic administration is not a prevention program but one geared to disease treatment. Fans may be delivered to older adults, but this intervention will not reduce infection.
24. The client tells the nurse, “I need to use the restroom.” Which safety
intervention must be done by the nurse first?
A) Assess the need for assistance with ambulation.
B) Ask the nurse assistant to help the client to the restroom.
C) Offer the bedpan to keep the client safe.
D) Ask a family member to help the client to the restroom.
Ans: A
Feedback:
The diverse physiologic and psychological capabilities of people and encounters with various safety hazards across the life span put various age groups at risk for different safety concerns and associated potential injuries. The older clients are at higher risk for hurting themselves while meeting their needs.
18. The nurse is assessing a client’s mental health competence and decision- making ability. Which activity will best provide the needed information to the nurse?
A) Ask the client to read and discuss a passage from a pamphlet.
B) Ask the client "what if" questions to determine level of thought organization.
C) Ask the client to review his or her medical health history to assess for the level of organization of his or her thought processes.
D) Discuss with the client’s family any concerns about his or her mental stability.
Ans: B
Feedback:
When reviewing mental health and level of decision-making ability, the best method is to ask the client "what if" type of questions. Assessing the client’s reading ability and understanding of passages read will not provide the needed information. Asking the client to discuss his or her medical history will provide some information but will not provide information on his or her ability to reason and make clear decisions. Questioning the family provides only a secondary source of information and will not be as effective.
13. The nurse has just realized that the nurse committed a medication error by administering an antibiotic dosage greater than the dosage prescribed. The client does not appear to have experienced any obvious adverse effects. What action should the nurse perform first?
A) Report the actions as a sentinel event.
B) Contact the nursing supervisor.
C) Notify the client’s healthcare provider.
D) Complete an incident report.
Ans: C
Feedback:
Notification of the healthcare provider is an initial action after a medication error of this nature has taken place. A sentinel event is one that results in death or serious injury. The nursing supervisor may require notification but after the physician has been contacted. An incident report should be completed after the client’s safety has been assured.
10. The facility risk management team is preparing an in-service to nursing staff members. The presentation will highlight risk factor increase related directly to the type of clientele on a nursing unit. The presenter will correctly explain that which risk is increased for female nurses who work on an oncology care unit?
A) Back injuries
B) Blood-borne pathogens
C) Adverse reproduction
D) Neurologic disorders
Ans: C
Feedback:
Common risks in healthcare facilities are exposure to blood-borne pathogens from stick injuries via used needles, back injuries caused by heavy lifting, and potential adverse reproductive outcomes as a result of overexposure to antineoplastic medications. On oncology divisions, the nurse is continually exposed to antineoplastic agents.
25. During discharge planning, the nurse is assessing home safety for a client who
has repeatedly fallen. Which condition increases the client’s risk for falls? Select all
that apply.
A) Climbs two flights of stairway to get to the bedroom
B) Prefers to use the bathtub when taking a bath
C) Drinks two shots of alcoholic beverages before dinner
D) Takes a diuretic pill early in the morning
E) Uses nonskid socks all day
Ans: A, B, C, D
Feedback:
Unintentional injuries at home are common for the older adult. Safety habits, no longer reinforced by watchful adults, can become rusty; disregard of judgment, overconfidence, or ignorance can place adults in danger’s path. In addition, adults may consume alcohol, which interferes with judgment to interpret the environment and with physical capabilities to operate machinery, thus contributing to injuries.
12. Which factor is related to the highest proportion of falls in long-term care settings?
A) Toileting
B) Agitation
C) Polypharmacy
D) Impaired sleep patterns
Ans: A
Feedback:
More than 42% of falls in an acute care agency were toileting related, often involving getting out of bed or ambulating to the bathroom, slipping from the toilet or commode, or standing to use the urinal. This exceeds the role of other variables, including agitation, polypharmacy, and impaired sleep.
4. Which reason best explains why adolescents behave in an unsafe manner
despite knowledge of a particular activity’s risk?
A) Past experience
B) Poor judgment
C) Social pressure
D) Normal rebellion
Ans: C
Feedback:
As adolescents explore opportunities, they may know that certain behaviors are unsafe, but social pressure can persuade them to act against their better judgment.
22. 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) Wash the eyes with a hypertonic solution for at least 30 minutes.
B) Advise the client to avoid blinking until after the eyes are irrigated. C) Flush the eyes with water for 10 minutes.
D) Flush the eyes with a cool saline solution for a 10-minute period.
Ans: C
Feedback:
If poisonous substances have been instilled into the eye, immediate irrigation with lukewarm water for 10 to 15 minutes may reduce harmful effects.
8. In large metropolitan areas, clients who suffer from asthma will be affected by:
A) air pollution.
B) noise pollution.
C) radiation.
D) asbestos contamination.
Ans: A
Feedback:
Air pollution increases the risk for, and severity of, respiratory problems such as asthma and chronic bronchitis.
6. The older adult will have an increased risk for developing which of the following? A) Fire injuries
B) Gunshot wounds
C) Heatstroke
D) Poisoning
Ans: C
Feedback:
The ability to thermoregulate may become impaired; older adults are at higher risk than younger adults for hypothermia and heatstroke.