Deck 27: Patient Safety

Question 1

The nurse knows that children in late infancy and toddlerhood are at risk for injury owing to

A) Learning to walk.
B) Trying to pull up on furniture.
C) Being dropped by a caregiver.
D) Growing ability to explore and oral activity.

Answer 1

Growing ability to explore and oral activity.

Question 2

The nurse is completing discharge education for the patient regarding home medications.Which patient behavior is an indication that the patient understands the directions regarding the antibiotic medication?

A) The patient nods throughout the educational session.
B) The patient reads the medication prescription out loud.
C) The patient states, "I will finish the antibiotic in ten days."
D) The patient asks where to get the prescription filled.

Answer 2

The patient states, "I will finish the antibiotic in ten days."

Question 3

The nurse discussed threats to adult safety with a college group.Which of the following statements would indicate understanding of the topic?

A) "Our campus is safe; we leave our dorms unlocked all the time."
B) "As long as I have only two drinks, I can still be the designated driver."
C) "I am young, so I can work nights and go to school with 2 hours' sleep."
D) "I guess smoking even at parties is not good for my body."

Answer 3

"I guess smoking even at parties is not good for my body."

Question 4

A homeless adult patient presents to the emergency department.The nurse obtains the following vital signs: temperature 94.8° F,blood pressure 100/56,apical pulse 56,respiratory rate 12.Which of the vital signs should be addressed immediately?

A) Respiratory rate
B) Temperature
C) Apical pulse
D) Blood pressure

Question 5

The nurse is preparing a patient for surgery.The nurse explains that the reason for writing in indelible ink on the surgical site the word "correct" is to

A) Distinguish the correct surgical site.
B) Label the correct patient.
C) Comply with the surgeon's preference.
D) Adhere to the correct regulatory standard.

Question 6

The nurse preceptor recognizes the new nurse's ability to determine patient safety risks when which behavior is observed?

A) Checking patient identification once every shift
B) Multitasking by gathering two patients' medications
C) Disposing of used needles in a red needle container
D) Raising all four side rails per family request

Question 7

The nurse is presenting an educational session on safety for parents of adolescents.The nurse should include which of the following teaching points?

A) Adolescents need unsupervised time with friends two to three times a week.
B) Parents and friends should teach adolescents how to drive.
C) Adolescents need information about the effects of beer on the liver.
D) Adolescents need to be reminded to use seatbelts on long trips.

Question 8

The nurse is discussing with a patient's physician the need for restraint.The nurse indicates that alternatives have been utilized.What behaviors would indicate that the alternatives are working?

A) The patient continues to get up from the chair at the nurses' station.
B) The patient apologizes for being "such a bother."
C) The patient folds three washcloths over and over.
D) The sitter leaves the patient alone to go to lunch.

Question 9

The nurse is teaching a group of older adults at an assisted-living facility about age-related physiological changes.Which question would be the most important to ask this group?

A) "Are you able to hear the tornado sirens in your area?"
B) "Are you able to read your favorite book?"
C) "Are you able to remember the name of the person you just met?"
D) "Are you able to open a jar of pickles?"

Question 10

The nurse is caring for a patient with a urinary catheter.After the nurse empties the collection bag and disposes of the urine,the next step is to

A) Use alcohol-based gel on hands.
B) Wash hands with soap and water.
C) Remove eye protection and dispose of in garbage.
D) Remove gloves and dispose of in garbage.

Question 11

The nurse is caring for an elderly patient admitted with nausea,vomiting,and diarrhea.Upon completing the health history,which priority concern would require collaboration with social services to address the patient's health care needs?

A) The electricity was turned off 2 days ago.
B) The water comes from the county water supply.
C) A son and family recently moved into the home.
D) The home is not furnished with a microwave oven.

Question 12

A nurse is teaching a community group of school-aged parents about safety.The most important item to prioritize and explain is how to check the proper fit of

A) a bicycle helmet.
B) swimming goggles.
C) soccer shin guards.
D) baseball sliding shorts.

Question 13

The nurse knows that four categories of risk have been identified in the health care environment.Which of the following provides the best examples of those risks?

A) Tile floors, cold food, scratchy linen, and noisy alarms
B) Carpeted floors, ice machine empty, unlocked supply cabinet, and call light in reach
C) Wet floors, pinching fingers in door, failure to use lift for patient, and alarms not functioning properly
D) Dirty floors, hallways blocked, medication room locked, and alarms set

Question 14

The nurse is caring for a hospitalized patient.Which of the following behaviors alerts the nurse to consider the need for restraint?

A) The patient refuses to call for help to go to the bathroom.
B) The patient continues to remove the nasogastric tube.
C) The patient gets confused regarding the time at night.
D) The patient does not sleep and continues to ask for items.

Question 15

The nurse identifies that a patient has received Mylanta (simethicone)instead of the prescribed Pepto-Bismol (bismuth subsalicylate)for the problem of indigestion.The nurse's next intervention is to

A) Do nothing, no harm has occurred.
B) Assess and monitor the patient.
C) Notify the physician, treat and document.
D) Complete an incident report.

Question 16

A patient has been admitted and placed on fall precautions.The nurse explains to the patient that interventions for the precautions include

A) Encouraging visitors in the early evening.
B) Placing all four side rails in the "up" position.
C) Checking on the patient once a shift.
D) Placing a high risk for falls armband on the patient.

Question 17

The patient has been diagnosed with a respiratory illness and complains of shortness of breath.The nurse adjusts the temperature to facilitate the comfort of the patient.What is the usual comfort range for most patients?

A) 65° F to 75° F
B) 60° F to 75° F
C) 15° C to 17° C
D) 25° C to 28° C

Question 18

Equipment-related accidents are risks in the health care agency.The nurse assesses for this risk when using

A) Sequential compression devices.
B) A measuring device that measures urine.
C) Computer-based documentation.
D) A manual medication-dispensing device.

Question 19

The nurse is caring for a patient who suddenly becomes confused and tries to remove an intravenous infusion.The nurse begins to develop a plan to care for the patient.Which nursing intervention should take priority?

A) Gather restraint supplies.
B) Try alternatives to restraint.
C) Assess the patient.
D) Call the physician for a restraint order.

Question 20

A home health nurse is performing a home assessment for safety.Which of the following comments by the patient would indicate a need for further education?

A) "I will schedule an appointment with a chimney inspector next week."
B) "Daylight savings is the time to change batteries on the carbon monoxide detector."
C) "If I feel dizzy when using the heater, I need to have it inspected."
D) "When it is cold outside in the winter, I can warm my car up in the garage."

Question 21

A confused patient is restless and continues to try to remove his oxygen and urinary catheter.What is the priority nursing diagnosis and intervention to implement for this patient?

A) Risk for injury: Prevent harm to patient, use restraints if alternatives fail.
B) Deficient knowledge: Explain the purpose of oxygen therapy and the urinary catheter.
C) Disturbed body image: Encourage patient to express concerns about body.
D) Caregiver role strain: Identify resources to assist with care.

Question 22

The older patient presents to the emergency department after stepping in front of a car at a crosswalk.After the patient has been triaged,the nurse interviews the patient.Which of the following comments would require follow-up by the nurse?

A) "I try to exercise, so I walk that block almost every day."
B) "I waited and stepped out when the traffic sign said go."
C) "The car was going too fast, the speed limit is 20."
D) "I was so surprised; I didn't see or hear the car coming."

Question 23

The emergency department has been notified of a potential bioterrorist attack.The nurse assigned to the department realizes that the most important task for safety in this situation is to

A) Carry out the role and responsibilities of the nurse quickly and efficiently.
B) Cluster all patients with the same symptoms to a specific part of the department.
C) Determine the biologic agent and manage all patients using Standard Precautions.
D) Prepare for post-traumatic stress associated with this bioterrorist attack.

Question 24

The patient applies sequential compression devices after going to the bathroom.The nurse checks the patient's application of the devices and finds that they have been put on upside down.Which of the following nursing diagnoses will the nurse add to the patient's plan of care?

A) Risk for poisoning
B) Deficient knowledge
C) Risk for imbalanced body temperature
D) Risk for suffocation

Question 25

An elderly patient presents to the hospital with a history of falls,confusion,and stroke.The nurse determines that the patient is at high risk for falls.Which of the following interventions is most appropriate for the nurse to take?

A) Place the patient in restraints.
B) Lock beds and wheelchairs when transferring.
C) Place a bath mat outside the tub.
D) Silence fall alert alarm upon request of family.

Question 26

The nurse has placed a patient on high-risk alert for falls.Which of the following observations by the nurse would indicate that the patient has an understanding of this alert?

A) The patient removes the high alert armband to bathe.
B) The patient wears the red nonslip footwear.
C) The call light is kept on the bedside table.
D) The patient insists on taking a "water" pill on home schedule in the evening.

Question 27

A nurse is caring for an adult patient who has had a minor motor vehicle accident.The health history reveals that the patient is currently in the process of obtaining a divorce.Which of the following actions should the nurse take?

A) Agree upon and make time for the patient to talk.
B) Use active listening skills and therapeutic touch as appropriate.
C) Teach stress reduction strategies.
D) Inform patient that stressed individuals are more likely to have accidents.
E) Agree to witness telephone conversations with separated husband.
F) Refer the patient to the nurse's church marriage counselor.

Question 28

The nurse has been called to a hospital room where a patient is using a hair dryer from home.The patient has received an electrical shock from the dryer.The patient is unconscious and is not breathing.What is the best next step?

A) Ask the family to leave the room.
B) Check for a pulse.
C) Begin compressions.
D) Defibrillate the patient.

Question 29

The nurse is caring for an older adult who presents to the clinic after a fall.The nurse reviews fall prevention in the home.Which of the following should the patient avoid?

A) Watering outdoor plants with a nozzle and hose
B) Purchasing light bulbs with strength greater than 60 watts
C) Missing yearly eye examinations
D) Using bathtubs without safety strips
E) Unsecured rugs throughout the home
F) Walking to the mailbox in the summer

Question 30

The nurse is instructing the student nurse regarding discharge teaching and medications.Which response by the student would indicate that learning has occurred?

A) "I need to be precise when teaching a patient about Zyprexa (olanzapine) and Zyrtec (cetirizine)."
B) "The medications can be picked up at the pharmacy on the way out of the hospital."
C) "I need to be sure to give the patient leftover medications from the medication drawer."
D) "I need to remember to teach the patient to take all medications at the same time of the day."

Question 31

During the admission assessment,the nurse assesses the patient for fall risk.Which of the following has the greatest potential to increase the patient's risk for falls?

A) The patient is 59 years of age.
B) The patient walks 2 miles a day.
C) The patient takes Benadryl (diphenhydramine) for allergies.
D) The patient recently became widowed.

Question 32

A patient with an intravenous infusion requests a new gown after bathing.Which of the following actions is most appropriate?

A) Disconnect the intravenous tubing, thread the end through the sleeve of the old gown and through the sleeve of the new gown, and reconnect.
B) Thread the intravenous bag and tubing through the sleeve of the old gown and through the sleeve of the new gown without disconnecting.
C) Inform the patient that a new gown is not an option while receiving an intravenous infusion in the hospital.
D) Call the charge nurse for assistance because linen use is monitored and this is not a common procedure.

Question 33

The nurse suspects the possibility of a bioterrorist attack.Which of the following factors is most likely related to this possibility?

A) A rapid increase in patients presenting with fever or respiratory or gastrointestinal symptoms
B) Lower rates of symptoms among patients who spend time primarily indoors
C) Large number of rapidly fatal cases of patients with presenting symptoms
D) Shortage of personal protective equipment available from central supply
E) An increase in the number of staff calling in sick for their assigned shift
F) Patients with symptoms all coming from one location in the area

Question 34

A nurse is in the hallway assisting a patient to ambulate and hears an alarm sound.What is the best next step for the nurse to take?

A) Seek out the source of the alarm.
B) Wait to see if the alarm discontinues.
C) Ask another nurse to check on the alarm.
D) Continue ambulating the patient.

Question 35

The patient is confused,is trying to get out of bed,and is pulling at the intravenous infusion tubing.These data would help to support a nursing diagnosis of

A) Risk for poisoning.
B) Knowledge deficit.
C) Impaired home maintenance.
D) Risk for injury.

Question 36

The nurse is precepting a student nurse and is careful to check with the student all components of the medication process.The nurse explains to the student that most errors occur in

A) Ordering and transcribing.
B) Dispensing and administering.
C) Dispensing and transcribing.
D) Ordering and administering.

Question 37

The nurse is providing information regarding safety and accidental poisoning to a grandmother who will be taking custody of a 1-year-old grandchild.Which of the following comments would indicate that the grandmother needs further instruction?

A) "The number for poison control is 800-222-1222."
B) "Never induce vomiting if my grandchild drinks bleach."
C) "I should call 911 if my grandchild loses consciousness."
D) "If my grandchild eats a plant, I should provide syrup of ipecac."

Question 38

The nurse enters the patient's room and notices a small fire in the headlight above the patient's bed.Immediately,the nurse assigns a nursing diagnosis of risk for injury with a goal for the patient to be safe.Which of the following actions should the nurse take first?

A) Activate the alarm.
B) Extinguish the fire.
C) Remove the patient.
D) Confine the fire.

Question 39

The patient presents to the clinic with a family member.The family member states that the patient has been wandering around the house and mumbling.What is the first assessment the nurse should do?

A) Ask the patient why she has been wandering around the house.
B) Introduce self and ask the patient her name.
C) Take the patient's blood pressure, pulse, temperature, and respiratory rate.
D) Immediately do a complete head-to-toe neurologic assessment.

Question 40

Which of the following concepts are important to utilize when evaluating orders for restraints?

A) Behaviors that necessitate the use of restraint are part of the nursing plan of care.
B) A physician's order is required for restraint and includes a face-to-face evaluation.
C) The physician's preference for the format of the order can override agency policy.
D) Orders are time limited. Restraints are not ordered prn (as needed).
E) It should be specified that restraints are to be removed periodically.
F) Restraint orders are time dated and signed by the physician.

Question 41

The nurse is completing an admission history on a new home health patient.The patient has been experiencing seizures as the result of a recent brain injury.The nurse diagnoses risk for injury with a goal of keeping the patient safe in the event of a seizure.Which interventions should the nurse utilize for this patient?

A) Teach the family how to insert an oral airway during the seizure.
B) Assess the home for items that could harm the patient during a seizure.
C) Provide information on how to obtain a Medical Alert bracelet.
D) Teach the patient to communicate to the caregiver plans for bathing.
E) Discuss with family steps to take if the seizure does not discontinue.
F) Demonstrate how to restrain the patient in the event of a seizure.

Question 42

The home health nurse is caring for a patient in the home who is using an electrical infusion device.While visiting the patient,the nurse smells smoke and notices an electrical fire started by this device.The nurse uses the fire extinguisher and fights the fire when

A) All occupants have left the home.
B) Fire department has been called.
C) Fire is confined to one room.
D) An exit route is available.
E) The correct extinguisher is available.
F) The nurse thinks she can use the fire extinguisher.

Question 43

The nurse is caring for a group of medical-surgical patients.The unit has been notified of a fire on an adjacent wing of the hospital.The nurse quickly formulates a plan to keep the patients safe.Which of the following should the nurse implement?

A) Close all doors.
B) Note evacuation routes.
C) Note oxygen shut-offs.
D) Await direction from the fire department.
E) Evacuate everyone from the building.
F) Review "Stop, drop, and roll" with the nursing staff.

Question 44

The nurse is caring for a patient in restraints.Which of the following pieces of information about restraints requires nursing documentation in the medical record?

A) The patient states that her gown is soiled and needs changing.
B) Attempts to distract the patient with television are unsuccessful.
C) The patient has been placed in bilateral wrist restraints at 0815.
D) One family member has gone to lunch.
E) Bilateral radial pulses present, 2+, hands warm to touch
F) Released from restraints, active range-of-motion exercises complete