Chapter 22- Safety Nursing School Test Banks

 

1.

The occupational health nurse is planning a safety inservice for a group of clerical workers. Which of the following topics 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 combustable 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.

2.

A patient has presented to the Emergency Department after splashing a chemical in the eyes. When managing the injury, which of the following should be included in the plan of care?

A)

Wash the eyes with a hypertonic solution for at least 30 minutes.

B)

Advise the patient 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 or on the skin, immediate irrigation with lukewarm water for 10 to 15 minutes may reduce harmful effects.

3.

The nurse is discussing car safety with the mother of a 6-year-old child. The childs 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.

4.

After identifying a medication error, the nurse completes an incident report. The nurse correctly recognizes which of the following about the use of these documents? Select all that apply.

A)

The incident report should be placed with the patients medical records.

B)

Incident reports provide a clear, concise recording of the situation that can be provided to the patients legal representative in the event of a lawsuit.

C)

The incident report should include factual information about the incident.

D)

The nurse should include their own personal perception about the cause of the incident in the report.

E)

Completion of the incident report should be noted in the nurses 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 patients medical record. It completely describes all the aspects of the event that occurred. Specifically, the report should include the accident, patient assessment, and interventions provided for the patient. The report is used for internal review to improve the system to prevent similar errors and cannot be subpoenaed by a court of law.

5.

The nurse is assessing the patients sensory input. Which of the following assessments should be included? Select all that apply.

A)

Assessment of sensitivity to touch

B)

Assessment of sensitivity of sharp to dull stimulation

C)

Assessment of ability to maintain balance

D)

Assessment of pupil sensitivity to light changes

E)

Assessment of 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.

6.

The nurse is assessing a patients mental health competence and decision-making ability. What activities will best provide the needed information to the nurse?

A)

Ask the patient to read and discuss a passage from a pamphlet.

B)

Ask the patient what if questions to determine level of thought organization.

C)

Ask the patient to review his medical health history to assess for the level of organization of his thought processes.

D)

Discuss with the patients family any concerns about his mental stability.

Ans:

B

Feedback:

When reviewing mental health and level of decision-making ability, the best method is to ask the patient what if type of questions. Assessing the patients reading ability and understanding of passages read will not provide the needed information. Asking the patient to discuss his medical history will provide some information but will not provide information on his ability to reason and make clear decisions. Questioning the family provides only a secondary source of information and will not be as effective.

7.

A nurse is completing an intake assessment. The nurse notes that an older adult male patient appears to have bruises in varying stages of healing. Which of the following actions by the nurse indicates an understanding of her responsibilities?

A)

The nurse should notify the primary care physician about the bruises.

B)

The nurse should contact the facilitys social services department.

C)

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

D)

The nurse should request permission from the patient 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 patient. If the nurse feels there is potential abuse the nurse is obligated to report it.

8.

The nurse is preparing to discuss safety with a group of parents of infants. When planning the program, which of the following topics would be most important to include?

A)

The use of skid-proof mats for the bath tub

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.

9.

The nurse manager is reviewing the QSEN quality and safety competencies for nurses. Which of the following are included in this initiative? Select all that apply.

A)

Patient-centered care

B)

Teamwork and collaboration

C)

Establishment of clinical career ladders

D)

Development of multidisciplinary committees to review patient satisfaction

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: Patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics.

10.

The facility is conducting an educational seminar for newly employed nurses. The program addresses the reporting of sentinel events. Which of the following occurrences qualify for this criteria? Select all that apply.

A)

A patient reports plans to file a complaint concerning the amount of time it took for a nurse to respond to a call light.

B)

A patients baby is misidentified and receives breast milk from another mother.

C)

A patient experiences a reaction to a unit of blood, resulting in itching and hives.

D)

A patient faints during ambulation with the nurse, resulting in a concussion.

E)

The nurse administers a lethal dosage of medication in error.

Ans:

B, D, E

Feedback:

A sentinel event is one in which a patient experiences death or serious injury.

11.

The nurse has committed a medication error. The nurse administered an antibiotic dosage greater than the dosage prescribed. The patient did not experience any adverse effects. What initial action by the nurse is most appropriate?

A)

Report the actions as a sentinel event

B)

Contact the nursing supervisor

C)

Notify the physician

D)

Complete an incident report

Ans:

C

Feedback:

Notification of the physician 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.

12.

The health department is reviewing community health initiatives for the year. During the summer, health department focuses infection control activities on which of the following programs?

A)

Administering immunizations

B)

Administering free antibiotics

C)

Using pesticides for mosquitoes

D)

Delivering fans to elderly residents

Ans:

C

Feedback:

Community problems such as water supply contaminated with sewage or tick infestations near residential areas also can result in infection. Immunization administration projects are not limited to the summer months. Antibiotic administration is not a prevention program but one geared to disease treatment. Fans may be delivered to the elderly but this intervention will not reduce infection.

13.

The facility risk management team is preparing an inservice to nursing staff members. The presentation will highlight risk factor increase related directly to the type of patientele on a nursing unit. The presenter will correctly explain that which of the following risks is increased for female nurses who work on an oncology care unit?

A)

Back injuries

B)

Bloodborne pathogens

C)

Adverse reproduction

D)

Neurologic disorders

Ans:

C

Feedback:

Common risks in healthcare facilities are exposure to bloodborne 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.

14.

The nurse instructs the family of an elderly patient with a visual impairment and decreased mobility that the most common problem for these patients is related to which of the following?

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.

15.

In large metropolitan areas, patients 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.

16.

A patient has developed neuropathy as he has aged. What would be the most important teaching intervention for the patient and family?

A)

Provide a comfortable temperature in the home

B)

Reduce the temperature on the water heater

C)

Keep the environment warmer in winter

D)

In high temperatures, have adequate ventilation

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. Patients with neuropathy will definitely need the hot water heater temperature reduced.

17.

The older adult will have an increased risk for developing which of the following?

A)

Fire hazards

B)

Gun shot 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.

18.

Which of the following statements should the nurse include in the teaching plan regarding safety issues that she is preparing for a group of adult patients?

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 controls for all workplace hazards

D)

Environmental lead is a primary cause of death in adult patients

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.

19.

Which of the following reasons best explains why adolescents behave in an unsafe manner despite knowledge of a particular activitys 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.

20.

A group of girls are 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 others whereabouts and well-being during certain high-risk activities, is an important outdoor and water safety strategy.

21.

A child is learning to ride a bicycle. He should be instructed to use which of the following protective devices?

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 but not with the same degree of importance as a helmet.

22.

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.

23.

A nurse instructs a group of parents of preschool-age children that the rules of safe social interaction for this age group are often learned by

A)

Trial and error

B)

Interaction with parents

C)

Interaction with peers

D)

Through preschool

Ans:

A

Feedback:

Preschoolers learn the rules of safe social interaction by trial and error.

24.

Which of the following safety topics is the most appropriate for the nurse to discuss with mothers of preschoolers?

A)

Taking baths alone

B)

Bicycle safety

C)

Crossing streets alone

D)

Safety zones

Ans:

D

Feedback:

Preschoolers usually can avoid bumps and learn to climb safely up and down stairs. They also benefit from learning about safety zones, which are safe places to stand or sit when potentially dangerous activity is underway.

25.

When educating parents of preschoolers, what is most important to include in your presentation?

A)

Use wrist guards with rollerblades

B)

Teach preschoolers to tread water

C)

Keep chemicals in a locked cabinet

D)

Strict discipline with potty training

Ans:

C

Feedback:

Increasing mobility, lack of life experience and judgment, and still immature musculoskeletal and neurologic systems lead to potentially hazardous encounters for toddlers and preschoolers.

26.

What national organization determined that unintentional injuries were the fifth-leading cause of all deaths in the United States?

A)

Centers for Disease Control and Prevention

B)

American Medical Association

C)

American Nurses Association

D)

National Patient Safety Foundation

Ans:

A

Feedback:

The Centers for Disease Control and Prevention determined that unintentional injuries were the fifth-leading cause of all deaths in the United States in 2002.

27.

Which of the following items would alert the home care nurse to a safety hazard threatening to a young child?

A)

Three blankets in a crib

B)

A gated stairway

C)

Padded child safety seat

D)

Dangling blind cords

Ans:

D

Feedback:

As babies gain neurologic and musculoskeletal functions, they learn and explore by pulling objects to themselves and placing almost everything in their mouths. Cords, tablecloths, plastic bags, bottles, and cans are tempting, dangerous objects that caregivers must strive to keep out of reach.

28.

One of the leading causes of death in the United States, particularly in southwestern states, is drowning. How can the nurse assist in lowering this statistic?

A)

Educate children in cardiopulmonary resuscitation

B)

Begin swim lessons with toddlers

C)

Implement drowning-prevention strategies

D)

Require fencing around all pools

Ans:

C

Feedback:

The principles of injury control have interventions centered at three primary levels: the individual level, providing education about safety hazards and prevention strategies; the design phase, using engineering and environmental controls; and the regulatory level, creating, monitoring, and enforcing regulations to ensure safe products and environments among manufacturers, retailers, employers, workers, and product users.

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