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Safety Flashcards

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1
Q

On arrival in the postanesthesia care unit, the practical nurse assists the registered nurse in performing the initial assessment of a client who had surgery under general anesthesia. Which assessment finding is the most concerning?

A

Muscle stiffness

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2
Q

an outbreak of meningococcal meningitis, what is the medication to prevent this disease. ?

A

ciprofloxacin, Rifampin, and meningococcal conjugate vaccine.

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3
Q

When kids are playing together but interacting. what is it called?

A

Parallel

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4
Q

Which age group is at the highest risk of getting Hepatitis A?

A

CHILDREN OLDER THAN 1 YEAR BUT YONGER THAN 15 YEARS OLD

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5
Q

what age group

sitting without support, rolling over

A

6-9months old

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6
Q

assessment finding of eczema?

A

erythema
pruritus
papules

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7
Q

contact precaution Infection

A

-Pediculosis
-Scabies
-Clostridium Difficle
Position supine
Impetigo
MRSA
vancomycin-resistant Enterococcus

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8
Q

ppe to wear for contact ,droplet & airbone

A

Contact precautions :will require a gown and gloves before entering the room.face shield is. required.Place the client in private room .hand hygiene is required
Droplet precautions: a face mask and gloves must be worn to prevent transmission.
Airborn precautions: N95 , hand washing,negative air pressure room.

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9
Q

Airborne Infection

A
  • keep the door close and maintain negative air pressure.
  • varicella
  • tuberculosis
  • measles
  • rubeola
  • Herpes Zoster ( Gown, gloves, N95 mask)
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10
Q

droplet Precaution disease

A 
pertussis
rubella
adenovirus
influenza
 meningococcal meningitis
Group A Streptococcus (strep throat)
Mumps
Neisseria meningitidis
Haemophilus influenzae type B
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11
Q

causes of metabolic acidosis

A

severe diarrhea, starvation, and diabetes Mellitus.

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12
Q

which of the following is an internal disaster ?

A

a loss of electrical power to the facility,

the sudden cessation of internal communication and a toxic chemical spill in the lobby

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13
Q

What is the first priority when a patient is exposed to radioactive?

A

remove any radioactive materials from the patient and decontaminate

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14
Q

Diphtheria

A

the agent of the infection Corynebacterium diphtheriae
the incubation period for this infection is 2-5 days
diphtheria bacteria spread from person to person, usually through respiratory droplets, like from coughing or sneezing.

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15
Q

Nursing intervention for a patient who is one hour post-operative from cardiac catheterization.

A

metformin should be held

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16
Q

the patient is experiencing post-operative tachycardia with low blood pressure indicates what ?

A

Hemorrhage

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17
Q

the patient is experiencing post-operative tachycardia with fever indicates what ?

A

the development of infection

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18
Q

a patient taking haloperidol, the patient complains of dry mouth,weight gain,& muscle stiffness.what is the adverse effect and what medication to prescribe.

A

extrapyramidal symptoms & Administering diphenhydramine.

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19
Q

red, yellow, green, and black tag during triag

A

Red tags- IMMEDIATE - highest priority treatment/transfer. These patients cannot survive without immediate treatment but have a high chance of post-treatment survival. E.g. Tension pneumothorax, cardiac tamponade, massive hemorrhage.
Yellow tags- DELAYED - medium priority. No immediate danger of death, stable but will still need hospital care. Under normal circumstances, these patients will be treated immediately, but in mass casualty scenarios, they are medium priority. E.g. isolated humerus or femur fracture.
Green Tags- MINOR - lowest priority - those with minor injuries, ambulating (“walking” wounded). E.g. abrasions sprain. These are attended to after high and medium-priority patients are addressed.
Black Tags- EXPECTANT - keep comfortable, pain medications only until death. These are patients with injuries so extensive that they will not be able to survive with the best available care or those dead already. E.g. Massive head injury with fixed pupil, third-degree burns involving 95% body surface.

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20
Q 
Which stage of psychosocial development ?
 Initiative vs. Guilt
Autonomy vs. Shame and Self Doubt
Trust vs. Mistrust
 Industry vs. Inferiority
A

3-5years pre-schooler
2-3years
birth-to18months old
6-11 years school age

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21
Q

You are teaching a group of new graduate nurses about the long term effects of congestive heart failure. You know that they understand your teaching when they state the following expected findings

A

Polycythemia & Clubbing

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22
Q

Mannitol

A

is a diuretic used for a reduction in increased intracranial pressure. This is because mannitol is an osmotic diuretic that does not cross the blood-brain barrier

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23
Q

Hydrochlorothiazide

A

This diuretic is used in the treatment for Congestive Heart Failure because it is a loop-diuretic and allows for decreased absorption of sodium.

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24
Q

Spironolactone

A

helps with high blood pressure, edema, and high levels of hormones.

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25
Q

Furosemide

A

helps decrease edema and fluid retention caused by heart disease, liver disease, and kidney disease

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26
Q

removing the Personal Protective Equipment (PPE)

A 
Remove gloves
Take off goggles or face shield
Take off gown
Remove the N95 respirator
Perform hand hygiene
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27
Q

putting on the Personal Protective Equipment (PPE):

A

Put on the gown
Put on mask or respirator
Put on goggles or a face shield
Put on gloves

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28
Q

Which of the following interventions are appropriate for a pediatric patient experiencing contact dermatitis?

A

Diphenhydramine
Hydrocortisone
Cyclosporine
Tacrolimus

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29
Q

You are the nurse caring for a 4-month-old infant status post cleft lip repair. Which of the following nursing actions are appropriate for this patient?

A

Position supine
Clean the suture line with saline
Apply elbow restraints

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30
Q

On arrival in the postanesthesia care unit, the practical nurse assists the registered nurse in performing the initial assessment of a client who had surgery under general anesthesia. Which assessment finding is the most concerning?

A

2.

Muscle stiffness

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31
Q

A client who just arrived in the postanesthesia care unit after general anesthesia would be expected ?

A

to be difficult to rouse and have small pupil size

32
Q 
lab values
Hemoglobin
INR
PLATELET COUNT
Hematorocrit
A

H:13.2-17.3
INR:0.75-1.25
PC: 150,000- 400,000
HE:39%-50%

33
Q

A nurse is making a home visit when a fire starts in the client’s kitchen trash can. The client has a fire extinguisher. The nurse should take which actions to properly operate the fire extinguisher?

A

Pull out the pin on the handle
Aim the nozzle at the base of the fire
Squeeze the handle to spray
Sweep the spray from side to side

34
Q

Which client is most at risk for hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA)?

A

80-year-old with chronic obstructive pulmonary disease (COPD) who is on a ventilator.
Clients at highest risk for hospital-acquired MRSA are older adults and those with suppressed immunity, long history of antibiotic use, or invasive tubes or lines

35
Q

A client with a tracheostomy is alert and oriented and able to tolerate oral intake. Which action would be appropriate to reduce the client’s risk of aspiration pneumonia?

A
  • Having the client sit upright with the chin flexed slightly toward the chest
  • Monitoring for a wet or garbled-sounding voice
  • Monitoring for signs of feve
36
Q

A home health nurse is supervising a home health aide who is changing the dressing for a client with a chronic heel wound. Which actions by the aide indicate adherence to appropriate infection control procedures?

A
  1. Wash hands prior to putting on gloves and after removing them
  2. Open a sterile container of 4 x 4’s using the outermost corner to peel back the cover
  3. Pull glove off over the soiled dressing to encase it before disposal
37
Q

The practical nurse is collaborating with the registered nurse to admit a client who will receive general anesthesia in the same-day surgery unit. The client has never had surgery before. Which question is most critical for the nurse to ask the client during preoperative assessment and health history taking?

A

Has any family member ever had a bad reaction to general anesthesia?”

38
Q

The nurse is caring for a client who performs frequent urinary self-catheterizations. Which of the following client assessments would indicate a potential for a latex allergy?

A

Known allergy to avocados, kiwis,tomatoes and bananas & Lip swelling when blowing up balloons

39
Q

A client is able to partially bear weight and follow the nurse’s instructions. Which would be the most appropriate method for the nurse to use to safely transfer this client?

A

1-person stand and pivot with gait belt and walker

40
Q

A nurse is performing a dressing change for a hospitalized client with an infected surgical incision. Which actions should the nurse take?

A

Wear clean gloves to remove the existing dressing, changing to sterile gloves to apply the new dressing

41
Q

The nurse receives an obese client in the postanesthesia care unit who underwent a procedure under general anesthesia. The nurse notes an oxygen saturation of 88%. Which is the most appropriate initial intervention?

A

Perform head tilt and chin lift (

42
Q

The intensive care nurse is monitoring the central venous catheters of 4 clients. Which central line should be removed the earliest to prevent infection?

A

Femoral line inserted in emergency department post cardiac arrest 48 hours ago

43
Q

A client with suspected foot osteomyelitis is scheduled for an MRI. Which client findings should the nurse report before the test?

A
  • Cardiac pacemaker
  • Retained metal foreign body in eye
  • Total hip replacement
44
Q

The nurse recognizes that which factors place a client at increased risk for falls?

A
  • Lying pulse 80/min, standing pulse 110/min
  • Osteoarthritis of knees
  • Takes carbidopa/levodopa( medication for parkinson)
  • Uses a cane to ambulate
45
Q

The patient is using topical glucocorticoids. The nurse should assess for all the following systemic effect. ?

A

A.Mood changes.
B. Osteoporosis.
C. Adrenal insufficiency.

46
Q

What is Topical glucocorticoids or corticosteroids. used. for ?

A

they are used in cases of dermatitis and eczema to treat symptoms of burning, itching, and inflammation. They may also be used in conjunction with other medical therapies for the treatment of psoriasis.

47
Q

Which procedures necessitate the use of surgical asepsis techniques? Select all that apply.

A
  • Central line intravenous medication administration.
  • Donning gloves in the operating room.
  • Foley catheter insertion.
48
Q

If reported by the patient, which of the following symptoms is expected with the administration of Cisplatin to a patient on the oncology unit? Select all that apply:

A 
Nausea and vomiting (may be severe)
Diarrhea
Temporary hair loss (alopecia)
Loss of inability to taste food
Hiccups
Dry mouth
Dark urine
Decreased sweating
Dry skin and other signs of dehydration
lower back pain
vision changes
49
Q

When a patient receiving oxygen at a flow rate of 6L/min by nasal cannula complains of nasal passage discomfort, what intervention should the nurse suggest to improve the patient’s comfort?

A
  • Suggest adding humidification to the oxygen delivery system.
  • When the flow rate of oxygen is higher than 4L/min; the mucous membranes can become dry
50
Q

Which of the following are symptoms of true labor? Select all that apply.

A
  • Contractions that come in regular intervals.
  • Lower back pain.
  • Contractions of increase intensity
51
Q

In which of the following cases taking rectal temperature is contraindicated? Select All That Apply.

A

A. A newborn who has hypothermia.

B. Post myocardial infarction patient.

C. A teenager who has leukemia with low white cell count.
D. An adult patient with recent rectal surgery
E. Children with diarhea

52
Q

When instructing a client on medications, which of the following medications would the nurse indicate are used to treat panic disorders? Select All That Apply ?

A

A. Amitriptyline.
B. Diazepam.
C. Phenelzine

53
Q

In Piaget’s Stages of Cognitive development, the ______________ stage occurs from 0 to 2 years old.

A

sensorimotor stage

54
Q

A client has a pressure ulcer with a shallow, partial skin ­thickness eroded area but no necrotic areas. The nurse would treat the area with which dressing?

A

Hydrocolloid

55
Q

A client has a pressure ulcer with wounds with significant drainage. The nurse would treat the area with which dressing?

A

Alginates

56
Q

A client has a pressure ulcer with new granulation and result in more damage. The nurse would treat the area with which dressing?

A

Dry gauze

57
Q

Which of the following diseases decreases the metabolic rate?

A

Hypothyroidism.

58
Q

Which of the following are opportunistic infections that adversely affect patients infected with HIV/AIDS? Select all that apply.

A

A. Kaposi’s sarcoma.
B. Tuberculosis.
C. Toxoplasma gondii.

59
Q

Which of the following clients is at greatest risk for experiencing impaired vascular perfusion?

A

64-year-old male client who has hypotension

60
Q

Which is an intrinsic risk factor that increases the risk of patients developing pressure ulcers?

A 
Poor nutritional status
Incontinence
Alterations in fluid balance
Altered neurological status
Impaired tissue perfusion
61
Q

Which is an extrinsic risk factor that increases the risk of patients developing pressure ulcers?

A

Shearing, friction, and pressure

62
Q

A.Which of the following terms describe the soft down hairs present on the shoulders, back, and forehead of newborns?
B.tiny white bumps that commonly appear on newborns’ forehead ?
C.the “cheese-like” substance coating the skin of newborns after birth ?
D.spots are a type of birthmark ?A

A

A.Lanugo
B.Milia
C.Vernix
D. Mongolian spot

63
Q

What is the NAS score for this patient?

A 
High pitched cry = 2 points.
No tremors = 0 points
Increased muscle tone = 2 points.
Sleeping for 3 hours in between feedings =0 points
No congestion = 0 points
RR = 42 = 0 points
Excessive sucking on the pacifier = 1 point
Poor feeding = 2 points
No vomiting = 0 points
No loose stools = 0 points
64
Q

At the 24-week visit, a pregnant woman demonstrates less than expected growth in uterine size, an easily palpable fetus that can be outlined by the nurse, and the absence of fetal ballottement. Which of the following is this most likely related to the development of?

A

Oligohydramnios.

65
Q

is a condition in which excessive amniotic fluid accumulates during pregnancy. Hydramnios’ symptoms can include rapid growth of the uterus, discomfort in the abdomen, trouble breathing, and possibly uterine contraction ?

A

Hydramnios

66
Q

is a rare obstetric emergency. When this does occur, amniotic fluid enters the bloodstream of the mother. The mother’s body responds with cardiorespiratory collapse.

A

An amniotic fluid embolism (AFE)

67
Q

refers to a newborn who is significantly larger than average. A baby diagnosed with fetal macrosomia has a birth weight of more than 8 pounds, 13 ounces, regardless of his or her gestational ag

A

Macrosomia

68
Q

Which of the following signs and symptoms would you expect in a patient diagnosed with Graves’ Disease? Select all that apply.

A

A. Diaphoresis.
B. Exophthalmos.
C. Weight loss.
D. Increased appetite.

69
Q

Which of the following statements are true regarding hyperparathyroidism? Select all that apply.

A

A. Patients with hyperparathyroidism have increased serum calcium levels.
B. Patients with hyperparathyroidism have decreased serum phosphate levels.
C. Hyper-parathyroid patients are typically more sedated and lethargic

70
Q

Which of the following would be a priority action for a nurse who sustained a needlestick injury while working with an AIDS patient?

A

Start prophylactic AZT

71
Q

When observing a patient on antivirals, the nurse notices the patient has developed bruising. This could indicate which of the following?

A

The patient may be experiencing bone marrow suppression

72
Q

When assessing the new stoma of a client diagnosed with Crohn’s disease, which will alert the healthcare provider that the stoma has retracted?

A

Concave and bowl-shaped

73
Q

Which of the following drugs is associated with photosensitivity? Select All That Apply.

A 
A. Ciprofloxacin (Cipro).
B. Sulfonamide.
C. Norfloxacin (Noroxin).
D. Sulfamethoxazole and Trimethoprim (Bactrim).
E. Isotretinoin (Accutane).
74
Q

Which of the following findings would prompt immediate investigation when performing an assessment of a patient on a medical/surgical unit?

A

High-pitched bowel sounds at a rate of 4 per minute

75
Q

Normal vital sign for infant

A

Pulse: 90-140
RR: 25-40
BP: 85/60

76
Q

The nurse is caring for a patient with atrial fibrillation, who is on warfarin. Which of the following alternative therapies should the nurse advise this patient to avoid?

A

Ginger
Garlic
Ginko biloba

77
Q

A patient is conducting infection control assessments on the nursing unit. Which patient is at greatest risk for infection?

A

A patient who is receiving total parenteral nutrition (TPN) via a central line.

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