Unit 3 - Safety

Question 1

Factors affecting safety?

Answer 1

1. Psychosocial considerations (smoking)
2. Basic needs (Maslow)
3. Physical Hazards (exposure to infection, pollution, terrorism)

Question 2

Developmental considerations

Infants/toddlers/preschoolers

Answer 2

injuries, poisoning, incorrect vehicle restraints,

* Must educate parents

Question 3

Developmental considerations

Adolescents

Answer 3

identity, peers, act impulsively, risk-taking, behaviours (smoking), ingestion of drugs increase drowning, vehicle accidents

Question 4

Developmental considerations

School-Aged children

Answer 4

bullying, increased activity –> helmets

Question 5

Developmental considerations

Young Adults

Answer 5

Lifestyle habits, stress

Question 6

Developmental considerations

Middle-aged adults

Answer 6

responsibilities; accidents

Question 7

Developmental considerations

Older adults

Answer 7

physiological changes (e.g., decreased vision, hearing, reaction time), chronic conditions, risk of falls,

Question 8

Health care enviro risks

Answer 8

Chemicals – disinfectants, meds, Stronger in hospitals
Microorganisms – nosocomial infections
Equipment – check regularly (Suction/ 02 working)
Perception of safety
Risk for medical/procedural errors – incident reports

Question 9

Falls can be caused by

Answer 9

Medications
Delirium
Limited mobility

Question 10

4 individual risk factors

Answer 10

1. Lifestyle (dangerous job, drug withdrawal)
2. Impaired mobility (poor coordination, weakness)
3. Sensory/ Communication impairment (visual, hearing, language barrier)
4. Lack of safety awareness (expiration dates, poisonous substances storage)

Question 11

9 Life-saving Pt safety sol’n

Answer 11

1. Be aware of look-alike & sound-alike medications
2. Use pt identification
3. Communicate during pt handover
4. Perform correct procedure @ correct body site
5. Control concentrated electrolyte sol’n
6. Ensure meds accuracy @ transition in care
7. Avoid catheter & tubing misconnections
   8 Don’t reuse single-use injection devices
8. Improve hand hygiene to prevent HAI

Question 12

Ways to prevent falls

Answer 12

Check pts frequently.
Use brakes on beds, commodes, wheel chairs, ect.
Use shoes or rubberized slippers.
Keep necessary items w/in reach.

Question 13

Types of restraints

Answer 13

Physical (impeding pt movement) –> Side rails
Chemical (meds)
Environmental (locking doors)

Question 14

Risks of using physical restraints

Answer 14

Humiliation; fear; impaired circulation; pressure ulcers; incontinence; decreased muscle mass; death; entrapment

Question 15

Objectives that must be met in order to use restraints

Answer 15

1. Reduce risk of pt injury
2. Prevent interruption of therapy (nasogastric tube feeding)
3. Prevent pt from removing life-support equipment
4. Reduce risk of injury to others

Question 16

In which of the following situations is a physical restraint appropriate?
A. To restrain a patient on a very busy shift when the unit is short staffed.
B. In situations where bed exit alarms (e.g., Bed-check or Ambularm) have been unsuccessful.
C. To restrain a patient who has just struck a nursing colleague.
D. On a newly admitted patient who has just crawled out of bed.

Answer 16

B. In situations where bed exit alarms (e.g., Bed-check or Ambularm) have been unsuccessful.

Question 17

After the nurse assists a patient with a history of seizures to a recliner chair, the patient begins to have a seizure. What should the nurse do immediately?
A. Turn the patient onto his or her stomach.
B. Recline the patient’s chair all the way back.
C. Return the patient to the bed and place the patient on his or her side.
D. Slide the patient to the floor and cradle the patient’s head.

Answer 17

D. Slide the patient to the floor and cradle the patient’s head.

Question 18

Which of the following statements are true?
Select all that apply.
A. An example of an environmental restraint is a locked nursing unit.
B. Mechanical restraints should be applied when the nurse is busy.
C. Chemical restraints are psychoactive medications.
D. Restraints must not be considered punitive.

Answer 18

A. An example of an environmental restraint is a locked nursing unit.
C. Chemical restraints are psychoactive medications.
D. Restraints must not be considered punitive.

Question 19

A couple has brought in their adolescent daughter for a school physical examination. The parents tell the nurse that they are worried about all the safety risks for this age group. As the nurse plans to teach the parents about these risks, the nurse remembers that adolescents are at a greater risk for injury from which of the following?
A. Home accidents
B. Poisoning and child abduction
C. Physiological changes of aging
D.Automobile accidents, suicide, and substance abuse

Answer 19

D.Automobile accidents, suicide, and substance abuse

Question 20

As a member of the hospital’s bioterrorism team, the nurse understands the importance of knowing how an organism is transmitted. Smallpox has the potential to spread quickly because it is transmitted via which route?
A. Airborne
B. Ingestion
C. Absorption
D. Bloodborne

Answer 20

A. Airborne

Question 21

The nurse discovers an electrical fire in a patient’s room. What would the nurse’s first action be?
A. Activate the fire alarm.
B. Confine the fire by closing all doors and windows.
C. Evacuate any patients or visitors in immediate danger.
D. Extinguish the fire by using the nearest fire extinguisher.

Answer 21

C. Evacuate any patients or visitors in immediate danger.

Question 22

When providing health maintenance teaching to new employees in the food-handling department, the nurse emphasizes the need to perform hand hygiene after using the bathroom to prevent which of the following?
A. Food poisoning
B. Spread of hepatitis A
C. Bacterial food infections
D. Salmonella contamination

Answer 22

B. Spread of hepatitis A

Question 23

Helen Chow, an 89-year-old patient, has a history significant for confusion, impaired judgement, and incontinence. Helen’s cousin remarks that Helen is “cheerful” and “kind.” Living alone, Helen may be at risk for which of the following?
A. Falls
B. Substance abuse
C. Vision loss
D. Depression

Answer 23

A. Falls

Question 24

The family of your confused ambulatory patient insists that all four side rails be up when the patient is alone. Which is the best way to handle this situation?
A. Ask them to stay with the patient at all times.
B. Inform them of the risks associated with side rail use.
C. Thank them for being conscientious, and raise all four rails.
D. Provide the patient with a one-to-one sitter while the side rails are up.

Answer 24

B. Inform them of the risks associated with side rail use.

Question 25

``` A student nurse is designing a health fair project aimed at reducing motor vehicle accidents. For which group of patients would this subject be most appropriate? A. Adolescents B. Older adults C. Middle-aged adults D. Adults with dementia ```

Answer 25

A. Adolescents

Question 26

``` Which action by the nurse is most effective in limiting the transfer of microorganisms? A. Use of hand lotions B. Use of sterile gloves C. Handwashing D. Immunization ```

Answer 26

C. Handwashing

Question 27

A child for whom the nurse is caring in the hospital starts to have a grand mal seizure while playing in the playroom. What is the most important nursing intervention during this situation? A. Suction the child’s airway. B. Restrain the child to prevent injury. C. Place a tongue blade over the tongue to prevent aspiration. D. Clear the area around the child to protect the child from injury.

Answer 27

D. Clear the area around the child to protect the child from injury.

Question 28

A parent calls the pediatrician’s office frantic because her 2-year-old son drank a bottle of cleaner. Which of the following is the most important instruction the nurse can give to this parent? A. Give the child milk. B. Call the poison control centre. C. Try to make the child vomit. D. Take the child to the emergency department.

Answer 28

B. Call the poison control centre.

Question 29

During the night shift, a patient is found wandering the hospital halls looking for a bathroom. What would your initial intervention be? A. Insert a urinary catheter. B. Ask the physician to order a restraint. C. Assign a staff member to stay with the patient. D. Provide scheduled toileting during the night shift.

Answer 29

D. Provide scheduled toileting during the night shift.

Question 30

During the nurse’s assessment of a 56-year-old man, he reports increased alcohol consumption because of stress at work. Which of the following is one of the expected outcomes for this patient? A. Decrease stress in his life. B. Teach him ways to promote sleep. C. Decrease his alcohol intake during times of stress. D. Provide the patient with information about stress management classes.

Answer 30

D. Provide the patient with information about stress management classes.

Question 31

``` Which of the following types of restraint is commonly used with an infant or small child? A. Mummy restraint B. Wrist restraint C. No restraint D. Waist restraint ```

Answer 31

A. Mummy restraint

Question 32

Lisa, a trained unregulated care provider, is working with you during your shift. One of your patients has upper limb restraints. In delegating care of this patient to Lisa, you would tell her to do which of the following? A. Secure the restraints to the side rails. B. Check to see if the patient can have a medication for sleep. C. Call the physician if the patient becomes more agitated with the restraint. D. Report any signs of redness, excoriation, or constriction of circulation under the restraint.

Answer 32

D. Report any signs of redness, excoriation, or constriction of circulation under the restraint.