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Fundamentals of Nursing 1st Edition Yoost Crawford Test Bank

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Fundamentals of Nursing 1st Edition Yoost Crawford Test Bank

ISBN-13: 978-0323295574

ISBN-10: 0323295576

 

 

Description

Fundamentals of Nursing 1st Edition Yoost Crawford Test Bank

ISBN-13: 978-0323295574

ISBN-10: 0323295576

 

 

 

 

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Free Nursing Test Questions:

Chapter 25: Safety

 

MULTIPLE CHOICE

 

  1. The increase focus in nursing on patient safety has resulted in a project funded by the Robert Wood Johnson Foundation called:
a. OSHA.
b. MSDS.
c. QSEN.
d. ADA.

 

 

ANS:  C

QSEN, or the Quality and Safety Education for Nurses, was funded by the RWJ to focus on preparing nurses of the future with the knowledge, skills and attitudes to advance quality and safety on the job. MSDS are material safety data sheets, OSHA is the Occupational Safety and Health Agency, and ADA is the Americans with Disability Act.

 

DIF:    Remembering                                 REF:   p. 461             TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. Individual factors affecting safety include those that are related to the functioning of body systems and those that are directly associated with a person’s particular lifestyle. Changes in which body system affect overall mobility increasing the propensity of falling?
a. Neurologic
b. Hepatic
c. Cardiopulmonary
d. Musculoskeletal

 

 

ANS:  D

Impairments in the musculoskeletal system can impact mobility through restrictions of range of motion and strength, increasing the chances of falling. Changes to the neurologic system can impair cognitive functioning, changes to the hepatic system can affect mental status and changes to the cardiopulmonary system can affect activity tolerance.

 

DIF:    Understanding                                 REF:   pp. 461-462    TOP:   Assessment

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The nurse is visiting a patient with cardiac disease who has been experiencing increased episodes of shortness of breath when she tries to exercise. The nurse is concerned that her decrease in activity may lead to:
a. orthostatic hypotension.
b. increase risk of heart disease.
c. loss of short-term memory.
d. worsening shortness of breath.

 

 

ANS:  A

Inactivity in patients with cardiopulmonary disease can lead to an unsafe drop in blood pressure with position changes, or orthostatic hypotension. The patient already has heart disease so there is no further risk. Loss of short-term memory is not related to the shortness of breath. The lack of activity is not likely to worsen the shortness of breath; improving activity level may help things eventually.

 

DIF:    Applying        REF:   pp. 461-462    TOP:   Assessment

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. Conversations about safe sexual practices, including the consequences of unprotected sex such as pregnancy and sexually transmitted infections, are important to begin in what patient population?
a. Adults
b. School-aged children
c. Adolescents
d. Older adults

 

 

ANS:  C

Sexual curiosity and experimentation occur in the adolescent patient population. Conversations about safe sexual practices, including the consequences of unprotected sex, such as pregnancy and sexually transmitted infections, are important. These conversations are also important for adults and older adults but are handled differently in context with their age-related needs. School-aged children may be too young depending on their age and their environment. The nurse must use judgment on when to have the conversation.

 

DIF:    Understanding                                 REF:   p. 463             TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The nurse manager is developing a training guide. Which is the best organization to help her develop guidelines she can use to help her to prevent exposure to hazardous situations and decrease the risk of injury in the work place?
a. OSHA
b. CDC
c. QSEN
d. NIOSH

 

 

ANS:  A

Occupational Safety and Health Administration (OSHA) was established in 1970 to provide employers with guidelines for preventing exposure to hazardous chemicals and hazardous situations and reducing the risk of injury in the workplace. The CDC is the Centers for Disease Control and Prevention and provides information to address exposure to infectious diseases. QSEN, or the Quality and Safety Education for Nurses, was funded by the RWJ to focus on preparing nurses of the future with the knowledge, skills, and attitudes to advance quality and safety on the job. NIOSH, or the National Institute for Occupational Safety and Health, is a federal agency within the CDC that was established to conduct research and recommend interventions for the prevention of work-related injury and illness.

 

DIF:    Understanding                                 REF:   pp. 463-464    TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care

NOT:  Concepts: Health Care Organizations

 

  1. The nurse is educating parents about firearm safety. Which of the following statements indicates a need for further education?
a. “I should make sure I obtain the proper permits.”
b. “It is okay to store firearms with ammunition loaded.”
c. “I should store all firearms without ammunition.”
d. “I should make sure all firearms have trigger locks in place.”

 

 

ANS:  B

Firearms should be stored in a secure location with trigger locks in place. Ammunition should be stored in a separate location also locked. Proper permits should be obtained as appropriate. Loaded firearms should never be stored where children can access them.

 

DIF:    Applying        REF:   p. 475            TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The nurse recognizes that a patient is using a portable generator in the house as a power source. What source of poisoning does the nurse appropriately identify?
a. Lead
b. Carbon monoxide
c. Antifreeze
d. Pesticide

 

 

ANS:  B

Sources of carbon monoxide include automobiles, stoves, gas ranges, portable generators, lanterns, the burning of charcoal and wood, and heating systems. Lead is found in lead-based paints in toys, buildings, and ceramic dishes; sources of lead include water from lead pipes or pipes soldered with lead, gasoline or soil contaminated by gasoline, and household dust that may contain paint chips or soil. Antifreeze and pesticides are liquids.

 

DIF:    Applying        REF:   p. 464            TOP:   Assessment

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The nurse is educating the patient about the proper disposal of medications in the home. Which statement by the patient indicates she has a good understanding of the information?
a. “Remove the label from the bottle and throw in the trash.”
b. “Flush the medication.”
c. “Mix the medications with kitty litter and place the mixture in a jar and put the jar in the trash.”
d. “Dissolve the medication in water and pour down the drain.”

 

 

ANS:  C

Flushing or pouring the medication down the drain can contaminate the water system. Throwing the medication in the trash poses potential for someone to remove the medication and use it. This can be avoided by mixing it with an undesirable substance like kitty litter or coffee grounds.

 

DIF:    Applying        REF:   p. 465            TOP:   Intervention

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The nurse knows that which of the following patients has a teaching need based on statements by the patient or the patient’s parents?
a. “My 6-month-old daughter only sleeps with me when she’s ill.”
b. “I do not put pillows in the bed with my 3-month-old son.”
c. “I do not feed popcorn to my 2-year-old.”
d. “I have discussed the risks of the ‘choking game’ with my 16-year-old.”

 

 

ANS:  A

Small children should never sleep in the bed with others because of the risk of suffocation. The rest of the statements are appropriate. Pillows do present a hazard to a 3-month-old, and popcorn is a choking risk for a 2-year-old. The choking game is a risk to any adolescent.

 

DIF:    Applying        REF:   p. 466            TOP:   Intervention

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Patient Education

 

  1. The nurse is working with a student nurse to teach her about restraint use in patients. Which statement by the student nurse indicates a learning need regarding restraints?
a. “Having all four side rails up on the bed is considered a restraint.”
b. “The use of restraints has been shown to decrease fall-related injuries.”
c. “Death has been associated with the use of restraints.”
d. “Medications administered to control behavior are considered a chemical restraint.”

 

 

ANS:  B

Restraints may be physical or chemical. A physical restraint is a mechanical or physical device, such as material or equipment attached or adjacent to the patient’s body, used to restrict movement (CMS, 2006). Examples of physical restraints are wrist or ankle restraints, a jacket or vest, and side rails. A medication that is administered to a patient to control behavior is a chemical restraint. The use of restraints has been associated with patient injury including death and does not prevent patient falls.

 

DIF:    Applying        REF:   p. 466            TOP:   Intervention

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The nurse displays an understanding of high-risk populations for MRSA when identifying which group as the lowest risk?
a. Prison inmates
b. College dorm residents
c. Team athletes
d. Food service workers

 

 

ANS:  D

High-risk populations for MRSA include those living in close quarters or those who have frequent skin-to-skin contact, including prison inmates, college dorm residents and team athletes. Food service workers work together but do not generally live in close quarters or have skin-to-skin contact frequently.

 

DIF:    Understanding                                 REF:   p. 467             TOP:   Assessment

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Infection

 

  1. The nurse knows that which of the following is not used to assess fall risk?
a. Glasgow Falls Scale
b. Johns Hopkins Hospital Fall Assessment Tool
c. Morse Fall Scale
d. Hendrich II Fall Risk Model

 

 

ANS:  A

The Glasgow is a coma scale used to measure level of consciousness, not falls. The rest are scales used to assess the risk for falls in patients.

 

DIF:    Remembering                                 REF:   p. 467             TOP:   Assessment

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The patient has a nursing diagnosis of risk for falls. Which goal is most important?
a. Patient will ambulate twice a day.
b. Patient will have no symptoms of infection.
c. Patient will perform activities of daily living.
d. Patient will have no injuries during hospital stay.

 

 

ANS:  D

All of the goals except lack of infection are appropriate for a patient with a risk-for-falls diagnosis; however, the most important goal is for the patient to have no injuries during the hospitalization.

 

DIF:    Applying        REF:   pp. 471-472    TOP:   Planning

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. Which collaborative team member would be most effective in assisting the nurse to identify medication alternatives that are less likely to cause drowsiness and dizziness to reduce the risk of falls in the elderly patient?
a. Nursing house manager
b. Charge nurse
c. Physical therapist
d. Pharmacist

 

 

ANS:  D

The nurse collaborates with the pharmacist and physician to identify and implement safe medication alternatives for older adults to minimize side effects such as drowsiness, dizziness, and orthostatic hypotension, which can increase fall risk. Although house managers and charge nurses might have some experience in this area, pharmacists are educated to focus on medication. Physical therapists evaluate the patient’s ability to perform and maintain balance during routine activities such as sitting, standing, and walking. They make recommendations for assistive devices such as canes and walkers to promote safe performance of these activities.

 

DIF:    Applying        REF:   p. 472            TOP:   Planning

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The nurse is concerned about helping the patient find resources to obtain assistive equipment to be used in the home. Which team member should the nurse contact first?
a. Occupational therapist
b. Physical therapist
c. Physician
d. Social worker

 

 

ANS:  D

The nurse should collaborate with the social worker to identify community resources for obtaining assistive equipment. The social worker facilitates contact with insurance companies or other agencies to assist with the financing of recommended therapeutic assistive and specialty devices. Occupational therapists evaluate the patient for safe performance of activities of daily living (ADLs) such as bathing, dressing, and grooming, and they make recommendations to enhance safe performance of these activities, such as the use of specialty equipment (e.g., grippers for pants, oversized shoehorns). Physical therapists evaluate the patient’s ability to perform and maintain balance during routine activities such as sitting, standing, and walking. They make recommendations for assistive devices such as canes and walkers to promote safe performance of these activities. Physicians order the equipment.

 

DIF:    Understanding                                 REF:   p. 472             TOP:   Planning

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Collaboration

 

  1. Which statement by the patient indicates a teaching need regarding safety in the home?
a. “I will put a night light in every room.”
b. “I will not use an extension cord to plug in multiple items.”
c. “I will wash my throw rugs in the bathroom regularly.”
d. “I will keep all cleaning supplies out of reach of children.”

 

 

ANS:  C

Throw rugs present a fall or tripping hazard. Nights lights help light halls to prevent falls, extension cords can present a trip hazard, and cleaning supplies can contain poisonous materials.

 

DIF:    Applying        REF:   p. 474            TOP:   Planning

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The ER nurse is triaging a patient with suspected poisoning. Who should the nurse anticipate contacting first?
a. Family services
b. Radiology
c. Poison Control Center
d. Respiratory

 

 

ANS:  C

If poisoning is suspected, the National Poison Control Center should be contacted immediately. This information will be needed to determine treatment. Respiratory may be needed, and radiology and family services may also be needed, but that will be determined after the treatment plan is determined.

 

DIF:    Applying        REF:   p. 475            TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Caring Behaviors

 

  1. Many health care facilities use the fire emergency response defined by the acronym:
a. RACE.
b. PASS.
c. PACE.
d. QSEN.

 

 

ANS:  A

RACE stands for rescue, alarm, contain, and extinguish. QSEN is the Quality and Safety Education for Nurses. PASS is pull, aim, squeeze, and sweep for fire extinguishers.

 

DIF:    Understanding                                 REF:   p. 474             TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The nurse is ambulating her patient back from the bath when the patient begins to have a seizure. Which of the following actions should the nurse do first?
a. Lower the patient to the floor if standing.
b. Move sharp or hard objects away from the patient.
c. Turn the patient to his/her side to prevent aspiration.
d. Attempt to place a tongue blade to prevent choking.

 

 

ANS:  A

During a seizure, a patient should be protected from injury by first lowering the patient to the ground if he/she is standing. The nurse should then place the head on a soft surface and turn it to the side to prevent aspiration and move sharp or hard objects out of the way. You should never attempt to force any object into a seizing patient’s mouth.

 

DIF:    Applying        REF:   p. 477            TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The nurse is caring for a confused, combative patient. Which action would be considered last by the nurse to control behavior of the client?
a. Orient the patient frequently.
b. Apply restraints.
c. Move the patient to a room close to the nurse’s station.
d. Encourage the family to spend time with the patient.

 

 

ANS:  B

All alternatives to physical restraints should be considered prior to their use.

 

DIF:    Applying        REF:   p. 477            TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The nurse knows that which of the following is an appropriate way to tie restraints?
a. Knot tied to the bed frame
b. Quick-release knot tied to the side rail
c. Bow tied to the bed frame
d. Quick-release knot tied to the bed frame

 

 

ANS:  C

Restraints should never be tied in a knot because the knot may prohibit a quick exit in the event of an emergency requiring evacuation. Instead, use quick-release ties or mechanisms such as buckles. Restraints should never be tied to side rails because injuries may result when they are raised or lowered. They should be tied to a stable part of the bed such as the frame.

 

DIF:    Understanding                                 REF:   p. 478             TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. Which statement by the nurse correctly identifies the UAP role in patient restraint use?
a. “The UAP can perform initial assessment.”
b. “The UAP can apply a restraint.”
c. “The UAP can assist with applying and monitoring of a physical restraint.”
d. “The UAP can contact the physician and request an order for restraints.”

 

 

ANS:  C

The UAP cannot perform the initial assessment, and most facilities require that a registered nurse or licensed practical nurse Applying a restraint. The physician should be contacted by the nurse not the UAP. The UAP can assist with applying the restraint and can perform monitoring checks under the direction of a Registered Nursing

 

DIF:    Applying        REF:   p. 481            TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

MULTIPLE RESPONSE

 

  1. The nurse is explaining the National Patient Safety Goals (NPSG) to the student nurse. Which of the following answers indicates that the student has a good understanding of these goals? (Select all that apply.)
a. The NPSG’s focus on treating all infections quickly
b. The NPGS’s focus on improving staff communication
c. The NPGS’s focus on using medications safely
d. The NPGS’s focus on identifying patients correctly

 

 

ANS:  B, C, D

The NPSG focus on specific goals each year. The goals for 2014 included: identify patients correctly, improve staff communication, and use medicines safely. Although treating infections quickly is important, it is not an NPSG.

 

DIF:    Applying        REF:   p. 461            TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Safety

 

  1. The nurse is providing education to a cardiac patient who has multiple life stressors that are impacting the patient’s health. Which of the following statements by the patient indicate he has a good understanding of actions he can take to reduce his stressors? (Select all that apply.)
a. “I should change my job.”
b. “I should plan some downtime.”
c. “I should meet with a financial counselor.”
d. “I should talk with my family about my situation.”
e. “I should make my family go to counseling with me.”

 

 

ANS:  B, C, D

In adulthood, life stressors such as financial concerns, work-related demands, and efforts to balance work with family life are common challenges that can take a physical toll on the body. Individuals should plan relaxation periods or vacations. Meeting with financial counselors and talking with family can help to achieve that balance. Changing jobs may be beneficial but could also create more stress, and forcing family to go to counseling may also not be a wise choice.

 

DIF:    Applying        REF:   p. 462            TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Patient Education

 

  1. The nurse is providing some education to a community group on environmental safety. Which of the following safety measures are effective in improving their environmental safety? (Select all that apply.)
a. Use of night lights throughout the home
b. Illumination of stairwells and pathways
c. Installation of motion-activated lighting on the exterior of the home
d. Application of wax to all floor to increase shine

 

 

ANS:  A, B, C

Inadequate lighting presents safety concerns in home, work, community, and health care environments. For an individual to safely and successfully navigate pathways and perform various activities while avoiding potential obstacles and hazards, the environment must be well illuminated. Well-lit, glare-free halls, stairways, rooms, and work spaces help to reduce the risk of tripping, slipping, and falling. Night lights reduce the risk of injuries to children, guests, and older adults.

 

DIF:    Applying        REF:   p. 462            TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care   NOT:  Concepts: Patient Safety

 

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