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A nurse enters a patient’s room and notices water spilled on the floor. What is the
nurse’s priority action?
A. Call housekeeping
B. Document the spill
C. Place a warning sign
D. Clean the spill immediately
Answer: D
Rationale: Immediate action to remove hazards prevents falls and promotes patient
safety. Delegation or documentation can follow once the danger is addressed.
Which patient is highest priority?
A. Stable fracture
B. Difficulty breathing
C. Mild fever
D. Rash
Answer: B
Rationale: Airway and breathing issues are life-threatening.
What is the best infection control method?
,A. Antibiotics
B. Hand hygiene
C. Isolation
D. Vaccines
Answer: B
Rationale: Prevents spread of pathogens.
A nurse notes abnormal vital signs. First action?
A. Ignore
B. Reassess
C. Document
D. Call family
Answer: B
Rationale: Confirms accuracy before intervention.
Which is a fall prevention strategy?
A. Clutter
B. Proper lighting
C. Slippery floors
D. High beds
Answer: B
Rationale: Visibility reduces falls.
What is priority for bleeding wound?
A. Elevate and pressure
, B. Document
C. Clean later
D. Ignore
Answer: A
Rationale: Controls hemorrhage.
Which patient is at highest risk for falls?
A. A 30-year-old with a sprained ankle
B. A 65-year-old taking diuretics
C. A 40-year-old with a cold
D. A 50-year-old post appendectomy
Answer: B
Rationale: Older adults on diuretics may experience frequent urination and dizziness,
increasing fall risk.
What is the most effective way to prevent medication errors?
A. Administer medications quickly
B. Follow the six rights of medication administration
C. Ask another nurse to administer medications
D. Skip documentation
Answer: B
Rationale: The six rights (right patient, drug, dose, route, time, documentation) ensure
safe medication administration.
A nurse is caring for a patient with confusion. Which intervention promotes safety?
A. Leave patient alone