FUNDAMENTA MSN5320 Chapter 27: Patient Safety and
Quality Potter et al.: Fundamentals of Nursing, 9th Edition
Chapter 27: Patient Safety and Quality
Potter et al.: Fundamentals of Nursing, 9th Edition
MULTIPLE CHOICE
1. A home health nurse is performing a home assessment for safety. Which comment by the
patient will cause the nurse to follow up?
a.
“Every December is the time to change batteries on the carbon monoxide detector.”
b.
“I will schedule an appointment with a chimney inspector next week.”
c.
“If I feel dizzy when using the heater, I need to have it inspected.”
d. “When it is cold outside in the winter, I will use a nonvented furnace.”
ANS: D
Using a nonvented heater introduces carbon monoxide into the environment and decreases the
available oxygen for human consumption and the nurse should follow up to correct this
behavior. Checking the chimney and heater, changing the batteries on the detector, and
following up on symptoms such as dizziness, nausea, and fatigue are all statements that are
safe and appropriate and need no follow-up.
DIF: Analyze (analysis) REF: 374
OBJ: Describe environmental hazards that pose risks to a person’s safety.
TOP: Assessment MSC: Safety and Infection Control
2. The nurse is caring for an older-adult patient admitted with nausea, vomiting, and
diarrhea due to food poisoning. The nurse completes the health history. Which
priority concern will require collaboration with social services to address the patient’s
health care needs?
a.
The electricity was turned off 3 days ago.
b.
The water comes from the county water supply.
c.
A son and family recently moved into the home.
d.
This home is not furnished with a microwave oven.
ANS: A
Electricity is needed for refrigeration of food, and lack of electricity could have contributed to
the nausea, vomiting, and diarrhea due to food poisoning. This discussion about the patient’s
electrical needs can be referred to social services. Foods that are inadequately prepared or
stored or subject to unsanitary conditions increase the patient’s risk for infections and food
poisoning, and an assessment should include storage practices. The water supply, the
increased number of individuals in the home, and not having a microwave may or may not be
concerns but do not pertain to the current health care needs of this patient.
DIF: Analyze (analysis) REF: 374 | 381 | 388
OBJ: Describe environmental hazards that pose risks to a person’s safety.
TOP: Planning MSC: Management of Care
,3. The patient has been diagnosed with a respiratory illness and reports shortness of
breath. The nurse adjusts the temperature to facilitate the comfort of the patient.
At which temperature range will the nurse set the thermostat?
a. 60° to 64° F
b. 65° to 75° F
c. 15° to 17° C
d. 25° to 28° C
ANS: B
A person’s comfort zone is usually between 18.3° and 23.9° C (65° and 75° F). The other
ranges are too low or too high and do not reflect the average person’s comfort zone.
DIF: Understand (comprehension) REF: 374
OBJ: Describe environmental hazards that pose risks to a person’s safety.
TOP: Implementation MSC: Basic Care and Comfort
4. A homeless adult patient presents to the emergency department. The nurse obtains the
following vital signs: temperature 94.8° F, blood pressure 106/56, apical pulse 58, and
respiratory rate 12. Which vital sign should the nurse address immediately?
a.
Respiratory rate
b. Temperature
c.
Apical pulse
d.
Blood pressure
ANS: B
The temperature indicates the patient is experiencing hypothermia. Homeless individuals are
more at risk for hypothermia. While all the vital signs are low, the most critical vital sign at
this time is the temperature.
DIF: Analyze (analysis) REF: 374
OBJ: Describe environmental hazards that pose risks to a person’s safety.
TOP: Assessment MSC: Reduction of Risk Potential
5. A nurse is teaching the patient and family about wound care. Which technique will the
nurse teach to best prevent transmission of pathogens?
a.
Wash hands
b.
Wash wound
c.
Wear gloves
d.
Wear eye protection
ANS: A
One of the most effective methods for limiting the transmission of pathogens is the medically
aseptic practice of hand hygiene. The most common means of transmission of pathogens is by
the hands. While washing the wound is needed, the best method to prevent transmission is
hand hygiene. Wearing gloves and possibly eye protection help protect the nurse, but
handwashing is best for limiting the transmission of pathogens.
DIF: Understand (comprehension) REF: 375
OBJ: Discuss methods to reduce physical hazards and the transmission of pathogens.
, TOP: Teaching/Learning MSC: Safety and Infection Control
6. The nurse is monitoring for Never Events. Which finding indicates the nurse will
report a Never Event?
a.
No blood incompatibility occurs with a blood transfusion.
b. A surgical sponge is left in the patient’s incision.
c.
Pulmonary embolism after lung surgery
d.
Stage II pressure ulcer
ANS: B
The Centers for Medicare and Medicaid Services names select serious reportable events as
Never Events (i.e., adverse events that should never occur in a health care setting). A
surgical sponge left in a patient’s incision is a Never Event. No blood incompatibility
reaction is safe practice. Pulmonary embolism after certain orthopedic procedures is like a
total knee and hip replacement. Stage III and IV pressure ulcers are Never Events.
DIF: Understand (comprehension) REF: 377-378
OBJ: Discuss the importance of consensus standards for public reporting of patient safety events.
TOP: Implementation MSC: Management of Care
7. The nurse discovers a patient on the floor. The patient states that he fell out of bed.
The nurse assesses the patient and places the patient back in bed. Which action should
the nurse take next?
a.
Do nothing, no harm has occurred.
b. Notify the health care provider.
c.
Complete an incident report.
d.
Assess the patient.
ANS: B
Report immediately to physician or health care provider if the patient sustains a fall or an
injury. The nurse must provide safe care, and doing nothing is not safe care. The
scenario indicates the nurse has already assessed the patient. After the patient has
stabilized, completing an incident report would be the last step in the process.
DIF: Apply (application) REF: 399
OBJ: Define the knowledge, skills, and attitudes necessary to promote safety in a health care setting.
TOP: Implementation MSC: Safety and Infection Control
8. When making rounds the nurse observes a purple wristband on a patient’s wrist.
How will the nurse interpret this finding?
a.
The patient is allergic to certain medications or foods.
b. The patient has do not resuscitate preferences.
c.
The patient has a high risk for falls.
d.
The patient is at risk for seizures.
ANS: B
In 2008 the American Hospital Association issued an advisory recommending that
hospitals standardize wristband colors: red for patient allergies, yellow for fall risk, and
purple for do not resuscitate preferences. Purple does not indicate seizures.
Quality Potter et al.: Fundamentals of Nursing, 9th Edition
Chapter 27: Patient Safety and Quality
Potter et al.: Fundamentals of Nursing, 9th Edition
MULTIPLE CHOICE
1. A home health nurse is performing a home assessment for safety. Which comment by the
patient will cause the nurse to follow up?
a.
“Every December is the time to change batteries on the carbon monoxide detector.”
b.
“I will schedule an appointment with a chimney inspector next week.”
c.
“If I feel dizzy when using the heater, I need to have it inspected.”
d. “When it is cold outside in the winter, I will use a nonvented furnace.”
ANS: D
Using a nonvented heater introduces carbon monoxide into the environment and decreases the
available oxygen for human consumption and the nurse should follow up to correct this
behavior. Checking the chimney and heater, changing the batteries on the detector, and
following up on symptoms such as dizziness, nausea, and fatigue are all statements that are
safe and appropriate and need no follow-up.
DIF: Analyze (analysis) REF: 374
OBJ: Describe environmental hazards that pose risks to a person’s safety.
TOP: Assessment MSC: Safety and Infection Control
2. The nurse is caring for an older-adult patient admitted with nausea, vomiting, and
diarrhea due to food poisoning. The nurse completes the health history. Which
priority concern will require collaboration with social services to address the patient’s
health care needs?
a.
The electricity was turned off 3 days ago.
b.
The water comes from the county water supply.
c.
A son and family recently moved into the home.
d.
This home is not furnished with a microwave oven.
ANS: A
Electricity is needed for refrigeration of food, and lack of electricity could have contributed to
the nausea, vomiting, and diarrhea due to food poisoning. This discussion about the patient’s
electrical needs can be referred to social services. Foods that are inadequately prepared or
stored or subject to unsanitary conditions increase the patient’s risk for infections and food
poisoning, and an assessment should include storage practices. The water supply, the
increased number of individuals in the home, and not having a microwave may or may not be
concerns but do not pertain to the current health care needs of this patient.
DIF: Analyze (analysis) REF: 374 | 381 | 388
OBJ: Describe environmental hazards that pose risks to a person’s safety.
TOP: Planning MSC: Management of Care
,3. The patient has been diagnosed with a respiratory illness and reports shortness of
breath. The nurse adjusts the temperature to facilitate the comfort of the patient.
At which temperature range will the nurse set the thermostat?
a. 60° to 64° F
b. 65° to 75° F
c. 15° to 17° C
d. 25° to 28° C
ANS: B
A person’s comfort zone is usually between 18.3° and 23.9° C (65° and 75° F). The other
ranges are too low or too high and do not reflect the average person’s comfort zone.
DIF: Understand (comprehension) REF: 374
OBJ: Describe environmental hazards that pose risks to a person’s safety.
TOP: Implementation MSC: Basic Care and Comfort
4. A homeless adult patient presents to the emergency department. The nurse obtains the
following vital signs: temperature 94.8° F, blood pressure 106/56, apical pulse 58, and
respiratory rate 12. Which vital sign should the nurse address immediately?
a.
Respiratory rate
b. Temperature
c.
Apical pulse
d.
Blood pressure
ANS: B
The temperature indicates the patient is experiencing hypothermia. Homeless individuals are
more at risk for hypothermia. While all the vital signs are low, the most critical vital sign at
this time is the temperature.
DIF: Analyze (analysis) REF: 374
OBJ: Describe environmental hazards that pose risks to a person’s safety.
TOP: Assessment MSC: Reduction of Risk Potential
5. A nurse is teaching the patient and family about wound care. Which technique will the
nurse teach to best prevent transmission of pathogens?
a.
Wash hands
b.
Wash wound
c.
Wear gloves
d.
Wear eye protection
ANS: A
One of the most effective methods for limiting the transmission of pathogens is the medically
aseptic practice of hand hygiene. The most common means of transmission of pathogens is by
the hands. While washing the wound is needed, the best method to prevent transmission is
hand hygiene. Wearing gloves and possibly eye protection help protect the nurse, but
handwashing is best for limiting the transmission of pathogens.
DIF: Understand (comprehension) REF: 375
OBJ: Discuss methods to reduce physical hazards and the transmission of pathogens.
, TOP: Teaching/Learning MSC: Safety and Infection Control
6. The nurse is monitoring for Never Events. Which finding indicates the nurse will
report a Never Event?
a.
No blood incompatibility occurs with a blood transfusion.
b. A surgical sponge is left in the patient’s incision.
c.
Pulmonary embolism after lung surgery
d.
Stage II pressure ulcer
ANS: B
The Centers for Medicare and Medicaid Services names select serious reportable events as
Never Events (i.e., adverse events that should never occur in a health care setting). A
surgical sponge left in a patient’s incision is a Never Event. No blood incompatibility
reaction is safe practice. Pulmonary embolism after certain orthopedic procedures is like a
total knee and hip replacement. Stage III and IV pressure ulcers are Never Events.
DIF: Understand (comprehension) REF: 377-378
OBJ: Discuss the importance of consensus standards for public reporting of patient safety events.
TOP: Implementation MSC: Management of Care
7. The nurse discovers a patient on the floor. The patient states that he fell out of bed.
The nurse assesses the patient and places the patient back in bed. Which action should
the nurse take next?
a.
Do nothing, no harm has occurred.
b. Notify the health care provider.
c.
Complete an incident report.
d.
Assess the patient.
ANS: B
Report immediately to physician or health care provider if the patient sustains a fall or an
injury. The nurse must provide safe care, and doing nothing is not safe care. The
scenario indicates the nurse has already assessed the patient. After the patient has
stabilized, completing an incident report would be the last step in the process.
DIF: Apply (application) REF: 399
OBJ: Define the knowledge, skills, and attitudes necessary to promote safety in a health care setting.
TOP: Implementation MSC: Safety and Infection Control
8. When making rounds the nurse observes a purple wristband on a patient’s wrist.
How will the nurse interpret this finding?
a.
The patient is allergic to certain medications or foods.
b. The patient has do not resuscitate preferences.
c.
The patient has a high risk for falls.
d.
The patient is at risk for seizures.
ANS: B
In 2008 the American Hospital Association issued an advisory recommending that
hospitals standardize wristband colors: red for patient allergies, yellow for fall risk, and
purple for do not resuscitate preferences. Purple does not indicate seizures.
