Chapter 18: Safety
Fundamental Nursing Skills and Concepts 12th Edition, Timby
MULTIPLE CHOICE
1. When caring for a patient with acute radiation sickness (ARS) after an accident at an
atomic power plant, the nurse should:
a. wear a paper gown and boots, gloves, and a mask.
b. stay in the room and talk to the patient to alleviate anxiety.
c. decrease the amount of time spent in the room.
d. wear a chemical mask with a filtered respirator.
ANS: A
For prolonged periods in caring for a patient with ARS, the nurse should use the
barrier protection of gown, boots, a mask, and gloves.
DIF: Cognitive Level: Application REF: k 325 OBJ: Theory #1
TOP: Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe Effective Care Environment: safety and infection
control
2. There is evidence that a resident in a home care environment might have accidentally
ingested gasoline left by the gardeners. The nurse should first:
a. call the family members to notify them of the incident.
b. call the poison control center and describe the situation.
c. induce the patient to vomit.
d. place the gasoline can in a safe place.
ANS: B
If a nurse suspects gasoline poisoning, it is important to call the poison control center
to obtain further instructions. It is also important to prevent vomiting, because this
may cause respiratory problems.
DIF: Cognitive Level: Application REF: k 326 OBJ: Clinical Practice #1
TOP: Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: prevention and
early detection of disease
3. A nursing assistant on the day shift reports that he has raised the bed rails to keep an
agitated patient from climbing out of bed. The nurses best response to this information is:
a. Good idea. Be sure to check on the patient every hour to assess the patients
comfort.
b. A vest protective device will work better; put one on the patient, please.
c. The rails wont prevent falling; bring the patient out to sit by the nurses station
where we can watch
d. Youll need to check the patient every 15 minutes and reorient the patient as to
why the rails are up.
ANS: C
Seating the patient close to the nurses station will allow the nurse to check on the
patient frequently. The nurse needs to get an order for a vest restraint.
, DIF: Cognitive Level: Application REF: k 322, Box 20-3 OBJ:
Clinical Practice #6 TOP: Safety KEY: Nursing Process Step:
Implementation MSC: NCLEX: Safe Effective Care Environment
4. A patient who has right-sided weakness following a stroke is admitted to a long-term care
facility and exhibits increasing wandering and inability for self-care. To protect the
patient from the most frequent cause of injury among the elderly, the nurses most
efficient intervention would be:
a. provide a night-light in the bathroom.
b. keep pathways clear of paper, shoes, and equipment.
c. apply a personal alarm.
d. provide hip protectors.
ANS: C
Because falls are the most common accidents among residents, the provision of a
personal alarm to sound when the person attempts to get out of bed is the most
efficient intervention. Keeping the pathways clear, provision of adequate light, and
provision of hip protectors are all safety oriented but do not prevent falls.
DIF: Cognitive Level: Analysis REF: k 322, Box 20-3 OBJ:
Theory #3 TOP: Safety KEY: Nursing Process Step:
Implementation MSC: NCLEX: Safe Effective Care Environment:
safety and infection control
5. A diabetic patient has chronic peripheral vascular disease, which results in edema and
poor circulation to her feet. She constantly complains of cold legs. The best nursing
action is to provide:
a. a heating pad and place it under the patients feet.
b. an electric blanket to increase warmth to legs at night.
c. a hot shower to increase circulation to legs.
d. additional blankets and encourage the use of warm bed socks.
ANS: D
Extra blankets and bed socks will reduce the sense of cold. A person with diabetes or
impaired circulation is more easily burned than a person in good health.
DIF: Cognitive Level: Application REF: k 323 OBJ: Theory #1
TOP: Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: basic care and comfort
6. An agitated resident who is seated in his wheelchair calls the nurse because the bed linens
are smoldering. After moving the patient to the hall, the nurse should:
a. close the door to the room to confine the fire.
b. assess the patient for burns.
c. extinguish the flames with an appropriate extinguisher.
d. activate the fire alarm system immediately.
ANS: D
RACE is used as an acronym to respond to fire. RACE represents Rescuing the
patient from immediate danger, Activating the fire alarm system, Containing the fire
by closing doors and windows, and Extinguishing the flames with an appropriate
extinguisher.
Fundamental Nursing Skills and Concepts 12th Edition, Timby
MULTIPLE CHOICE
1. When caring for a patient with acute radiation sickness (ARS) after an accident at an
atomic power plant, the nurse should:
a. wear a paper gown and boots, gloves, and a mask.
b. stay in the room and talk to the patient to alleviate anxiety.
c. decrease the amount of time spent in the room.
d. wear a chemical mask with a filtered respirator.
ANS: A
For prolonged periods in caring for a patient with ARS, the nurse should use the
barrier protection of gown, boots, a mask, and gloves.
DIF: Cognitive Level: Application REF: k 325 OBJ: Theory #1
TOP: Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe Effective Care Environment: safety and infection
control
2. There is evidence that a resident in a home care environment might have accidentally
ingested gasoline left by the gardeners. The nurse should first:
a. call the family members to notify them of the incident.
b. call the poison control center and describe the situation.
c. induce the patient to vomit.
d. place the gasoline can in a safe place.
ANS: B
If a nurse suspects gasoline poisoning, it is important to call the poison control center
to obtain further instructions. It is also important to prevent vomiting, because this
may cause respiratory problems.
DIF: Cognitive Level: Application REF: k 326 OBJ: Clinical Practice #1
TOP: Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: prevention and
early detection of disease
3. A nursing assistant on the day shift reports that he has raised the bed rails to keep an
agitated patient from climbing out of bed. The nurses best response to this information is:
a. Good idea. Be sure to check on the patient every hour to assess the patients
comfort.
b. A vest protective device will work better; put one on the patient, please.
c. The rails wont prevent falling; bring the patient out to sit by the nurses station
where we can watch
d. Youll need to check the patient every 15 minutes and reorient the patient as to
why the rails are up.
ANS: C
Seating the patient close to the nurses station will allow the nurse to check on the
patient frequently. The nurse needs to get an order for a vest restraint.
, DIF: Cognitive Level: Application REF: k 322, Box 20-3 OBJ:
Clinical Practice #6 TOP: Safety KEY: Nursing Process Step:
Implementation MSC: NCLEX: Safe Effective Care Environment
4. A patient who has right-sided weakness following a stroke is admitted to a long-term care
facility and exhibits increasing wandering and inability for self-care. To protect the
patient from the most frequent cause of injury among the elderly, the nurses most
efficient intervention would be:
a. provide a night-light in the bathroom.
b. keep pathways clear of paper, shoes, and equipment.
c. apply a personal alarm.
d. provide hip protectors.
ANS: C
Because falls are the most common accidents among residents, the provision of a
personal alarm to sound when the person attempts to get out of bed is the most
efficient intervention. Keeping the pathways clear, provision of adequate light, and
provision of hip protectors are all safety oriented but do not prevent falls.
DIF: Cognitive Level: Analysis REF: k 322, Box 20-3 OBJ:
Theory #3 TOP: Safety KEY: Nursing Process Step:
Implementation MSC: NCLEX: Safe Effective Care Environment:
safety and infection control
5. A diabetic patient has chronic peripheral vascular disease, which results in edema and
poor circulation to her feet. She constantly complains of cold legs. The best nursing
action is to provide:
a. a heating pad and place it under the patients feet.
b. an electric blanket to increase warmth to legs at night.
c. a hot shower to increase circulation to legs.
d. additional blankets and encourage the use of warm bed socks.
ANS: D
Extra blankets and bed socks will reduce the sense of cold. A person with diabetes or
impaired circulation is more easily burned than a person in good health.
DIF: Cognitive Level: Application REF: k 323 OBJ: Theory #1
TOP: Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: basic care and comfort
6. An agitated resident who is seated in his wheelchair calls the nurse because the bed linens
are smoldering. After moving the patient to the hall, the nurse should:
a. close the door to the room to confine the fire.
b. assess the patient for burns.
c. extinguish the flames with an appropriate extinguisher.
d. activate the fire alarm system immediately.
ANS: D
RACE is used as an acronym to respond to fire. RACE represents Rescuing the
patient from immediate danger, Activating the fire alarm system, Containing the fire
by closing doors and windows, and Extinguishing the flames with an appropriate
extinguisher.
