CHAPTER 25: Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford

Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford Chapter 25: Safety Multiple Choice Questions 1. The nursing instructor asks the student nurse to identify which Robert Wood Johnson Foundation-funded project focuses on nurses' increased attention to patient safety? A. OSHA (Occupational Safety and Health Agency) B. MSDS (material safety data sheets) C. QSEN (Quality and Safety Education for Nurses) D. ADA (Americans with Disability Act) Answer: C Explanation: QSEN, or the Quality and Safety Education for Nurses, was funded by the Robert Wood Johnson Foundation to prepare future nurses with the knowledge, skills, and attitudes needed to advance quality and safety in their practice. Why Other Options Are Wrong: A refers to a regulatory agency for workplace safety, B pertains to chemical safety documentation, and D is legislation for disability rights, none of which focus on nursing education like QSEN. 2. The nurse knows that changes in which body system affect overall mobility, increasing the propensity of falling? A. Neurologic B. Hepatic C. Cardiopulmonary D. Musculoskeletal Answer: D Explanation: The musculoskeletal system directly impacts mobility through range of motion and strength, making impairments in this system a primary cause of falls. Why Other Options Are Wrong: A affects cognitive function, B impacts mental status, and C influences activity tolerance, none of which directly impair mobility like musculoskeletal changes. 3. The nurse is visiting a patient with cardiac disease who experiences shortness of breath during exercise. The nurse is concerned that decreased activity may lead to which outcome? A. Orthostatic hypotension B. Increased risk of heart disease C. Loss of short-term memory D. Worsening shortness of breath Answer: A Explanation: Inactivity in patients with cardiopulmonary disease can cause orthostatic hypotension due to reduced blood pressure regulation during position changes. Why Other Options Are Wrong: B is incorrect because the patient already has heart disease. C is unrelated to cardiopulmonary symptoms. D is unlikely as improving activity levels would help alleviate breathlessness. 4. The nurse recognizes conversations about safe sexual practices, including the consequences of unprotected sex, are important to begin in what patient population? A. Adults B. School-aged children C. Adolescents D. Older adults Answer: C Explanation: Adolescents are the primary group for such discussions due to their developmental stage of sexual curiosity and experimentation. Why Other Options Are Wrong: A and D may need tailored discussions but not as urgently as adolescents. B is too young for most sexual health conversations. 5. The nurse manager is developing a training guide and identifies which organization as the best resource for workplace injury prevention guidelines? A. OSHA (Occupational Safety and Health Administration) B. CDC (Centers for Disease Control and Prevention) C. QSEN (Quality and Safety Education for Nurses) D. NIOSH (National Institute for Occupational Safety and Health) Answer: A Explanation: OSHA provides employers with guidelines to prevent workplace injuries and exposure to hazards, making it the most relevant resource. Why Other Options Are Wrong: B focuses on infectious diseases, C on nursing education, and D on research, not direct guidelines like OSHA. 6. The nurse is educating parents about firearm safety. Which parent statement 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." Answer: B Explanation: Firearms should never be stored loaded, as this increases the risk of accidental injury, especially for children. Why Other Options Are Wrong: A, C, and D are all correct safety measures for firearm storage. 7. The nurse recognizes a patient using a portable generator indoors. What source of poisoning does the nurse identify? A. Lead B. Carbon monoxide C. Antifreeze D. Pesticide Answer: B Explanation: Portable generators emit carbon monoxide, a deadly gas that can accumulate in enclosed spaces. Why Other Options Are Wrong: A is found in paint and pipes, C is a liquid coolant, and D is used for pest control, none of which are emitted by generators. 8. The nurse is educating a patient about proper medication disposal. Which statement indicates good understanding? A. "Remove the label from the bottle and throw it in the trash." B. "Flush the medication down the disposal." C. "Mix the medications with kitty litter, place the mixture in a jar, and put the jar in the trash." D. "Dissolve the medication in water and pour it down the drain." Answer: C Explanation: Mixing medications with an undesirable substance like kitty litter prevents misuse and avoids water contamination. Why Other Options Are Wrong: A risks improper use if the medication is retrieved. B and D contaminate water systems. 9. The nurse knows which patient has a teaching need based on parental statements? 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." Answer: A Explanation: Co-sleeping with infants poses a suffocation risk, regardless of illness. Why Other Options Are Wrong: B, C, and D are all appropriate safety measures for their respective age groups. 10. The nurse is teaching a student about restraint use. Which statement by the student indicates a learning need? 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." Answer: B Explanation: Restraints do not prevent falls and are associated with risks like injury or death. Why Other Options Are Wrong: A, C, and D are accurate statements about restraints. 11. The nurse displays understanding of high-risk populations for MRSA by identifying which group as lowest risk? A. Prison inmates B. College dorm residents C. Team athletes D. Food service workers Answer: D Explanation: Food service workers have less skin-to-skin contact and do not live in close quarters, unlike high-risk groups. Why Other Options Are Wrong: A, B, and C are high-risk due to close living conditions or frequent physical contact. 12. The nurse knows which assessment tool 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 Answer: A Explanation: The Glasgow Coma Scale measures consciousness, not fall risk. Why Other Options Are Wrong: B, C, and D are validated tools for fall risk assessment. 13. 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 the hospital stay. Answer: D Explanation: The primary goal for fall risk is preventing injuries, as this directly addresses safety. Why Other Options Are Wrong: A and C are secondary goals, and B is unrelated to fall prevention. 14. Which collaborative team member would help identify medication alternatives to reduce fall risk in elderly patients? A. Nursing case manager B. Charge nurse C. Physical therapist D. Pharmacist Answer: D Explanation: Pharmacists specialize in medication management and can recommend alternatives with fewer side effects like dizziness. Why Other Options Are Wrong: A and B lack specialized medication knowledge. C focuses on physical mobility, not medications. 15. The nurse is helping a patient obtain assistive equipment for home use. Which team member should the nurse contact first? A. Occupational therapist B. Physical therapist C. Health care provider D. Social worker Answer: D Explanation: Social workers connect patients with resources for financing and obtaining assistive devices. Why Other Options Are Wrong: A and B evaluate needs but do not arrange resources. C prescribes equipment but does not facilitate access. 16. Which patient statement indicates a teaching need about home safety? 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." Answer: C Explanation: Throw rugs are a tripping hazard and should be removed, not just cleaned. Why Other Options Are Wrong: A, B, and D are all correct safety measures. 17. The ER nurse is triaging a patient with suspected poisoning. Who should the nurse contact first? A. Family services B. Radiology C. Poison Control Center D. Respiratory Answer: C Explanation: Poison Control provides immediate guidance on treatment for poisoning cases. Why Other Options Are Wrong: A, B, and D may be involved later but are not the first point of contact. 18. The nurse knows that many health care facilities use which acronym for fire emergency response? A. RACE B. PASS C. PACE D. QSEN Answer: A Explanation: RACE (Rescue, Alarm, Contain, Extinguish) is the standard protocol for fire emergencies. Why Other Options Are Wrong: B is for fire extinguisher use, C is not a healthcare acronym, and D relates to nursing education. 19. The nurse is ambulating a patient who begins having a seizure. What 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's head to the side to prevent aspiration. D. Attempt to place a tongue blade to prevent choking. Answer: A Explanation: Protecting the patient from injury by lowering them to the ground is the priority during a seizure. Why Other Options Are Wrong: B and C are secondary actions. D is dangerous and unnecessary. 20. The nurse is caring for a confused, combative patient. Which action would be considered last to control behavior? 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. Answer: B Explanation: Restraints are a last resort after all other interventions (e.g., reorientation, family support) have failed. Why Other Options Are Wrong: A, C, and D are non-restraint strategies to manage behavior. 21. The nurse knows which method is appropriate for tying restraints? A. Knot tied to the bed frame B. Quick-release knot tied to the side rail C. Bow tied to the bed rail D. Quick-release ties attached to the bed frame Answer: D Explanation: Quick-release ties attached to the bed frame ensure safety and allow for rapid removal in emergencies. Why Other Options Are Wrong: A and C are unsafe knots, and B is incorrect because side rails are unstable. 22. Which statement correctly identifies the UAP role in patient restraint use? A. "The UAP can perform the 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 health care provider and request an order for restraints." Answer: C Explanation: UAPs can assist with restraint application and monitoring under RN supervision but cannot assess or order restraints. Why Other Options Are Wrong: A, B, and D are outside the UAP's scope of practice. MULTIPLE RESPONSE QUESTIONS 1. The nurse is explaining the National Patient Safety Goals (NPSG) to a student nurse. Which answers indicate the student understands these goals? (Select all that apply.) A. The NPSG's focus on treating chronic infections quickly B. The NPSG's focus on improving staff communication C. The NPSG's focus on using medications safely D. The NPSG's focus on identifying patients correctly Answer: B, C, D Explanation: NPSGs prioritize correct patient identification, staff communication, and medication safety to reduce errors and improve care quality. Why Other Options Are Wrong: A is incorrect because NPSGs do not specifically target chronic infection treatment. 2. The nurse is educating a cardiac patient with life stressors. Which statements indicate the patient understands stress-reducing actions? (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." Answer: B, C, D Explanation: Planning downtime, seeking financial advice, and communicating with family are practical strategies to manage stress. Why Other Options Are Wrong: A may create additional stress, and E is coercive rather than collaborative. 3. The nurse is teaching a community group about environmental safety. Which measures improve 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 floors to increase shine E. Staying indoors when air pollution is high Answer: A, B, C, E Explanation: Proper lighting reduces fall risks, and avoiding polluted air protects respiratory health. Why Other Options Are Wrong: D is incorrect because waxed floors increase slip hazards.