Chapter 27: Patient Safety practice
questions
1. A home health nurse is performing a home assessment for safety. Which of the
following
comments by the patient would indicate a need for further education?
A. "I will schedule an appointment with a chimney inspector next week."
B. "Daylight savings is the time to change batteries on the carbon monoxide detector."
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 can warm my car up in the garage." - ANS -
ANS: D
Allowing a car to run in the garage introduces carbon monoxide into the environment
and decreases the available oxygen for human consumption. Garages should be
opened and not just cracked to allow fresh air into the space and allay this concern.
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 would indicate that the individual
has understood the education.
2. The nurse is caring for an elderly patient admitted with nausea, vomiting, and
diarrhea. Upon completing the health history, which priority concern would require
collaboration with social
services to address the patient's health care needs?
A. The electricity was turned off 2 days ago.
B. The water comes from the county water supply.
C. A son and family recently moved into the home.
D. The home is not furnished with a microwave oven. - ANS - ANS: A
Electricity is needed for refrigeration of food, and lack of electricity could have
contributed to the nausea, vomiting, and diarrhea—potential food poisoning. This
discussion about the patient's electrical needs can be referred to social services. 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.
,3. The patient has been diagnosed with a respiratory illness and complains of shortness
of breath. The nurse adjusts the temperature to facilitate the comfort of the patient.
What is the usual comfort range for most patients?
A. 65° F to 75° F
B. 60° F to 75° F
C. 15° C to 17° C
D. 25° C to 28° C - ANS - ANS: A
The comfort zone for most individuals is the range between 65° F and 75° F (18.3° C to
23.9° C). The other ranges do not reflect the average person's comfort zone.
4. A homeless adult patient presents to the emergency department. The nurse obtains
the
following vital signs: temperature 94.8° F, blood pressure 100/56, apical pulse 56,
respiratory
rate 12. Which of the vital signs should be addressed immediately?
A. Respiratory rate
B. Temperature
C. Apical pulse
D. Blood pressure - ANS - ANS: B
Hypothermia is defined as a core body temperature of 95° F or below. Homeless
individuals are more at risk for hypothermia owing to exposure to the elements.
5. The nurse is caring for a patient with a urinary catheter. After the nurse empties the
collection
bag and disposes of the urine, the next step is to
A. Use alcohol-based gel on hands.
B. Wash hands with soap and water.
C. Remove eye protection and dispose of in garbage.
D. Remove gloves and dispose of in garbage. - ANS - ANS: D
After disposing of the urine, the first step in removing personal protective equipment is
removing gloves and disposing of them properly. In this scenario, the next step would
be to remove eye protection followed by hand hygiene. Wash hands if the hands are
visibly soiled; otherwise the use of alcohol-based gel is indicated for routine
decontamination of hands.
6. The nurse is preparing a patient for surgery. The nurse explains that the reason for
writing in indelible ink on the surgical site the word "correct" is to
A. Distinguish the correct surgical site.
B. Label the correct patient.
C. Comply with the surgeon's preference.
, D. Adhere to the correct regulatory standard. - ANS - ANS: A
The purpose of writing on the surgical site as part of the Universal Protocol from the
Joint Commission is to distinguish the correct site on the correct patient and match with
the correct surgeon for patient safety and prevention of wrong site surgery. All patients
who are having an invasive procedure should receive labeling in many different ways,
including the record and patient armbands. Writing in indelible ink may comply with the
surgeon's preference, but safety is the driving factor. Although labeling of the site helps
to meet regulatory standards, this is not the reason to do this activity—the reason is to
keep the patient safe.
7. The nurse identifies that a patient has received Mylanta (simethicone) instead of the
prescribed Pepto-Bismol (bismuth subsalicylate) for the problem of indigestion. The
nurse's next intervention is to
A. Do nothing, no harm has occurred.
B. Assess and monitor the patient.
C. Notify the physician, treat and document.
D. Complete an incident report. - ANS - ANS: B
After providing an incorrect medication, assessing and monitoring the patient to
determine the effects of the medication is the first step. Notifying the physician and
providing treatment would be the best next step. After the patient has stabilized,
completing an incident report would be the last step in the process.
8. The nurse preceptor recognizes the new nurse's ability to determine patient safety
risks when which behavior is observed?
A. Checking patient identification once every shift
B. Multitasking by gathering two patients' medications
C. Disposing of used needles in a red needle container
D. Raising all four side rails per family request - ANS - ANS: C
Needles, syringes, and other single-use injection devices should be used once and
disposed of in safety red needle containers that will be disposed of properly. Patient
identification should be checked multiple times a day, including before each medication,
treatment, procedure,
blood administration, and transfer, and at the beginning of each shift. Gathering more
than one patient's medication increases the likelihood of error. Raising all four side rails
is considered a restraint and requires special orders, assessment, and monitoring of the
patient
9. The nurse is completing discharge education for the patient regarding home
medications. Which patient behavior is an indication that the patient understands the
directions regarding the antibiotic medication?
questions
1. A home health nurse is performing a home assessment for safety. Which of the
following
comments by the patient would indicate a need for further education?
A. "I will schedule an appointment with a chimney inspector next week."
B. "Daylight savings is the time to change batteries on the carbon monoxide detector."
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 can warm my car up in the garage." - ANS -
ANS: D
Allowing a car to run in the garage introduces carbon monoxide into the environment
and decreases the available oxygen for human consumption. Garages should be
opened and not just cracked to allow fresh air into the space and allay this concern.
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 would indicate that the individual
has understood the education.
2. The nurse is caring for an elderly patient admitted with nausea, vomiting, and
diarrhea. Upon completing the health history, which priority concern would require
collaboration with social
services to address the patient's health care needs?
A. The electricity was turned off 2 days ago.
B. The water comes from the county water supply.
C. A son and family recently moved into the home.
D. The home is not furnished with a microwave oven. - ANS - ANS: A
Electricity is needed for refrigeration of food, and lack of electricity could have
contributed to the nausea, vomiting, and diarrhea—potential food poisoning. This
discussion about the patient's electrical needs can be referred to social services. 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.
,3. The patient has been diagnosed with a respiratory illness and complains of shortness
of breath. The nurse adjusts the temperature to facilitate the comfort of the patient.
What is the usual comfort range for most patients?
A. 65° F to 75° F
B. 60° F to 75° F
C. 15° C to 17° C
D. 25° C to 28° C - ANS - ANS: A
The comfort zone for most individuals is the range between 65° F and 75° F (18.3° C to
23.9° C). The other ranges do not reflect the average person's comfort zone.
4. A homeless adult patient presents to the emergency department. The nurse obtains
the
following vital signs: temperature 94.8° F, blood pressure 100/56, apical pulse 56,
respiratory
rate 12. Which of the vital signs should be addressed immediately?
A. Respiratory rate
B. Temperature
C. Apical pulse
D. Blood pressure - ANS - ANS: B
Hypothermia is defined as a core body temperature of 95° F or below. Homeless
individuals are more at risk for hypothermia owing to exposure to the elements.
5. The nurse is caring for a patient with a urinary catheter. After the nurse empties the
collection
bag and disposes of the urine, the next step is to
A. Use alcohol-based gel on hands.
B. Wash hands with soap and water.
C. Remove eye protection and dispose of in garbage.
D. Remove gloves and dispose of in garbage. - ANS - ANS: D
After disposing of the urine, the first step in removing personal protective equipment is
removing gloves and disposing of them properly. In this scenario, the next step would
be to remove eye protection followed by hand hygiene. Wash hands if the hands are
visibly soiled; otherwise the use of alcohol-based gel is indicated for routine
decontamination of hands.
6. The nurse is preparing a patient for surgery. The nurse explains that the reason for
writing in indelible ink on the surgical site the word "correct" is to
A. Distinguish the correct surgical site.
B. Label the correct patient.
C. Comply with the surgeon's preference.
, D. Adhere to the correct regulatory standard. - ANS - ANS: A
The purpose of writing on the surgical site as part of the Universal Protocol from the
Joint Commission is to distinguish the correct site on the correct patient and match with
the correct surgeon for patient safety and prevention of wrong site surgery. All patients
who are having an invasive procedure should receive labeling in many different ways,
including the record and patient armbands. Writing in indelible ink may comply with the
surgeon's preference, but safety is the driving factor. Although labeling of the site helps
to meet regulatory standards, this is not the reason to do this activity—the reason is to
keep the patient safe.
7. The nurse identifies that a patient has received Mylanta (simethicone) instead of the
prescribed Pepto-Bismol (bismuth subsalicylate) for the problem of indigestion. The
nurse's next intervention is to
A. Do nothing, no harm has occurred.
B. Assess and monitor the patient.
C. Notify the physician, treat and document.
D. Complete an incident report. - ANS - ANS: B
After providing an incorrect medication, assessing and monitoring the patient to
determine the effects of the medication is the first step. Notifying the physician and
providing treatment would be the best next step. After the patient has stabilized,
completing an incident report would be the last step in the process.
8. The nurse preceptor recognizes the new nurse's ability to determine patient safety
risks when which behavior is observed?
A. Checking patient identification once every shift
B. Multitasking by gathering two patients' medications
C. Disposing of used needles in a red needle container
D. Raising all four side rails per family request - ANS - ANS: C
Needles, syringes, and other single-use injection devices should be used once and
disposed of in safety red needle containers that will be disposed of properly. Patient
identification should be checked multiple times a day, including before each medication,
treatment, procedure,
blood administration, and transfer, and at the beginning of each shift. Gathering more
than one patient's medication increases the likelihood of error. Raising all four side rails
is considered a restraint and requires special orders, assessment, and monitoring of the
patient
9. The nurse is completing discharge education for the patient regarding home
medications. Which patient behavior is an indication that the patient understands the
directions regarding the antibiotic medication?
