Which action would the nurse take first when discovering a fire in a patients room?

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RACE: Remove, Alarm, Confine and Extinguish or Evacuate

This easy to remember acronym is our University procedure in the case of a fire. Particularly in the hospital, every staff member is trained to recognize and respond appropriately in the case of a fire using this term.

Remove everyone from the area. If a fire occurred in a patient room, the staff should immediately remove the patient from the area.

The fire alarm pull station shall be activated call 911 to report fire. Fire alarm pull stations are located throughout the buildings, several on each floor. By activating the fire alarm, a fire action plan is set into motion were University Police receive the signal and initiate the emergency response. In addition, certain systems that could increase fire spread are automatically shutdown.

Once the room or area has been cleared of patients, the door shall be closed, thus confining the fire. This enables the fire response team the time needed to arrive.

When practical and only when an employee has been properly trained in the safe and proper use of a fire extinguisher, extinguisher shall be attempted using one fire extinguisher. Evacuate if you are not comfortable using a fire extinguisher or if more than one extinguisher is needed.

The Fire Marshal office has available, a portable fire extinguisher trainer for hands on training. Contact the office at  8-3893 to set up a session.

The nurse's first action after discovering an electrical fire in a patient's room is to: A. Activate the fire alarm. B. Confine the fire by closing all doors and windows. C. Remove all patients in immediate danger. D. Extinguish the fire by using the nearest fire extinguisher.

C. Remove all patients in immediate danger. Follow the acronym RACE. The first step, R, is to rescue and remove all patients in immediate danger.

A parent calls the pediatrician's office frantic about the bottle of cleaner that her 2-year-old son drank. Which of the following is the most important instruction the nurse gives to this parent? A. Give the child milk. B. Give the child syrup of ipecac. C. Call the poison control center. D. Take the child to the emergency department.

C. Call the poison control center. A poison control center is the best resource for patients and parents needing information about the treatment of an accidental poisoning.

The nursing assessment on a 78-year-old woman reveals shuffling gait, decreased balance, and instability. On the basis of the patient's data, which one of the following nursing diagnoses indicates an understanding of the assessment findings? A. Activity intolerance B. Impaired bed mobility C. Acute pain D. Risk for falls

D. Risk for falls For adults age 65 and older, impaired balance and difficulty with gait are risks for the nursing diagnosis of risk for falls.

A couple is with their adolescent daughter for a school physical and state they are worried about all the safety risks affecting this age. What is the greatest risk for injury for an adolescent? A. Home accidents B. Physiological changes of aging C. Poisoning and child abduction D. Automobile accidents, suicide, and substance abuse

D. Automobile accidents, suicide, and substance abuse Risks to the safety of adolescents involve many factors outside the home because much of their time is spent away from home and with their peer group. According to the Centers for Disease Control and Prevention, the risk of motor vehicle accidents is higher among 16- to 19-year-old drivers than any other age-group. In an attempt to relieve the tensions associated with physical and psychosocial changes and peer pressures, some adolescents engage in risk-taking behaviors such as smoking, drinking alcohol, and using drugs.

The nurse found a 68-year-old female patient wandering in the hall. The patient says she is looking for the bathroom. Which interventions are appropriate to ensure the safety of the patient? (Select all that apply.) A. Insert a urinary catheter. B. Leave a night light on in the bathroom. C. Ask the physician to order a restraint. D. Keep the bed in low position with upper and lower side rails up. E. Assign a staff member to stay with the patient. F. Provide scheduled toileting during the night shift. G. Keep the pathway from the bed to the bathroom clear.

B. Leave a night light on in the bathroom. F. Provide scheduled toileting during the night shift. G. Keep the pathway from the bed to the bathroom clear. Older adults in an unfamiliar environment may become confused. A night light may be beneficial for safety and orientation. Toileting is a common reason for a patient attempting to get out of bed. Placing the patient on a routine toileting schedule should help decrease this risk factor. Hospital environments can quickly become cluttered with equipment, personal items, and other things that create a hazard for falling. Keep pathways clear. All alternatives should be tried and considered before using a restraint. Restraint should not be an initial response. The bed should be kept in a low position. Upper side rails may be used; however, the addition of lower side rails can increase the risk of injury. The use of side rails alone for a disoriented patient may cause more confusion and further injury. A confused patient who is determined to get out of bed attempts to climb over the side rail or climbs out at the foot of the bed. Either attempt usually results in a fall or injury.

The family of a patient who is confused and ambulatory insists that all four side rails be up when the patient is alone. What is the best action to take in this situation? (Select all that apply.) A. Contact the nursing supervisor. B. Restrict the family's visiting privileges. C. Ask the family to stay with the patient. D. Inform the family of the risks associated with side-rail use. E. Thank the family for being conscientious and put the four rails up. F. Discuss alternatives with the family that are appropriate for this patient.

C. Ask the family to stay with the patient.

D. Inform the family of the risks associated with side-rail use.

F. Discuss alternatives with the family that are appropriate for this patient. The family is concerned about ensuring a safe environment for their loved one. The nurse should discuss their concerns, the risk of using restraints related to using four side rails, and safer alternatives such as the presences of a family member. If the family still insists on use of four side rails, you could contact the nursing supervisor to further discuss the situation with them. This is not a reason to restrict visitation; but, although you should appreciate their concern, the use of four side rails should be avoided.

A child in the hospital starts to have a grand mal seizure while playing in the playroom. What is your most important nursing intervention during this situation? A. Begin cardiopulmonary respiration. B. Restrain the child to prevent injury. C. Place a tongue blade over the tongue to prevent aspiration. D. Clear the area around the child to protect the child from injury.

D. Clear the area around the child to protect the child from injury. Once a seizure begins, you need to monitor the patient and provide a safe environment. A seizure is not an indication for cardiopulmonary resuscitation. A person having a seizure should not be restrained, but the environment should be made safe. Objects should not be forced into the mouth. See the Skills in the chapter for more information.

A 62-year-old woman is being discharged home with her husband after surgery for a hip fracture from a fall at home. When providing discharge teaching about home safety to this patient and her husband, the nurse knows that: A. A safe environment promotes patient activity. B. Assessment focuses on environmental factors only. C. Teaching home safety is difficult to do in the hospital setting. D. Most accidents in the older adult are caused by lifestyle factors.

A. A safe environment promotes patient activity. Older adults are frequently fearful of falling and thus often limit activity. A safe environment, which decreases the risk of a fall, promotes patient activity.

The nursing assessment of an 80-year-old patient who demonstrates some confusion but no anxiety reveals that the patient is a fall risk because she continues to get out of bed without help despite frequent reminders. The initial nursing intervention to prevent falls for this patient is to: A. Place a bed alarm device on the bed. B. Place the patient in a belt restraint. C. Provide one-on-one observation of the patient. D. Apply wrist restraints.

A. Place a bed alarm device on the bed. Consider and implement alternatives as appropriate before the use of a restraint. A bed alarm is an alternative that the nurse implements independently.

To ensure the safe use of oxygen in the home by a patient, which of the following teaching points does the nurse include? (Select all that apply.) A. Smoking is prohibited around oxygen. B. Demonstrate how to adjust the oxygen flow rate based on patient symptoms. C. Do not use electrical equipment around oxygen. D. Special precautions may be required when traveling with oxygen

A. Smoking is prohibited around oxygen. C. Do not use electrical equipment around oxygen. D. Special precautions may be required when traveling with oxygen When oxygen is in use, precautions need to be taken to prevent fire and protect the patient. Patients need to be taught precautions, which include posting "Oxygen in Use" signage, not using oxygen around electrical equipment or flammable products, properly handling oxygen cylinders/containers, ensuring that tubing is unobstructed, not adjusting liter flow without a physician's order, and taking precautions when traveling with oxygen.

How does the nurse support a culture of safety? (Select all that apply.) A. Completing incident reports when appropriate B. Completing incident reports for a near miss C. Communicating product concerns to an immediate supervisor D. Identifying the person responsible for an incident

A. Completing incident reports when appropriate B. Completing incident reports for a near miss C. Communicating product concerns to an immediate supervisor Completing incident reports for actual and near-miss events helps the facility track information and identify trends and patterns that need to be addressed. Communicating product concerns to a responsible supervisor allows the facility to further investigate and determine if additional action is required.

You are admitting Mr. Jones, a 64-year-old patient who had a right hemisphere stroke and a recent fall. The wife stated that he has a history of high blood pressure, which is controlled by an antihypertensive and a diuretic. Currently he exhibits left sided neglect and problems with spatial and perceptual abilities and is impulsive. He has moderate left-sided weakness that requires the assistance of two and the use of a gait belt to transfer to a chair. He currently has an intravenous (IV) line and a urinary catheter in place. What factors increase his fall risk at this time? (Select all that apply.) A. Smokes a pack a day B. Used a cane to walk at home C. Takes antihypertensive and diuretics D. History of recent fall E. Neglect, spatial and perceptual abilities, impulsive F. Requires assistance with activity, unsteady gait G. IV line, urinary catheter

C. Takes antihypertensive and diuretics D. History of recent fall E. Neglect, spatial and perceptual abilities, impulsive F. Requires assistance with activity, unsteady gait G. IV line, urinary catheter

Smoking is not a risk factor for falls. Because the patient used the cane at home, it is not a current risk factor for falls. Risk is determined by his current status.

At 3 AM the emergency department nurse hears that a tornado hit the east side of town. What action does the nurse take first? A. Prepare for an influx of patients B. Contact the American Red Cross C. Determine how to restore essential services D. Evacuate patients per the disaster plan

a. Prepare for an influx of patients

The emergency department nurse needs to prepare for the potential influx of patients first. Staff need to be aware of the disaster plan. Patients may need to be evaluated but not initially. The American Red Cross is not contacted initially. Determination of how to restore essential services is part of the disaster plan and is determined before an actual event.

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