A nurse is assisting with teaching a class about the importance of fire safety. Which of the following hazards should the nurse include as an example of the leading cause of residential fires?

Placing a space heater 5 ft from bed

Smoking in bed

Leaving the stove on

Lack of smoke detectors

Answer and Explanation

The Correct Answer is B

Choice A reason: A space heater 5 feet from a bed is relatively safe if unobstructed, not a leading fire cause. Scientifically, heaters rank lower than smoking, as ignition requires closer flammable contact, making this less statistically significant per fire safety data.

Choice B reason: Smoking in bed is a top cause of residential fires, as embers easily ignite bedding. Scientifically, NFPA data show it’s a leading ignition source due to direct fuel contact, causing rapid flame spread, making it a critical hazard to highlight.

Choice C reason: Leaving the stove on causes kitchen fires, but smoking surpasses it in residential fatalities. Scientifically, unattended cooking ranks high, yet smoking’s bedroom context increases risk of sleeping victims, amplifying danger per fire incidence studies.

Choice D reason: Lack of smoke detectors increases fire deaths, not ignition. It’s a detection failure, not a cause. Scientifically, this affects outcomes, not initiation, making it irrelevant to identifying the leading hazard source per fire safety causation statistics.

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Correct Answer is C

Explanation

Choice A reason: Seclusion is a last resort, not first, per de-escalation principles. It risks escalating agitation or trauma without addressing the cause. Scientifically, verbal intervention precedes restraint, as identifying triggers can calm the client, aligning with evidence-based psychiatric care prioritizing least restrictive measures.

Choice B reason: Assisting with needs is vague and secondary to identifying the agitation’s source. Without understanding the trigger, this lacks focus. Scientifically, pinpointing the upset first guides effective support, making this a follow-up, not initial, step in managing acute behavioral distress.

Choice C reason: Asking what upset the client de-escalates by engaging them, identifying triggers for targeted intervention. This aligns with scientific psychiatric practice, reducing agitation through communication before medication or seclusion, addressing the root cause effectively as the first step in evidence-based care.

Choice D reason: Administering lorazepam IM is premature without de-escalation attempts. It risks over-sedation or side effects, bypassing verbal strategies. Scientifically, medication follows failed non-pharmacological efforts per guidelines, making this a later option, not the first, in managing agitation safely and effectively.

A. Evaluate the need for the client to remain in mitten restraints. B. Determine the circulation status of the affected extremities every 2 hr. C. Instruct the client's family about the purpose of mitten restraints. D. Assist the client with range-of-motion exercises of the hands.

Correct Answer is D

Explanation

Choice A reason: Evaluating restraint need requires nursing judgment, beyond assistive personnel scope. It involves assessing behavior and alternatives, reserved for licensed staff only.

Choice B reason: Circulation checks demand clinical assessment skills, like pulse and color evaluation. This exceeds assistive personnel training, requiring a nurse’s expertise instead.

Choice C reason: Educating family about restraints involves explaining medical rationale, a nursing role. Assistive personnel lack authority to provide such detailed clinical instruction.

Choice D reason: Assisting with range-of-motion exercises is within assistive personnel scope. It supports mobility under nurse direction, safely maintaining hand function in restraints.

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A nurse is assisting with teaching a class about the importance of fire safety. Which of the following hazards should the nurse include as an example of the leading cause of residential fires?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is visibly agitated and talking loudly in a group therapy session. Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

A nurse at a long-term care facility is reviewing the plan of care for a client who has a prescription for mitten restraints. Which of the following tasks should the nurse assign to an assistive personnel?

Correct Answer is D

Explanation

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