A nurse notices smoke coming from a client's room and discovers a fire in the wastebasket.
After moving the client to safety, which of the following is the priority action?

Notify the facility operator.

Close the fire doors on the unit.

Turn off oxygen sources.

Put out the fire with the appropriate extinguisher.

Answer and Explanation

The Correct Answer is C

A. Notifying the facility operator is important, but it is not the immediate priority when there is a fire endangering the client's safety.

B. While closing fire doors can help contain the fire, it is not the priority action after ensuring the client's immediate safety.

C. Turning off oxygen sources is crucial because oxygen can fuel the fire and cause it to spread rapidly. This action helps prevent the fire from worsening.

D. Putting out the fire with the appropriate extinguisher is important, but it comes after ensuring the fire's fuel source is cut off to prevent further escalation of the fire.

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Correct Answer is C

Explanation

A. Encourage the client to ambulate in the hallway 1 hr before bedtime - While light exercise during the day can promote better sleep, exercising close to bedtime can actually disrupt sleep.

B. Tell the client to avoid drinking fluids 1 hr before bedtime - While limiting fluids close to bedtime can reduce nighttime awakenings to urinate, it may not directly address difficulty falling asleep.

C. Schedule routine care tasks during hours when the client is awake - This action ensures that the client can maximize restful sleep during the night by minimizing disruptions from care

activities.

D. Advise the client to leave the television in the room on when trying to fall asleep - Screen

time before bed can interfere with falling asleep due to the stimulating effect of light and content.

A. Clear fluid drainage from the nares B. Report of pain around the eyes C. Dried blood in the mouth D. Mandibular asymmetry

Correct Answer is A

Explanation

A. Clear fluid drainage from the nares, especially if it is continuous or persistent, may indicate a cerebrospinal fluid (CSF) leak, which can occur with a skull fracture.

B. Pain around the eyes is more commonly associated with a nasal fracture or orbital fracture, rather than a skull fracture.

C. Dried blood in the mouth may indicate nasal bleeding but does not necessarily indicate a skull fracture.

D. Mandibular asymmetry may indicate a jaw fracture or injury but is not typically associated with a skull fracture.

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A nurse notices smoke coming from a client's room and discovers a fire in the wastebasket.After moving the client to safety, which of the following is the priority action?

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A nurse notices smoke coming from a client's room and discovers a fire in the wastebasket.
After moving the client to safety, which of the following is the priority action?