The nurse is assisting in the care of clients during a mass casualty event.

Exhibits

For each client, click to specify if the client should be assigned a red, yellow, or black tag. A tag color may be assigned to more than one client.

Client 4

Client 2

Client 1

Client 3

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"C"}}

Rationale

Client 1: Red tag. This client has a significant loss of blood and a low heart rate, indicating they are in critical condition and need immediate intervention to survive.
Client 2: Yellow tag. This client has second-degree burns and is in pain, but their condition is stable and not immediately life-threatening.
Client 3: Black tag. This client is unresponsive with multiple severe burn injuries and Cheyne-Stokes respirations, indicating a very poor prognosis and unlikely survival.
Client 4: Red tag. This client is experiencing severe chest pain and shortness of breath, which could indicate a life-threatening condition such as a heart attack and requires immediate attention.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

A. Keeping the water heater set below 60° C (140° F) is important for preventing scalding but may not be feasible for everyone, as some people prefer hotter water for hygiene.
B. Disposing of unused medications is a critical safety measure to prevent accidental ingestion or misuse, making it the best choice for home safety education.
C. Setting the refrigerator temperature to 7.2° C (45° F) is higher than the recommended maximum of 4° C (40° F) to prevent food spoilage and bacterial growth.
D. Running electrical cords under carpeting poses a fire hazard and should be avoided, thus is not suitable advice for a safety presentation.

A. Administering a pain medication to a client before ambulation B. Stopping feeding for a client who becomes short of breath C. Telling a client she will return with a medication and she does D. Dividing time and care evenly between clients

Correct Answer is C

Explanation

A. Administering pain medication before ambulation is an example of patient-centered care and pain management but does not specifically demonstrate fidelity, which relates to keeping promises and being trustworthy.
B. Stopping feeding when a client becomes short of breath is an appropriate response to prevent aspiration, but it is not an example of fidelity.
C. Telling a client she will return with a medication and following through with that commitment demonstrates fidelity by fulfilling a promise and showing reliability.
D. Dividing time and care between clients is part of effective time management, but it does not specifically represent fidelity, which emphasizes keeping promises to clients.

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The nurse is assisting in the care of clients during a mass casualty event. Exhibits For each client, click to specify if the client should be assigned a red, yellow, or black tag. A tag color may be assigned to more than one client.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the preparation of a presentation about home safety for a health fair. Which of the following information should the nurse include in the presentation?

Correct Answer is B

Explanation

A nurse on a medical-surgical unit is caring for four clients. Which of the following actions by the nurse demonstrates fidelity?

Correct Answer is C

Explanation

A nurse working on an acute care unit is supervising a team of assistive personnel (AP). Which of the following actions by the nurse is an example of laissez-faire leadership?

A nurse is contributing to a quality improvement plan to improve the shift reporting process on the unit. Which of the following actions is the first step the nurse should suggest to promote a change in the reporting process?

A nurse enters a client's room and sees smoke coming from a wall outlet. After removing the client from the room, which of the following actions should the nurse take next?

A nurse is reinforcing teaching with a newly licensed nurse about client confidentiality. Which of the following information should the nurse include?

A nurse is assisting with the development of an in-service about client advocacy. Which of the following information should the nurse include when describing advocacy?

A nurse is observing an assistive personnel (AP) provide care to a group of clients. Which of the following actions by the AP requires intervention by the nurse?

A nurse in a long-term care facility is collecting data for an interprofessional care conference for a client who has Parkinson's disease. Which of the following findings is the priority for the nurse to report at the conference?

A nurse is prioritizing care for four clients. Which of the following tasks should the nurse perform first?

The nurse is assisting in the care of clients during a mass casualty event.

Exhibits

For each client, click to specify if the client should be assigned a red, yellow, or black tag. A tag color may be assigned to more than one client.