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Showing 17 questions, Sign in for moreA nurse sees smoke emerging from the suction equipment being used. Which is the greatest priority in the event of a fire?
A 75-year-old client, hospitalized with a cerebrovascular accident (stroke), becomes disoriented at times and tries to get out of bed, but is unable to ambulate without help. What is the most appropriate safety measure?
Which nursing intervention is the highest in priority for a client at risk for falls in a hospital setting?
The physiological changes of aging increase the risk for which of the following?
A physician writes an order to apply a wrist restraint to a patient who has been pulling out a surgical wound drain. Place the following steps for applying the restraint in the correct order.
Explanation
Step 1: Determine that restraint alternatives fail to ensure patient’s safety.
Restraints are never a first-line intervention. Nurses must assess and document that all less restrictive alternatives (like distraction, sitter, or repositioning) have been tried and failed.
Step 2: Identify the patient using proper identifier.
Patient identification using at least two identifiers (e.g., name and date of birth) ensures that care is delivered to the correct person, preventing potential errors.
Step 3: Explain what you plan to do.
Communication promotes trust and cooperation. Even if the patient is confused, explaining actions respects their dignity and may reduce agitation.
Step 4: Pad the patient’s wrist.
Padding prevents skin breakdown, bruising, and nerve damage by distributing pressure.
Step 5: Wrap a limb restraint around wrist or ankle with soft part toward skin and secure.
The restraint must be applied properly (soft side to skin, quick-release knot to bed frame) to ensure effectiveness and safety.
Take home points:
- Always attempt alternatives before restraints and document the failure of these measures; restraint use must be justified and time-limited.
- Patient safety and dignity are key-proper identification, explanation, and padding are essential steps before applying any restraint.
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 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?
How does the nurse support a culture of safety? Select all that apply
A school nurse is preparing a talk on healthcare topics for adolescents. Which of the following would be important for the nurse to include?
A nurse is assessing the following children. Which child would the nurse identify as having the greatest risk for choking and suffocating?
An 87-year-old man is admitted to the hospital for cellulitis of the left arm. He ambulates with a walker and takes a diuretic medication to control symptoms of fluid retention. Which intervention is most important to protect him from injury?
Medication errors can place the client at significant risk. Which practice(s) will help decrease the possibility of errors? Select all that apply
The nurse is teaching parents of a toddler about the use of car seats. The nurse demonstrates an understanding of this measure by stating that car seats are mandatory in which of the following conditions?
Which of the following would be most important for the nurse to keep in mind regarding the use of side rails for a confused patient?
When discussing emergency preparedness with a group of first responders, which of the following would be important to include about preparation for a terrorist attack?
When assessing a temperature rectally, the nurse would use extreme care when inserting the thermometer to prevent which of the following?
A nurse is assessing vital signs on several hospitalized children. The nurse would plan to use the oral route to assess temperature for which patient?
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