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A nurse is teaching a community group of school-aged parents about safety. Which safety item is most important for the nurse to include in the teaching session?
- A. Proper fit of a bicycle helmet.
- B. Proper fit of soccer shin guards.
- C. Proper fit of swimming goggles.
- D. Proper fit of baseball sliding shorts.
Correct Answer: A
Rationale: The correct answer is A: Proper fit of a bicycle helmet. This is the most important safety item to include because head injuries from bicycle accidents can be life-threatening. Properly fitting helmets can significantly reduce the risk of head injuries. Soccer shin guards, swimming goggles, and baseball sliding shorts are important for their respective activities, but they do not have the same potential life-saving impact as a bicycle helmet. It is crucial for the nurse to emphasize the importance of wearing a properly fitting helmet to prevent head injuries during biking.
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The patient is confused, is trying to get out of bed, and is pulling at the intravenous infusion tubing. Which nursing diagnosis will the nurse add to the care plan?
- A. Impaired home maintenance
- B. Deficient knowledge
- C. Risk for poisoning
- D. Risk for injury
Correct Answer: D
Rationale: The correct answer is D: Risk for injury. The patient's confusion and behavior of trying to get out of bed and pulling at the IV tubing indicate a potential risk for self-injury. Confusion can lead to falls or accidents, and pulling at the IV tubing can cause dislodgement leading to infection or inadequate medication delivery. The nurse's priority is to prevent harm to the patient.
Other choices are incorrect because:
A: Impaired home maintenance focuses on the patient's ability to maintain a safe and healthy home environment, not applicable in this acute care setting.
B: Deficient knowledge pertains to lack of understanding about a health condition or treatment, not relevant to the immediate safety concern.
C: Risk for poisoning does not align with the current scenario of potential physical harm due to the patient's confused behavior.
A patient may need restraints. Which task can the nurse delegate to a nursing assistive personnel?
- A. Determining the need for restraints
- B. Assessing the patient's orientation
- C. Obtaining an order for a restraint
- D. Applying the restraint
Correct Answer: D
Rationale: The correct answer is D: Applying the restraint. The rationale is that nursing assistive personnel can perform tasks that involve direct patient care under the supervision of a nurse. Applying restraints is a task that involves following specific guidelines and does not require critical thinking or decision-making skills. Tasks A, B, and C involve assessing, determining the need, and obtaining orders for restraints, which require nursing judgment and cannot be delegated to nursing assistive personnel. Other choices are left blank as they are not relevant to the question.
The nurse is discussing threats to adult safety with a college group. Which statement by a group member indicates understanding of the topic?
- A. Smoking even at parties is not good for my body.
- B. Our campus is safe; we leave our dorms unlocked all the time.
- C. As long as I have only two drinks, I can still be the designated driver.
- D. I am young, so I can work nights and go to school with 2 hours' sleep.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Smoking is a significant threat to adult safety, increasing the risk of various health issues.
2. The statement acknowledges the harmful effects of smoking even in social settings, showing awareness of health risks.
3. It demonstrates understanding of personal responsibility for one's health and safety.
Summary:
B: Leaving dorms unlocked poses a safety risk, indicating a lack of understanding of safety concerns.
C: Drinking and driving, even with only two drinks, is unsafe and illegal, showing a lack of awareness.
D: Working nights with minimal sleep can lead to fatigue-related accidents, reflecting poor judgment on safety.
A home health nurse is performing a home assessment for safety. Which comment by the patient will cause the nurse to follow up?
- A. Every December is the time to change batteries on the carbon monoxide detector.
- B. I will schedule an appointment with a chimney inspector next week.
- C. If I feel dizzy when using the heater, I need to have it inspected.
- D. When it is cold outside in the winter, I will use a nonvented furnace.
Correct Answer: D
Rationale: The correct answer is D because using a nonvented furnace can lead to carbon monoxide poisoning. Carbon monoxide is a colorless, odorless gas that can be deadly if inhaled in high concentrations. The other choices demonstrate good safety practices such as changing batteries on detectors, scheduling chimney inspections, and recognizing symptoms of heater issues. Using a nonvented furnace is the only unsafe practice mentioned, hence requiring immediate follow-up to educate the patient on the dangers of carbon monoxide poisoning.
The nurse is presenting an educational session on safety for parents of adolescents. Which information will the nurse include in the teaching session?
- A. Increased aggressiveness and blood spots on clothing may indicate substance abuse.
- B. Increased aggressiveness is an environmental clue that may indicate an adolescent is abusing.
- C. Adolescents need information about the effects of uncoordination on accidents.
- D. Adolescents need to be reminded to use seat belts primarily on long trips.
Correct Answer: A
Rationale: The correct answer is A. Increased aggressiveness and blood spots on clothing are potential signs of substance abuse in adolescents. This is important information for parents to be aware of as it can indicate a serious issue that needs to be addressed promptly.
Choice B is incorrect because it only partially addresses the issue by mentioning aggressiveness but does not include the specific indication of blood spots on clothing related to substance abuse.
Choice C is incorrect as it focuses on uncoordination and accidents, which is not directly related to the signs of substance abuse mentioned in the question.
Choice D is incorrect as it discusses seat belt use, which is important but not the main focus of the educational session on safety for parents of adolescents.
In summary, choice A is the correct answer because it provides crucial information about potential signs of substance abuse in adolescents, which is relevant to the safety concerns of parents.