Nokea
The nurse is assessing a patient who reports a previous fall and is using the SPLATT acronym. Which questions will the nurse ask the patient? (Select all that apply.)
- A. Where did you fall?
- B. What time did the fall occur?
- C. What were you doing when you fell?
- D. What types of injuries occurred after the fall?
- E. Did you obtain an electronic safety alert device after the fall?
Correct Answer: A,B,C,D
Rationale: The correct answers are A, B, C, and D. Asking where, when, and what the patient was doing during the fall helps to assess the circumstances leading to the fall and potential risk factors. Inquiring about types of injuries provides insight into the severity of the fall and any complications. Choice E is incorrect as it focuses on post-fall actions rather than the fall event itself. The other choices, F and G, are not provided in the question and are therefore irrelevant.
You may also like to solve these questions
The nurse is caring for a group of medical-surgical patients. The unit has been notified of a fire on an adjacent wing of the hospital. The nurse quickly formulates a plan to keep the patients safe. Which actions will the nurse take? (Select all that apply.)
- A. Close all doors.
- B. Note evacuation routes.
- C. Note oxygen shut-offs.
- D. Move bedridden patients in their bed.
- E. Wait until the fire department arrives to act.
- F. Use type B fire extinguishers for electrical fires.
Correct Answer: A, B, C, D
Rationale: The correct actions for the nurse to take in this situation are A, B, C, and D. Closing all doors helps contain the fire and smoke. Noting evacuation routes ensures a safe exit plan. Knowing oxygen shut-offs prevents fire hazards. Moving bedridden patients in their beds aids in their evacuation. Choice E is incorrect because waiting for the fire department delays necessary actions. Choice F is incorrect as type B fire extinguishers are not suitable for electrical fires, which require type C extinguishers.
The nurse is monitoring for the four categories of risk that have been identified in the health care environment. Which examples will alert the nurse that these safety risks are occurring?
- A. Tile floors, cold food, scratchy linen, and noisy alarms.
- B. Dirty floors, hallways blocked, medication room locked, and alarms set.
- C. Carpeted floors, ice machine empty, unlocked supply cabinet, and call light in reach.
- D. Wet floors unmarked, patient pinching fingers in door, failure to use lift for patient, and alarms not functioning properly.
Correct Answer: D
Rationale: The correct answer is D because wet floors unmarked pose slip hazards, patient pinching fingers in the door indicates lack of safety measures, failure to use a lift for patient increases risk of injury, and alarms not functioning properly can lead to delayed response. Choice A includes minor inconveniences but not significant safety risks. Choice B focuses on facility maintenance rather than direct patient safety risks. Choice C mentions minor issues like empty ice machine and unlocked supply cabinet that do not directly impact patient safety.
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.
The emergency department has been notified of a potential bioterrorism attack. Which action by the nurse is priority?
- A. Monitor for specific symptoms.
- B. Manage all patients using standard precautions.
- C. Transport patients quickly and efficiently through the elevators.
- D. Prepare for post-traumatic stress associated with this bioterrorism attack.
Correct Answer: B
Rationale: The correct answer is B: Manage all patients using standard precautions. This is the priority action because in a potential bioterrorism attack, protecting both patients and staff from exposure to any harmful agents is crucial. Standard precautions help prevent the spread of infections and ensure safety for everyone in the emergency department. Monitoring for specific symptoms (choice A) is important but comes after ensuring immediate safety. Transporting patients quickly (choice C) may increase the risk of spreading potential agents. Preparing for post-traumatic stress (choice D) is important but not the priority in the initial response to a bioterrorism threat.
A nurse is inserting a urinary catheter. Which technique will the nurse use to prevent a procedure-related accident?
- A. Pathogenic asepsis
- B. Medical asepsis
- C. Surgical asepsis
- D. Clean asepsis
Correct Answer: C
Rationale: The correct answer is C: Surgical asepsis. This technique involves creating and maintaining a sterile field to prevent contamination during invasive procedures like catheter insertion. The nurse will use sterile gloves, drapes, and equipment to minimize the risk of infection. Pathogenic asepsis (A) focuses on removing or destroying pathogens but may not ensure sterility. Medical asepsis (B) aims to reduce the number of pathogens but does not achieve a sterile environment. Clean asepsis (D) involves cleanliness but not the level of sterility required for invasive procedures.