MODULE 6 SAFETY AND INFECTION CONTROL EXAM-43 QUESTIONS AND ANSWERS.

Lesson 28 Providing a Secure and Safe Environment A hospital nurse transcribing a primary health care provider's prescriptions for a client is unable to read a prescribed dosage because the primary health care provider's handwriting is unclear. Which action should the nurse take? Call the primary health care provider Ask the client about the usual dosage of the medication Call the pharmacy to ask about the usual dosage of the prescribed medication Contact the nursing supervisor for clarification of the primary health care provider's prescriptions Call the primary health care provider RATIONALE: It is the nurse's responsibility to follow the primary health care provider's prescriptions unless the nurse believes that a prescription is in error or would cause harm to the client. If the nurse implements a prescription that is inaccurate and causes harm to the client, the nurse is responsible. If a primary health care provider's prescription is illegible, it is the nurse's responsibility to clarify the prescription with the primary health care provider. The nurse would contact the nursing supervisor if he or she were unable to make contact with the primary health care provider for any reason, but, because of the unclear handwriting, asking the nursing supervisor for clarification of the primary health care provider's prescription is not the best action; the primary health care provider must make the prescription clear. Calling the pharmacy to ask about the usual dosage is incorrect, for the same reason; the primary health care provider must make the prescription clear. Asking the client about the usual dosage is incorrect, in part because the primary health care provider may have changed the dosage. Brainpower Read More 0:10 / 0:15 A client has a prescription for an intravenous (IV) infusion of 1000 mL of 0.9% normal saline solution with 10 mEq of potassium chloride at a rate of 100 mL/hr. The nurse obtains an infusion control device with which to administer the prescription and hangs the IV solution at 7 a.m. At 10 a.m. the nurse notes that 500 mL of solution has infused. The nurse assesses the client, checks the infusion rate, obtains a new infusion control device, and contacts the primary health care provider. The primary health care provider prescribes a decrease in the rate of infusion to 50 mL/hr and orders a serum potassium level. The potassium level is 3.5 mEq/L (3.5 mmol/L). Which information should be included on the incident report in regard to this event? Select all that apply. The primary health care provider was contacted. The serum potassium level at 10:30 a.m. was 3.5 mEq/L (3.5 mmol/L). A total of 200 mL of IV fluid was accidentally infused into the client. There was 500 mL of solution remaining in the IV bag at 10 a.m. The infusion control device malfunctioned causing an excess amount of IV fluid to infuse into the client. The primary health care provider was contacted. The serum potassium level at 10:30 a.m. was 3.5 mEq/L (3.5 mmol/L). There was 500 mL of solution remaining in the IV bag at 10 a.m. RATIONALE: The incident report should contain the client's name, age, and diagnosis. The report should also contain a factual description of the incident, any injuries sustained by those involved, and the outcome of the situation. The nurse avoids the use of subjective data and documents objective data. The nurse also avoids any implication that an accident occurred or that an error was made. The statement that 200 mL of IV fluid was accidentally infused into the client implies that an accident resulted from an error. Likewise, the statement that the infusion control device malfunctioned, causing an excess amount of IV fluid to be infused into the client, poses an implication. The remaining statements identify factual and observable data free of unwanted implications. A nurse is setting up an intravenous pump that will be used for a client who will be receiving a continuous intravenous infusion of normal saline solution containing heparin. As the nurse prepares to plug the pump's electrical cord into the wall socket, she notes that no socket is available because of other medical equipment being used in the room. Which action by the nurse is most appropriate? Allowing the pump to run in battery mode Obtaining an extension cord from the nurses' lounge Moving the client into the hallway, near a wall socket Calling the hospital's electrical department for assistance Calling the hospital's electrical department for assistance RATIONALE: The nurse would most appropriately contact the hospital's electrical department for assistance in safely setting up electrical equipment. Safety-type extension cords are used only if necessary, and although this may be an option, it is not the most appropriate one. Electrical outlets should not be overloaded, because this presents an electrical hazard. The nurse would not allow the pump to run on its battery for an extended period. It is inappropriate to place a client in a hallway. This would constitute an invasion of the client's privacy. A nurse receives a telephone call from her next-door neighbor, who is frantically seeking help because her 3-year-old son has swallowed pills from a bottle of ibuprofen. The neighbor tells the nurse that her teenage daughter takes the pills for menstrual cramps and apparently forgot to put the bottle away before leaving for school this morning. After the nurse rushes to the neighbor's house, which action should she take first? Calling the poison center Asking the mother to call an ambulance Assessing the child for airway patency and removing any visible material from the child's mouth Asking the neighbor to call the school and ask her daughter how many pills remained in the bottle Assessing the child for airway patency and removing any visible material from the child's mouth RATIONALE: In the event of an accidental poisoning, the nurse would first assess airway patency, breathing, and circulation. The nurse would remove any visible material from the child's mouth and then try to identify the type and amount of substance ingested, because this may help determine the correct antidote. The Poison Control Center is also called, but airway is the priority. If the Poison Control Center says that the child should be taken to an emergency department, an ambulance is called. It may be necessary to contact the daughter at school, but this would not be the first action. TESTLET Mary Houder, a new nursing graduate, has been hired to work as a staff nurse on a medical nursing unit in a large hospital. Mary is required to complete the hospital's orientation program, which includes a fire safety program. During the program, each new employee is given a scenario and expected to demonstrate how he or she would respond to the situation set forth in the scenario. Mary's case scenario reads: You are working on a medical nursing unit and are delivering medications to a client who is ambulatory, is under respiratory precautions, and is receiving oxygen by nasal cannula. When you enter the client's room, you discover a fire blazing in the laundry basket, caused when the client used a match to light a candle. The case scenario asks Mary to respond to the questions that follow. When the fire is discovered, what will you do first? Activate the fire alarm Assist the client in leaving the room Get the fire extinguisher located outside the client's room Assist the client into a corner of the room, as far away from the fire as possible, and shut the oxygen off Assist the client in leaving the room RATIONALE: In the event of a fire, the nurse would use the mnemonic RACE to set priorities. The nurse's first action would be to rescue and remove all clients in immediate danger away from the fire. The nurse would next activate the fire alarm, confine the fire by closing doors and windows and turning off oxygen and electrical equipment, and then extinguish the fire, using a fire extinguisher.