Fundamentals Patient Safety (Test Bank)
Exam Questions and Answers
Offering diversionary activities such as something to hold is a way to keep the hands
busy and provides an alternative to restraints. Assigning a room near the nurses'
station or a chair at the desk can be an alternative for continuous monitoring. Getting
up constantly can be cause for concern. Apologizing is not an alternative to
restraints. Having a sitter sit with the patient to keep him occupied can be an
alternative to restraints, but the sitter needs to be continuous.
The nurse is caring for a patient who suddenly becomes confused and tries to
remove an intravenous infusion. The nurse begins to develop a plan to care for the
patient. Which nursing intervention should take priority?
a. Gather restraint supplies.
b. Try alternatives to restraint.
c. Assess the patient.
d. Call the physician for a restraint order. - Answer-ANS: C
When a patient becomes suddenly confused, the priority is to assess the patient,
including checking laboratory test and oxygen status and treating and eliminating the
cause of the change in mental status. If interventions and alternatives are exhausted,
the nurse working with the physician may determine the need for restraints
The nurse knows that four categories of risk have been identified in the health care
environment. Which of the following provides the best examples of those risks?
a. Tile floors, cold food, scratchy linen, and noisy alarms
b. Carpeted floors, ice machine empty, unlocked supply cabinet, and call light in
reach
c. Wet floors, pinching fingers in door, failure to use lift for patient, and alarms not
functioning properly
d. Dirty floors, hallways blocked, medication room locked, and alarms set - Answer-
ANS: C
The four categories are falls, patient-inherent accidents, procedure-related
accidents, and equipment-related accidents. Wet floors contribute to falls, pinching
finger in door is patient inherent, failure to use the lift is procedure related, and an
alarm not functioning properly is equipment related. Tile floors and carpeted or dirty
floors do not necessarily contribute to falls. Cold food, ice machine empty, and
hallways blocked are not patient-inherent issues in the hospital setting but are more
of patient satisfaction or infection control issues or fire safety issues. Scratchy linen,
unlocked supply cabinet, and medication room locked are not procedure-related
accidents. These are patient satisfaction issues and control of supply issues, and are
examples of actually following a procedure correctly. Noisy alarms, call light within
reach, and alarms set are not equipment-related accidents but are patient
satisfaction issues and examples of following a procedure correctly.
Equipment-related accidents are risks in the health care agency. The nurse
assesses for this risk when using
a. Sequential compression devices.
b. A measuring device that measures urine.
c. Computer-based documentation.
d. A manual medication-dispensing device. - Answer-ANS: A
, Sequential compression devices are used on a patient's extremities to assist in
prevention of deep vein thrombosis and have the potential to malfunction and harm
the patient. Measuring devices used by the nurse to measure urine, computer
documentation, and manual dispensing devices can break or malfunction but are not
used directly on a patient.
A patient has been admitted and placed on fall precautions. The nurse explains to
the patient that interventions for the precautions include
a. Encouraging visitors in the early evening.
b. Placing all four side rails in the "up" position.
c. Checking on the patient once a shift.
d. Placing a high risk for falls armband on the patient. - Answer-ANS: D
Placing a high risk for falls armband on the patient encourages communication
among the whole interdisciplinary team. Anyone who interacts with the patient
should see this armband, understand its meaning, and assist the patient as
necessary. The timing of visitors would not affect falls. All four side rails are
considered a restraint and can contribute to falling. Individuals on high risk for fall
alerts should be checked frequently, at least every hour
A patient with an intravenous infusion requests a new gown after bathing. Which of
the following actions is most appropriate?
a. Disconnect the intravenous tubing, thread the end through the sleeve of the old
gown and through the sleeve of the new gown, and reconnect.
b. Thread the intravenous bag and tubing through the sleeve of the old gown and
through the sleeve of the new gown without disconnecting.
c. Inform the patient that a new gown is not an option while receiving an intravenous
infusion in the hospital.
d. Call the charge nurse for assistance because linen use is monitored and this is not
a common procedure. - Answer-ANS: B
Procedure-related accidents such as contamination of sterile items can occur in the
health care setting. Keeping the intravenous tubing intact without breaks in the
system is imperative to decrease the risk of infection while changing a patient's gown
and satisfying the patient's request.
The nurse is precepting a student nurse and is careful to check with the student all
components of the medication process. The nurse explains to the student that most
errors occur in
a. Ordering and transcribing.
b. Dispensing and administering.
c. Dispensing and transcribing.
d. Ordering and administering. - Answer-ANS: D
Most medication errors occur in the ordering and administering stages of the
medication process.
During the admission assessment, the nurse assesses the patient for fall risk. Which
of the following has the greatest potential to increase the patient's risk for falls?
a. The patient is 59 years of age.
b. The patient walks 2 miles a day.
c. The patient takes Benadryl (diphenhydramine) for allergies.
d. The patient recently became widowed. - Answer-ANS: C
Benadryl (diphenhydramine) has the potential to cause drowsiness and dizziness as
a side effect, thereby increasing the risk for falls. Over 60 is the age typically found
on fall assessments that increase the risk for falls. Walking has many benefits,
including increasing strength, which would be beneficial in decreasing risk.
Exam Questions and Answers
Offering diversionary activities such as something to hold is a way to keep the hands
busy and provides an alternative to restraints. Assigning a room near the nurses'
station or a chair at the desk can be an alternative for continuous monitoring. Getting
up constantly can be cause for concern. Apologizing is not an alternative to
restraints. Having a sitter sit with the patient to keep him occupied can be an
alternative to restraints, but the sitter needs to be continuous.
The nurse is caring for a patient who suddenly becomes confused and tries to
remove an intravenous infusion. The nurse begins to develop a plan to care for the
patient. Which nursing intervention should take priority?
a. Gather restraint supplies.
b. Try alternatives to restraint.
c. Assess the patient.
d. Call the physician for a restraint order. - Answer-ANS: C
When a patient becomes suddenly confused, the priority is to assess the patient,
including checking laboratory test and oxygen status and treating and eliminating the
cause of the change in mental status. If interventions and alternatives are exhausted,
the nurse working with the physician may determine the need for restraints
The nurse knows that four categories of risk have been identified in the health care
environment. Which of the following provides the best examples of those risks?
a. Tile floors, cold food, scratchy linen, and noisy alarms
b. Carpeted floors, ice machine empty, unlocked supply cabinet, and call light in
reach
c. Wet floors, pinching fingers in door, failure to use lift for patient, and alarms not
functioning properly
d. Dirty floors, hallways blocked, medication room locked, and alarms set - Answer-
ANS: C
The four categories are falls, patient-inherent accidents, procedure-related
accidents, and equipment-related accidents. Wet floors contribute to falls, pinching
finger in door is patient inherent, failure to use the lift is procedure related, and an
alarm not functioning properly is equipment related. Tile floors and carpeted or dirty
floors do not necessarily contribute to falls. Cold food, ice machine empty, and
hallways blocked are not patient-inherent issues in the hospital setting but are more
of patient satisfaction or infection control issues or fire safety issues. Scratchy linen,
unlocked supply cabinet, and medication room locked are not procedure-related
accidents. These are patient satisfaction issues and control of supply issues, and are
examples of actually following a procedure correctly. Noisy alarms, call light within
reach, and alarms set are not equipment-related accidents but are patient
satisfaction issues and examples of following a procedure correctly.
Equipment-related accidents are risks in the health care agency. The nurse
assesses for this risk when using
a. Sequential compression devices.
b. A measuring device that measures urine.
c. Computer-based documentation.
d. A manual medication-dispensing device. - Answer-ANS: A
, Sequential compression devices are used on a patient's extremities to assist in
prevention of deep vein thrombosis and have the potential to malfunction and harm
the patient. Measuring devices used by the nurse to measure urine, computer
documentation, and manual dispensing devices can break or malfunction but are not
used directly on a patient.
A patient has been admitted and placed on fall precautions. The nurse explains to
the patient that interventions for the precautions include
a. Encouraging visitors in the early evening.
b. Placing all four side rails in the "up" position.
c. Checking on the patient once a shift.
d. Placing a high risk for falls armband on the patient. - Answer-ANS: D
Placing a high risk for falls armband on the patient encourages communication
among the whole interdisciplinary team. Anyone who interacts with the patient
should see this armband, understand its meaning, and assist the patient as
necessary. The timing of visitors would not affect falls. All four side rails are
considered a restraint and can contribute to falling. Individuals on high risk for fall
alerts should be checked frequently, at least every hour
A patient with an intravenous infusion requests a new gown after bathing. Which of
the following actions is most appropriate?
a. Disconnect the intravenous tubing, thread the end through the sleeve of the old
gown and through the sleeve of the new gown, and reconnect.
b. Thread the intravenous bag and tubing through the sleeve of the old gown and
through the sleeve of the new gown without disconnecting.
c. Inform the patient that a new gown is not an option while receiving an intravenous
infusion in the hospital.
d. Call the charge nurse for assistance because linen use is monitored and this is not
a common procedure. - Answer-ANS: B
Procedure-related accidents such as contamination of sterile items can occur in the
health care setting. Keeping the intravenous tubing intact without breaks in the
system is imperative to decrease the risk of infection while changing a patient's gown
and satisfying the patient's request.
The nurse is precepting a student nurse and is careful to check with the student all
components of the medication process. The nurse explains to the student that most
errors occur in
a. Ordering and transcribing.
b. Dispensing and administering.
c. Dispensing and transcribing.
d. Ordering and administering. - Answer-ANS: D
Most medication errors occur in the ordering and administering stages of the
medication process.
During the admission assessment, the nurse assesses the patient for fall risk. Which
of the following has the greatest potential to increase the patient's risk for falls?
a. The patient is 59 years of age.
b. The patient walks 2 miles a day.
c. The patient takes Benadryl (diphenhydramine) for allergies.
d. The patient recently became widowed. - Answer-ANS: C
Benadryl (diphenhydramine) has the potential to cause drowsiness and dizziness as
a side effect, thereby increasing the risk for falls. Over 60 is the age typically found
on fall assessments that increase the risk for falls. Walking has many benefits,
including increasing strength, which would be beneficial in decreasing risk.
