Chapter 27: Hospital client
ra ra ra r a Safety and Quality ra ra ra
MULTIPLE CHOICE ra
1. A home health nursing attendant is performing a home assessment for safety. Whic
ra ra ra ra ra ra ra ra ra ra ra ra
h comment by the hospital client will cause the nursing attendant to follow up? a.
ar ra ra ra ra ra ra ra ra ra ra ra ra
―Every December is the time to change batteries on the carbon monoxide d
ar ra ra ra ra ra ra ra ar ra ra ar
etector.‖
b. ―I will schedule an appointment with a chimney inspector next week.‖
ra ra ra ar ra ar ra ra ra ra
c. ―If I feel dizzy when using the heater, I need to have it inspected.‖
ra ra ra ar ra ra ra ra ra ra ra ra ra
d. ―When it is cold outside in the winter, I will use a non-vented heater.‖ ra ra ra ra ra ra ra ra ra ra ra ra ra
ACCURATE ANSWER:-D ra
Using a nonvented heater introduces carbon monoxide into the environment and decreases the a
ra ra ra ra ra ra ra ra ra ra ra ar ra
vailable o ra
xygen for human consumption and the nursing attendant should follow up to correct this beh
ra ra ra ra ra ra ra ra ra ra ra ar ra ra
avior. Checking the chimney and heater, changing the batteries on the detector, and followi
ra ra ra ra ra ra ra ra ra ra ra ra ra
ng up on symptoms such as dizziness, nausea, and fatigue are all statements that are safe an
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
d appropriate and need no follow-up.
ra ra ra ra ra
DIF:Analyze (analysis) ra
OBJ:Discuss common environmental hazards and methods for preventing them.
ra ra ra ra ra ra ra ra ar
TOP:Assessment MSC: Safety and Infection Control ra ra ra ra
2. The nursing attendant is caring for an olderadult hospital client admitted with nau
ra ra ra ra ra ra ra ra ra ra ra ra
sea, vomiting, and diarrhea due to food poisoning.
ra ra ra ra ra ra ra r
The nursing attendant completes the health history. Which priority concern will r
a ra ra ra ra ra ar ra ra ra ra ra
equire ra
collaboration with social services to address the hospital client ’s health care needs
ra ra ra ra ra ar ra ra ra ra ra ra
? a. The electricity was turned off 3 days ago.
ra ra ra ra ra ra ra
b. The water comes from the county water supply.
ra ra ra ra ra ra ra
c. A son and family recently moved into the home.
ra ra ra ra ra ra ra ra
d. This home is not furnished with a microwave oven.
ra ra ra ra ra ra ra ra
ACCURATE ANSWER:-A ra
Electricity is needed for refrigeration of food, and lack of electricity could have contributed to t
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
he nausea, vomiting, and diarrhea due to food poisoning. This discussion about the hospital c
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
lient ’s electrical needs can be referred to social services. Foods that are inadequately prepare
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
d or stored or subject to unsanitary conditions increase the hospital client ’s risk for infection
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
s and food poisoning, and an assessment should include storage practices. The water supply, t
ra ra ra ra ra ra ra ra ra ra ra ra ar ra
he increased number of individuals in the home, and not having a microwave may or may not
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar ra ra
be concerns but do not pertain to the current health care needs of this hospital client .
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Analyze (analysis) ra
OBJ:Discuss common environmental hazards and methods for preventing them.
ra ra ra ra ra ra ra ra ar
TOP:Planning MSC: Management of Care ra ra ra
,3. What statement by the nursing attendant demonstrates an understanding of food safety to
ra ra ra ra ra ra ra ra ra ra ra ra r
abe provided for a hospital client living alone?
ar ra ra ra ra ra ra
a. ―It’s acceptable to eat unwashed fruits and vegetables if they are organically g rown.‖
ra ra ra ra ra ra ra ra ar ar ra ar
b. ―It’s best to allow cooked foods to thoroughly cool off before putting them into the re
ra ra ra ra ra ar ra ar ra ra ra ra ra ra ar
frigerator.‖
c. ―You can use the same cutting board for meats and for vegetables if it is washed be
ra ar ra ra ra ra ra ra ra ra ra ra ra ra ra ar
tween uses.‖ ra
d. ―Your perishable left-over food should be stored in a refrigerator at below
ra ‖ ra ra ra ra ra ra ar ra ra ra ra
ACCURATE ANSWER:-D ra
Keep a refrigerator below
ra ra to assure proper storage of perishable foods. Keep raw meat, ra ra ra ra ra ra ra ra ra ra ra ra ar
poultry, seafood, and their juices away from other foods. Use separate cutting boards. Rinse
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
fruits and vegetables thoroughly. Refrigerate leftovers promptly.
ra ra ra ra ra ra
DIF:Analyze (analysis) ra
OBJ:Discuss common environmental hazards and methods for preventing them.
ra ra ra ra ra ra ra ra ar
TOP:Implementation MSC: Basic Care and Comfort ra ra ra
4. An adult hospital client presents to the emergency department and is treated for
ra ra ra ra ra ra ra ra ra ra ra ra ar
hypothermia. What risk factor should the hospital client be assessed for? a. Tobacco use
ra ra ra ra ra ra ra ra ra ra ra
b. Homelessness
c. High carbohydrate diet ra ra
d. History of chronic respiratory disorder ra ra ra ra
ACCURATE ANSWER:-B ra
The temperature indicates the hospital client is experiencing hypothermia. Homeless indivi
ra ra ra ra ra ra ra ra ra ra
duals are more at risk for hypothermia. None of the other options are a known risk factor for
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar ra ra
hypothermia.
DIF:Analyze (analysis) ra
OBJ:Discuss common environmental hazards and methods for preventing them.
ra ra ra ra ra ra ra ra ar
TOP:Assessment MSC: Reduction of Risk Potential ra ra ra ra
5. A nursing attendant is teaching the hospital client and family about wound care. Whic
ra ra ra ra ra ra ra ra ra ra ra ra ra
h technique will the nursing attendant teach to best prevent transmission of pathogens? a.
ar ra ra ra ra ra ra ra ra ra ra ra
Effective hand hygiene ra ra
b. Saline wound irrigation ra ra
c. Appropriate use of gloves ra ra ra
d. When eye protection is needed ra ra ra ra
ACCURATE ANSWER:-A ra
One of the most effective methods for limiting the transmission of pathogens is the medically
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
aseptic practice of hand hygiene. The most common means of transmission of pathogens is by t
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
he hands. While washing the wound is needed, the best method to prevent transmission is ha
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
nd hygiene. Wearing gloves and possibly eye protection help protect the nursing attendant , b
ra ra ra ra ra ra ra ra ra ra ra ra ra ar
ut handwashing is best for limiting the transmission of pathogens.
ra ra ra ra ra ra ra ra ra
DIF:Understand (comprehension) ra
OBJ:Explain the role critical thinking and clinical judgment play in planning care for a hospital clien
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
t’
ar
s safety needs. TOP:Teaching/Learning
ra ra MSC: Safety and Infection Control
ra ra ra ra
, 6. The nursing attendant is monitoring for Never Events. Which finding indicates th
ra ra ra ra ra ra ra ra ra ra ra
e nursing attendant will report a Never Event?
ar ra ra ra ra ra ra
a. Lack of blood incompatibility with a blood transfusion
ra ra ra ra ra ra ra
b. A surgical sponge is left in the hospital client ’s incision
ra ra ra ra ra ra ra ra ra ra
c. Pulmonary embolism after lung surgery ra ra ra ra
d. Stage II pressure ulcer ra ra ra
ACCURATE ANSWER:-B ra
The Centers for Medicare and Medicaid Services names select serious reportable events as Ne
ra ra ra ra ra ra ra ra ra ra ra ra ra
ver Events (i.e., adverse events that should never occur in a health care setting). A surgical spon
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
ge left in a hospital client ’s incision is a Never Event. No blood incompatibility reaction is safe
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar ra ra
practice. Pulmonary embolism is more after certain orthopedic procedures like a total knee a
ra ra ra ra ra ra ra ra ra ra ra ra ra
nd hip replacement. Stage III and IV pressure ulcers are Never Events.
ra ra ra ra ra ra ra ra ra ra ra
DIF:Understand (comprehension) ra
OBJ:Explain the role critical thinking and clinical judgment play in planning care for a hospital clien
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
t’
ar
s safety needs. TOP:Implementation
ra ra MSC: Management of Care ra ra ra ra
7. When the nursing attendant discovers a hospital client on the floor, the hospital client
ra ra ra ra ra ra ra ra ra ra ra ra ra ar
states, ―I fell out of bed‖. The nursing attendant assesses the hospital client and then
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
places the hospital client back in bed. Which action should the nursing attendant ta
ra ra ra ra ra ra ra ra ra ra ra ra ra
ke next? ar
a. Do nothing, no harm has occurred.
ra ra ra ra ra
b. Notify the health care provider. ra ra ra ra
c. Complete an incident report. ra ra ra
d. Re-assess the hospital client . ra ra ra ra
ACCURATE ANSWER:-B ra
Report immediately to physician or health care provider if the hospital client sustains a fall or a
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
n injury. The nursing attendant must provide safe care and doing nothing is not safe care.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
The scenario indicates the nursing attendant has already assessed the hospital client . After th
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
e hospital client has stabilized, completing an incident report would be the last step in the pro
ar ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
cess.
DIF:Apply (application) ra
OBJ:Describe the complex nature of clinical judgment for nursing attendant s delivering hospit
ra ra ra ra ra ra ra ra ra ra ra ra
al client -centered care for hospital client s’ improved safety. TOP:Implementation MSC:
ar ra ra ra ra ra ra ra ra ra
Safety and Infection Controlra ra ra
8. When making rounds the nursing attendant observes a purple wristband on a hospit
ra ra ra ra ra ra ra ra ra ra ra ra
al client ’s wrist. What information about the hospital client does this provide the nu
ar ra ra ra ra ra ra ra ra ra ra ra ra ra
rsing attendant ? ra ra
a. They are allergic to certain medications or foods.
ra ra ra ra ra ra ra
b. A ―Do not resuscitate‖ order is in effect.
ra ra ra ra ra ra ra
c. The hospital client has a high risk for falls.
ra ra ra ra ra ra ra ra
d. The hospital client is at risk for seizures.
ra ra ra ra ra ra ra
ACCURATE ANSWER:-B ra
In 2008 the American Hospital Association issued an advisory recommending that hospital
ra ra ra ra ra ra ra ra ra ra ra
s standardize wristband colors: red for hospital client
ar allergies, yellow for fall risk, and pur
ra ra ra ra ra ra r a ra ra ra ra ra ra
ple for do not resuscitate preferences. Purple does not indicate seizures.
ra ra ra ra ra ra ra ra ra ra
DIF:Understand (comprehension) ra
ra ra ra r a Safety and Quality ra ra ra
MULTIPLE CHOICE ra
1. A home health nursing attendant is performing a home assessment for safety. Whic
ra ra ra ra ra ra ra ra ra ra ra ra
h comment by the hospital client will cause the nursing attendant to follow up? a.
ar ra ra ra ra ra ra ra ra ra ra ra ra
―Every December is the time to change batteries on the carbon monoxide d
ar ra ra ra ra ra ra ra ar ra ra ar
etector.‖
b. ―I will schedule an appointment with a chimney inspector next week.‖
ra ra ra ar ra ar ra ra ra ra
c. ―If I feel dizzy when using the heater, I need to have it inspected.‖
ra ra ra ar ra ra ra ra ra ra ra ra ra
d. ―When it is cold outside in the winter, I will use a non-vented heater.‖ ra ra ra ra ra ra ra ra ra ra ra ra ra
ACCURATE ANSWER:-D ra
Using a nonvented heater introduces carbon monoxide into the environment and decreases the a
ra ra ra ra ra ra ra ra ra ra ra ar ra
vailable o ra
xygen for human consumption and the nursing attendant should follow up to correct this beh
ra ra ra ra ra ra ra ra ra ra ra ar ra ra
avior. Checking the chimney and heater, changing the batteries on the detector, and followi
ra ra ra ra ra ra ra ra ra ra ra ra ra
ng up on symptoms such as dizziness, nausea, and fatigue are all statements that are safe an
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
d appropriate and need no follow-up.
ra ra ra ra ra
DIF:Analyze (analysis) ra
OBJ:Discuss common environmental hazards and methods for preventing them.
ra ra ra ra ra ra ra ra ar
TOP:Assessment MSC: Safety and Infection Control ra ra ra ra
2. The nursing attendant is caring for an olderadult hospital client admitted with nau
ra ra ra ra ra ra ra ra ra ra ra ra
sea, vomiting, and diarrhea due to food poisoning.
ra ra ra ra ra ra ra r
The nursing attendant completes the health history. Which priority concern will r
a ra ra ra ra ra ar ra ra ra ra ra
equire ra
collaboration with social services to address the hospital client ’s health care needs
ra ra ra ra ra ar ra ra ra ra ra ra
? a. The electricity was turned off 3 days ago.
ra ra ra ra ra ra ra
b. The water comes from the county water supply.
ra ra ra ra ra ra ra
c. A son and family recently moved into the home.
ra ra ra ra ra ra ra ra
d. This home is not furnished with a microwave oven.
ra ra ra ra ra ra ra ra
ACCURATE ANSWER:-A ra
Electricity is needed for refrigeration of food, and lack of electricity could have contributed to t
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
he nausea, vomiting, and diarrhea due to food poisoning. This discussion about the hospital c
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
lient ’s electrical needs can be referred to social services. Foods that are inadequately prepare
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
d or stored or subject to unsanitary conditions increase the hospital client ’s risk for infection
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
s and food poisoning, and an assessment should include storage practices. The water supply, t
ra ra ra ra ra ra ra ra ra ra ra ra ar ra
he increased number of individuals in the home, and not having a microwave may or may not
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar ra ra
be concerns but do not pertain to the current health care needs of this hospital client .
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Analyze (analysis) ra
OBJ:Discuss common environmental hazards and methods for preventing them.
ra ra ra ra ra ra ra ra ar
TOP:Planning MSC: Management of Care ra ra ra
,3. What statement by the nursing attendant demonstrates an understanding of food safety to
ra ra ra ra ra ra ra ra ra ra ra ra r
abe provided for a hospital client living alone?
ar ra ra ra ra ra ra
a. ―It’s acceptable to eat unwashed fruits and vegetables if they are organically g rown.‖
ra ra ra ra ra ra ra ra ar ar ra ar
b. ―It’s best to allow cooked foods to thoroughly cool off before putting them into the re
ra ra ra ra ra ar ra ar ra ra ra ra ra ra ar
frigerator.‖
c. ―You can use the same cutting board for meats and for vegetables if it is washed be
ra ar ra ra ra ra ra ra ra ra ra ra ra ra ra ar
tween uses.‖ ra
d. ―Your perishable left-over food should be stored in a refrigerator at below
ra ‖ ra ra ra ra ra ra ar ra ra ra ra
ACCURATE ANSWER:-D ra
Keep a refrigerator below
ra ra to assure proper storage of perishable foods. Keep raw meat, ra ra ra ra ra ra ra ra ra ra ra ra ar
poultry, seafood, and their juices away from other foods. Use separate cutting boards. Rinse
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
fruits and vegetables thoroughly. Refrigerate leftovers promptly.
ra ra ra ra ra ra
DIF:Analyze (analysis) ra
OBJ:Discuss common environmental hazards and methods for preventing them.
ra ra ra ra ra ra ra ra ar
TOP:Implementation MSC: Basic Care and Comfort ra ra ra
4. An adult hospital client presents to the emergency department and is treated for
ra ra ra ra ra ra ra ra ra ra ra ra ar
hypothermia. What risk factor should the hospital client be assessed for? a. Tobacco use
ra ra ra ra ra ra ra ra ra ra ra
b. Homelessness
c. High carbohydrate diet ra ra
d. History of chronic respiratory disorder ra ra ra ra
ACCURATE ANSWER:-B ra
The temperature indicates the hospital client is experiencing hypothermia. Homeless indivi
ra ra ra ra ra ra ra ra ra ra
duals are more at risk for hypothermia. None of the other options are a known risk factor for
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar ra ra
hypothermia.
DIF:Analyze (analysis) ra
OBJ:Discuss common environmental hazards and methods for preventing them.
ra ra ra ra ra ra ra ra ar
TOP:Assessment MSC: Reduction of Risk Potential ra ra ra ra
5. A nursing attendant is teaching the hospital client and family about wound care. Whic
ra ra ra ra ra ra ra ra ra ra ra ra ra
h technique will the nursing attendant teach to best prevent transmission of pathogens? a.
ar ra ra ra ra ra ra ra ra ra ra ra
Effective hand hygiene ra ra
b. Saline wound irrigation ra ra
c. Appropriate use of gloves ra ra ra
d. When eye protection is needed ra ra ra ra
ACCURATE ANSWER:-A ra
One of the most effective methods for limiting the transmission of pathogens is the medically
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
aseptic practice of hand hygiene. The most common means of transmission of pathogens is by t
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
he hands. While washing the wound is needed, the best method to prevent transmission is ha
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
nd hygiene. Wearing gloves and possibly eye protection help protect the nursing attendant , b
ra ra ra ra ra ra ra ra ra ra ra ra ra ar
ut handwashing is best for limiting the transmission of pathogens.
ra ra ra ra ra ra ra ra ra
DIF:Understand (comprehension) ra
OBJ:Explain the role critical thinking and clinical judgment play in planning care for a hospital clien
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
t’
ar
s safety needs. TOP:Teaching/Learning
ra ra MSC: Safety and Infection Control
ra ra ra ra
, 6. The nursing attendant is monitoring for Never Events. Which finding indicates th
ra ra ra ra ra ra ra ra ra ra ra
e nursing attendant will report a Never Event?
ar ra ra ra ra ra ra
a. Lack of blood incompatibility with a blood transfusion
ra ra ra ra ra ra ra
b. A surgical sponge is left in the hospital client ’s incision
ra ra ra ra ra ra ra ra ra ra
c. Pulmonary embolism after lung surgery ra ra ra ra
d. Stage II pressure ulcer ra ra ra
ACCURATE ANSWER:-B ra
The Centers for Medicare and Medicaid Services names select serious reportable events as Ne
ra ra ra ra ra ra ra ra ra ra ra ra ra
ver Events (i.e., adverse events that should never occur in a health care setting). A surgical spon
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
ge left in a hospital client ’s incision is a Never Event. No blood incompatibility reaction is safe
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar ra ra
practice. Pulmonary embolism is more after certain orthopedic procedures like a total knee a
ra ra ra ra ra ra ra ra ra ra ra ra ra
nd hip replacement. Stage III and IV pressure ulcers are Never Events.
ra ra ra ra ra ra ra ra ra ra ra
DIF:Understand (comprehension) ra
OBJ:Explain the role critical thinking and clinical judgment play in planning care for a hospital clien
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
t’
ar
s safety needs. TOP:Implementation
ra ra MSC: Management of Care ra ra ra ra
7. When the nursing attendant discovers a hospital client on the floor, the hospital client
ra ra ra ra ra ra ra ra ra ra ra ra ra ar
states, ―I fell out of bed‖. The nursing attendant assesses the hospital client and then
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
places the hospital client back in bed. Which action should the nursing attendant ta
ra ra ra ra ra ra ra ra ra ra ra ra ra
ke next? ar
a. Do nothing, no harm has occurred.
ra ra ra ra ra
b. Notify the health care provider. ra ra ra ra
c. Complete an incident report. ra ra ra
d. Re-assess the hospital client . ra ra ra ra
ACCURATE ANSWER:-B ra
Report immediately to physician or health care provider if the hospital client sustains a fall or a
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
n injury. The nursing attendant must provide safe care and doing nothing is not safe care.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
The scenario indicates the nursing attendant has already assessed the hospital client . After th
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
e hospital client has stabilized, completing an incident report would be the last step in the pro
ar ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
cess.
DIF:Apply (application) ra
OBJ:Describe the complex nature of clinical judgment for nursing attendant s delivering hospit
ra ra ra ra ra ra ra ra ra ra ra ra
al client -centered care for hospital client s’ improved safety. TOP:Implementation MSC:
ar ra ra ra ra ra ra ra ra ra
Safety and Infection Controlra ra ra
8. When making rounds the nursing attendant observes a purple wristband on a hospit
ra ra ra ra ra ra ra ra ra ra ra ra
al client ’s wrist. What information about the hospital client does this provide the nu
ar ra ra ra ra ra ra ra ra ra ra ra ra ra
rsing attendant ? ra ra
a. They are allergic to certain medications or foods.
ra ra ra ra ra ra ra
b. A ―Do not resuscitate‖ order is in effect.
ra ra ra ra ra ra ra
c. The hospital client has a high risk for falls.
ra ra ra ra ra ra ra ra
d. The hospital client is at risk for seizures.
ra ra ra ra ra ra ra
ACCURATE ANSWER:-B ra
In 2008 the American Hospital Association issued an advisory recommending that hospital
ra ra ra ra ra ra ra ra ra ra ra
s standardize wristband colors: red for hospital client
ar allergies, yellow for fall risk, and pur
ra ra ra ra ra ra r a ra ra ra ra ra ra
ple for do not resuscitate preferences. Purple does not indicate seizures.
ra ra ra ra ra ra ra ra ra ra
DIF:Understand (comprehension) ra
