CHAPTER 20: PATIENT ENVIRONMENT AND SAFETY {Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th Edition}

C HAPTER 20: P ATIENT E NVIRONMENT AND
S AFETY
Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th
Edition




MULTIPLE CHOICE


1. When caring for a patient with acute radiation sickness (ARS) after an
accident at an atomic power plant, the nurse should:
a. wear a paper gown and boots, gloves, and a mask.
b. stay in the room and talk to the patient to alleviate anxiet y.
c. decrease the amount of time spent in the room.
d. wear a chemical mask with a filtered respirator.



ANS: A



For prolonged periods in caring for a patient with ARS, the nurse
should use the barrier protection of gown, boots, a mask, and gloves.



DIF: Cognitive Level: Application REF: p. 333 OBJ:
Theory #1 TOP: Safet y KEY: Nursing Process Step:
Implementation MSC: NC LEX: Safe, Effective Care
Environment: Safet y and Infection Control



2. There is evidence that a resident in a home care environment might have
accidentall y ingested gasol ine left by the gardeners. The nurse should
first:

, a. call the famil y members to notify them of the incident.
b. call the poison control center and describe the situation.
c. induce the patient to vomit.
d. place the gasoline can in a safe place.



ANS: B



If a nurse suspects gasoline poisoning, it is important to call the poison
control center to obtain further instructions. It is also important to
prevent vomiting, because this may cause respiratory problems.



DIF: Cognitive Level: Application REF: p. 335 OBJ:
Clinical Practice #1 TOP: Safet y KEY: Nursing
Process Step: Implementation MSC: NC LEX: Health
Promotion and Maintenance: Prevention and Earl y Detection of
Disease



3. A nursing assistant on the day shift reports that he has raised the bed rails
to keep an agitated patient from climbing out of bed. The nurse’s best
response to this information is:
a. “Good idea. Be sure to check on the patient every hour to assess the
patient’s comfort.”
b. “A vest protective device will work better; put one on the patient,
please.”
c. “The rails won’t prevent falling; bring the patient out to sit by the
nurses’ station where we can watch her.”
d. “You’ll need to check the patient every 15 minutes and reorient the
patient as to why the rails are up.”



ANS: C

, Seating the patient close to t he nurses’ station will allow the nurse to
check on the patient frequentl y. The nurse needs to get an order for a
vest protective device.



DIF: Cognitive Level: Application REF: p. 330|Box 20 -3
OBJ: Clinical Practice #6 TOP: Safet y KEY:
Nursing Process Step: Implementation MSC: NC LEX: Safe,
Effective Care Environment



4. A patient is agitated and confused and keeps getting out of bed and needs
to be observed constantl y. The best initial nursing intervention is to:
a. have a famil y member or friend sit with the patient.
b. obtain an order for a sedative from the health care provider.
c. instruct the nurse’s aide to appl y a vest protective device.
d. make sure the side rails are up and close the door.



ANS: A



Local and federal laws prohibit the use of physical and c hemical
restraints except those authorized by a health care provider. Health
care workers are encouraged to find other alternatives such as asking a
famil y member to supervise the patient before resorting to the use of
protective devices.



DIF: Cognitive Level: Application REF: p. 340 OBJ:
Theory #1 TOP: Safet y KEY: Nursing Process Step:
Implementation MSC: NC LEX: Physiological Integrit y: Basic
Care and Comfort