Chapter 13: Safety and Quality Improvement

Chapter 13: Safety and Quality Improvement

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The patient is admitted to the hospital with orders for activity as tolerated. He is wheelchair-bound at home and has brought his own electric wheelchair and battery charger to help him maintain mobility. The nurse realizes that:

a.	patients are not allowed to bring in an electric wheelchair.
b.	electrical equipment is banned from all hospitals.
c.	the charger needs to be checked by hospital engineers.
d.	electrical devices are not a cause for concern.

 

 

ANS:  C

The third (longer) prong in an electrical plug is the ground. If a patient brings an electrical device to the hospital, an engineer inspects the device for safe wiring and function before use. Many patients with disabilities use battery chargers for mobility equipment function. These devices need to be inspected by hospital engineers. Fires in health care settings typically are electrical or anesthetic-related.

 

DIF:    Cognitive Level: Comprehension     REF:   Text reference: p. 313

OBJ:   Describe methods used to evaluate interventions designed to maintain or promote a patient’s safety.           TOP:           Fire/Electrical Safety

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity

 

2. Upon entering the patient’s room, the nurse sees a fire burning in the trash can next to the bed. The nurse removes the patient and reports the fire. What is the nurse’s next action?

a.	Extinguish the fire.
b.	Remove all other patients from the unit.
c.	Close all doors of patient rooms.
d.	Move the trash can into the bathroom.

 

 

ANS:  C

Using the “RACE” acronym, the next action the nurse should take is to confine the fire by closing doors and windows and turning off oxygen and electrical equipment (Rescue, Activate, Contain, and Evacuate). Extinguish the fire by using an extinguisher after ensuring patient and individual safety after closing the doors of patient rooms. After activating the alarm, the nurse should close all the doors, not remove all the other patients from the unit. Moving the trash can would not be an appropriate action, as the nurse could get burned in this attempt.

 

DIF:    Cognitive Level: Application           REF:   Text reference: p. 313

OBJ:   Describe nursing interventions taken in the event of fire and electrical shock.

TOP:   Fire Safety      KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity

 

3. In a long-term care facility, an elderly patient drops his burning cigarette into a trash can and starts a fire. A Type _____  fire extinguisher is the most appropriate type of fire extinguisher for the nurse to use in this situation.

a.	A
b.	B
c.	C
d.	D

 

 

ANS:  A

Type A fire extinguishers are used for ordinary combustibles such as wood, cloth, paper, and plastic. A trash can fire would require a type A fire extinguisher. Type B fire extinguishers are used for flammable liquids such as gasoline, grease, paint, and anesthetic gas. Type C fire extinguishers are used for electrical fires. There is no Type D fire extinguisher.

 

DIF:    Cognitive Level: Comprehension     REF:   Text reference: p. 314

OBJ:   Describe nursing interventions performed in the event of fire and electrical shock.

TOP:   Fire Extinguishers                           KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity

 

4. Given the most common causes of hospital fires, which of the following choices are most appropriate in preventing patient injury?

a.	Assure that all electrical devices are checked by engineering.
b.	Assist patients who smoke to a safe area to smoke.
c.	Prop fire doors open for easier patient access.
d.	Educate patients on the importance of smoking cessation.

 

 

ANS:  A

Fires in health care settings are usually electrical or anesthetic-related, so ensuring all electrical devices are inspected will greatly reduce the risk of fire. Look for inspection labels verifying recent inspection for all electrical devices. Fire door should never be propped open. While educating patients on smoking cessation is a good idea, it will have little impact on immediate hospital safety. Although smoking is no longer allowed in the hospital setting, smoking-related fires continue to pose a risk due to unauthorized smoking in bed or the bathroom.

 

DIF:    Cognitive Level: Analysis                REF:   Text reference: p. 312

OBJ:   Describe nursing interventions performed in the event of fire and electrical shock.

TOP:   Fire Extinguishers                           KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity

 

5. After recognizing that a patient has received an electrical shock and removing the source of the shock, what should the nurse do next?

a.	Call for assistance.
b.	Immediately start CPR.
c.	Obtain emergency equipment.
d.	Assess for the presence of a pulse.

 

 

ANS:  D

If the patient receives an electrical shock, immediately assess for the presence of a pulse. Electrical shock can cause cardiac arrest, asystole. Do not leave the patient. Only if the patient is pulseless will the nurse institute cardiopulmonary resuscitation. If the patient has a pulse and remains alert and oriented, obtain vital signs and assess the skin for signs of thermal injury. Electrical current will cause burn at points of entry and exit from the body.

 

DIF:    Cognitive Level: Application           REF:   Text reference: p. 314

OBJ:   Describe nursing interventions performed in the event of fire and electrical shock.

TOP:   Electrical Shock                              KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity