Client Safety Lecture

Key Points

• TOPIC: Client Safety
• FORMAT: Practice questions

Questions and Answers

Question 1: Fall Risk Indicator

• Scenario: Client admitted with Alzheimer's to an extended care facility.
• Question: Greatest indicator of fall risk?
  1. Confusion
  2. Impaired judgment
  3. Sensory deficits
  4. History of Falls (Correct)
• Explanation: Patients with a history of falls are three times more likely to fall again, placing them at high risk.

Question 2: Electrical Fire in ICU

• Scenario: Electrical fire in ICU, client on ventilator in next room.
• Question: First action nurse should take?
  1. Pull fire alarm
  2. Attempt to extinguish fire
  3. Call the physician
  4. Use Ambu bag and remove the client from the area (Correct)
• Explanation: Use R.A.C.E. (Rescue, Alarm, Contain, Extinguish). The first step is to rescue the patient using the Ambu bag.

Question 3: Vision-Impaired Ambulatory Client

• Scenario: Home assessment of the ambulatory client with decreased vision.
• Question: Beneficial action?
  1. Install fluorescent lighting
  2. Become oriented to furniture and stairways (Correct)
  3. Maintain complete bed rest
  4. Apply physical restraints
• Explanation: Familiarity with the environment reduces fall risk. Also ensure good lighting, no throw rugs, and use handrails.

Question 4: Child Car Safety

• Scenario: Parent's statement regarding child safety.
• Question: Which statement needs further teaching?
  1. Allowing a two-year-old to sit in the front seat (Correct)
  2. Ensuring child wears a helmet
  3. Discussing safe sex with child
  4. Child taking swimming classes
• Explanation: Children under 13 years need to sit in the back seat according to CDC guidelines.

Question 5: Restraint Protocol

• Scenario: The use of restraints.
• Question: Correct statement about restraints?
  1. Order can be indefinite
  2. Ordered as-needed basis
  3. No order necessary for long-term care
  4. Periodically remove to reevaluate (Correct)
• Explanation: Restraints require a doctor's order, valid for 24 hours, with periodic checks on circulation and basic needs.

Question 6: Child Poisoning

• Scenario: Child found with a bottle of cleanser.
• Question: First action?
  1. Call Poison Control
  2. Provide epicac syrup
  3. Check airway and breathing (Correct)
  4. Remove particles from the mouth
• Explanation: Follow ABCs (Airway, Breathing, Circulation). First ensure there is no airway obstruction.

Question 7: Heat Stroke Risk

• Scenario: August heat and a client’s risk.
• Question: Highest risk for heat stroke?
  1. 65-year-old with COPD (Correct)
  2. 35-year-old marathon runner
  3. 15-year-old playing tennis
  4. 9-month-old with a fan-cooled room
• Explanation: Elderly and those with chronic health conditions like COPD are at highest risk.

Question 8: Unintentional Death Risk

• Scenario: Various clients at risk.
• Question: Greatest risk for unintentional death?
  1. 58-year-old skier
  2. 44-year-old alcoholic
  3. 72-year-old high fall-risk client (Correct)
  4. 34-year-old with depression
• Explanation: Elderly with fall risk could suffer severe injury when alone, making it hard to seek help.

Question 9: Leading Cause of Death in One-Year-Olds

• Scenario: Healthy one-year-old child.
• Question: Leading cause of death?
  1. Physical abuse
  2. Accidental injury (Correct)
  3. Contagious diseases
  4. Stranger abduction
• Explanation: Accidental injuries are prevalent due to balance and coordination issues at this age.

Question 10: Risk of Injury by Medical Conditions

• Scenario: Clients with different diagnoses.
• Question: Highest risk for injury?
  1. Asthma and alcohol abuse
  2. Heart failure and urinary urgency (Correct)
  3. Hypertension and corrective lenses
  4. Chronic bronchitis and impaired hearing
• Explanation: Heart failure treatments can cause frequent and urgent urination, increasing fall risk.

Question 11: Decreasing Injury in Children

• Scenario: Discussing home safety with a mother.
• Question: Which suggestion reduces injury risk the most?
  1. Assess safety needs in the home (Correct)
  2. Keep toxic liquids capped
  3. Install safety gates
  4. Keep children away from harmful appliances
• Explanation: Assessing what needs improvement helps target the most critical areas for that specific home.

Question 12: Safety Workshop for Teens

• Scenario: Teaching safety to early teens (13-15 years old).
• Question: Greatest potential for decreasing injuries?
  1. Avoid nicotine
  2. Keep immunizations up to date
  3. Eat a balanced diet
  4. Wear seatbelts in cars (Correct)
• Explanation: Motor vehicle accidents are the leading cause of death in this age group.

Question 13: Safety for Elderly Driver

• Scenario: 83-year-old who drives alone.
• Question: Best suggestion?
  1. Take public transportation
  2. Plan errands around appointments
  3. Drive short trips during daylight (Correct)
  4. Arrange for rides
• Explanation: Ensures safety while maintaining independence.

Question 14: Critical Restraint Assessment

• Scenario: Client in mechanical restraints.
• Question: Most critical finding?
  1. Angry crying
  2. Urinary incontinence
  3. Reddened wrists
  4. Hands cool to touch (Correct)
• Explanation: Cool hands indicate poor circulation, needing immediate attention.

Question 15: Teaching Diuretic Safety to Elderly

• Scenario: Teaching about newly ordered diuretic.
• Question: Best suggestion to minimize injury?
  1. Decrease fluid intake after 6 PM
  2. Illuminate bathroom path
  3. Urinate before bed
  4. Take medication early in the morning (Correct)
• Explanation: Prevents night-time urgency, reducing fall risk when groggy.

Question 16: Preventing Nosocomial Infections

• Scenario: Elderly client post-surgery in hospital.
• Question: Most important action to prevent nosocomial infection?
  1. Practice appropriate hand hygiene (Correct)
  2. Request prophylactic antibiotics
  3. Place client in isolation
  4. Encourage turn, cough, deep breathe
• Explanation: Hand hygiene is the most effective measure.

Question 17: Delegating Restraint Application

• Scenario: Confused client needing restraints.
• Question: What can be delegated to nursing assistant?
  1. Apply restraints (Correct)
  2. Obtain physician’s order
  3. Document restraining events
  4. Evaluate effectiveness
• Explanation: Nursing assistants can apply restraints if trained, but RNs must handle orders, documentation, and evaluations.

Question 18: Fire in Client’s Room

• Scenario: Client’s room has electrical fire.
• Question: First action?
  1. Activate alarm
  2. Confine fire
  3. Remove the client (Correct)
  4. Extinguish fire
• Explanation: Follow R.A.C.E. protocol: Rescue is always the first step.

Additional Points

• Preventing Falls: Furniture orientation, good lighting, no throw rugs, handrails.
• Fire Safety: R.A.C.E. protocol (Rescue, Alarm, Confine, Extinguish).
• Medication Safety: Timing diuretic intake, e.g., in the morning.
• Hand Hygiene: Key prevention for nosocomial infections.
• Delegation in Nursing: Know what tasks nursing assistants can perform; critical thinking and decision-making tasks are for RNs.