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Chapter 36: Safety
Test Bank
MULTIPLE CHOICE
1. The nurse has investigated safety hazards and recognizes that which of the following
statements is accurate regarding safety needs?
a. Bacterial contamination of foods is uncontrollable.
b. Fire is the greatest cause of unintentional death.
c. Carbon monoxide levels should be monitored in home settings.
d. Temperature extremes seldom affect the safety of patients in acute care facilities.
ANS: C
Feedback
A
B
C
D
Bacterial contamination of foods is controllable. Health Canada is the
government agency responsible for the enforcement of federal regulations
regarding the manufacture, processing, and distribution of foods, drugs, and
cosmetics to protect consumers against the sale of impure or dangerous
substances.
Motor vehicle accidents are the leading cause of unintentional death, not fire.
Heating systems, chimneys, and appliances should be inspected annually in
private homes. Carbon monoxide detectors are available but should not be used
as a replacement for proper use and maintenance of fuel-burning appliances.
Temperature extremes can affect the safety of patients in acute care facilities,
especially older adults.
DIF: Cognitive Level: Knowledge
TOP: Nursing Process: Assessment
REF: page 808
OBJ: 10
MSC: CRNE: HW-1
2. An ambulatory patient is admitted to the extended care facility with a diagnosis of
Alzheimer’s disease. In using a fall assessment tool, the nurse knows that which one of the
following is the greatest indicator of risk for falls?
a. Confusion
b. Impaired judgement
c. Sensory deficit
d. History of falls
ANS: D
Feedback
A
B
C
D
According to the fall assessment tool, the second leading risk factor for falls is
confusion.
According to the fall assessment tool, impaired judgement is the fourth leading
risk factor for falls.
According to the fall assessment tool, sensory deficit is the fifth leading risk
factor for falls.
According to the fall assessment tool, the greatest indicator of risk for falls is a
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history of falls.
DIF: Cognitive Level: Knowledge
REF: page 798, Table 36-1
OBJ: 7
TOP: Nursing Process: Assessment
MSC: CRNE: CH-4
3. Injuries among older adults resulting from falls in the home are due to intrinsic and extrinsic
factors. Which one of the following is an example of an extrinsic factor?
a. Illness
b. Drug therapy
c. Environmental obstacles
d. Alcohol use
ANS: C
Feedback
A
B
C
D
Falls can occur as a result of intrinsic factors such as illness. Intrinsic factors
may be difficult to modify or eliminate.
Falls can occur as a result of intrinsic factors such as drug therapy. Intrinsic
factors may be difficult to modify or eliminate.
Injuries in the home result from extrinsic environmental factors such as tripping
over doormats, small rugs on the stairs and floor, wet spots on the floor, and
clutter on bedside tables, closet shelves, and bookshelves. Extrinsic factors can
be modified or eliminated.
Falls can occur as a result of intrinsic factors such as alcohol use. Intrinsic
factors may be difficult to modify or eliminate.
DIF: Cognitive Level: Application
TOP: Nursing Process: Assessment
REF: page 791
OBJ: 10
MSC: CRNE: HW-12
4. One of the most effective methods for limiting the transmission of pathogens is which of the
following aseptic practices?
a. Immunization
b. Isolation
c. Disinfection
d. Handwashing
ANS: D
Feedback
A
B
C
D
Immunization is the process by which resistance to an infectious disease is
produced or augmented.
Isolation helps in controlling the spread of pathogens but is not the most
effective practice.
Disinfection helps in controlling the spread of pathogens but is not the most
effective practice.
Handwashing has been proven to be one of the most effective ways of
controlling the spread of pathogens.
DIF: Cognitive Level: Knowledge
REF: page 791
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OBJ: 10
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TOP: Nursing Process: Implementation
MSC: CRNE: HW-2
5. A 1-year-old child is scheduled to receive an intravenous (IV) line. What is the most
appropriate type of restraint to use for this patient to prevent removal of the IV line?
a. Wrist restraint
b. Jacket restraint
c. Elbow restraint
d. Mummy restraint
ANS: D
Feedback
A
B
C
D
The wrist restraint maintains immobility of an extremity to prevent the patient
from removing a therapeutic device, such as an IV tube. It would not be the best
choice for starting an IV on a 1-year-old.
The jacket restraint is often used to prevent a patient from getting up and falling.
It is not the best choice for starting an IV line.
An elbow restraint is commonly used with infants and children to prevent elbow
flexion, such as after an IV line is in place.
A mummy restraint is used in the short term for a small child or infant for
examination or treatment involving the head and neck. This would be the most
appropriate type of restraint to use for a 1-year-old who is going to receive an IV
line.
DIF: Cognitive Level: Application
REF: page 817, Skill 36-1
OBJ: 5
TOP: Nursing Process: Implementation
MSC: CRNE: HW-12
6. According to the Workplace Hazardous Materials Information System, what is the meaning of
this symbol?
a.
b.
c.
d.
Compressed gas
Corrosive material
Oxidizing material
Dangerously reactive material
ANS: D
Feedback
A
B
C
D
This symbol does not signify compressed gas.
This symbol does not signify corrosive material.
This symbol does not signify oxidizing material.
This symbol signifies dangerously reactive material.
DIF: Cognitive Level: Comprehension
REF: page 795, Figure 36-2
OBJ: 1
TOP: Nursing Process: Assessment
MSC: CRNE: HW-18
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7. Some workers accidentally cause an electrical fire when installing a new piece of equipment
in the intensive care unit. A patient is on a ventilator in the next room. What is the nurse’s
priority action?
a. Pull the fire alarm.
b. Attempt to extinguish the fire.
c. Call the physician to obtain orders to take the patient off the ventilator.
d. Use an Ambu-bag and remove the patient from the area.
ANS: D
Feedback
A
B
C
D
The first action of the nurse is not to pull the fire alarm. The workers could do
that.
The workers can attempt to extinguish the fire. The nurse should attend to the
patient who is closest to the fire in the next room.
The nurse should not call the physician to obtain orders to take the patient off the
ventilator, as this will take valuable time. The patient must be moved away from
the fire and the source of oxygen must be discontinued, as it is combustible. The
patient will have to be manually resuscitated with an Ambu-bag.
If there is a fire and the patient is on life support, the nurse should maintain the
patient’s respiratory status manually with an Ambu-bag and move the patient
away from the fire.
DIF: Cognitive Level: Application
TOP: Nursing Process: Implementation
REF: page 808
OBJ: 9
MSC: CRNE: CH-32
8. An older adult patient in a long-term care facility drops his burning cigarette in a garbage can
and starts a fire. What is the most appropriate type of fire extinguisher for the nurse to use in
this instance?
a. Type A
b. Type B
c. Type C
d. Type D
ANS: A
Feedback
A
B
C
D
Type A fire extinguishers are used for ordinary combustibles such as wood,
cloth, paper, and plastic. A garbage can fire would require a type A fire
extinguisher.
Type B fire extinguishers are used for flammable liquids such as gasoline,
grease, paint, and anaesthetic gas.
Type C fire extinguishers are used for electrical equipment.
There is no Type D fire extinguisher.
DIF: Cognitive Level: Application
TOP: Nursing Process: Implementation
REF: page 808
OBJ: 10
MSC: CRNE: HW-24
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9. A visiting nurse completes an assessment of the ambulatory patient in the home and
determines the nursing diagnosis of “Risk for injury related to decreased vision.” Based on
this assessment, the patient will benefit the most from which of the following actions?
a. Installing fluorescent lighting throughout the house
b. Evaluating the need to reposition furniture
c. Maintaining complete bed rest in a hospital bed with side rails
d. Applying physical restraints
ANS: B
Feedback
A
B
C
D
Attempts should be made to reduce glare. Light bulbs that are 60 watts or less
may be increased to 75 watts nonglare to help improve visibility. The best
intervention to prevent falls is first to orient the patient to the surroundings.
Evaluating the positioning of furniture in the room and stairways is the best
intervention to help prevent falls for the patient with decreased vision.
Maintaining complete bed rest is not the best option. Complete bed rest can
cause other health problems because of a lack of mobility.
The patient should not be restrained for poor vision. Attempts should be made to
help compensate for the decreased vision to prevent falls.
DIF: Cognitive Level: Analysis
TOP: Nursing Process: Assessment
REF: page 799
OBJ: 10
MSC: CRNE: HW-24
10. Which of the following statements made by the parent of a child indicates that further
teaching by the nurse about child safety is required?
a. “Now that my child is 2 years old, I can let her sit in the front seat of the car with
me.”
b. “I make sure that my child wears a helmet when he rides his bicycle.”
c. “I have spoken to my child about safe sex practices.”
d. “My child is taking swimming classes at the community centre.”
ANS: A
Feedback
A
B
C
D
The parent’s statement “Now that my child is 2 years old, I can let her sit in the
front seat of the car with me” indicates that further teaching is required. Children
who weigh less than 36 kg or who are younger than 8 years of age should always
be seated in an age- or weight-appropriate car seat that has been installed
according to the manufacturer’s directions. In cars with a passenger airbag,
children younger than 13 should sit in the back seat.
Wearing a helmet is an appropriate safety measure to reduce injuries from falling
off a bike or being hit by a car.
Speaking to a child about safe sex practices is an important safety measure, as
many adolescents begin sexual relationships.
Enrolling a child for swimming lessons is an appropriate safety measure that
may someday save a child from drowning.
DIF: Cognitive Level: Analysis
REF: page 804, Table 36-2
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OBJ: 11
TOP: Nursing Process: Evaluation
MSC: CRNE: HW-12
11. The nurse assesses that the patient may need a restraint and recognizes which one of the
following?
a. An order for a restraint may be implemented indefinitely until it is no longer
required by the patient.
b. Restraints may be ordered on an as-needed basis.
c. No order or consent is necessary for restraints in long-term care facilities.
d. Restraints are to be periodically removed to have the patient re-evaluated.
ANS: D
Feedback
A
B
C
D
It is not true that an order for a restraint may be implemented indefinitely until it
is no longer required by the patient. A physician’s order for restraints must have
a limited time frame. If the orders are renewed, this should be done within a
specified time frame according to the agency’s policy.
Restraints are not to be ordered prn (as needed).
The use of restraints must be part of the patient’s medical treatment and must be
ordered according to provincial or territorial legislation and agency policy. In
some settings, physicians and nurses may order restraints.
Restraints must be periodically removed, and the nurse must assess the patient to
determine if the restraints continue to be needed.
DIF: Cognitive Level: Application
REF: pages 814–818, Skill 36-1
OBJ: 5
TOP: Nursing Process: Implementation
MSC: CRNE: HW-24
12. On entering the patient’s room, the nurse sees a fire burning in the garbage can next to the bed.
The nurse removes the patient and calls to report the fire. Which of the following should be
the nurse’s next action?
a. Extinguish the fire.
b. Remove all of the other patients from the unit.
c. Close all the doors of patient rooms.
d. Move the garbage can into the bathroom.
ANS: C
Feedback
A
B
C
D
The nurse should extinguish the fire by using an extinguisher after closing the
doors of the patient rooms.
After activating the alarm, the nurse should close all the doors, not remove all of
the other patients from the unit.
The nurse’s next action should be to confine the fire by closing doors and
windows and turning off oxygen and electrical equipment.
Moving the garbage can into the bathroom would not be an appropriate action,
because the nurse could get burned in attempting to move the garbage can.
DIF: Cognitive Level: Application
REF: page 807, Box 36-9
OBJ: 11
TOP: Nursing Process: Implementation
MSC: CRNE: HW-24
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13. When teaching a parent about interventions for accidental poisoning, what instruction should
be included regarding flushing a child’s eye, in relation to the water temperature?
a. Cold
b. Lukewarm
c. Room temperature
d. Above room temperature
ANS: C
Feedback
A
B
C
D
The water for an eye flush is not to be cold.
The water for an eye flush is not to be lukewarm.
The nurse should teach the parent that an eye flush is to be done with water at
room temperature.
The water for an eye flush is not to be above room temperature.
DIF: Cognitive Level: Application
REF: page 805, Box 36-7
OBJ: 11
TOP: Nursing Process: Implementation
MSC: CRNE: HW-13
14. The nurse recognizes which one of the following as the leading cause of death for persons
between the ages of 1 and 34 years?
a. Physical abuse
b. Accidental injury
c. Contagious diseases
d. Falls
ANS: B
Feedback
A
B
C
D
Physical abuse is not the leading cause of death in this age group.
In Canada, accidental injuries are the leading cause of death for persons between
the age of 1 and 34 years. Accidental injuries are also a major cause of disability.
Contagious diseases are not the leading cause of death in this age group.
Falls are not the leading cause of death in this age group.
DIF: Cognitive Level: Knowledge
TOP: Nursing Process: Assessment
REF: page 791
OBJ: 3
MSC: CRNE: HW-12
15. The nurse is discussing measures to minimize the risk of injury from an automobile accident
with an 84-year-old independent female patient who lives alone and claims to drive only to
church, the doctor’s office, and for groceries. Which of the following suggestions has the
greatest potential for affecting the patient’s safety?
a. Take public transportation whenever it is available.
b. Plan all trips around church and doctor appointments.
c. Plan to drive for short trips and only during daylight hours.
d. Arrange for family and friends to drive the patient whenever possible.
ANS: C
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Feedback
A
B
C
D
Taking public transportation may not meet the needs of an independent patient.
Planning all trips around church and doctor appointments may not be realistic.
The nurse should educate the patient regarding safe driving tips (e.g., driving
shorter distances and only during daylight hours, using side and rearview mirrors
carefully, and looking toward the “blind spot” before changing lanes).
Arranging for family and friends to drive the patient may not meet her needs.
DIF: Cognitive Level: Analysis
REF: page 807, Box 36-8
OBJ: 9
TOP: Nursing Process: Implementation
MSC: CRNE: HW-4
16. A confused patient needs to have restraints applied to prevent him from pulling out his Foley
catheter. Which of the following options can the nurse delegate to an unregulated care
provider (UCP)?
a. Applying restraints
b. Obtaining a physician’s order to restrain the patient
c. Documenting the events that led to restraining the patient
d. Evaluating the effectiveness of the restraints
ANS: A
Feedback
A
B
C
D
Although the UCP can apply the restraints under the nurse’s direction, he or she
cannot document, evaluate, or take physicians’ orders. The nurse is always
responsible for assessment of patients’ safety needs.
A UCP cannot take physicians’ orders.
A UCP cannot document the events that led to restraining the patient.
A UCP cannot evaluate the effectiveness of the restraints.
DIF: Cognitive Level: Application
REF: page 815, Skill 36-1
OBJ: 5
TOP: Nursing Process: Implementation
MSC: CRNE: PP-22
17. Which of the following assessment findings is most critical for a patient who is currently
being restrained with mechanical wrist restraints?
a. Angry, loud crying
b. Urinary incontinence
c. Reddened areas on wrists
d. Hands cool to the touch
ANS: D
Feedback
A
B
C
D
Angry, loud crying is a concern for the patient, but it is not the most critical
concern of the patient with mechanical wrist restraints.
Urinary incontinence is a concern for the patient, but it is not the most critical
concern of the patient with mechanical wrist restraints.
Reddened areas on the wrists are a concern for the patient, but it is not the most
critical concern for the patient with wrist restraints.
While the use of any restraint may be associated with serious complications,
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including pressure ulcers, constipation, pneumonia, urinary and fecal
incontinence, and urinary retention, the most serious concerns are contractures,
nerve damage, and circulatory impairment. The coolness of the patient’s hands
indicates poor circulation and can result in permanent damage.
DIF: Cognitive Level: Analysis
REF: page 818, Skill 36-1
OBJ: 5
TOP: Nursing Process: Assessment
MSC: CRNE: HW-12
18. Which of the following is an age-related musculoskeletal change that predisposes the older
adult to accidents?
a. Increase in muscle function
b. Increase in joint mobility
c. Increase in nocturia
d. Decrease in muscle strength
ANS: D
Feedback
A
B
C
D
Rather than increasing with age, muscle function decreases.
Joints become less mobile with age, not more mobile.
Nocturia is common in older adults and increases their risk of injury; however, it
is a genitourinary change, not a musculoskeletal system change.
Musculoskeletal system changes associated with aging that increase the risk of
accidents in the older adult include decreased muscle strength and function,
joints becoming less mobile, bones becoming more brittle, postural changes, and
limited range of motion.
DIF: Cognitive Level: Comprehension
REF: page 793, Box 36-1
OBJ: 3
TOP: Nursing Process: Assessment
MSC: CRNE: CH-8
19. According to the Workplace Hazardous Materials Information System, what is the meaning of
this symbol?
a.
b.
c.
d.
Compressed gas
Corrosive material
Oxidizing material
Dangerously reactive material
ANS: C
Feedback
A
B
C
D
This symbol does not signify compressed gas.
This symbol does not signify corrosive material.
This symbol signifies oxidizing material.
This symbol does not signify dangerously reactive material.
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DIF: Cognitive Level: Comprehension
REF: page 795, Figure 36-2
OBJ: 1
TOP: Nursing Process: Assessment
MSC: CRNE: HW-18
20. According to the Hendrich II Fall Risk Model, a patient with a risk score of 6 is considered to
be at which of the following risk levels?
a. No risk
b. Low risk
c. Medium risk
d. High risk
ANS: D
Feedback
A
B
C
D
According to the Hendrich II Fall Risk Model, a score of 6 is not classified as
“No risk.”
According to the Hendrich II Fall Risk Model, a score of 6 is not classified as
“Low risk.”
According to the Hendrich II Fall Risk Model, a score of 6 is not classified as
“Medium risk.”
According to the Hendrich II Fall Risk Model, a score of 5 or greater indicates
that the patient is at high risk for a fall.
DIF: Cognitive Level: Analysis
REF: page 798, Table 36-1
OBJ: 7
TOP: Nursing Process: Assessment
MSC: CRNE: CH-6
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