ATI LPN
Fundamentals of Nursing: The Art and Science of Person-Centered Care Tenth, North American Edition
Chapter 28 Questions
Question 1 of 5
The nurse manager and nurses in an acute care hospital are participating in a safety huddle to identify patients at risk for falling. Which patients will the nurses determine require follow-up? Select all that apply.
Correct Answer: B,D,F
Rationale: Risk factors for falls include age >65 years, documented history of falls, postural hypotension which can cause dizziness, and unfamiliar environment. A medication regimen that includes diuretics creating urinary urgency and tranquilizers, sedatives, hypnotics, or analgesics causing altered mental status and impaired judgment are also risks. Chemotherapy or antibiotics are not included as factors leading to falls.
Question 2 of 5
A school nurse is teaching parents about home and fire safety. What information will be included in the teaching plan? Select all that apply.
Correct Answer: C,D,E
Rationale: Eighty percent of fire deaths in the United States occur in the home. Most fatal home fires occur while people are sleeping, and most deaths result from smoke inhalation rather than burns. The widespread availability and use of home smoke alarms is considered the primary reason for the decline in fire-related injury and death. People with limited financial resources may use space or kerosene heaters, wood stoves, or a fireplace as the sole source of heat if utilities are turned off. Bedroom doors should be kept closed when sleeping and monitors used to listen for children.
Question 3 of 5
A community health nurse is providing education on child safety. Who does the nurse identify as at highest risk for choking and suffocation?
Correct Answer: C
Rationale: Infants should be placed on their backs to sleep. A young child may place small or loose parts in the mouth. Anything that will fit through the average toilet paper roll is not safe for a toddler. A 3-year-old and a 4-year-old drinking juice and eating yogurt are developmentally appropriate.
Question 4 of 5
While discussing home safety with the nurse, a patient admits that they smoke a cigarette in bed before falling asleep at night. Which health problem is the priority for this patient?
Correct Answer: D
Rationale: Because the patient is not aware or denies that smoking in bed poses a danger for fire and toxic fumes, education about the risk for burns and suffocation is needed. The other three nursing diagnoses are correctly stated but are not a priority in this situation.
Question 5 of 5
A nurse working in a pediatrician's office receives calls from parents whose children have ingested a toxic substance from under the sink. How will the nurse advise the parents?
Correct Answer: D
Rationale: The nurse tells the parents to call the PCC immediately, before attempting a home remedy. Parents may be instructed to bring the child to an emergency facility for immediate treatment. Activated charcoal is not appropriate to use at home but under medical supervision, after the risks and benefits have been assessed. Syrup of ipecac is no longer recommended because vomiting may exacerbate the hazard as it vomited up. Gastric lavage is no longer prescribed routinely for the treatment of ingestion of a toxic substance because it may propel the poison into the small intestine, where absorption will occur. The amount of toxin removed by gastric lavage is relatively small.