RN exams safety and infection control practice questions, set 4
RN exams · safety and infection control
RN exams safety and infection control practice questionsset 4
You stop the harm first: isolation, falls, equipment, and the order that keeps the unit safe. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the RN exams exam guide or more RN exams practice questions.
Five safety and infection control questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
A client diagnosed with chronic schizophrenia presents in an emergency department (ED) with uncontrollable tongue movements, stiff neck, and difficulty swallowing. The nurse would expect the physician to recognize which condition and implement which treatment?
A. Neuroleptic malignant syndrome and treat by discontinuing antipsychotic medications
B. Agranulocytosis and treat by administration of clozapine (Clozaril)
C. Extrapyramidal symptoms and treat by administration of benztropine (Cogentin)
D. Tardive dyskinesia and treat by discontinuing antipsychotic medications
Show answer and rationale
Correct answer: D — Tardive dyskinesia and treat by discontinuing antipsychotic medications
Step 1: The client's symptoms of uncontrollable tongue movements, stiff neck, and difficulty swallowing are indicative of a movement disorder commonly associated with long-term antipsychotic use, known as tardive dyskinesia.
Step 2: Tardive dyskinesia is characterized by involuntary repetitive movements, often affecting the face and tongue, and can be irreversible if not addressed promptly.
Step 3: The standard treatment for tardive dyskinesia involves discontinuing the offending antipsychotic medication, as these symptoms are typically a side effect of prolonged exposure to dopamine-blocking medications.
Step 4: Therefore, the correct answer is D: Tardive dyskinesia and treat by discontinuing antipsychotic medications. This approach aims to halt the progression of symptoms and potentially reverse some of the effects of the condition.
Summary:
A: Neuroleptic malignant syndrome presents with fever, altered mental status, muscle rigidity, and autonomic instability. Treatment involves discontin
Question 2
A nurse learns about a huge disaster a few states away. Which of the following actions by the nurse would be most helpful in this situation?
A. Donating to any charity that is assisting the victims
B. Driving over to the area and volunteering to assist
C. Sending clothes and food to the area for distribution
D. Training to become a Red Cross disaster volunteer
Show answer and rationale
Correct answer: D — Training to become a Red Cross disaster volunteer
Disaster workers must know what kinds of populations they are attempting to assist. Thus, formal training related to disaster management and response would be important for the nurse to complete. Without having formal training and having official sponsorship, volunteers may not be able to be used. Lack of information or inaccurate information regarding the scope of the disaster and its initial effects can contribute to the misuse of resources. Often too many volunteers who lack official sponsorship convene at the site of disaster and are disappointed when their help cannot be used. Similarly, well-meaning people may send clothes and food to disaster sites. The unneeded contributions of food and clothing add to the stress of coping with the disaster, particularly if refrigeration and storage are not available. Although contributing to an organization like the American Red Cross is to be encouraged and commended, many fraudulent scam charities may pop up claiming to collect funds for the victims.
Question 3
A nurse learns about a huge disaster a few states away. Which of the following actions by the nurse would be most helpful in this situation?
A. Donating to any charity that is assisting the victims
B. Driving over to the area and volunteering to assist
C. Sending clothes and food to the area for distribution
D. Training to become a Red Cross disaster volunteer
Show answer and rationale
Correct answer: D — Training to become a Red Cross disaster volunteer
Disaster workers must know what kinds of populations they are attempting to assist. Thus, formal training related to disaster management and response would be important for the nurse to complete. Without having formal training and having official sponsorship, volunteers may not be able to be used. Lack of information or inaccurate information regarding the scope of the disaster and its initial effects can contribute to the misuse of resources. Often too many volunteers who lack official sponsorship convene at the site of disaster and are disappointed when their help cannot be used. Similarly, well-meaning people may send clothes and food to disaster sites. The unneeded contributions of food and clothing add to the stress of coping with the disaster, particularly if refrigeration and storage are not available. Although contributing to an organization like the American Red Cross is to be encouraged and commended, many fraudulent scam charities may pop up claiming to collect funds for the victims.
Question 4
A patient with hypercapnic respiratory failure has a respiratory rate of 8 and an SpO2 of 89%. The patient is increasingly lethargic. Which collaborative intervention will the nurse anticipate?
A. Administration of 100% oxygen by non-rebreather mask
B. Endotracheal intubation and positive pressure ventilation
C. Insertion of a mini-tracheostomy with frequent suctioning
D. Initiation of bilevel positive pressure ventilation (BiPAP)
Show answer and rationale
Correct answer: B — Endotracheal intubation and positive pressure ventilation
The correct answer is B: Endotracheal intubation and positive pressure ventilation. In hypercapnic respiratory failure, the patient's respiratory rate is low, indicating inadequate ventilation. The SpO2 of 89% and increasing lethargy suggest severe hypoxemia and impending respiratory failure. Endotracheal intubation allows for mechanical ventilation to improve oxygenation and ventilation. Positive pressure ventilation can help improve gas exchange and prevent further deterioration.
A: Administration of 100% oxygen by non-rebreather mask would not address the underlying issue of inadequate ventilation in hypercapnic respiratory failure.
C: Insertion of a mini-tracheostomy with frequent suctioning is not the initial intervention for managing hypercapnic respiratory failure.
D: Initiation of bilevel positive pressure ventilation (BiPAP) may not be sufficient for this patient with impending respiratory failure; endotracheal intubation provides better control over ventilation and oxygenation.
Question 5
A charge nurse is providing an inservice for staff nurses on the use of new IV pumps. Which of the following actions should the charge nurse take to best evaluate staff competency with the new equipment?
A. Ask each nurse to read the procedure and sign a form acknowledging competency.
B. Allow time during the workday when each nurse can demonstrate proficiency.
C. Require each nurse to take a written examination about the new equipment.
D. Verbally question the staff about the new equipment.
Show answer and rationale
Correct answer: B — Allow time during the workday when each nurse can demonstrate proficiency.
The correct answer is B because allowing nurses to demonstrate proficiency during the workday is the most effective way to evaluate their competency with the new IV pumps. This method ensures hands-on experience and real-time application of knowledge. It allows the charge nurse to observe each nurse in action, identify any areas needing improvement, and provide immediate feedback. This approach is more practical and directly assesses the nurses' ability to use the equipment correctly.
Choices A, C, and D are incorrect because:
A: Asking nurses to read and sign a form only shows that they have acknowledged the procedure, but it does not demonstrate their actual competency in using the equipment.
C: Requiring a written examination tests theoretical knowledge but does not assess practical skills in using the IV pumps.
D: Verbally questioning the staff may not accurately reflect their hands-on competency and may not provide a comprehensive evaluation of their proficiency with the new equipment.
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Question 6
A community health nurse is developing a community-wide health promotion program to reduce high blood pressure in community members. Which sectors will the nurse need to work with to develop this program?
A. The health sector only
B. The combined roles of multiple sectors
C. The health sector and the food and agriculture sector
D. Different sectors for each individual
Correct answer:
The correct answer is B: The combined roles of multiple sectors. To address high blood pressure effectively, a comprehensive approach involving multiple sectors such as healthcare, food and agriculture, education, urban planning, and more is essential. This is because high blood pressure is influenced by various factors including diet, physical activity, environment, and access to healthcare. By working collaboratively with multiple sectors, the nurse can develop a holistic program that addresses the social determinants of health and promotes a supportive environment for managing blood pressure. Working with just the health sector (option A) would be too narrow and overlook other important influences. Involving only the health sector and the food and agriculture sector (option C) would miss out on the broader societal factors affecting blood pressure. Lastly, different sectors for each individual (option D) would lack a coordinated and comprehensive approach needed for community-wide impact.
A community health nurse is developing a community-wide health promotion program to reduce high blood pressure in community members. Which sectors will the nurse need to work with to develop this program?
A. The health sector only
B. The combined roles of multiple sectors
C. The health sector and the food and agriculture sector
D. Different sectors for each individual
Correct answer:
The correct answer is B: The combined roles of multiple sectors. To address high blood pressure effectively, a comprehensive approach involving multiple sectors such as healthcare, food and agriculture, education, urban planning, and more is essential. This is because high blood pressure is influenced by various factors including diet, physical activity, environment, and access to healthcare. By working collaboratively with multiple sectors, the nurse can develop a holistic program that addresses the social determinants of health and promotes a supportive environment for managing blood pressure. Working with just the health sector (option A) would be too narrow and overlook other important influences. Involving only the health sector and the food and agriculture sector (option C) would miss out on the broader societal factors affecting blood pressure. Lastly, different sectors for each individual (option D) would lack a coordinated and comprehensive approach needed for community-wide impact.
Which action will the community health nurse take during the primary prevention stage of bioterrorism preparedness?
A. Participating in disaster simulations
B. Recognizing signs and symptoms of a bioterrorist attack
C. Immediately treating disease caused by a biologic agent
D. Responding to the psychological aftermath of the bioterrorism event
Correct answer:
The correct answer is A: Participating in disaster simulations. During the primary prevention stage of bioterrorism preparedness, the focus is on preventing the event from occurring. By participating in disaster simulations, the community health nurse can practice response protocols, identify gaps in preparedness, and enhance coordination with other agencies. This proactive approach helps in developing effective response strategies and improving overall readiness.
Choices B, C, and D are incorrect:
B: Recognizing signs and symptoms of a bioterrorist attack - This is more relevant to the early detection and response stages, not primary prevention.
C: Immediately treating disease caused by a biologic agent - This is part of the secondary prevention stage focused on early treatment to prevent complications.
D: Responding to the psychological aftermath of the bioterrorism event - This falls under the tertiary prevention stage, which involves addressing the long-term consequences of the event.
A patient with hypercapnic respiratory failure has a respiratory rate of 8 and an SpO2 of 89%. The patient is increasingly lethargic. Which collaborative intervention will the nurse anticipate?
A. Administration of 100% oxygen by non-rebreather mask
B. Endotracheal intubation and positive pressure ventilation
C. Insertion of a mini-tracheostomy with frequent suctioning
D. Initiation of bilevel positive pressure ventilation (BiPAP)
Correct answer:
The correct answer is B: Endotracheal intubation and positive pressure ventilation. In hypercapnic respiratory failure, the patient's respiratory rate is low, indicating inadequate ventilation. The SpO2 of 89% and increasing lethargy suggest severe hypoxemia and impending respiratory failure. Endotracheal intubation allows for mechanical ventilation to improve oxygenation and ventilation. Positive pressure ventilation can help improve gas exchange and prevent further deterioration.
A: Administration of 100% oxygen by non-rebreather mask would not address the underlying issue of inadequate ventilation in hypercapnic respiratory failure.
C: Insertion of a mini-tracheostomy with frequent suctioning is not the initial intervention for managing hypercapnic respiratory failure.
D: Initiation of bilevel positive pressure ventilation (BiPAP) may not be sufficient for this patient with impending respiratory failure; endotracheal intubation provides better control over ventilation and oxygenation.
Which of the following are the major sources of air pollution in the United States? (Select all that apply.)
A. Burning of fossil fuels
B. Waste incineration
C. Wood burning fireplaces
D. Motor vehicles
Correct answer:
The correct answer is A: Burning of fossil fuels. Fossil fuels, such as coal, oil, and natural gas, are major sources of air pollution due to the release of harmful pollutants like carbon dioxide, sulfur dioxide, and nitrogen oxides. These pollutants contribute to smog, acid rain, and climate change.
Explanation:
1. Fossil fuels are widely used for electricity generation, transportation, and industrial processes.
2. Combustion of fossil fuels releases pollutants into the air.
3. The pollutants contribute to the formation of smog and acid rain, impacting air quality and the environment.
4. The release of carbon dioxide from burning fossil fuels is a significant contributor to climate change.
Summary:
B: Waste incineration is a source of air pollution but not as significant as burning fossil fuels.
C: Wood burning fireplaces can contribute to local air pollution but are not a major source at the national level.
D: Motor vehicles are significant sources of air pollution, but the question
Hospital leadership should consider which of the following ethical dilemmas prior to experiencing an actual disaster? (Select all that apply.)
A. Which clinical leader will make the decision about distribution of scarce resources
B. Criteria to determine which patients receive aggressive treatment and which will receive palliative care
C. Which nursing staff will be the first to report to the hospital in the event of a disaster
D. How prophylactic pharmaceuticals will be distributed to protect staff and their families
Correct answer:
Step-by-step rationale for why choice A is correct: Hospital leadership should consider the decision-making process for distributing scarce resources before a disaster. This is crucial for ensuring fair and ethical allocation of resources to maximize patient outcomes. Clinical leaders must be identified in advance to make these difficult decisions based on established criteria and ethical guidelines. This proactive approach helps prevent chaos and ensures a more organized response during a crisis.
Summary of why the other choices are incorrect:
B: While determining treatment criteria is important, it is typically done on a case-by-case basis during a disaster, not necessarily in advance.
C: Identifying nursing staff reporting order is important, but it does not directly address an ethical dilemma related to resource allocation.
D: Distributing prophylactic pharmaceuticals is important for staff safety but does not directly address an ethical dilemma related to resource allocation.
The nurse is assessing the victims of a train derailment using the Sort, Assess, Life-saving Interventions, and Triage/treatment (SALT) system. Which action will the nurse take during the Sort phase of this triage system?
A. Moving victims who cannot walk to a staging area
B. Placing color-coded triage tags on victims
C. Opening the airway of victims who are not breathing
D. Asking victims to walk to a staging area
Correct answer:
During the Sort phase of the SALT triage system, the nurse will move victims who cannot walk to a staging area. This is because sorting involves quickly identifying and separating victims based on their ability to walk. Those who can walk are considered to have a better chance of survival and are typically grouped together for further assessment and treatment. By moving victims who cannot walk to a staging area, the nurse ensures that these individuals receive prompt attention and appropriate care.
Summary:
A: Moving victims who cannot walk to a staging area (Correct) - This is done to prioritize care for those who are unable to walk.
B: Placing color-coded triage tags on victims (Incorrect) - This is typically done in the Triage/treatment phase.
C: Opening the airway of victims who are not breathing (Incorrect) - This is a life-saving intervention done in the Life-saving Interventions phase.
D: Asking victims to walk to a staging area (Incorrect) - Not appropriate as it may
A nurse is preparing to administer a soap suds enema to a client who has constipation. As the nurse explains the procedure, the client states, 'The doctor didn't tell me I was supposed to receive an enema.' Which of the following nursing actions is appropriate at this time?
A. Check the client's medical record for the provider's prescription.
B. Explain to the client that the provider prescribed the procedure.
C. Assure the client that enemas are commonly prescribed for constipation.
D. Inform the charge nurse that the client refused the enema.
Correct answer:
The correct answer is A: Check the client's medical record for the provider's prescription. This is the appropriate action as it ensures the nurse follows the correct procedure and verifies if the enema was indeed prescribed by the provider. By checking the medical record, the nurse can confirm the order, ensuring patient safety and adherence to medical protocols.
Choices B, C, and D are incorrect:
B: Explaining to the client that the provider prescribed the procedure may not provide sufficient evidence or assurance to the client. It is crucial to verify the prescription through the medical record.
C: Assuring the client that enemas are commonly prescribed for constipation does not address the client's specific concern about not being informed by the doctor.
D: Informing the charge nurse that the client refused the enema is premature without confirming if the enema was actually prescribed by the provider. The nurse should verify the prescription before taking further action.
Which intervention is key to preventing ventilator-associated pneumonia as a complication in a patient with acute respiratory distress syndrome (ARDS)?
A. Scheduled prophylactic nasopharyngeal suctioning
B. Instilling normal saline down the endotracheal tube to loosen secretions
C. Providing frequent mouth care and oral hygiene
D. Using high tidal volumes on the ventilator
Correct answer:
Rationale for Choice C: Providing frequent mouth care and oral hygiene is key to preventing ventilator-associated pneumonia in ARDS patients. This intervention helps reduce the risk of oral bacteria entering the lungs, which can lead to pneumonia. Maintaining oral hygiene also decreases the colonization of pathogens in the oropharynx, reducing the risk of aspiration. This intervention is supported by evidence-based practice guidelines for preventing ventilator-associated pneumonia.
Summary of other choices:
A: Scheduled prophylactic nasopharyngeal suctioning is not recommended as a routine preventive measure for ventilator-associated pneumonia in ARDS patients.
B: Instilling normal saline down the endotracheal tube can increase the risk of infection and does not address the root cause of ventilator-associated pneumonia.
D: Using high tidal volumes on the ventilator can exacerbate lung injury in ARDS patients and is not a preventive measure for ventilator-associated pneumonia.
Hospital leadership should consider which of the following ethical dilemmas prior to experiencing an actual disaster? (Select all that apply.)
A. Which clinical leader will make the decision about distribution of scarce resources
B. Criteria to determine which patients receive aggressive treatment and which will receive palliative care
C. Which nursing staff will be the first to report to the hospital in the event of a disaster
D. How prophylactic pharmaceuticals will be distributed to protect staff and their families
Correct answer:
Step-by-step rationale for why choice A is correct: Hospital leadership should consider the decision-making process for distributing scarce resources before a disaster. This is crucial for ensuring fair and ethical allocation of resources to maximize patient outcomes. Clinical leaders must be identified in advance to make these difficult decisions based on established criteria and ethical guidelines. This proactive approach helps prevent chaos and ensures a more organized response during a crisis.
Summary of why the other choices are incorrect:
B: While determining treatment criteria is important, it is typically done on a case-by-case basis during a disaster, not necessarily in advance.
C: Identifying nursing staff reporting order is important, but it does not directly address an ethical dilemma related to resource allocation.
D: Distributing prophylactic pharmaceuticals is important for staff safety but does not directly address an ethical dilemma related to resource allocation.
About these RN exams safety and infection control questions
RN exams safety and infection control practice questions, set 4 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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