A fire is reported in the kitchen on the first floor of a three-floor community hospital, and the operator notifies the charge nurse on the third floor to start evacuation procedures. Which intervention should the charge nurse
implement?

Instruct unlicensed assistive personnel (UAPs) to transfer all non-ambulatory clients via wheelchairs.

Instruct the nursing staff to evacuate ambulatory clients to the nearest fire exits.

Shut all doors to client rooms and tell everyone to stay in their rooms until the fire department arrives.

Announce in a calm voice that all visitors should proceed immediately to the first floor via the service elevators.

Answer and Explanation

The Correct Answer is B

Choice A Reason: Instructing UAPs to transfer all non-ambulatory clients via wheelchairs is not a good intervention, as it may expose the clients and the UAPs to smoke and fire, and cause panic and congestion in the hallways. The charge nurse should follow the RACE protocol (Rescue, Alarm, Contain, Extinguish), which means rescuing only those clients who are in immediate danger, and containing the fire by closing doors and windows.

Choice B Reason: Following the RACE acronym, evacuation of those in immediate danger is the priority. Instructing ambulatory clients to move toward the nearest fire exit is the most efficient way to clear the unit. Nursing staff must guide these individuals to safety first to minimize congestion and allow for focused assistance.

department's efforts. The charge nurse should follow the RACE protocol, which means evacuating only as a last resort, and only after receiving instructions from the fire department.

Choice C Reason: Staying in rooms is a "defend in place" strategy, but it is inappropriate once an official evacuation order has been issued by the operator. Closing doors is vital to contain smoke and fire, but instructing everyone to remain stationary during an active evacuation order increases the risk of injury.

Choice D Reason: Announcing in a calm voice that all visitors should proceed immediately to the first floor via the service elevators is not a good intervention, as it may endanger the visitors and cause more damage. The charge nurse should follow the RACE protocol, which means alarming others by activating the fire alarm system and calling 911. The charge nurse should also instruct visitors not to use elevators during a fire, as they may malfunction or trap them inside.

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Correct Answer is D

Explanation

Choice A Reason: This action requires assessment and evaluation skills, which are beyond the scope of practice of the PN. The nurse is responsible for providing client education and ensuring that the client understands the discharge instructions.

Choice B Reason: This action requires teaching and evaluation skills, which are beyond the scope of practice of the PN. The nurse is responsible for educating the clients about their prescribed dietary changes and assessing their learning needs and readiness.

Choice C Reason: This action requires critical thinking and decision-making skills, which are beyond the scope of practice of the PN. The nurse is responsible for establishing the blood pressure parameters for client monitoring and adjusting them as needed.

Choice D Reason: This action can be safely delegated to the PN, as it involves reinforcing previous teaching done by the nurse. The PN can review the diet information with the client and answer any questions they may have.

A. The brain natriuretic peptide (BNP) assay for a client with shortness of breath after a myocardial infarction (MI) increases to 1000 pg/mL (1000 ng/L). B. The international normalized ratio (INR) for a client who is receiving warfarin therapy increases to 2.5. C. The serum glucose level for a client receiving corticosteroids increases to 150 mg/dL (8.3 mmol/L). D. The potassium level for a client scheduled for renal dialysis increases to 5 mEq/L(5 mmol/L).

Correct Answer is A

Explanation

Choice A Reason: This client has a very high BNP level, which indicates severe heart failure and fluid overload. The nurse should follow up with this client first, as they may need urgent interventions such as oxygen therapy, diuretics, and vasodilators.

Choice B Reason: This client has an INR within the therapeutic range for warfarin therapy, which is usually between 2 and 3. The nurse should monitor this client for signs of bleeding or clotting, but they do not require immediate follow-up.

Choice C Reason: This client has a mildly elevated glucose level, which may be caused by the corticosteroids that

increase blood sugar. The nurse should check the client's blood glucose regularly and administer insulin as ordered, but they do not require immediate follow-up.

Choice D Reason: This client has a normal potassium level, which is within the reference range of 3.5 to 5 mEq/L. The nurse should ensure that the client is ready for dialysis and avoid foods high in potassium, but they do not require immediate follow-up.

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A fire is reported in the kitchen on the first floor of a three-floor community hospital, and the operator notifies the charge nurse on the third floor to start evacuation procedures. Which intervention should the charge nurse implement?

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Explanation

Correct Answer is A

Explanation

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A fire is reported in the kitchen on the first floor of a three-floor community hospital, and the operator notifies the charge nurse on the third floor to start evacuation procedures. Which intervention should the charge nurse
implement?