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.
Announce in a calm voice that all visitors should proceed immediately to the first floor via the service elevators.
The Correct Answer is C
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: Instructing the nursing staff to evacuate ambulatory clients to the nearest fire exits is not a good intervention, as it may also expose the clients and the staff to smoke and fire, and interfere with the fire
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: Shutting all doors to client rooms and telling everyone to stay in their rooms until the fire
department arrives is the best intervention, as it follows the RACE protocol, which means containing the fire by closing doors and windows, and extinguishing it if possible with a fire extinguisher. This intervention also helps protect the clients and staff from smoke inhalation and fire spread, and allows the fire department to access and control the fire.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason: This assignment does not require immediate follow-up action by the charge nurse because a practical nurse can transport a stable postoperative client to another unit and report any changes or concerns to the primary nurse.
Choice B Reason: This assignment does not require immediate follow-up action by the charge nurse because a practical nurse can monitor the blood pressure of a client with hypertension and administer antihypertensive medications as prescribed and delegated by the primary nurse.
Choice C Reason: This assignment does not require immediate follow-up action by the charge nurse because a graduate nurse can obtain a unit of packed red blood cells from the blood bank and verify the compatibility and identification with another registered nurse before transfusing it to the client.
Choice D Reason: This is the correct answer because checking a client for fecal impaction is beyond the scope of practice of unlicensed assistive personnel. It involves inserting a finger into the rectum and assessing for hard stool, which can cause injury or infection to the client. The charge nurse should intervene and assign this task to a registered nurse or a practical nurse.
Correct Answer is D
Explanation
Choice A reason: Demonstrating the proper use of personal protective equipment is important, but not the first action. The charge nurse should first assess the UAP's level of understanding and address any misconceptions or fears about HIV transmission.
Choice B reason: Offering to assist the UAP with the collection of the specimen may be helpful, but not the first action. The charge nurse should first educate the UAP about HIV transmission and infection control measures, and then evaluate the UAP's competence and confidence in performing the task.
Choice C reason: Providing the UAP with the infection control policy is relevant, but not the first action. The charge nurse should first explain the rationale and principles of infection control to the UAP, and then refer to the policy as a guideline and resource.
Choice D reason: Determining the UAP's knowledge about HIV transmission is the first and most appropriate action for the charge nurse to take, as it will help identify any gaps or misinformation that may cause fear or anxiety in the UAP. The charge nurse should then provide accurate and evidence-based information about HIV transmission, prevention, and treatment, and answer any questions or concerns that the UAP may have.
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