A nurse is assisting with the evaluation of a facility's safety plan. Which of the following indicates that the safety plan is effective?

Staff members used a class A fire extinguisher during an electrical fire

Staff members review the locations of fire extinguishers every 2 to 3 years.

An evacuation was ordered during a fire when fire extinguishers were not effective.

Fire alarms in the facility have the same sound as other alarms.

Answer and Explanation

The Correct Answer is A

A) Staff members used a class A fire extinguisher during an electrical fire.
This response indicates that the safety plan is effective because it shows that the staff used the correct type of fire extinguisher for the fire they encountered. Class A fire extinguishers are designed for ordinary combustibles (e.g., wood, paper, cloth), but using a fire extinguisher that is correctly suited to the fire type demonstrates that the staff are trained and prepared to respond appropriately in an emergency. For electrical fires, however, a Class C fire extinguisher should be used. This suggests a review of fire safety plan training might be necessary to align fire extinguisher types with fire classes.

B) Staff members review the locations of fire extinguishers every 2 to 3 years.
Reviewing the locations of fire extinguishers every 2 to 3 years is not an adequate frequency. Fire safety protocols should be reviewed more frequently to ensure that staff are consistently aware of fire extinguisher locations. Routine and more frequent checks (e.g., annually) are required to ensure proper preparedness in an emergency.

C) An evacuation was ordered during a fire when fire extinguishers were not effective.
While evacuations are necessary in certain situations, an evacuation being ordered because fire extinguishers were ineffective could indicate that the safety plan was not properly executed or that there was an issue with fire extinguisher maintenance or staff training. The effectiveness of fire safety plans should reduce the need for evacuations due to inadequate response efforts.

D) Fire alarms in the facility have the same sound as other alarms.
Fire alarms should have a distinct sound that differentiates them from other types of alarms (e.g., medical or security alarms). If fire alarms have the same sound as other alarms, it could create confusion in an emergency, undermining the effectiveness of the safety plan. The alarm system should be unique and easily identifiable.

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Correct Answer is B

Explanation

A) Arterial blood gases: Arterial blood gas (ABG) tests are typically used to assess respiratory and metabolic function, including the balance of oxygen and carbon dioxide in the blood. While important in many clinical situations, ABGs are not specifically relevant for monitoring a client on levothyroxine, as it does not directly affect gas exchange or acid-base balance.

B) Thyroid stimulating hormone (TSH): TSH is the most important laboratory test to monitor in a client taking levothyroxine, as this medication is used to replace or supplement thyroid hormone levels. Levothyroxine directly affects thyroid hormone levels in the body, so monitoring TSH levels is essential for determining whether the medication dosage needs to be adjusted. Elevated TSH levels may indicate that the dose is too low, while low levels may suggest an overdose.

C) Prothrombin time: Prothrombin time (PT) is used to assess blood clotting and coagulation status. While certain thyroid conditions can influence coagulation, PT is not a routine test to monitor in clients on levothyroxine therapy unless there are specific concerns related to bleeding or clotting. It is not the most relevant test for monitoring thyroid function in this context.

D) Blood urea nitrogen (BUN): Blood urea nitrogen (BUN) levels reflect kidney function and hydration status. While kidney function is always important to monitor, BUN is not specifically used to assess the effects of levothyroxine therapy. It would not provide direct information regarding the effectiveness of the medication or the thyroid status of the client.

A. Use a moisturizing soap to clean the skin around the client's stoma. B. Create an opening on the skin barrier that is 1.27 cm (0.5 in) larger than the client's stoma. C. Empty the client's ostomy pouch before removing the skin barrier. D. Change the client's ostomy appliance hr after breakfast.

Correct Answer is C

Explanation

A) Use a moisturizing soap to clean the skin around the client's stoma:
Using a moisturizing soap is not recommended for cleaning the skin around the stoma. Moisturizing soaps can leave a residue that may interfere with the adhesion of the ostomy appliance. The skin around the stoma should be cleaned with warm water and mild soap that does not contain lotions, fragrances, or oils. This helps ensure the skin is clean and dry, promoting better adhesion of the skin barrier.

B) Create an opening on the skin barrier that is 1.27 cm (0.5 in) larger than the client's stoma:
The opening in the skin barrier should be about 1/8 inch (approximately 0.32 cm) larger than the stoma's diameter, not 1.27 cm (0.5 in) larger. A larger opening can cause the skin barrier to fit too loosely, leading to leakage and skin irritation. The skin barrier should fit snugly around the stoma to prevent any leakage and protect the surrounding skin.

C) Empty the client's ostomy pouch before removing the skin barrier:
It is essential to empty the ostomy pouch before removing the skin barrier to prevent fecal material from spilling or leaking during the appliance change. This helps maintain cleanliness, reduces the risk of skin irritation, and makes the procedure more comfortable for both the client and the nurse.

D) Change the client's ostomy appliance 1 hour after breakfast:
There is no specific time required after breakfast to change the ostomy appliance. The timing of appliance changes should be based on the client's individual needs and lifestyle, and it is more important to change the appliance when necessary (e.g., when the pouch is full or when the skin barrier is no longer intact) rather than adhering to a specific time after meals.

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A nurse is assisting with the evaluation of a facility's safety plan. Which of the following indicates that the safety plan is effective?

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Explanation

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Correct Answer is C

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