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A nurse manager along with members of the nurse practice committee are conducting a skills day for assistive personnel in the medical surgical unit to validate competency.

Fire Safety

Objectives:

All Staff will:

Know the location of exits, alarms, fire extinguishers, and oxygen turnoff valves.

Make sure equipment does not block fire doors.

Know the evacuation plan for the unit and the facility.

Enact RACE sequence for fire response.

Remove

Alarm

Confine

Extinguish/Evacuate

Fall Safety

Infection Control

Objectives

The staff will:

Perform proper hand hygiene.

Properly put on and remove personal protective equipment.

Gloves

Gowns

Masks

Properly disinfect patient care equipment

Review levels of precaution (standard, airborne, droplet, contact)

Which skills demonstrated by assistive personnel require immediate follow-up. Select the "3" findings that require immediate follow-up.

AP 1-Quickly pulls fire alarm, then proceeds to remove the client from room. AP 3-Raised bedrails of the bed for client who was reported not alert or oriented, and was sleeping.

AP 2-Verifies with nurse the order in which protective equipment should be removed.

AP 7- While disinfecting portable vital sign monitor wore gloves and washed hand prior to leaving room.

AP 6 - During simulation, which included assisting client into bed, there was no observed handwashing.

AP 5-Following simulation, was unable to identify the locations of alarms on medical surgical unit.

AP 4-Successfully completed skills of simulation including emptying the client's trash can

Answer and Explanation

Correct Answer : A,D,E

A. While pulling the fire alarm is correct, removing the client from the room without following the full RACE sequence (Remove, Alarm, Confine, Extinguish/Evacuate) is incorrect. The immediate safety measures should include ensuring that the alarm is activated before evacuation and confining the fire if possible.

B. Verifying the order of protective equipment removal with the nurse shows a good practice and adherence to proper infection control procedures.

C. Washing hands prior to leaving the room after disinfecting equipment indicates proper infection control practice.

D. Handwashing is a crucial aspect of infection control. Failure to perform hand hygiene during or after patient care increases the risk of infection transmission. Immediate follow-up is needed to ensure that proper hand hygiene practices are adhered to.

E. Knowing the locations of alarms is vital for effective fire safety. Inability to identify these locations indicates a significant gap in preparedness for emergencies. Immediate follow-up is necessary to ensure that staff are familiar with fire safety procedures and equipment locations.

F. Successfully completing the skills in simulation, including emptying the client's trash can, shows adherence to task requirements but is not a critical issue requiring immediate follow-up compared to the other findings.

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Correct Answer is C

Explanation

A. "The client works in the hospital radiology department": This information is irrelevant to the client’s current health status and does not imply a need for total care by the nurse.

B. "The client discussed having prior thoughts of suicide": While suicidal ideation is serious and requires careful monitoring and assessment, this information alone does not necessarily indicate that the nurse must assume total care. A nurse would still delegate non-critical tasks to the AP, but constant monitoring and appropriate interventions would still be the nurse’s responsibility.

C. "The client's blood pressure and pulse have been fluctuating throughout the day": Fluctuating vital signs, especially blood pressure and pulse, can indicate an unstable condition that may require immediate attention and careful monitoring. This scenario suggests that the client’s condition may be critical and requires ongoing assessment and evaluation by the nurse, rather than simply delegating tasks like monitoring vital signs to assistive personnel (AP). The nurse needs to assess the situation thoroughly, interpret the fluctuations, and adjust the care plan accordingly.

D. "The client's family members have been present most of the day": Family presence alone does not impact the need for total care by the nurse. It is important for the nurse to communicate with the family, but this statement does not indicate the need for the nurse to assume total care over other team members.

A. Ask the AP about her concerns with the assignment. B. Report the AP to the charge nurse. C. Take the specimen to the laboratory. D. Complete an incident report.

Correct Answer is A

Explanation

Rationale:

A. Ask the AP about her concerns with the assignment is appropriate as it allows the nurse to understand and address any potential issues or reasons for refusal.

B. Report the AP to the charge nurse should only be done if the refusal cannot be resolved through discussion.

C. Take the specimen to the laboratory should be done if needed, but it is important to first understand why the AP refused.

D. Complete an incident report might be premature without understanding the reason behind the refusal.

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Naxlex Comprehensive Predictor Exams

A nurse is receiving change-of-shift report at the start of the shift. Which of the following statements by the nurse giving report indicates to the oncoming nurse that she should assume total care for the client, rather than assigning tasks to the assistive personnel (AP)?

Correct Answer is C

Explanation

A nurse asks the assistive personnel (AP) to take a specimen to the laboratory and the AP refuses. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse in a provider's office is reviewing the laboratory findings for a client who is scheduled for surgery. Which of the following findings requires follow up by the nurse?

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A nurse is participating in a disaster simulation in which a toxic substance is released into a crowded stadium. Multiple clients are transported to the facility. Which of the following activities would be the lowest priority for the nurse?

A nurse who is leading a team of nurse managers is planning to make a major announcement. The nurse should use which of the following nonverbal communication techniques to enhance the importance of the announcement?

A charge nurse is planning to conduct a performance appraisal of a staff member on her unit. Which of the following actions should the nurse take?

A charge nurse hears a provider speaking to a staff nurse in anger concerning incorrect supplies that are available to perform a procedure. Which of the following statements by the charge nurse is appropriate?

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