A nurse receives notification of a fire on the unit. Which of the following actions should the nurse take first?
Assist clients who are in immediate danger to a safe location.
Close doors and windows on the unit.
Attempt to extinguish the fire using an ABC fire extinguisher.
Discontinue oxygen use for clients who can breathe without it.
The Correct Answer is A
Choice A rationale:
The nurse's first priority in the event of a fire is the safety and well-being of the clients. Clients who are in immediate danger due to the fire should be assisted to a safe location as quickly as possible. This choice is supported by the principles of prioritizing client safety during emergencies.
Choice B rationale:
Closing doors and windows on the unit is a secondary action and comes after ensuring the safety of clients in immediate danger. While it can help contain the fire's spread, it should not be the nurse's first action, as it does not address the immediate risk to clients' lives.
Choice C rationale:
Attempting to extinguish the fire using an ABC fire extinguisher might be a consideration in emergency situations; however, the nurse's first responsibility is to ensure the safety of clients. The nurse should not put themselves or clients at risk by attempting to extinguish the fire before moving clients to safety.
Choice D rationale:
Discontinuing oxygen use for clients who can breathe without it is not the nurse's primary action during a fire emergency. While it's important to manage resources, such as oxygen, the immediate focus should be on evacuating clients from the danger zone.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Digoxin is a medication used to treat heart conditions like heart failure and atrial fibrillation. A digoxin level of 1.0 ng/mL is within the therapeutic range (usually 0.5-2.0 ng/mL), indicating that the client's digoxin dosage is appropriate. However, this value doesn't indicate an urgent need for a home visit.
Choice B rationale:
A white blood cell count (WBC) of 6,000/mm³ falls within the normal range (typically 4,500-11,000/mm³). While this value could suggest a stable immune system, it doesn't provide information requiring immediate attention or a home visit.
Choice C rationale:
Platelets are essential for blood clotting. A platelet count of 100,000/mm³ is significantly below the normal range (usually 150,000-450,000/mm³), indicating a risk of bleeding and potentially a serious medical condition. This client is at risk for spontaneous bleeding and requires prompt assessment and intervention, making this choice the correct answer.
Choice D rationale:
A serum potassium level of 4.0 mEq/L falls within the normal range (typically 3.5-5.0 mEq/L). While maintaining electrolyte balance is important, this potassium level doesn't indicate an immediate need for a home visit.
Correct Answer is D
Explanation
Choice A rationale:
A nurse cannot provide basic treatment information to the client's employer without the client's explicit consent. This information falls under the client's confidentiality rights and cannot be shared without proper authorization.
Choice B rationale:
While a nurse can inform the client about the risks and benefits of electroconvulsive therapy, this statement does not encompass the entirety of the client's rights. Clients have the right to be informed about the risks and benefits of all treatments, not just electroconvulsive therapy.
Choice C rationale:
Clients on a mental health unit who are admitted voluntarily have the right to leave against medical advice, as long as they are deemed capable of making that decision. Voluntary admission does not negate a client's autonomy to make decisions about their own care.
Choice D rationale:
The correct answer. Clients on a mental health unit have the right to refuse their medication, as long as they are deemed competent to make that decision. This is an important aspect of respecting a client's autonomy and informed consent, even in a mental health setting. However, if a client's refusal poses a serious risk to their health or the health of others, healthcare providers may need to take appropriate actions while respecting legal and ethical standards.
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