A winter storm has prevented most of the staff on a busy medical-surgical unit from getting to work, one RN, two LPNs, and three unlicensed assistive personnel (UAP) began their shift. What nursing care delivery system should be implemented?

Rationale:

A. Using a class C fire extinguisher is appropriate for electrical fires, but it is not the first action. Immediate safety protocols prioritize alerting the facility to initiate a coordinated emergency response. Attempting to extinguish the fire without alerting others could delay evacuation or professional fire response.

B. Ventilating clients on life support is important if smoke or fire threatens their airway. However, before focusing on individual patient care, the nurse must first ensure the hospital’s emergency response system is activated so that help is on the way. Immediate alarm activation triggers staff mobilization, evacuation procedures, and fire suppression resources.

C. Unplugging the toaster may help prevent further electrical ignition, but approaching the fire without activating the alarm puts the nurse at risk. Safety protocols dictate alerting the entire unit and fire response team first.

D. Activating the fire alarm is the first action. This follows the “RACE” acronym for hospital fire safety:

• R – Rescue: Rescue anyone in immediate danger if safe to do so.
• A – Alarm: Activate the fire alarm immediately to notify all personnel and initiate the facility’s fire response plan.
• C – Contain: Close doors to prevent fire and smoke spread.
• E – Extinguish/Evacuate: Use an appropriate fire extinguisher if safe, or evacuate if the fire is uncontrollable.

Activating the alarm ensures rapid notification of security, fire response, and other staff, enabling coordinated evacuation and fire suppression.

Rationale:

A. The primary principle in any situation involving electricity is safety. The client has already reported feeling an electric shock, which indicates that the device is still potentially hazardous. The first step must be to eliminate the source of danger by unplugging the radio or ensuring it is no longer connected to electricity. This protects both the client and anyone else in the area from further injury. Safety always takes precedence over assessment or administrative tasks.

B. While taking an apical pulse is important after an electric shock to assess for arrhythmias or other cardiac effects, it is secondary to removing the hazard. Performing an assessment while the source of electricity is still present could put the nurse or client at additional risk. Once the radio is disconnected and the client is safe, the nurse should then immediately assess cardiac status, including pulse, heart rhythm, and vital signs.

C. Having the maintenance department check the device is necessary to prevent future hazards, but it is a later action, not the first priority. Immediate safety and assessment of the client’s condition take precedence over administrative follow-up.

D. Inspecting for burns or other injuries is essential, as electric shocks can cause external burns, internal tissue damage, or cardiac complications, but again, it is secondary. The nurse must first remove the source of electricity to prevent additional injury. After the device is disconnected, the nurse can safely evaluate for burns, neurological changes, or other complications.