Exam (elaborations)
Chapter 20 Patient Environment and Safety
- Institution
- Chamberlain School Of Nursing
Chapter 20 Patient Environment and Safety
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Stuvia.com - The Marketplace to Buy and Sell your Study MaterialChapter 20: Patient Environment and Safety
MULTIPLE CHOICE
1. An older adult patient who is unable to get out of bed complains that the room is too cold
because of the air-conditioning and asks the nurse to open the window. The nurse’s best
reply is:
a. “Certainly, that will let in warm air from outside and should make you warmer.”
b. “The air conditioner is set to keep the most comfortable temperature in the room.”
c. “I’ll adjust the thermostat in your room and get a blanket for you.”
d. “Agency policy prevents me from opening the window.”
ANS: C
Older inactive people need a warmer environment because of their poor thermoregulation.
Rooms should be kept at a comfortable 68° to 74° F. Most health care facilities prohibit the
opening of windows for safety reasons.
DIF: Cognitive Level: Application REF: p. 321 OBJ: Theory #1
TOP: Environment Management KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
2. An appropriate environmental nursing intervention for a patient with respiratory congestion
is to:
a. maintain the room temperature slightly cooler to decrease congestion.
b. moisten the respiratory passages with the use of an air humidifier.
c. order a large floor fan to make it easier to breathe.
d. open the windows to encourage air circulation.
ANS: B
A very low humidity will dry respiratory passages. Vaporizers or humidifiers may be
ordered for a patient with a respiratory condition. Small table fans may help some persons to
breathe more easily.
DIF: Cognitive Level: Application REF: p. 322
OBJ: Clinical Practice #1 TOP: Environment
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. The patient complains of an odor in his room that smells like something is rotting. The nurse
makes an assessment of the room and:
a. changes the linens, which are wrinkled and rumpled from 24-hour use.
b. rinses out the emesis basin of used dry tissues.
c. removes an old flower arrangement.
d. heavily sprays room deodorant around the patient’s bed.
ANS: C
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Odors in health care facilities are frequently unpleasant. The odor from a deteriorating
flower arrangement is offensive. The arrangement should be discarded in a container outside
the patient’s room.
DIF: Cognitive Level: Analysis REF: p. 322|Box 20-1
OBJ: Theory #1 TOP: Environment
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
4. A patient complains of not being able to sleep because of the noise in the hall at night. The
nurse should:
a. move the patient to the far end of the hall.
b. ask the doctor for a sleeping medication for the patient.
c. tell the patient to close the door.
d. request that co-workers limit hallway conversations.
ANS: D
The main cause of noise is people. Encourage the staff to limit conversations in the hallway
and speak in lowered voices.
DIF: Cognitive Level: Application REF: p. 322 OBJ: Theory #2
TOP: Environment KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
5. The best way to maintain safety measures relative to helping a patient get into bed is to:
a. set the bed height at the nurse’s waist level.
b. make sure that the bed wheels are locked.
c. place the bed against the wall.
d. insist that the patient stays in bed.
ANS: B
The goal is to provide safety when getting a patient into or out of bed. Locking the wheels to
the bed is one way to ensure this safety measure.
DIF: Cognitive Level: Application REF: p. 323 OBJ: Theory #4
TOP: Safety KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
6. When the nurse is making an occupied bed, back safety indicates that the nurse should
initially:
a. raise the bed to the proper working height before starting.
b. encourage the patient to use the side rail to help turn side to side.
c. keep one side rail up at all times to keep the patient from falling.
d. complete the linen change on one side before moving to the other side.
ANS: A
Bringing the bed to height appropriate working level can prevent a back injury. Although
other options are part of the occupied bed skill, they are not directed at preventing back
strain.
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