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Nclex RN > Safe and Effective Care Environment > Flashcards

Safe and Effective Care Environment Flashcards

(100 cards)

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1
Q

What is the most important action when a nurse discovers a medication error?

A

Assess the client immediately for adverse effects

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2
Q

Which client should the nurse see first after receiving report?

A

The client with chest pain rated 8/10

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3
Q

What is the proper way to verify client identity before medication administration?

A

Check two client identifiers (name and date of birth or medical record number)

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4
Q

When should standard precautions be used?

A

With all clients, regardless of diagnosis

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5
Q

What is the correct procedure for hand hygiene in healthcare settings?

A

Wash for at least 20 seconds or use alcohol-based hand rub until dry

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6
Q

Which action demonstrates proper use of personal protective equipment (PPE)?

A

Remove gloves before touching environmental surfaces

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7
Q

What is the priority nursing action when a fire alarm sounds?

A

Remove clients from immediate danger (RACE: Rescue, Alarm, Contain, Evacuate)

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8
Q

How should controlled substances be handled?

A

Keep locked in secure storage with witness verification for waste

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9
Q

What is the nurse’s responsibility regarding informed consent?

A

Verify the client understands the procedure and has signed consent

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10
Q

When should an incident report be completed?

A

Whenever an unexpected event occurs that could affect client safety

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11
Q

What is the correct response to a needle stick injury?

A

Immediately wash the area, report to supervisor, and seek medical evaluation

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12
Q

Which clients require contact precautions?

A

Those with MRSA, VRE, or C. difficile infections

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13
Q

What is the proper technique for surgical asepsis?

A

Maintain sterile field, use sterile gloves, and avoid contamination

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14
Q

When is it appropriate to break client confidentiality?

A

When there is imminent danger to the client or others

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15
Q

What should the nurse do if unable to read a physician’s order?

A

Contact the physician for clarification before proceeding

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16
Q

How should hazardous materials be disposed of?

A

According to facility policy in appropriate containers

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17
Q

What is the nurse’s role in disaster preparedness?

A

Know emergency procedures and maintain current CPR certification

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18
Q

When should restraints be used?

A

Only when less restrictive measures have failed and client safety is at risk

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19
Q

What is required documentation for restraint use?

A

Justification, type used, duration, and client response

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20
Q

How often should restrained clients be assessed?

A

Every 15 minutes for safety and circulation

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21
Q

What is the correct procedure for counting narcotics?

A

Two nurses count together and document discrepancies immediately

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22
Q

When should a client be placed in isolation?

A

When they have a communicable disease requiring transmission precautions

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23
Q

What is the nurse’s responsibility in quality improvement?

A

Participate in identifying problems and implementing solutions

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24
Q

How should the nurse respond to a family’s complaint about care?

A

Listen actively, document concerns, and report to appropriate personnel

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25
What constitutes negligence in nursing practice?
Failure to provide care that meets standard of practice, resulting in harm
26
When should the nursing supervisor be notified?
For significant changes in client condition or safety concerns
27
What is the purpose of sentinel event reporting?
To analyze serious adverse events and prevent recurrence
28
How should blood products be verified before administration?
Two nurses verify client identity, blood type, and unit numbers
29
What is the time limit for hanging blood products?
Must be hung within 30 minutes of leaving blood bank
30
When should a "time out" be called in the operating room?
Before any invasive procedure to verify client, site, and procedure
31
What is the nurse's role in preventing healthcare-associated infections?
Follow hand hygiene, use appropriate precautions, and maintain aseptic technique
32
How should equipment be cleaned between clients?
According to manufacturer's instructions and facility policy
33
What action should be taken if a client refuses treatment?
Document refusal, ensure client understands consequences, and notify physician
34
When is it appropriate to delegate tasks to unlicensed personnel?
For stable clients requiring basic care within their scope of practice
35
What cannot be delegated to unlicensed assistive personnel?
Assessment, medication administration, and client teaching
36
How should the nurse prioritize client assignments?
Based on acuity, stability, and complexity of care needed
37
What is the correct response to a client fall?
Assess for injury, do not move client, and notify physician
38
When should fall risk assessment be completed?
On admission and with any change in client condition
39
What interventions reduce fall risk?
Keep bed in low position, use non-slip socks, and ensure adequate lighting
40
How should suspicious injuries be handled?
Document objectively, report per facility policy, and provide supportive care
41
What is the nurse's legal obligation regarding child abuse?
Report suspected abuse to appropriate authorities immediately
42
When should security be called?
When there is threat of violence or aggressive behavior
43
What is the proper procedure for client identification during emergencies?
Use available identification methods and verify when possible
44
How should visitors be managed during an emergency?
Remove from immediate area while maintaining family communication
45
What is the nurse's role in organ donation?
Support family decisions and coordinate with organ procurement team
46
When should the ethics committee be consulted?
For complex ethical dilemmas affecting client care
47
What is required for valid informed consent?
Client must be competent, informed, and consent must be voluntary
48
How should advance directives be handled?
Honor client wishes and communicate with healthcare team
49
What is the nurse's responsibility regarding DNR orders?
Ensure order is current and communicate to all team members
50
When should life support be continued despite family wishes?
When legally required or ethically indicated per facility policy
51
What is the correct procedure for medication reconciliation?
Compare current medications with new orders at all transition points
52
How should "do not use" abbreviations be handled?
Spell out terms completely to prevent misinterpretation
53
What is the time frame for completing medication administration?
Within 30 minutes before or after scheduled time
54
When should a medication not be administered?
If client identification cannot be verified or order is unclear
55
What is the proper response to a medication allergy?
Stop medication, assess client, and notify physician immediately
56
How should high-alert medications be handled?
Use double verification and follow special protocols
57
What constitutes a complete medication order?
Client name, medication, dose, route, frequency, and prescriber signature
58
When should PRN medications be given?
Only when client meets specified criteria and within time limits
59
What is required documentation for medication administration?
Time, dose, route, site (if applicable), and client response
60
How should medication refusals be handled?
Document refusal, determine reason, and notify physician
61
What is the nurse's role in medication education?
Teach purpose, effects, side effects, and proper administration
62
When should medications be held?
If vital signs are outside parameters or client shows adverse effects
63
What is the proper storage for refrigerated medications?
Maintain temperature between 36-46°F (2-8°C)
64
How should expired medications be handled?
Remove from stock and dispose according to facility policy
65
What is the maximum time IV tubing can remain in use?
Typically 72-96 hours depending on solution and facility policy
66
When should IV sites be assessed?
At least every 4 hours for peripheral IVs
67
What indicates IV infiltration?
Swelling, coolness, pallor, and discomfort at insertion site
68
How should blood transfusion reactions be managed?
Stop transfusion, maintain IV access, and notify physician immediately
69
What are signs of allergic transfusion reaction?
Hives, itching, bronchospasm, and hypotension
70
When should vital signs be taken during blood transfusion?
Baseline, 15 minutes after start, then hourly
71
What is the proper procedure for hanging TPN?
Use central line, filter if required, and monitor glucose levels
72
How often should central line dressings be changed?
Every 7 days or when loose, wet, or soiled
73
What is the nurse's role in infection prevention?
Follow evidence-based practices and monitor for signs of infection
74
When should antibiotics be administered?
As soon as possible after culture collection
75
What constitutes proper specimen collection?
Use sterile technique and transport immediately to lab
76
How should isolation rooms be maintained?
Keep door closed and maintain negative/positive pressure as indicated
77
What is required when entering contact isolation rooms?
Gown and gloves before entering, remove before leaving
78
When should masks be worn?
For droplet precautions or when within 3 feet of client
79
What type of mask is required for airborne precautions?
N95 respirator or higher level protection
80
How should soiled linens be handled?
Place in appropriate bags without shaking
81
What is the proper technique for removing contaminated gloves?
Peel off first glove, use clean hand to remove second glove
82
When should eye protection be used?
When splashing of body fluids is anticipated
83
What is the purpose of surgical hand scrub?
Remove transient bacteria and reduce resident flora
84
How long should surgical hand scrub take?
2-6 minutes depending on facility protocol
85
What is the difference between clean and sterile technique?
Clean reduces microorganisms
86
When is sterile technique required?
For invasive procedures and when entering sterile body cavities
87
What breaks sterile technique?
Turning back to sterile field or reaching across sterile area
88
How should sterile packages be opened?
Open away from body first, sides next, then toward body
89
What is considered contaminated in sterile field?
Anything below waist level or out of direct vision
90
How should sterile gloves be removed?
Grab outside of one glove, remove inside-out, then remove second glove
91
What is the nurse's role in emergency response?
Follow facility protocols and maintain client safety
92
How should equipment malfunction be handled?
Remove from service immediately and report to biomedical engineering
93
What should be done if oxygen levels drop during transport?
Increase oxygen delivery and assess client status
94
When should rapid response teams be activated?
For acute changes in client condition requiring immediate intervention
95
What is the priority during code blue situations?
Ensure effective chest compressions and airway management
96
How should family be managed during resuscitation?
Provide support person and keep informed of efforts
97
What documentation is required after emergency situations?
Detailed chronological account of events and interventions
98
When should post-mortem care be initiated?
After physician pronounces death and family has been notified
99
How should cultural/religious practices be respected during care?
Ask family about specific requirements and accommodate when possible
100
What is the nurse's role in end-of-life care?
Provide comfort, support family, and honor client wishes

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