BCC Exam 1 Questions and Answers
The Joint Commission Answer- an independent, not-for-profit group in the United States
that accredits hospitals and other health care-related agencies.
National Patient Safety Goals Answer- Identify patients correctly.
Improve staff communication.
Use medicines safely.
Use alarms safely.
Prevent infection.
Identify patient safety risks.
Prevent mistakes in surgery.
Quality and Safety Education for Nurses (QSEN) project Answer- overarching goal of preparing nurses of the future with the knowledge, skills, and attitudes needed to advance quality and safety on the job in their health care settings.
Centers for Medicare and Medicaid Services Answer- The federal organization that certifies all Medicare- and Medicaid-participating hospitals (facilities for psychiatric and rehabilitation services, and long-term care, and treatment centers for alcohol and chemical dependence)
Physical restraint Answer- : Mechanical or physical device, such as material or equipment attached or adjacent to the patient's body, used to restrict movement
Chemical restraint Answer- Medication that is administered to a patient to control behavior
Centers for Medicare and Medicaid Services (CMS) no longer Answer- makes payments to hospitals for the cost of additional care resulting from patient falls because they are considered reasonably preventable.
Medication errors Answer- Medications should be checked and double-checked in accordance with the six rights of medication administration: the right drug, in the right dose, at the right time, to the right patient, by the right route, and with the right documentation.
Overexposure to radiation Answer- Nurses at risk for radiation exposure are typically those who work with patients receiving radioactive iodine treatments or work in areas where special procedures are performed involving radiation. Nurses must be aware of diagnostic procedures that can increase the amount of radiation exposure to themselves and their patients.
microorganisms have evolved strains Answer- that are resistant to common antibiotics.
Procedural errors Answer- An example of a procedural error is the failure to properly identify a patient when entering a room to administer medication
assessment of fall risk should be completed on admission Answer- assessment of fall risk includes personal factors (e.g., incontinence, unsteady gait) and environmental factors (e.g., tubes or drains, floor surfaces).
Johns Hopkins Hospital Fall Assessment Tool Answer- Seven-item tool, used nationally and internationally in hospitals, can be completed quickly and easily, includes fall prevention intervention guidelines of advanced age; fall history; specific medication classes; patient care equipment that tethers; and mobility, cognitive, and elimination functions.
Morse Fall Scale Answer- Six-item fall risk assessment tool, widely used nationally and internationally since the late 1980s in acute care and long-term care settings
(1) history of falling, (2) existence of a secondary diagnosis, (3) use of an ambulatory aid, (4) use of an intravenous (IV) line or a saline lock, (5) gait, and (6) mental status
Hendrich II Fall Risk Model Answer- Eight-factor assessment model, well established and used widely in acute care settings to assess the fall risk of patients
(1) confusion/disorientation/impulsivity, (2) symptomatic depression, (3) altered elimination, (4) dizziness/vertigo, (5) male gender, (6) use of antiepileptics, (7) use of benzodiazepines, and (8) performance on the Get Up and Go Test.
The most common nursing diagnoses directly associated with safety concerns include: Answer- Risk for injury
Risk for falls Risk for poisoning
Risk for infection
Risk for aspiration
Planning Answer- Before implementing interventions for the promotion of safety of individuals across settings, the nurse considers critical assessment findings such as the
patient's developmental level, cultural background, and baseline understanding of the issue. Falls Answer- Events in which an individual unintentionally and through the force of gravity drops to the ground, floor, or some other lower level.
Some interventions include to prevent falls Answer- Keeping a call light within patient's reach
Keeping frequently used items close to the patient
Making hourly rounds to check on patients
Keeping patients who are at a high risk for falling in rooms close to the nurse's station
Alternatives to Physical Restraints Answer- Orient the patient to the surroundings, and explain all care-related interventions. •Relocate the patient to a room near the nurses' station. •Use pressure- and motion-sensitive bed and chair alarms consistently. Tabs and Bed-
Check alarm systems can be used in the bed or chair.
•Ensure that alarms and sensors are properly placed, functioning, and perform battery checks according to facility protocol. •Encourage the family and significant others to spend time with the patient. •Minimize environmental stimuli (e.g., noise, bright lights).
Physical restraints Answer- can be applied only with a physician or health care provider order and only after all reasonable alternatives to restraint use have failed.
Physical restraints applied for 2 reasons Answer- Medical necessity Behavioral or mental health issues
Examples of common reasons for the use of physical restraints are as follows Answer- To immobilize an extremity To prevent harmful patient behavior To allow treatments or procedures to proceed without patient interference
Evidence-based practice Restraints Answer- Restraint use has caused negative health outcomes, such as deterioration in the ability to walk, in cognitive abilities, and in performing activities of daily living.
Side rail Answer- Note that when all four side rails are raised, it is considered a form of physical restraint, which requires an order from a primary care provider.
Use of all 4 side rails Answer- The reason for using all four side rails •Alternatives that have been attempted or considered •Has a patient been injured with side rail use? If so, follow facility policy and procedure for care and documentation. •If the patient or patient's family refuse side rail use, document the situation according to
facility policy and procedure.
Safety interventions for other areas of concern in the health care environment include Answer- Safe medication administration practices Reduction of pathogen transmission
Reduction of procedure- and equipment-related events
Successful management of bioterrorist attack
Alterations in Structure and Function Affecting Hygienic Care Answer- Any interruption in the skin, which is the body's first line of defense, can potentially lead to infection.
Excessively dry skin Answer- can lead to cracks and openings in the integumentary system
Excoriation Answer- red, scaly areas with surface loss of skin tissue) occurs in patients whose skin is exposed to bodily fluids such as stool, urine, or gastric juices.
alopecia Answer- (loss of hair) resulting from hereditary factors, certain illnesses, or the effects of drugs such as those used in chemotherapy.
Decreased sensation Answer- Patients with neurologic deficits, such as peripheral neuropathy resulting from diabetes, may not be able to identify extremes of hot and cold
Age Hygenic Needs Answer- Infants and young children are dependent on others to care for their hygienic needs. Skin becomes thinner, drier, and less elastic with age, making older adults more susceptible to skin breakdown.
chafing Answer- inflammation caused by friction
Good hygiene directly impacts the health of the Answer- integumentary system.
Health Assessment Hygiene Answer- Are you able to bathe yourself?
How often do you bathe or shower?
Has there been a change in your ability to care for yourself?
Can you reach your feet and legs when you bathe or shower?
Are you ever incontinent of urine or stool?
Do you become short of breath during your bath?
Can you raise your arms up to brush your teeth?
Are you able to shampoo and comb your hair?