Restraints and Protocols for Licensed and Unlicensed Individuals
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Questions and Answers

In older adults, age-related functional deterioration in immune system function leads to:

  • Increased immune response and cell production
  • Increased production of lymphocytes
  • Decreased ability to produce antibodies (correct)
  • Decreased susceptibility to infections

    • Which of the following is a source of infection categorized as endogenous?

  • Overgrowth of patient’s flora due to altered environment (correct)
  • Microorganisms from outside of the individual
  • Organisms that do not exist as normal flora
  • Infection from a medical procedure

    • What is the first step for donning sterile gloves?

  • Wash hands
  • Examine package for intactness
  • Select correct size/type of gloves (correct)
  • Inspect hands and nails

    • Which intervention is considered least invasive for fall prevention in older adults?

    <p>Consistent rounding</p> Signup and view all the answers

    What is the last step in the nursing process?

    <p>Evaluation</p> Signup and view all the answers

    What does PES statement in nursing diagnosis stand for?

    <p>Problem, Etiology, Symptoms</p> Signup and view all the answers

    What does subjective data refer to in nursing assessment?

    <p>What the patient says</p> Signup and view all the answers

    Which factor contributes to decreased immune response in older adults?

    <p>Poor nutrition</p> Signup and view all the answers

    What is the primary principle of sterility when donning sterile gloves?

    <p>&quot;Open package carefully&quot;</p> Signup and view all the answers

    What is the best predictor of risk for falls in older adults?

    <p>Past history of falls</p> Signup and view all the answers

    What does the nursing diagnosis component 'P' represent in a PES statement?

    <p>Problem</p> Signup and view all the answers

    Which intervention is considered most invasive for fall prevention in older adults?

    <p>Pharmaceutical sedation</p> Signup and view all the answers

    Which type of isolation is needed for diseases like influenza, adenovirus, and group A strep?

    <p>Airborne precautions</p> Signup and view all the answers

    What type of PPE is needed for patients requiring contact precautions?

    <p>Gown, mask, goggles, gloves</p> Signup and view all the answers

    Which condition is considered a 'never event' in hospitals?

    <p>Catheter-associated UTI</p> Signup and view all the answers

    When should hand hygiene be performed according to the text?

    <p>Before direct contact with patients; between patient contacts; after contact with blood, body fluids, and secretions; immediately after gloves are removed</p> Signup and view all the answers

    What type of precautions are needed for diseases like VRE, MRSA, and C. diff?

    <p>Contact precautions</p> Signup and view all the answers

    What do 'never events' in hospitals refer to?

    <p>Serious medical errors that should never occur</p> Signup and view all the answers

    Which procedure requires donning PPE in the following order: gown, mask, goggles, gloves?

    <p>Respiratory hygiene and cough etiquette</p> Signup and view all the answers

    What are the manifestations of poor glycemic control considered as 'never events' in hospitals?

    <p><strong>DKA</strong></p> Signup and view all the answers

    What is the main purpose of using protective environment for allogenic hematopoietic stem cell transplants?

    <p>To minimize the risk of airborne infections</p> Signup and view all the answers

    What should be done if needle recapping is necessary according to the text?

    <p>Use one-handed scoop method</p> Signup and view all the answers

    When should alcohol-based hand rub be used?

    <p>After contact with spores</p> Signup and view all the answers

    What type of isolation is needed for patients with respiratory syncytial virus (RSV)?

    <p>Contact precautions</p> Signup and view all the answers

    In hospitals, what is the maximum duration for each original restraint order for adults (18 years +)?

    <p>4 hours</p> Signup and view all the answers

    What is the responsibility of a registered nurse (RN) regarding assessing patients under restraint?

    <p>Assess every 2 hours for violent patients</p> Signup and view all the answers

    What is the role of a licensed practical nurse (LPN) in relation to taking patients out of restraints?

    <p>Cannot take the patient out of restraints</p> Signup and view all the answers

    What is the maximum duration for each original restraint order for children under 9 years in hospitals?

    <p>1.5 hours</p> Signup and view all the answers

    What is the goal in using restraints on patients?

    <p>To prevent interruption of therapy</p> Signup and view all the answers

    When are restraints considered appropriate in healthcare settings?

    <p>After trying least invasive measures first</p> Signup and view all the answers

    What is the responsibility of a healthcare provider if restraints are needed due to violence or self-destructive behavior?

    <p>Assess the patient within 60 minutes</p> Signup and view all the answers

    What skill related to restraint use and appropriate assessment cannot be delegated to non-RN staff?

    <p>Correct placement of restraint</p> Signup and view all the answers

    What must a provider specify when ordering restraints?

    <p>The location and type of restraint to be used</p> Signup and view all the answers

    What is the primary responsibility of a nurse in instructing assistive personnel about restraints?

    <p>To instruct about correct placement of restraints and changing position</p> Signup and view all the answers

    What must be done if restraints are found to be needed due to violence or self-destructive behavior?

    <p>The RN must inform the healthcare provider immediately</p> Signup and view all the answers

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