RN Safe and Effective Care Environment 1 — Questions and Answers
Question 1: A nurse is preparing to administer a blood transfusion. Which action is the most important safety check before beginning the infusion?
- Check the patient's allergy list
- Verify the blood product with another licensed nurse at the bedside using two patient identifiers (Correct answer)
- Confirm the patient had a recent CBC
- Ensure the IV line is 22-gauge or smaller
Correct answer: Verify the blood product with another licensed nurse at the bedside using two patient identifiers
Two-nurse verification of blood product compatibility using two patient identifiers (name and date of birth or medical record number) is the critical safety step to prevent transfusion reactions.
Question 2: A nurse is preparing to insert a urinary catheter. Which action is essential to prevent catheter-associated urinary tract infection (CAUTI)?
- Use clean technique for the insertion
- Maintain a closed drainage system and secure the catheter to the thigh (Correct answer)
- Change the catheter every 24 hours
- Irrigate the catheter daily with normal saline
Correct answer: Maintain a closed drainage system and secure the catheter to the thigh
A closed drainage system prevents bacteria from ascending into the bladder; catheter securement prevents movement that introduces microorganisms.
Question 3: Which transmission-based precaution is required for a patient admitted with active pulmonary tuberculosis?
- Contact precautions only
- Droplet precautions with a surgical mask
- Airborne precautions with a negative-pressure room and N95 respirator (Correct answer)
- Standard precautions only
Correct answer: Airborne precautions with a negative-pressure room and N95 respirator
Pulmonary TB is transmitted via airborne droplet nuclei; a negative-pressure room and NIOSH-approved N95 respirator are required to prevent nosocomial transmission.
Question 4: A nurse receives a verbal telephone order from a physician. Which action best ensures patient safety?
- Write the order directly in the chart without repeating it
- Read the order back to the physician to confirm accuracy before ending the call (Correct answer)
- Ask the physician to text the order
- Implement the order immediately and verify later
Correct answer: Read the order back to the physician to confirm accuracy before ending the call
Reading back verbal or telephone orders and receiving confirmation from the prescriber is the Joint Commission-required 'read-back' safety standard to prevent medication errors.
Question 5: A nurse is preparing to administer medication through a nasogastric tube. Which action must be performed first?
- Flush the tube with 60 mL of water
- Crush all medications and mix them together
- Verify tube placement by checking pH of aspirate and assessing tube markings (Correct answer)
- Clamp the tube for 30 minutes before medication administration
Correct answer: Verify tube placement by checking pH of aspirate and assessing tube markings
Confirming NG tube placement before each use prevents inadvertent pulmonary instillation; checking aspirate pH and tube length markings are the evidence-based methods.
Question 6: Which patient is at highest risk for a pressure injury?
- A 30-year-old ambulatory patient post-appendectomy
- An 80-year-old patient with diabetes, incontinence, and limited mobility on bedrest (Correct answer)
- A 45-year-old with controlled hypertension who walks twice daily
- A 60-year-old with mild arthritis who requires minimal assistance
Correct answer: An 80-year-old patient with diabetes, incontinence, and limited mobility on bedrest
Advanced age, diabetes (impaired circulation and healing), incontinence (moisture), and immobility are the highest-risk factors for pressure injury development per the Braden Scale.
RN Safe and Effective Care Environment 1
A nurse is preparing to administer a blood transfusion.
Which action is the most important safety check before beginning the infusion?