Question 1

Which appropriate nursing action when caring a patient Have a radium implant for cancer of cervix?

Accepted Answer

Answer reason: Limiting visitor time directly reduces cumulative dose to family and staff and is a standard precaution during active implant therapy. Routine body fluids like urine are not stored in lead-lined containers for sealed internal implants because the radioactive source is not excreted. A lead apron is not the primary or sufficient protection for gamma-emitting brachytherapy; minimizing time in the room and maintaining distance are more effective and emphasized.

Question 2

Plastic syringe is disposed in...?

Accepted Answer

Answer reason: In standard color-coding systems, contaminated recyclable plastic items (e.g., plastic syringe barrel without needle, IV tubing, catheters) are placed in the red bag/container for appropriate treatment (e.g., disinfection) prior to recycling/disposal. Yellow bags are reserved for infectious/pathological waste intended for incineration (e.g., soiled dressings, anatomical waste), not routine plastic disposables. Blue and black bags are used for other categories (e.g., glassware/metallic implants or general waste), making them less appropriate for contaminated plastic syringe components.

Question 3

Hospital dressing is best disposed of by?

Accepted Answer

Answer reason: Incineration is a standard final-disposal method for soiled dressings because high temperatures render microorganisms nonviable and reduce waste volume. Dumping and burying can spread infection through soil, water, animals, and human contact, making them unsafe. Autoclaving can disinfect certain waste streams but is primarily a treatment step and often requires subsequent controlled disposal; for contaminated dressings, incineration is typically the preferred definitive method where available.

Question 4

A nurse in the ED is admitting a child who ingested liquid bleach. Which of the following actions should the nurse take?

Accepted Answer

Answer reason: Neutralizing agents are avoided because acid-base reactions can generate heat and worsen tissue damage. Emesis is contraindicated due to risk of re-exposure of the esophagus and aspiration into the lungs. Offering small amounts of water or milk can dilute the substance and is an appropriate immediate nursing action while promptly contacting Poison Control for specific guidance.

Question 5

Following scheduled radioactive iodine therapy in a nuclear medicine department, a nurse is speaking with a client following the client's ingestion of radioactive iodine regarding strategies to avoid radiating the client's family members. The nurse recognizes the need for additional client teaching when the client states?

Accepted Answer

Answer reason: Radioactive iodine precautions focus on limiting close contact, preventing contamination of others with saliva/urine, and following time–distance–shielding guidance for a defined period. The statement indicates a misunderstanding because leaving home/traveling is not a standard or necessary safety strategy and could expose the public unnecessarily, while not addressing key contamination-control behaviors. Appropriate teaching includes avoiding close physical contact (especially with children/pregnant people) for several days and using meticulous bathroom hygiene because most radioiodine is excreted in urine. Avoiding shared utensils and flushing the toilet multiple times with the lid closed are consistent with minimizing radioactive contamination in the household.

Question 6

Nurses handling radiation sources can minimize exposure to radiation by recognizing the importance of?

Accepted Answer

Answer reason: Radiation safety follows the core ALARA principle: minimize time, maximize distance, and use shielding to reduce dose. Of these choices, reducing the duration of exposure directly lowers the total absorbed dose in a linear fashion. The other options are not the primary controllable factors taught for occupational radiation exposure reduction in clinical practice. A common related distractor is “distance,” but it is not offered here, making the time component the best answer.

Question 7

An immigrant family regularly purchases imported candy for their children at the local market. A child can be exposed to lead by eating candy imported from which country?

Accepted Answer

Answer reason: Lead is a toxic heavy metal hazard, and a key nursing safety concept is recognizing common nontraditional sources of pediatric exposure. Imported candies have been implicated in lead exposure when contamination occurs during production or when packaging/ink contains lead that can leach onto food. Products from Mexico are a well-known risk area cited in public health alerts and NCLEX-style safety content. The other countries listed are not commonly emphasized as high-yield sources of lead-contaminated candy in standard nursing test preparation, making this option the best choice.

Question 8

The nurse administers chemotherapeutic drugs to a client with breast cancer. Where should the nurse dispose of the medication vials?

Accepted Answer

Answer reason: Chemotherapeutic agents are hazardous drugs that require specialized disposal to prevent occupational exposure from residue, leaks, or aerosolization. Empty or partially used chemo vials are treated as trace hazardous waste and, because they are rigid glass containers with potential to break and contaminate, they must be discarded in a designated chemotherapy sharps container. Standard biohazard waste containers are intended for infectious materials and do not address the additional cytotoxic hazard. Using the chemo-specific sharps container reduces risk of needlestick/cut injury and limits environmental contamination in accordance with hazardous-drug handling standards.

Question 9

A client is involved in a chemical exposure event. Decontamination efforts are performed. The majority of decontamination is accomplished by?

Accepted Answer

Answer reason: The key principle in hazardous chemical exposure is to rapidly eliminate the source of contamination to reduce ongoing absorption and secondary exposure. Taking off contaminated clothing removes the largest reservoir of chemical and can eliminate most of the contaminant load quickly before it spreads. After clothing removal, copious irrigation and washing further reduce residual chemical on the skin, but these steps are typically less impactful if the contaminated garments remain in place. Initial water rinsing/skin flushing alone can also increase spread of some agents if clothing is not removed first.

Question 10

A 2-year old with pneumonia is placed in an oxygen tent with mist. Which nursing action is a priority?

Accepted Answer

Answer reason: Oxygen-enriched environments markedly increase the risk of fire, so ignition prevention is the top safety priority. Eliminating potential spark sources (battery toys, electrical devices, static, or poorly maintained equipment) directly prevents a rapid, catastrophic tent fire. Actions like tucking in the tent sides and maintaining temperature help maintain oxygen concentration and comfort, but they do not mitigate the immediate life-safety hazard. Frequent linen changes may be needed due to moisture, yet it is a comfort/infection-control measure rather than the highest priority safety intervention.

Question 11

Clients who were exposed to a white phosphorus chemical spill are arriving by ambulance. Which intervention should the ED nurse plan to implement first?

Accepted Answer

Answer reason: The priority in hazardous materials exposure is preventing secondary contamination and protecting staff and the environment before any direct patient contact. Donning appropriate PPE reduces the nurse’s risk of chemical injury and limits spread of white phosphorus residue within the ED. Decontamination steps like flushing or brushing are appropriate only after ensuring responder safety and appropriate controls are in place. Triage is important, but it occurs after initial scene/receiver protection so the triage process itself does not expose staff to an uncontrolled contaminant.

Question 12

The nurse is teaching a student nurse about standard precautions. Which action by the student nurse indicates that the teaching has been effective?

Accepted Answer

Answer reason: Standard precautions require safe containment and disposal of potentially infectious materials (blood and body fluids) using designated biohazard waste to prevent exposure and cross-contamination. Placing blood-soiled items in an approved biohazard container follows infection-control policy and OSHA bloodborne pathogen principles. Recapping needles is unsafe because it increases the risk of needlestick injury; used sharps should be disposed of immediately in a sharps container without recapping. Routine bed bathing does not inherently require goggles unless splash/spray is anticipated, and alcohol is not an appropriate high-level disinfectant/sterilant for blood-contaminated instruments compared with approved decontamination and sterilization processes.

Question 13

What information is most important for the nurse to be aware of when administering immunizations?

Accepted Answer

Answer reason: Vaccine safety and effectiveness depend on maintaining the cold chain and using correct preparation/administration technique to prevent loss of potency and contamination. Correct storage and adherence to recommended injection procedures (right vaccine, route, site, spacing, and aseptic technique) are universally applicable across immunizations and prevent avoidable harm. Monitoring for acute reactions is important, but a fixed 1-hour observation period is not standard for all vaccines and does not address the foundational requirement that the dose administered is potent and safely prepared. Taking vaccines out 1 hour early is not a universal rule and can be unsafe for products requiring strict temperature control, and giving multiple vaccines at the same site can impair local tissue tolerance and accurate documentation of reactions.

Question 14

Two military personnel are hospitalized after exposure more than 2 hours ago to liquid sulfur mustard during a terrorist attack. Which assessment finding should the nurse associate with the exposure to liquid sulfur mustard?

Accepted Answer

Answer reason: A classic finding is erythema followed by small vesicles/blisters on exposed skin, often developing hours after contact, especially with liquid exposure. In contrast, nerve hyperstimulation is more consistent with organophosphate nerve agents, which cause cholinergic signs (e.g., fasciculations, bronchorrhea). Profuse bleeding from orifices suggests a blood agent/anticoagulant-type exposure, and frothy sputum is more typical of pulmonary edema from choking agents rather than primary vesicant skin injury.

Question 15

A health care agency has different receptacles for the various categories of institutional waste. Into which container should the nurse dispose of a suction canister used to collect bloody drainage from the client’s NG tube?

Accepted Answer

Answer reason: A suction canister with bloody NG drainage is therefore disposed of in the facility’s infectious (biohazard) waste stream per infection-control policy. “Injurious” waste is intended for sharps or items that can puncture/tear (e.g., needles, broken glass), which does not best fit a closed canister. “Hazardous” waste typically refers to chemical/pharmaceutical/toxic materials, and a bathroom wastebasket is inappropriate due to contamination and exposure risk.

Question 16

A nurse administers intravenous chemotherapeutic drugs to a client. When the infusion is complete, the nurse should?

Accepted Answer

Answer reason: Chemotherapeutic agents are hazardous drugs, so post-infusion handling prioritizes containment to prevent staff exposure via skin contact, aerosolization, or environmental contamination. Discarding all contaminated disposables (e.g., tubing, bags, gloves, pads) into a designated chemotherapy waste container and securing the lid immediately limits leakage and accidental contact. Simply removing tubing from the bag increases the chance of spilling residual drug and contaminating hands/surfaces. Biohazard disposal is not the same as hazardous drug waste; chemotherapy waste requires the proper dedicated container per facility policy and hazardous materials standards.

Question 17

The physician instructs the nurse to place body tissue obtained from a biopsy into a container with formalin prior to sending it to pathology. The nurse is not familiar with formalin and obtains the MSDS to read the precautions for handling formalin. MSDS stands for?

Accepted Answer

Answer reason: Hazardous chemicals used in healthcare require standardized safety documentation so staff can quickly identify risks and protective measures. An MSDS provides key information such as required PPE, safe handling and storage, spill/first-aid procedures, and exposure hazards for substances like formalin. Accessing the MSDS is the appropriate step when unfamiliar with a chemical because it supports compliance with workplace safety regulations and reduces risk of toxic exposure. The other choices are not recognized occupational-safety documents and do not represent the established acronym used for chemical hazard communication.

Question 18

The nurse is caring for the client who received afterload internal radiotherapy (brachytherapy) for treatment of uterine cancer. The nurse manager evaluates that the nurse uses correct hazardous material precautions when noting that the nurse takes which action?

Accepted Answer

Answer reason: Limiting time near the client directly decreases cumulative radiation dose and is a core nursing precaution for brachytherapy. A distance of only 1 foot is insufficient; staff should maximize distance (typically about 6 feet) when possible. Double-bagging linens is not a routine radiation precaution unless contamination is suspected, and lead gloves/aprons are not the primary control compared with using assigned dosimetry and applying time/distance strategies.

Question 19

A client recently diagnosed with diabetes is sent home with a prescription for subcutaneous insulin. The client and family are concerned about how they should discard the needles at home. The client and family demonstrate they understand the teaching when they state?

Accepted Answer

Answer reason: Home sharps disposal teaching prioritizes preventing needlestick injury and containing contaminated needles in a puncture-resistant, leak-resistant, closable container. A rigid plastic container with a secure screw-on lid functions as an acceptable improvised sharps container when an FDA-cleared sharps box is not available, reducing risk to household members and waste handlers. Stating that no special handling is needed is unsafe because loose needles can puncture bags and injure others. Requiring a hospital-issued container or hospital drop-off is overly restrictive and not necessary for safe immediate home containment; local disposal rules may vary, but safe containment is the key principle.

Question 20

A vase falls from a table located in the hallway of an assisted living facility and shatters. Proper removal of the glass includes?

Accepted Answer

Answer reason: The core safety principle is to prevent staff/resident injury and avoid puncture or laceration hazards during cleanup. A broom and dustpan minimize direct hand contact with sharp fragments and reduce the risk of cuts while collecting pieces. Disposing of broken glass in a puncture-resistant container prevents bag punctures and subsequent injuries to housekeeping staff handling regular trash. Using a wet mop can spread small shards and contaminate equipment, and putting glass into a standard garbage can increases risk of puncture through liners and accidental cuts.

Question 21

A chemical exposure event occurs during a football game. The hospital is notified and expects to receive clients. Which statement is most important regarding the decontamination of clients who are nonambulatory?

Accepted Answer

Answer reason: In hazardous chemical exposure events, the first safety priority is preventing secondary contamination and protecting healthcare workers and the facility. Proper PPE (e.g., gloves, gown, eye/face protection, respirator as indicated) must be donned before any contact, especially when assisting nonambulatory clients who require close handling during decontamination. Keeping contaminated clothing on increases ongoing exposure and off-gassing and also contaminates transport areas, making that approach unsafe. Eye irrigation is commonly necessary when exposure is possible, and tepid/cool water is preferred because hot water can increase skin absorption and vasodilation, potentially worsening systemic uptake.

Question 22

Which of the following is an appropriate nursing action when caring a patient who has a radium implant for cancer of cervix?

Accepted Answer

Answer reason: Using shielding during direct care is appropriate because the implant emits radiation while it remains in place, and protective barriers reduce scatter to the caregiver. Visitor restriction is typically based on institutional policy and overall time/distance limits rather than a fixed universal “10 minutes,” so it is less reliably correct as written. Urine is not radioactive with a sealed radium implant, so special lead-lined storage is unnecessary, and IM injections are not contraindicated solely due to the implant.

Question 23

You are changing bed linens for a patient and notice an IV catheter needle in the bed. What should your next course of action be?

Accepted Answer

Answer reason: The safest action is to place it directly into a designated puncture-resistant sharps container without recapping or carrying it around unnecessarily. Delegating to environmental services delays hazard control and increases risk to others handling linens. Disposing of a needle in regular trash violates standard precautions and facility safety policy, creating a significant injury and infection-control risk.

Question 24

Gloves papers are discarded in which BMW dustbin?

Accepted Answer

Answer reason: Used gloves are considered contaminated recyclable plastic/rubber items and are therefore placed in the red category for disinfection (e.g., autoclaving/microwaving) followed by recycling. Yellow is reserved for infectious incinerable waste (e.g., soiled anatomical/pathological waste), and blue is mainly for glassware/metallic implants. Correct segregation reduces sharps/biological exposure risk and avoids improper treatment or environmental contamination.

Question 25

A patient is scheduled for transvaginal ultrasound testing. Which preparation by the nurse is appropriate?

Accepted Answer

Answer reason: A history of banana allergy raises suspicion for latex-fruit syndrome, which increases the likelihood of a clinically significant latex sensitivity and potential anaphylaxis. Screening beforehand allows substitution with latex-free equipment and appropriate precautions. Positioning and expectations about discomfort are secondary and do not address the highest-risk complication compared with an allergic reaction.

Question 26

Which medication should never been given IV push?

Accepted Answer

Answer reason: Concentrated potassium chloride must be diluted and administered via an infusion pump at a controlled rate, never as an IV bolus. Medications like morphine and midazolam may be given IV in carefully titrated doses per protocol with close monitoring, and furosemide can also be given slow IV push when ordered. The key safety principle is that electrolytes capable of causing immediate electrical instability of the myocardium require controlled infusion rather than push dosing.

Question 27

Contact of client on radiation therapy should be limited only to how many minutes to promote safety of the therapy personnel?

Accepted Answer

Answer reason: Limiting bedside time reduces cumulative occupational exposure, especially when caring for patients receiving internal radiation (brachytherapy) who can emit radiation while the source is in place. A commonly taught nursing guideline is to cluster care and keep close contact to brief periods, about 5 minutes, to reduce exposure while still meeting patient needs. Shorter limits like 1–3 minutes are not standard for routine care, while 10 minutes allows unnecessary exposure compared with recommended time-minimization practices.

Question 28

The registered nurse is making assignments for the day. Which client should be assigned to the pregnant nurse?

Accepted Answer

Answer reason: In contrast, clients with internal radiation sources (implants, soluble brachytherapy, or implanted seeds) emit radiation and require time, distance, and shielding precautions, with pregnant staff avoiding assignment when possible. Radium implants and iridium seeds involve a source inside the body that continues to deliver radiation, creating exposure risk to caregivers. Assigning the pregnant nurse to external-beam therapy best minimizes occupational fetal radiation exposure while maintaining safe patient care.

Question 29

Six clients arrive at the emergency department following exposure to chemicals during a spraying incident. All clients report itching but are conscious, alert, and have stable vital signs. What is the nurse's priority intervention?

Accepted Answer

Answer reason: " The priority principle in suspected chemical contamination is to stop ongoing exposure and prevent secondary contamination of staff and the environment. Removing contaminated clothing is the fastest high-impact decontamination step because it eliminates a major reservoir of the chemical and reduces continued dermal absorption that can worsen symptoms even when current vital signs are stable. Symptom treatment (e.g., antipruritics) is delayed until decontamination is initiated, because medication does not remove the offending agent. Ongoing assessment is important, but it follows immediate hazard control to reduce risk to everyone in the emergency department.

Question 30

The nurse is preparing to start a peripheral intravenous (IV) line in a client. The client’s record indicates a latex allergy. What action should be taken by the nurse?

Accepted Answer

Answer reason: Latex allergy requires preventing exposure to latex-containing medical supplies to reduce risk of urticaria, bronchospasm, or anaphylaxis. Many tourniquets contain natural rubber latex, so using a blood pressure cuff instead of a latex tourniquet avoids a common, high-contact latex source during IV insertion. Povidone-iodine relates to iodine sensitivity rather than latex, so it does not address the stated allergy. The best immediate nursing action is to choose equipment and techniques that minimize latex exposure during the procedure.

Question 31

The nurse provides care for a client who has an internal radium implant. Which action is appropriate for the nurse to take?

Accepted Answer

Answer reason: Radiation safety follows the principles of time, distance, and shielding to minimize staff exposure. Because an internal radium implant emits radiation, clustering care and limiting time at the bedside reduces cumulative dose while still meeting care needs. Shielding (e.g., lead) may be used based on isotope/energy and facility policy, but the universally appropriate nursing action is to reduce exposure time and avoid unnecessary room entry. A dedicated stethoscope addresses infection control rather than radiation, and caregiver sex assignment is irrelevant to radiation risk.

Question 32

A client’s radiation implant has become dislodged overnight, and the nurse finds it in the client’s bed. What does the nurse do first?

Accepted Answer

Answer reason: The priority is immediate radiation safety using time–distance–shielding to minimize staff and client exposure. Handling a dislodged sealed radioactive source requires using long-handled forceps/tongs to increase distance and placing it into the designated lead-lined container to provide shielding. After the source is secured, the nurse can notify radiation safety and then assess the client and environment for exposure issues. Attempting to replace it or handling it with gloves risks unnecessary exposure and violates hazardous material handling procedures.

Question 33

The nurse in the emergency department (ED) is notified that multiple workers in a local plant have been exposed to radioactive materials and will be arriving shortly. Which action does the nurse take first?

Accepted Answer

Answer reason: The priority in radiologic contamination events is to protect staff and other patients by preventing secondary contamination of the facility. Establishing an external decontamination area allows removal of clothing and irrigation/washing before the clients enter the ED, which rapidly reduces contamination spread and exposure risk. Locating a reaction kit is supportive but does not immediately control environmental contamination and is less time-critical than containment. Notifications and waiting for official verification delay safety actions and increase the risk that radioactive material is tracked into the department.

Question 34

A nurse is assigned to care for a client with an internal radiation implant. Which of the following should not be included in the plan of care?

Accepted Answer

Answer reason: Internal radiation implants (brachytherapy) require radiation-safety measures to protect staff and the public, including a private room to limit exposure to others. A semiprivate room would unnecessarily expose a roommate and additional visitors/staff to radiation, violating time–distance–shielding principles. Gloves for handling excreta and a lead apron for close, direct care are appropriate protective measures, and controlling potentially contaminated linens in the room supports safe handling procedures until the source is removed. Therefore, rooming the client with another patient should be excluded from the care plan.

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