A patient on warfarin had an unwitnessed fall in the bathroom. She was helped back to bed, says she feels fine and has no visible injury. Which follow-up is most important?

Regular neurological observations and prompt medical review

Holding the next warfarin dose without telling the doctor

Moving her to a chair so she can be watched more easily

Reassurance and routine four-hourly vital signs only

A woman who had spinal anaesthesia for a caesarean section asks to walk to the toilet 3 hours later. Before she gets up for the first time, the nurse should:

Check her leg strength and sensation, then help her stand

Keep her in bed until the next morning's ward round

Allow her to walk alone if she says that she feels well

Give her a urinal and tell her to stay flat

A high fall-risk patient with a hip replacement insists on getting up at dawn to perform ablution (wudu) before prayer. What is the most appropriate response?

Offer to help him with ablution at the bedside with a basin and jug

Explain that he must not pray until he is discharged home

Raise all four side rails until his prayer time has passed

Let him walk to the washroom alone because prayer is a private matter

A post-operative patient has RR 26/min, SpO2 92% on room air, BP 96/60 mmHg, HR 118/min, temperature 38.4 °C and is alert. Using NEWS2 (aggregate 5-6 urgent response, 7 or more emergency response), what response is needed?

Emergency response by the rapid response team, score 10

Routine four-hourly observations, score 4

Urgent ward review by the doctor, score 6

Hourly observations by the nurse, score 8

When a nurse receives a telephone order from a physician, IPSG 2 requires the nurse to:

Write the order down and read it back to the prescriber

Give the drug, then ask the prescriber to sign the order

Ask a colleague to listen on the speakerphone

Repeat the order and give it straight away

Patient safety goals, falls and restraints

40 Gulf Prometric RN (DHA, DOH, MOH, SCFHS) practice questions on Patient safety goals, falls and restraints, part of Fundamentals and Patient Safety. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
A patient on warfarin had an unwitnessed fall in the bathroom. She was helped back to bed, says she feels fine and has no visible injury. Which follow-up is most important?
1. AHolding the next warfarin dose without telling the doctor
2. BRegular neurological observations and prompt medical review
3. CMoving her to a chair so she can be watched more easily
4. DReassurance and routine four-hourly vital signs only
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Answer: B · Regular neurological observations and prompt medical review
An unwitnessed fall may include a head strike the patient does not remember. Anticoagulation raises the risk of delayed intracranial bleeding, which can appear hours later, so neurological observations are started and the doctor reviews her, often with a low threshold for CT. Any drop in consciousness, headache, vomiting or new weakness is reported at once. The fall risk is reassessed and an incident report completed.
- A: Changing an anticoagulant without an order is outside the nurse's role.
- C: A chair does not monitor for bleeding and may raise the fall risk further.
- D: Routine observations can miss a delayed intracranial bleed.
Question 2 · Medium
A woman who had spinal anaesthesia for a caesarean section asks to walk to the toilet 3 hours later. Before she gets up for the first time, the nurse should:
1. AKeep her in bed until the next morning's ward round
2. BAllow her to walk alone if she says that she feels well
3. CCheck her leg strength and sensation, then help her stand
4. DGive her a urinal and tell her to stay flat
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Answer: C · Check her leg strength and sensation, then help her stand
After spinal anaesthesia, the motor and sensory block may not have fully worn off. The nurse checks that she can lift and bend her legs and feel touch, then helps her sit, dangle and stand with assistance for the first time. Blood loss and analgesia add to the risk of fainting. Early mobilisation is still encouraged once it is safe.
- A: Unnecessary bed rest delays recovery and raises thrombosis risk.
- B: Feeling well does not prove the block has fully worn off.
- D: A urinal is not suited to most women, and lying flat is not required.
Question 3 · Medium
A high fall-risk patient with a hip replacement insists on getting up at dawn to perform ablution (wudu) before prayer. What is the most appropriate response?
1. AExplain that he must not pray until he is discharged home
2. BRaise all four side rails until his prayer time has passed
3. COffer to help him with ablution at the bedside with a basin and jug
4. DLet him walk to the washroom alone because prayer is a private matter
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Answer: C · Offer to help him with ablution at the bedside with a basin and jug
Respecting religious practice and preventing falls can both be achieved. A basin and jug at the bedside, or a staff-supported walk with his aids, lets him perform ablution safely. Islam permits ablution and prayer adapted to illness, and many patients welcome this. Forbidding prayer or restricting him harms trust and may make him get up alone.
- A: Forbidding prayer disrespects his faith and may drive him to get up unassisted.
- B: Four raised rails act as a restraint and raise the risk of climbing over them.
- D: Walking alone after hip surgery with a high fall risk is unsafe.
Question 4 · Hard
A post-operative patient has RR 26/min, SpO2 92% on room air, BP 96/60 mmHg, HR 118/min, temperature 38.4 °C and is alert. Using NEWS2 (aggregate 5-6 urgent response, 7 or more emergency response), what response is needed?
1. ARoutine four-hourly observations, score 4
2. BUrgent ward review by the doctor, score 6
3. CHourly observations by the nurse, score 8
4. DEmergency response by the rapid response team, score 10
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Answer: D · Emergency response by the rapid response team, score 10
NEWS2 scores: RR 26 = 3, SpO2 92% = 2, room air = 0, systolic 96 = 2, HR 118 = 2, alert = 0, temperature 38.4 = 1. The total is 3 + 2 + 2 + 2 + 1 = 10. A score of 7 or more calls for an emergency response, such as the rapid response team, with continuous monitoring. These findings also suggest sepsis, so the sepsis bundle is started.
- A: Routine observations ignore a very high score.
- B: A score of 6 undercounts several parameters, and the total is 10.
- C: Even a score of 8 calls for an emergency response, not just nursing observations.
Question 5 · Easy
When a nurse receives a telephone order from a physician, IPSG 2 requires the nurse to:
1. AGive the drug, then ask the prescriber to sign the order
2. BAsk a colleague to listen on the speakerphone
3. CRepeat the order and give it straight away
4. DWrite the order down and read it back to the prescriber
Show answerHide answer
Answer: D · Write the order down and read it back to the prescriber
The full process for verbal and telephone orders is write down, read back and confirm. The receiver records the complete order, reads it back, and the prescriber confirms that it is correct. Read-back catches mishearing of drug names, doses and units. The prescriber then signs the order within the time set by hospital policy.
- A: Giving the drug before confirming the order skips the safety check.
- B: A listener does not replace write-down and read-back with the prescriber.
- C: Repeating without writing it down first leaves no record and misses errors.
Question 6 · Medium
After caring for a patient with Clostridioides difficile diarrhoea, the nurse removes her gloves. The hand hygiene method required is:
1. AChlorhexidine-alcohol surgical rub
2. BAntiseptic wipe on hands and wrists
3. CAlcohol-based hand rub for 30 seconds
4. DWashing with soap and running water
Answer and explanation in LearnFree account
Question 7 · Medium
During the time out, the consent form says 'left inguinal hernia repair' but the site mark is on the right groin. The circulating nurse should:
1. AFollow the consent because it is the legal document
2. BFollow the site mark because the surgeon made it
3. CStop the procedure until the discrepancy is resolved
4. DRecord the discrepancy and let the surgeon decide later
Answer and explanation in LearnFree account
Question 8 · Easy
In the WHO Surgical Safety Checklist, the 'time out' is carried out:
1. AImmediately before the skin incision
2. BBefore induction of anaesthesia
3. COn arrival in the theatre reception area
4. DBefore the patient leaves theatre
Answer and explanation in LearnFree account
Question 9 · Medium
A pharmacy stores hydroxyzine and hydralazine in separate bins with labels printed as 'hydrOXYzine' and 'hydrALAZINE'. This practice reduces:
1. AErrors from unclear dose abbreviations
2. BAllergic reactions to the two medicines
3. CLook-alike, sound-alike drug errors
4. DDrug interactions between the two agents
Answer and explanation in LearnFree account
Question 10 · Hard
Using the Morse Fall Scale, score this patient: fell at home last month, has diabetes and hypertension, holds onto furniture to walk, has a saline lock, gait is weak, and he knows his limitations. High risk is 45 or more. What is the score and risk?
1. A40, moderate risk
2. B70, high risk
3. C85, high risk
4. D100, high risk
Answer and explanation in LearnFree account
Question 11 · Hard
A premixed bag of potassium chloride 40 mmol in 1,000 mL of 0.9% sodium chloride is ordered over 8 hours by pump. What rate should be set, and how much potassium will the patient receive each hour?
1. A250 mL/h, giving 10 mmol/h
2. B83 mL/h, giving 3.3 mmol/h
3. C40 mL/h, giving 1.6 mmol/h
4. D125 mL/h, giving 5 mmol/h
Answer and explanation in LearnFree account
Question 12 · Easy
Fall risk should be reassessed when a patient:
1. AHas had the bed linen changed
2. BHas eaten a full meal on the ward
3. CHas been given a new sedative or opioid
4. DHas been visited by several family members
Answer and explanation in LearnFree account
Question 13 · Medium
A confused patient has a physician's order for bilateral soft wrist restraints. How should the nurse care for him while they are on?
1. ACheck the restraints only when the patient calls out
2. BRelease one limb at a time to check skin, circulation and movement
3. CKeep both restraints on until the order expires
4. DRemove both restraints together once a day for skin care and bathing
Answer and explanation in LearnFree account
Question 14 · Hard
Four patients on a medical ward are listed below. Which one should receive the highest priority for fall precautions tonight?
1. AA 30-year-old who used a walker before but walks steadily now
2. BA 40-year-old walking independently after a day of IV antibiotics
3. CA 65-year-old on bed rest with traction applied to one leg
4. DAn 82-year-old with new confusion and urinary frequency on diuretics
Answer and explanation in LearnFree account
Question 15 · Medium
A patient undergoes surgery on the wrong side. What does the hospital carry out after this sentinel event?
1. ADisciplinary action against the scrub nurse alone
2. BA root cause analysis of system and process failures
3. CA note in the chart that the error was unavoidable
4. DA staff vote on whether the event should be reported
Answer and explanation in LearnFree account
Question 16 · Medium
Before a nurse starts an insulin infusion, hospital policy requires an independent double check. This means a second nurse:
1. AChecks the order, dose and pump settings separately without being prompted
2. BWatches the first nurse prepare the drug and then signs the drug chart afterwards
3. CConfirms the calculation that the first nurse reads out to her
4. DCountersigns the chart at the end of the shift after review
Answer and explanation in LearnFree account
Question 17 · Medium
Two patients named Mohammed Ali Hassan are admitted to the same medical ward on the same day. The best safety measure is to:
1. AIdentify each patient by his bed number for the rest of the stay
2. BAsk each patient to state his own name before every medication round
3. CFlag both charts with a name alert and nurse them in separate rooms
4. DWrite the admitting consultant's name on both identification bands
Answer and explanation in LearnFree account
Question 18 · Medium
A 76-year-old man on furosemide and amlodipine feels dizzy when he stands up. Which fall-prevention measure targets the most likely cause?
1. ATeach him to sit on the bed edge before standing
2. BGive him a walking frame to use on the ward
3. CFit a bed-exit alarm and keep side rails raised
4. DAsk the family to stay with him at night
Answer and explanation in LearnFree account
Question 19 · Medium
A patient is scheduled for a right knee arthroscopy. The operative site should be marked by:
1. AThe surgeon who will perform the procedure
2. BThe theatre nurse who positions the patient
3. CThe anaesthetist after the sign in check
4. DThe ward nurse who prepares the patient
Answer and explanation in LearnFree account
Question 20 · Medium
The daughter of a confused elderly man asks the nurse to tie her father's hands at night 'so he will not pull out his drip.' What is the best response?
1. AExplain the risks and discuss safer options such as covering the drip site
2. BTie his hands loosely without an order, as it is only for one night
3. CAgree, because the family has the right to decide his care
4. DTell her restraints are banned and nothing can be done
Answer and explanation in LearnFree account
Question 21 · Medium
During the sign out at the end of an abdominal operation, the scrub nurse reports that one swab is missing. What should happen next?
1. AThe team searches the wound and theatre before closure is completed
2. BThe surgeon closes the wound and an X-ray is booked for the next day
3. CThe count is documented as incorrect and the patient is sent to recovery
4. DThe swab is presumed discarded and the count sheet is corrected
Answer and explanation in LearnFree account
Question 22 · Medium
A nurse phones the on-call doctor using SBAR: 'Please come and see him within 15 minutes and I would like an order for a fluid bolus.' This statement is the:
1. ASituation
2. BBackground
3. CAssessment
4. DRecommendation
Answer and explanation in LearnFree account
Question 23 · Medium
A physician writes 'wrist restraints PRN for agitation' on a patient's chart. The nurse should:
1. AAsk for a time-limited order with the reason stated
2. BApply the restraints at night as a routine measure
3. CKeep the order on file for use in all future admissions
4. DApply the restraints at the first sign of agitation
Answer and explanation in LearnFree account
Question 24 · Easy
Which measure is a standard fall precaution for a hospital bed when the nurse leaves the bedside?
1. AHighest height with the wheels locked
2. BLowest height with the wheels locked
3. CHead of the bed raised to 90 degrees
4. DLowest height with the wheels unlocked
Answer and explanation in LearnFree account
Question 25 · Easy
Under IPSG 3, a high-alert medicine that should be removed from ward stock is:
1. AConcentrated potassium chloride ampoules
2. BSodium chloride 0.9% bags of 1,000 mL
3. CParacetamol 1 g intravenous infusion
4. DCeftriaxone 1 g powder for injection
Answer and explanation in LearnFree account

15 more Patient safety goals, falls and restraints questions

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Study Fundamentals and Patient Safety

Patient safety goals, falls and restraints

A patient on warfarin had an unwitnessed fall in the bathroom. She was helped back to bed, says she feels fine and has no visible injury. Which follow-up is most important?

A woman who had spinal anaesthesia for a caesarean section asks to walk to the toilet 3 hours later. Before she gets up for the first time, the nurse should:

A high fall-risk patient with a hip replacement insists on getting up at dawn to perform ablution (wudu) before prayer. What is the most appropriate response?

A post-operative patient has RR 26/min, SpO2 92% on room air, BP 96/60 mmHg, HR 118/min, temperature 38.4 °C and is alert. Using NEWS2 (aggregate 5-6 urgent response, 7 or more emergency response), what response is needed?

When a nurse receives a telephone order from a physician, IPSG 2 requires the nurse to:

After caring for a patient with Clostridioides difficile diarrhoea, the nurse removes her gloves. The hand hygiene method required is:

During the time out, the consent form says 'left inguinal hernia repair' but the site mark is on the right groin. The circulating nurse should:

In the WHO Surgical Safety Checklist, the 'time out' is carried out:

A pharmacy stores hydroxyzine and hydralazine in separate bins with labels printed as 'hydrOXYzine' and 'hydrALAZINE'. This practice reduces:

Using the Morse Fall Scale, score this patient: fell at home last month, has diabetes and hypertension, holds onto furniture to walk, has a saline lock, gait is weak, and he knows his limitations. High risk is 45 or more. What is the score and risk?

A premixed bag of potassium chloride 40 mmol in 1,000 mL of 0.9% sodium chloride is ordered over 8 hours by pump. What rate should be set, and how much potassium will the patient receive each hour?

Fall risk should be reassessed when a patient:

A confused patient has a physician's order for bilateral soft wrist restraints. How should the nurse care for him while they are on?

Four patients on a medical ward are listed below. Which one should receive the highest priority for fall precautions tonight?

A patient undergoes surgery on the wrong side. What does the hospital carry out after this sentinel event?

Before a nurse starts an insulin infusion, hospital policy requires an independent double check. This means a second nurse:

Two patients named Mohammed Ali Hassan are admitted to the same medical ward on the same day. The best safety measure is to:

A 76-year-old man on furosemide and amlodipine feels dizzy when he stands up. Which fall-prevention measure targets the most likely cause?

A patient is scheduled for a right knee arthroscopy. The operative site should be marked by:

The daughter of a confused elderly man asks the nurse to tie her father's hands at night 'so he will not pull out his drip.' What is the best response?

During the sign out at the end of an abdominal operation, the scrub nurse reports that one swab is missing. What should happen next?

A nurse phones the on-call doctor using SBAR: 'Please come and see him within 15 minutes and I would like an order for a fluid bolus.' This statement is the:

A physician writes 'wrist restraints PRN for agitation' on a patient's chart. The nurse should:

Which measure is a standard fall precaution for a hospital bed when the nurse leaves the bedside?

Under IPSG 3, a high-alert medicine that should be removed from ward stock is: