Emergency response, workplace safety and unsafe staff

56 NCLEX-RN practice questions on Emergency response, workplace safety and unsafe staff, part of Safety and Infection Prevention and Control. 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 · Easy · Select all that apply
The nurse teaches a family about home fire safety. Which points should the nurse include?
1. ATest smoke alarms once a month
2. BIf smoke fills a room, stand up and run to the nearest door
3. CKeep space heaters at least 3 feet (1 m) from anything that can burn
4. DPractice an escape plan with two ways out of every room
5. EInstall smoke alarms on every level and outside sleeping areas
6. FHide in a closet if fire blocks the way out
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Answer: A, C, D, E
Generate solutions: home fire safety relies on working smoke alarms, a practiced plan with two exits, safe heater spacing and staying low under smoke.
- B: Smoke rises; people should stay low and crawl under it.
- F: Hiding delays rescue; go to a window and signal for help instead.
Question 2 · Medium · Select all that apply
After a confirmed anthrax spore release at an office, a worker starts oral ciprofloxacin for prophylaxis. Which statements indicate the teaching was effective?
1. A"My family does not need to stay away from me, because it does not spread person to person."
2. B"I will take the tablets with a glass of milk."
3. C"I should report fever, cough or chest discomfort right away."
4. D"I will take every dose for the full 60 days, even if I feel fine."
5. E"I will stop the pills if I have no symptoms after 1 week."
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Answer: A, C, D
Evaluate outcomes: understanding is shown by completing the full 60-day course, knowing anthrax is not contagious and reporting early symptoms; stopping early or taking ciprofloxacin with dairy shows a need for more teaching.
- B: Calcium in dairy binds ciprofloxacin and reduces its absorption.
- E: Stopping early leaves the worker at risk from spores that germinate later.
Question 3 · Hard · Select all that apply
Which findings should make an emergency department nurse suspect a covert biological attack?
1. AIllness that does not respond to usual treatment
2. BA gradual rise in influenza cases during the winter
3. CSeveral previously healthy adults with the same severe illness within hours
4. DA disease that is rare in the region or out of its usual season
5. EMany sick or dead animals reported in the same area
6. FIll clients who all attended one event or shared one ventilation system
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Answer: A, C, D, E, F
Recognize cues: CDC warning signs of bioterrorism are clusters of severe illness in healthy people, unusual diseases, places or seasons, a shared exposure, animal deaths and illness that fails usual treatment.
- B: A slow seasonal rise is the expected pattern of influenza.
Question 4 · Hard · Select all that apply
An active shooter is reported in another wing of the hospital. The nurse is in a room with two ambulatory clients, and the hallway to the exit is not safe. Which actions should the nurse take?
1. APull the fire alarm to warn others on the unit
2. BKeep hands empty and visible when police enter
3. CStep into the corridor to see where the shooter is
4. DStay out of view of the window in the door
5. ELock or barricade the room door
6. FSilence cell phones and turn off the lights
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Answer: B, D, E, F
Take action: run if a safe route exists; if not, hide by locking or barricading, silencing phones and staying out of sight, and keep hands visible for arriving police. Fighting is the last resort.
- A: A fire alarm draws people into hallways where the shooter may be.
- C: Leaving cover exposes the nurse when escape is unsafe.
Question 5 · Hard · Select all that apply
The hospital activates its emergency operations plan for a mass-casualty incident. Which actions should the charge nurse on a medical unit take?
1. AAccept casualties directly from the scene without hospital triage
2. BIdentify stable clients who could be discharged or transferred
3. CCall in off-duty staff as directed by the command center
4. DReport the unit's available beds and staff to the command center
5. ESend all assistive personnel to the emergency department without an assignment
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Answer: B, C, D
Generate solutions: under the incident command system, units report capacity, create surge beds and act on command-center direction rather than acting independently.
- A: All casualties enter through triage so that the most urgent are treated first.
- E: Self-deployment outside the incident command structure creates chaos.
Question 6 · Medium · Select all that apply
A client in the emergency department is pacing, swearing loudly and refusing to sit down. Which actions should the nurse take while approaching the client?
1. AClose the door to the room to give the client privacy
2. BSpeak in a calm, low voice using short sentences
3. CRemove a stethoscope worn loosely around the neck
4. DStand at an angle, more than an arm's length away
5. ETurn away to document while the client calms down
6. FKeep a clear path to the door for both the nurse and the client
Answer and explanation in LearnFree account
Question 7 · Medium · Matrix
During a home visit to an older adult who lives alone, the nurse notes the following. For each finding, indicate whether it requires follow-up.
For each row, choose: Requires follow-up / Does not require follow-up
1. Hot tap water measured at 130°F (54°C)
2. A space heater about 1 foot (30 cm) from the curtains
3. Medicines kept in their original labeled bottles
4. A carbon monoxide alarm outside the bedrooms
5. A loose rug at the top of the stairs
6. Night lights from the bedroom to the bathroom
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Question 8 · Medium · Matrix
The nurse is caring for a client with external radioactive contamination. For each action, indicate the radiation protection principle it applies.
For each row, choose: Time / Distance / Shielding
1. Plan care in advance so tasks are done quickly
2. Rotate staff so each spends less time at the bedside
3. Stand away from the client when not giving direct care
4. Place a portable lead shield between staff and the source
5. Place removed contaminated items in a lead-lined container
6. Pick up a radioactive fragment with long forceps
Answer and explanation in LearnFree account
Question 9 · Medium · Select all that apply
A hurricane warning is issued for a coastal county. Which clients on a home health caseload need early evacuation planning?
1. AAdult with well-controlled hypertension who drives
2. BAdult recovering from knee arthroscopy who walks independently
3. CClient who has hemodialysis three times a week
4. DClient with type 2 diabetes controlled with oral metformin
5. EClient who uses a home mechanical ventilator
Answer and explanation in LearnFree account
Question 10 · Medium · Select all that apply
The nurse and a colleague are moving a dependent adult client up in bed. Which practices reduce the nurse's risk of back injury?
1. ABend at the waist and lift with the back muscles
2. BRaise the bed to about the nurse's waist height
3. CFace the direction of movement with feet apart
4. DReach with the arms fully extended from the body
5. EUse a friction-reducing sheet under the client
6. FLower the bed to its lowest position before moving
Answer and explanation in LearnFree account
Question 11 · Hard · Select all that apply
During a shift, a nurse sees a colleague put a vial of hydromorphone from a client's dispensed dose into a uniform pocket. The client later reports unrelieved pain. Which actions should the nurse take?
1. APost a warning about the colleague in a staff group chat
2. BReport the observation promptly to the charge nurse or nurse manager
3. CWait to collect more evidence over the next week
4. DReassess the client's pain and arrange relief
5. EAgree to keep it private if the colleague returns the vial
6. FWrite a factual account of what was seen, with time and place
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Question 12 · Easy · Select all that apply
A community nurse teaches families to prepare an emergency supply kit. Which items should the kit contain?
1. AFlashlight with spare batteries
2. BWater, 1 gallon (about 4 L) per person per day for at least 3 days
3. CCopies of prescriptions and important documents
4. DBattery-powered or hand-crank radio
5. ENonperishable food for at least 3 days
6. FCandles as the main source of light
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Question 13 · Medium · Select all that apply
A client with moderate Alzheimer disease lives with an adult daughter. Which recommendations by the nurse promote safety at home?
1. ARearrange the furniture often to stimulate memory
2. BRaise the bed rails at night to stop the client getting up
3. CLeave the car keys in their usual place so the client does not feel restricted
4. DFit door alarms or locks placed outside the client's usual line of sight
5. ERemove the stove knobs or fit an automatic shut-off
6. FSet the water heater at 120°F (49°C) or lower
Answer and explanation in LearnFree account
Question 14 · Hard · Matrix
A fire forces the evacuation of a medical unit. For each task, indicate whether the registered nurse should do it or may assign it to assistive personnel.
For each row, choose: Registered nurse / Assistive personnel
1. Escort stable, ambulatory clients to the safe area
2. Monitor a client who is receiving a blood transfusion during the move
3. Decide the order in which clients leave, based on their condition
4. Bring extra blankets and linens to the holding area
5. Assess a client with a new chest tube for readiness to move
6. Take vital signs of a stable client after the move
Answer and explanation in LearnFree account
Question 15 · Medium · Matrix
A hospital safety committee reviews conditions in the emergency department. For each condition, indicate whether it increases or reduces the risk of workplace violence.
For each row, choose: Increases risk / Reduces risk
1. Clear sight lines and good lighting in the waiting area
2. Duress alarms at the nurses' station and triage desk
3. Regular staff training in de-escalation
4. A nurse working alone in triage during the night shift
5. Long waits without updates for families
6. Unrestricted public entry to inpatient units
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Question 16 · Medium · Select all that apply
A home health nurse is planning visits in an unfamiliar neighborhood. Which actions promote the nurse's personal safety?
1. APark on the street facing the way out rather than in the driveway
2. BContinue the visit when a family member makes threats, to avoid abandoning the client
3. CGive the agency the visit schedule and check in after each visit
4. DEnd the visit and leave if a person in the home is armed or intoxicated
5. ELeave a purse and valuables visible on the car seat
6. FKeep car keys and a charged phone within easy reach
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Question 17 · Hard · Matrix
The nurse teaches the parent of a 9-month-old about home safety. For each statement by the parent, indicate whether the teaching was effective or needs more teaching.
For each row, choose: Effective / Needs more teaching
1. "She rides rear-facing in her car seat in the back seat."
2. "I set our water heater to 120°F (49°C)."
3. "Her crib is next to the window blinds so she can look outside."
4. "I put her to sleep on her back with no blankets or bumpers in the crib."
5. "A baby walker lets her move around the house safely."
6. "I keep a bottle of ipecac syrup in case she swallows something."
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Question 18 · Hard · Matrix
At a bus crash, the nurse uses START triage. For each casualty, indicate the triage category.
For each row, choose: Immediate (red) / Delayed (yellow) / Minor (green)
1. Cannot walk because of hip pain; RR 18/min, capillary refill under 2 seconds, follows commands
2. Cannot walk because of an open leg fracture; RR 20/min, radial pulse present, follows commands
3. Cannot walk; respiratory rate 36/min
4. Walks to the collection point holding a bleeding forearm cut
5. Cannot walk; RR 16/min, radial pulse present, cannot follow simple commands
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Question 19 · Medium · Matrix
The nurse is speaking with a family member who is angry about a long wait for a bed. For each statement, indicate whether it is therapeutic or nontherapeutic for de-escalation.
For each row, choose: Therapeutic / Nontherapeutic
1. "Would you like to talk here or in the quieter room by the window?"
2. "Calm down, or I will have security remove you."
3. "I can see you are frustrated about how long this is taking."
4. "You are acting like a child in front of everyone."
5. "I will check on the bed and come back to you in 10 minutes."
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Question 20 · Hard · Matrix
The nurse observes the following practices by colleagues during a shift. For each practice, indicate whether it is unsafe and needs reporting through the chain of command or is acceptable practice.
For each row, choose: Unsafe: report / Acceptable
1. Scans spare wristbands taped to the medication cart instead of the client's band
2. Charts hourly safety rounds before they are done
3. Asks the charge nurse for help with an unfamiliar insulin pump
4. Repeatedly skips hand hygiene between clients
5. Wastes part of an opioid dose while a second nurse watches
6. Takes a meal break after handing off clients to a colleague
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Question 21 · Hard · Select all that apply
The nurse is the first triage officer at a multiple-vehicle crash and is using START. Which actions are part of the initial START assessment?
1. AReposition the airway of a casualty who is not breathing
2. BCheck for a radial pulse or capillary refill
3. CBegin CPR on a casualty without a pulse
4. DSplint fractures before assigning a tag
5. EDirect everyone who can walk to a designated area
6. FAsk the casualty to follow a simple command
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Question 22 · Medium · Matrix
The nurse reviews findings in clients exposed after a suspected bioterrorism event. For each finding, indicate the agent it most suggests.
For each row, choose: Anthrax / Botulism / Smallpox
1. Widened mediastinum on chest x-ray after a flu-like illness
2. Deep, firm pustules all at the same stage of development
3. High fever and prostration for several days before a rash
4. Slurred speech and trouble swallowing with no fever
5. Symmetric weakness spreading downward from the face to the arms
6. Painless skin ulcer covered by a black eschar
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Question 23 · Hard
During a mass-casualty surge, an RN is working with an assistive personnel member. Which task should the RN delegate to the assistive personnel?
1. ATaking vital signs on clients tagged green
2. BRechecking a delayed client's mental status
3. CTeaching discharged clients about wound care
4. DTriaging new arrivals at the ambulance door
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Question 24 · Medium
At the start of the shift, a nurse notices that a coworker smells of alcohol and is slurring words while taking report. What should the nurse do?
1. AOffer the coworker black coffee
2. BCall the board of nursing immediately
3. CReport this to the charge nurse right away
4. DSpeak with the coworker after the shift
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Question 25 · Medium
At a train derailment, a nurse using START triage finds a woman who cannot walk. She is breathing 22 times a minute and follows commands, but no radial pulse can be felt. The nurse tags her:
1. AMinor (green)
2. BDelayed (yellow)
3. CImmediate (red)
4. DExpectant (black)
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Emergency response, workplace safety and unsafe staff

The nurse teaches a family about home fire safety. Which points should the nurse include?

After a confirmed anthrax spore release at an office, a worker starts oral ciprofloxacin for prophylaxis. Which statements indicate the teaching was effective?

Which findings should make an emergency department nurse suspect a covert biological attack?

An active shooter is reported in another wing of the hospital. The nurse is in a room with two ambulatory clients, and the hallway to the exit is not safe. Which actions should the nurse take?

The hospital activates its emergency operations plan for a mass-casualty incident. Which actions should the charge nurse on a medical unit take?

A client in the emergency department is pacing, swearing loudly and refusing to sit down. Which actions should the nurse take while approaching the client?

During a home visit to an older adult who lives alone, the nurse notes the following. For each finding, indicate whether it requires follow-up.

The nurse is caring for a client with external radioactive contamination. For each action, indicate the radiation protection principle it applies.

A hurricane warning is issued for a coastal county. Which clients on a home health caseload need early evacuation planning?

The nurse and a colleague are moving a dependent adult client up in bed. Which practices reduce the nurse's risk of back injury?

During a shift, a nurse sees a colleague put a vial of hydromorphone from a client's dispensed dose into a uniform pocket. The client later reports unrelieved pain. Which actions should the nurse take?

A community nurse teaches families to prepare an emergency supply kit. Which items should the kit contain?

A client with moderate Alzheimer disease lives with an adult daughter. Which recommendations by the nurse promote safety at home?

A fire forces the evacuation of a medical unit. For each task, indicate whether the registered nurse should do it or may assign it to assistive personnel.

A hospital safety committee reviews conditions in the emergency department. For each condition, indicate whether it increases or reduces the risk of workplace violence.

A home health nurse is planning visits in an unfamiliar neighborhood. Which actions promote the nurse's personal safety?

The nurse teaches the parent of a 9-month-old about home safety. For each statement by the parent, indicate whether the teaching was effective or needs more teaching.

At a bus crash, the nurse uses START triage. For each casualty, indicate the triage category.

The nurse is speaking with a family member who is angry about a long wait for a bed. For each statement, indicate whether it is therapeutic or nontherapeutic for de-escalation.

The nurse observes the following practices by colleagues during a shift. For each practice, indicate whether it is unsafe and needs reporting through the chain of command or is acceptable practice.

The nurse is the first triage officer at a multiple-vehicle crash and is using START. Which actions are part of the initial START assessment?

The nurse reviews findings in clients exposed after a suspected bioterrorism event. For each finding, indicate the agent it most suggests.

During a mass-casualty surge, an RN is working with an assistive personnel member. Which task should the RN delegate to the assistive personnel?

At the start of the shift, a nurse notices that a coworker smells of alcohol and is slurring words while taking report. What should the nurse do?

At a train derailment, a nurse using START triage finds a woman who cannot walk. She is breathing 22 times a minute and follows commands, but no radial pulse can be felt. The nurse tags her: