- What is an important follow-up action for the LPN?
Answer: Participate in the accounting for all clients on the unit.
After an evacuation or fire event, a critical safety step is to account for every client and staff member to ensure no one is missing. The LPN plays a vital role in this process by participating in the head count and reporting to the charge nurse. The room must be assessed and cleared by safety/maintenance personnel before a client can return.
- When reporting a fire to the emergency dispatcher or operator, what is the most critical piece of information the nurse must provide?
Answer: The specific location of the fire.
The most critical piece of information for a rapid and effective response is the exact location of the fire (e.g., unit, floor, room number). This allows firefighters to proceed directly to the scene without delay. While other information may be helpful, the location is the absolute priority.
- Which response by the nurse is most accurate?
Answer: "It stands for 'Extinguish' if the fire is small, or 'Evacuate' if it is not."
The 'E' in the RACE acronym represents two possible actions depending on the situation: Extinguish and Evacuate. Staff should only attempt to extinguish a fire if it is very small (e.g., in a trash can) and they are trained to do so. Otherwise, the priority is to evacuate the area.
- Which task is appropriate for the LPN to delegate to the UAP?
Answer: Assist ambulatory clients to walk to a safe location.
Within the scope of practice for a UAP, assisting stable, ambulatory clients during an evacuation is an appropriate task. The UAP can guide or help them walk to a designated safe area. Assessing clients, administering medication, and providing information to families are responsibilities of the licensed nurse.
- What is the nurse's priority action?
Answer: Turn off the client's oxygen supply.
When fire is suspected and a client is receiving oxygen therapy, the priority is to immediately turn off the oxygen supply. Oxygen supports combustion and creates a significant fire hazard. After discontinuing oxygen, the nurse should then investigate the smoke source and follow RACE protocols as appropriate.
- An LPN understands that the primary reason for confining a fire by closing doors is to prevent the spread of what?
Answer: Heat and smoke.
The 'C' in RACE stands for Confine. Closing doors is a critical step because it creates a barrier that contains the fire to a smaller area and, most importantly, stops the rapid spread of toxic smoke and heat. Smoke inhalation is a leading cause of death in fires.
- Which client should the LPN evacuate first?
Answer: A client who is ambulatory and is closest to the fire.
During a fire, the priority for evacuation is clients in immediate danger. This includes those closest to the fire. Ambulatory clients can be moved more quickly, making them a priority for initial rescue efforts to clear the area nearest the hazard.
- After rescuing the client, which type of fire extinguisher should the nurse select to use on this fire?
Answer: Type C, for electrical equipment.
Fires are classified based on their fuel source. An electrical fire is a Class C fire. A Type C extinguisher contains a non-conductive agent suitable for energized electrical equipment. Using a water-based extinguisher (Type A) on an electrical fire could cause electrocution. Most hospital extinguishers are Type ABC, suitable for all common types of fires.
- The nurse has decided a fire is small enough to be extinguished with a portable extinguisher. After pulling the pin and aiming at the base of the fire, what is the next step according to PASS?
Answer: Squeeze the handles together.
The PASS mnemonic for fire extinguisher use is Pull, Aim, Squeeze, Sweep. After pulling the pin and aiming, the next action is to (S) Squeeze the handles together firmly to discharge the extinguishing agent.
- Which method is an appropriate way to move this client horizontally to an area of refuge?
Answer: Using a blanket to drag the client along the floor.
For non-ambulatory clients during an emergency evacuation where a bed or stretcher is not feasible, a blanket drag is a safe and effective method to move a client horizontally. Wheelchairs cannot be used on stairs. Asking a client to crawl may not be safe or possible. Waiting for the fire department is not appropriate when immediate evacuation is necessary.
- Which statement by the UAP indicates a need for further teaching?
Answer: "During an evacuation, I can use the service elevator to move clients faster."
Elevators should never be used during a fire because they can malfunction, lose power, and trap occupants. This statement indicates a critical misunderstanding of fire evacuation procedures and requires immediate correction. All other statements demonstrate correct understanding of fire safety principles.
- What is the primary goal of horizontal evacuation?
Answer: To move clients from the fire area to a safe area on the same floor.
Horizontal evacuation is the process of moving individuals from a hazardous area to a safe area on the same level or floor. This is the preferred initial method of evacuation in healthcare facilities because it is faster and less strenuous than vertical evacuation (moving between floors). Safe areas are typically located beyond a set of fire doors.
- Which action should the nurse take first?
Answer: Unplug the heating pad and explain the fire risk to the visitor.
A frayed electrical cord is a significant fire hazard. The nurse's first action should be to eliminate the immediate danger by unplugging the device. After ensuring safety, the nurse should educate the visitor about the risk. Reporting and documenting are also important but secondary to removing the immediate hazard.
- The LPN is reinforcing teaching with a client about fire safety in the hospital. Which client statement indicates a correct understanding of the instructions?
Answer: "I should remain in my room with the door closed if there is a fire in the hallway."
If a fire is in the hallway, the safest place for a client is often in their room with the door closed. Closing the door creates a barrier against fire and smoke. Staff will provide further instructions. Opening a window can draw smoke and fire into the room. Evacuation priority is typically for those in immediate danger first, not necessarily the most critically ill. Smoking is prohibited in hospitals.
- The nurse is contributing to the facility's fire safety plan. Which action best promotes fire prevention on a client care unit?
Answer: Keeping hallways and fire exits clear of obstruction.
While all options relate to safety, keeping hallways and fire exits clear of obstruction is a direct fire prevention and safety measure. Blocked exits can impede evacuation and firefighting efforts, creating a significant hazard. Equipment, linen carts, and other items must be stored properly to ensure a clear path for egress.
- Which action completes the PASS procedure?
Answer: Sweep the nozzle from side to side at the fire's base.
The final 'S' in the PASS mnemonic stands for Sweep. The nurse should sweep the nozzle back and forth across the base of the fire until the fire is completely out. This ensures that the entire fuel source is covered with the extinguishing agent.
- When using a fire extinguisher, the nurse knows to aim the nozzle at which part of the fire?
Answer: The base of the fire.
The 'A' in the PASS acronym for fire extinguisher use stands for Aim. The nozzle should be aimed at the base of the fire, where the fuel source is. Extinguishing the fuel source is the most effective way to put out the fire.
- An LPN working in a long-term care facility is reviewing the fire evacuation plan. The plan should prioritize the evacuation of which group of residents first?
Answer: Residents who are located closest to the fire.
Regardless of mobility status, the absolute priority for evacuation is always those individuals in the most immediate danger, which means those physically closest to the fire. Once they are safe, rescue efforts can be organized based on factors like mobility.
- What is the most appropriate action for the LPN to take?
Answer: Close all doors on the unit and await further instructions.
When a fire alarm sounds but the fire is not in the immediate area, the standard procedure is to prepare for a potential evacuation by confining the area. This involves closing all doors to patient rooms, offices, and utility rooms to prevent the spread of smoke. Staff should then await instructions from the charge nurse or emergency personnel. Evacuating without orders could cause chaos, and leaving the unit is unsafe.
- What is the priority action for the nurse to take?
Answer: Assist the client out of the room.
The first step in the RACE fire response acronym is (R) Rescue. The nurse's immediate priority is to ensure the safety of the client by removing them from the area of immediate danger. After the client is safe, the nurse can proceed with the other steps of RACE: (A) Alarm, (C) Confine, and (E) Extinguish/Evacuate.
