# At 0200 on a medical-surgical unit, a trash can in room 412 catches fire. The nurse has moved the client in 412 into the corridor, and a coworker has pulled the alarm and called the fire code. Smoke is drifting toward room 414, where a client on bed rest is receiving oxygen at 2 L/min by nasal cannula from the wall outlet. Ambulatory clients are in rooms at the far end of the hall, on the other side of closed corridor fire doors, and a portable extinguisher is mounted next to room 412. Which actions should the nurse take? Select all that apply.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=617295&lang=en  
> language: en  
> subject: Emergency Response Plan  
> category: SIPC

## Question

At 0200 on a medical-surgical unit, a trash can in room 412 catches fire. The nurse has moved the client in 412 into the corridor, and a coworker has pulled the alarm and called the fire code. Smoke is drifting toward room 414, where a client on bed rest is receiving oxygen at 2 L/min by nasal cannula from the wall outlet. Ambulatory clients are in rooms at the far end of the hall, on the other side of closed corridor fire doors, and a portable extinguisher is mounted next to room 412. Which actions should the nurse take? Select all that apply.

1

Close the door to room 412 now that the client is out of the room

2

Shut off the zone oxygen valve before the client in 414 is moved

3

Use the extinguisher on the trash can before moving the client in 414

4

Move the client in 414 on a portable tank through the fire doors

5

Tell the clients beyond the fire doors to stay in their closed rooms

6

Leave the door to room 414 open after moving the client out of it

## Explanation

With rescue and alarm done, the nurse confines the fire by closing the 412 door and moves the client in greatest danger (414, in the smoke path) horizontally through the fire doors after switching to a portable tank. Clients already beyond the fire doors are in a protected compartment and remain in their closed rooms unless ordered to move. The zone oxygen valve is shut only after oxygen-dependent clients are on portable oxygen, rescuing the client in the smoke path comes before extinguishing, and doors of evacuated rooms are closed.

## In-depth explanation

Quick answer
Close 412, move the 414 client on portable oxygen through the fire doors, and keep the clients beyond the doors in place.

Why this is correct
The scenario says R and A are done, so the next priorities are confining the fire and moving the client in danger. The client in 414 depends on wall oxygen, so the transfer to a portable tank comes first, and only then can the zone valve be shut if ordered. Hospitals are built for defend-in-place: the far-end clients are already behind a fire barrier, so moving them would crowd the corridor and put them nearer the fire.

Easy analogy or mental picture
Think of the fire doors as a watertight door on a ship: the people on the dry side stay put, and you bring the people from the flooding side through.

Memory hook
Close it, carry the tank, keep the safe side still.

NCLEX decision rule
In a facility fire, act on the RACE step not yet done, evacuate by proximity to danger, and sequence oxygen shutoff after oxygen-dependent clients are protected.

Why the other choices are wrong
Shutting the zone oxygen valve is a real fire step, which makes it tempting, but doing it before the 414 client is on a portable tank cuts off that client's oxygen. Using the extinguisher is part of RACE and the fire is small, but the client in 414 is in the smoke path and must be moved first. Leaving the 414 door open may seem to show the room is empty, yet open doors let smoke spread; evacuated rooms are closed and marked instead.

References
1National Fire Protection Association (NFPA)Life Safety Code principles for health care occupancies: compartmentation and defend-in-place
2OSHA eTool — Evacuation Plans and ProceduresEmergency action and evacuation planning in workplaces

## Clinical scenario

Scenario
Trash-can fire in room 412 at night; client already rescued and alarm activated. Smoke spreading toward a bed-rest client on wall oxygen in 414; ambulatory clients are beyond closed fire doors in another smoke compartment.

## Key concepts

- **Horizontal evacuation** — Moving clients on the same floor through fire/smoke barrier doors into an adjacent compartment.
- **Defend-in-place** — A health care fire strategy in which clients in unaffected smoke compartments remain in place behind closed doors.
- **Zone oxygen shutoff valve** — A valve that stops piped oxygen to an area, closed only after oxygen-dependent clients have an alternate supply.

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