Nokea
Which statement made by a nurse about the goal of total quality management or continuous quality improvement in a health care setting is correct?
- A. It is to observe reactive service and product problem solving
- B. Improvement of the processes in a proactive, preventive mode is paramount
- C. A chart audits to find to the process in a proactive, preventive mode is paramount
- D. A flow chart to organize daily tasks is critical to the initial stages
Correct Answer: B
Rationale: Improvement of the processes in a proactive, preventive mode is paramount. Total quality management and continuous quality improvement have a major goal of identifying ways to do the right thing at the right time in the right way by proactive problem-solving.
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A client who is pregnant comes to the clinic for a first visit. The nurse gathers data about her obstetric history, which includes 3 year-old twins at home and a miscarriage 10 years ago. She is 8 weeks pregnant. Which description of her obstetric history is written correctly?
- A. Gravida 4 para 2
- B. Gravida 2 para 1
- C. Gravida 3 para 1
- D. Gravida 3 para 2
Correct Answer: C
Rationale: Gravida 3 para 1. Gravida is the number of pregnancies and Parity is the number of pregnancies that reach viability (not the number of fetuses). Thus, for this woman, she is now pregnant, had 2 prior pregnancies, and 1 viable birth (twins).
A client with diabetes phones the clinic stating, 'I have a terrible cold and I don't know what to do about taking my insulin.' Which of the following should be included in the nurse's teaching regarding the client's insulin needs?
- A. Infections decrease insulin needs, so she should withhold insulin injections until her cold symptoms improve.
- B. Infections cause a drop in blood glucose levels, so she should base her insulin needs on the results of urine glucose tests.
- C. Infections cause alterations and increase insulin needs, so she should check her blood glucose levels and urine ketones at least every 4 hours.
- D. Infections cause no change in insulin requirements, but she should avoid crowds and overfatigue.
Correct Answer: C
Rationale: Infections increase insulin resistance, raising insulin needs. Frequent glucose and ketone monitoring ensures proper management. Withholding insulin or relying on urine tests is dangerous, and infections do alter insulin requirements.
A nurse is reinforcing teaching to the parent of a 6 year-old with a urinary tract infection on how to avoid repeat infections. Which statements by the parent indicate that the teaching has been effective? Select all that apply.
- A. I just bought my child new nylon panties.
- B. I will make sure my child does not hold urine.
- C. I will not give my child any more bubble baths.
- D. I will teach my child to wipe from the front to the back.
- E. I will use antibacterial soap for bathing my child.
Correct Answer: B,C,D
Rationale: Nylon panties can trap moisture, increasing infection risk; cotton is preferred. Not holding urine prevents bacterial growth. Avoiding bubble baths reduces irritation. Wiping front to back prevents bacterial spread. Antibacterial soap may disrupt natural flora, increasing infection risk.
The nurse is observing a staff member perform ear irrigation for an adult client with impacted cerumen. The nurse should intervene if the staff member is observed
- A. using a slow, steady flow of solution to irrigate the ear canal
- B. placing the client in a lying position with the head tilted toward the affected ear
- C. straightening the ear canal by pulling the pinna down and back
- D. directing the tip of the syringe and irrigation solution toward the top of the ear canal
Correct Answer: C
Rationale: Pulling the pinna down and back is incorrect for adults; it should be up and back. Slow flow , head tilt , and directing solution upward are correct.
A client with chronic pancreatitis is receiving Pancreatin. Which of the following observations is most indicative that the drug treatment is having the desired effect?
- A. The client's appetite is improved.
- B. The client's weight loss is greater than 10 pounds.
- C. The client's stools contain less fat and occur with less frequency.
- D. The client's tissue bruises less easily.
Correct Answer: C
Rationale: Pancreatin replaces pancreatic enzymes, aiding fat digestion. Reduced fat in stools and less frequent bowel movements indicate effective treatment. Appetite improvement is secondary, weight loss is undesirable, and bruising is unrelated.