Nokea
Which of the following best describes the concept of evidence-based practice (EBP)?
- A. Clinical expertise as the primary basis for decision making
- B. Research findings as the sole basis for decision making
- C. Combining clinical expertise with the best available research evidence
- D. Following institutional guidelines for patient care
Correct Answer: C
Rationale: The correct answer is C because evidence-based practice (EBP) involves integrating clinical expertise with the best available research evidence and considering patient preferences. This approach ensures that decisions are informed by both the clinician's experience and the most current and relevant research findings, leading to the most effective and individualized patient care. Choice A is incorrect as it solely relies on clinical expertise without considering research evidence. Choice B is incorrect as it suggests solely relying on research findings, neglecting the importance of clinical judgment. Choice D is incorrect as it focuses on following institutional guidelines rather than on the integration of clinical expertise and research evidence.
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An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to
- A. give a bolus of 50% dextrose.
- B. insert a large-bore IV catheter.
- C. initiate oxygen via nasal cannula.
- D. administer glargine (Lantus) insulin.
Correct Answer: B
Rationale: The correct answer is B: insert a large-bore IV catheter. In HHS, patients are severely dehydrated due to high blood sugar levels. Inserting a large-bore IV catheter allows for rapid rehydration with isotonic fluids. This helps to correct the hyperosmolarity and electrolyte imbalances. Giving dextrose (choice A) would worsen hyperglycemia, initiating oxygen (choice C) is not directly related to managing HHS, and administering long-acting insulin like glargine (choice D) is not the initial priority in managing acute HHS.
Which of the following types of HMOs (Health Maintenance Organizations) contracts with two or more IPAs (Independent Practice Associations)?
- A. Staff model
- B. Point of service model
- C. Network model
- D. Group model
Correct Answer: C
Rationale: The correct answer is C: Network model. In a network model HMO, the organization contracts with two or more IPAs. IPAs are groups of independent doctors who work together to provide care. This model allows members to choose from a network of providers.
A: Staff model HMOs directly employ physicians.
B: Point of service model HMOs allow members to go out of network for care.
D: Group model HMOs contract with a single medical group, not multiple IPAs.
Therefore, the network model is the correct choice as it specifically involves contracting with multiple IPAs, distinguishing it from the other options.
Which of the following is a recommendation for avoiding charges of negligence and false imprisonment for confused clients?
- A. Carefully assess and document client status.
- B. Ensure all patient information is logged out and the nurse has signed out of the computer before leaving the computer station.
- C. Keep careful notes while providing care to ensure accurate documentation later in the day.
- D. Discuss safety needs with clients.
Correct Answer: A
Rationale: The correct answer is A. Carefully assessing and documenting client status is crucial to avoid charges of negligence and false imprisonment. By assessing and documenting client status, healthcare providers can ensure they are meeting the client's needs and providing appropriate care. This helps in demonstrating that the healthcare provider acted responsibly.
Option B is incorrect because ensuring all patient information is logged out and the nurse has signed out of the computer before leaving the computer station relates more to patient privacy and data security, rather than avoiding charges of negligence and false imprisonment. Option C, keeping careful notes while providing care, is important for accurate documentation but does not directly address the risk of negligence or false imprisonment. Option D, discussing safety needs with clients, is important but does not specifically address the legal aspects of negligence and false imprisonment.
The length of a coaching session should be no longer than:
- A. 15 minutes.
- B. 60 minutes.
- C. 10 minutes.
- D. 30 minutes.
Correct Answer: C
Rationale: The correct answer is C: 10 minutes. The rationale is that coaching sessions are most effective when kept concise and focused. A shorter duration helps maintain the participant's attention and ensures key points are covered without overwhelming them. Longer sessions can lead to decreased engagement and retention. Choice A (15 minutes) is slightly longer and may still risk losing focus. Choices B (60 minutes) and D (30 minutes) are too lengthy for a coaching session, increasing the likelihood of information overload and decreased effectiveness.
A client who is nonambulatory notifies the nurse that their trash can is on fire. After the nurse confirms the presence of the fire, which of the following actions should the nurse take next?
- A. Activate the emergency fire alarm.
- B. Extinguish the fire.
- C. Evacuate the client.
- D. Confine the fire.
Correct Answer: D
Rationale: The correct answer is D: Confine the fire. This is the most appropriate action because the nurse's first priority is to ensure the safety of the client by containing the fire to prevent it from spreading and causing harm. By confining the fire, the nurse can help protect the client and other individuals in the vicinity. Activating the fire alarm (choice A) may be necessary but should come after the fire is confined. Extinguishing the fire (choice B) may put the nurse and client at risk without proper training or equipment. Evacuating the client (choice C) should only be done if the fire cannot be quickly and safely confined.