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A client undergoing a surgical procedure at the hospital died related to complications during the procedure. The nurse is required to collect data about the event so that a cause can be determined. What type of quality indicators would be used in this incident?
- A. Prevention QIs
- B. Inpatient QIs
- C. Client safety QIs
- D. Pediatric QIs
Correct Answer: B
Rationale: Inpatient QIs reflect quality of care inside hospitals, including inpatient mortality for medical conditions and surgical procedures. Prevention QIs identify hospital admissions that could be avoided through high-quality outpatient care. Client safety QIs also reflect quality of care within hospitals but focus on potentially avoidable complications and adverse events. Pediatric QIs reflect quality of care inside hospitals and identify potentially avoidable hospitalization among children.
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A nurse has applied for a position in the hospital emergency department and is told that the facility only hires RNs and unlicensed assistive personnel (UAPs) in the emergency department. What concern does the nurse have with the practice of hiring UAPs in place of LPNs?
- A. LPNs will be phased out of the healthcare field altogether when more UAPs are hired.
- B. UAPs are performing some of the duties that practical nurses typically provide and may jeopardize the quality of care.
- C. UAPs will replace nurses because they deliver a better quality of care.
- D. State boards of nursing will begin to credential UAPs.
Correct Answer: B
Rationale: Changes in the healthcare industry have also affected employment for healthcare workers. Hospitals employ UAPs to perform some duties that practical and registered nurses once provided. Many are concerned that the use of UAPs will jeopardize the quality of care. There is no evidence to indicate that LPNs will be phased out of the healthcare system or that UAPs will replace nurses. State boards of nursing cannot credential an unlicensed person that does not go through a formal education program.
A client is brought into the emergency department by the rescue squad after involvement in a motorcycle accident with a severe spinal cord injury. As what type of illness does the nurse view this event?
- A. Terminal
- B. Acute
- C. Chronic
- D. Catastrophic
Correct Answer: D
Rationale: Illness refers to a state of being sick and can be viewed as catastrophic or a sudden, traumatic illness, which has occurred with this client. The client has suffered a traumatic accident with serious injury and would be classified as catastrophic. This event is not chronic, terminal, or acute.
A client comes to the clinic and reports being ill for several weeks but does not have insurance and has delayed care. What does the nurse understand about the overall healthcare reform goals that will address issues such as this client?
- A. The goal of healthcare reform is to provide care to women, infants, and children.
- B. The goal of healthcare reform is to provide more healthcare programs to address illness.
- C. The goal of healthcare reform is to provide quality healthcare for those that can afford it.
- D. The goal of healthcare reform is to provide affordable healthcare to more citizens.
Correct Answer: D
Rationale: The overall goal of healthcare reform is to provide affordable healthcare to more U.S. citizens. Other goals are to reduce the insurance companies' control of healthcare and to provide more assistance to senior citizens on fixed incomes. Providing care to women, infants and children and offering more healthcare programs to address illness may be results of healthcare reform but are not themselves the overall goal. Healthcare reform seeks to provide quality healthcare that is affordable to as many U.S. citizens as possible, not to only provide it to those who can already afford it.
A nurse is providing care for a client who has had a hip replacement and is going to be discharged in 2 days. The nurse has provided the client instructions for care after discharge. Which instruction would be considered accessing tertiary care?
- A. Begin physical therapy in 1 week.'
- B. Follow up with your primary health care provider in 2 days to discuss laboratory results.'
- C. Go to the outpatient laboratory for blood studies in 3 days.'
- D. Report to the emergency department for signs of infection, shortness of breath, or chest pain.'
Correct Answer: A
Rationale: Starting physical therapy, a type of rehabilitation, is a form of tertiary care. Tertiary care focuses on complex medical and surgical interventions, and specialized services such as cancer care and rehabilitative services. Encouraging the client to see a family health care provider would be promoting primary care. Sending the client for lab studies or instructing them to go to the emergency department would be directing the client to seek secondary care, which includes additional testing and emergency care.
What does the nurse understand is the focus of healthcare when a client receives services from a health maintenance organization (HMO)?
- A. Avoiding coverage for needed services
- B. Health promotion and maintenance
- C. To offer discounted services to all patients
- D. High-quality service and contain cost
Correct Answer: B
Rationale: If the HMO does not require much high-cost care, providers make money; if members use many high-cost resources, providers lose money. This method of financing provides the strongest incentives for limiting use of expensive services and focusing healthcare on health maintenance and promotion. If services such as diagnostic testing are required, the HMO will cover this and not avoid payment. Services are not discounted for patients that are nonmembers or members. The goals of a physician hospital organization (PHO) are to maintain high-quality service and contain costs while fostering group contracts, collaboration, and capitation.