A client with limited mobility in their lower extremities is at risk for skin breakdown. Which of the following actions should the nurse take to prevent skin breakdown?
- A. Place the client in high-Fowler's position.
- B. Increase the client's intake of carbohydrates.
- C. Massage areas of skin that are darker than the surrounding skin tissue with unscented lotion.
- D. Have the client use a trapeze bar when changing position
Correct Answer: B
Rationale: The correct answer is B: Increase the client's intake of carbohydrates. Adequate nutrition, including carbohydrates, is essential for skin health and wound healing. Carbohydrates provide energy for the body's healing processes. Skin breakdown can be prevented by ensuring the client has a well-balanced diet.
A: Placing the client in high-Fowler's position is not directly related to preventing skin breakdown in this scenario.
C: Massaging areas of skin that are darker than the surrounding skin tissue with lotion may cause more harm than good, as it can increase the risk of skin breakdown.
D: Having the client use a trapeze bar when changing position is important for mobility but does not directly address the prevention of skin breakdown.
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When using an open irrigation technique to irrigate a client's indwelling urinary catheter, which of the following actions should the nurse take?
- A. Position the client in a side-lying position.
- B. Perform the irrigation using a 20-mL syringe.
- C. Instill 15 mL of irrigation fluid into the catheter with each flush.
- D. Measure and record the amount of irrigant used.
Correct Answer: B
Rationale: The correct answer is B: Perform the irrigation using a 20-mL syringe. This is the correct action because using a 20-mL syringe allows for precise and controlled instillation of the irrigation fluid into the catheter. Using a smaller syringe helps prevent excessive pressure within the catheter, reducing the risk of trauma or damage to the client's urinary system.
A: Positioning the client in a side-lying position is not essential for open irrigation technique, as long as the client is comfortable and the procedure can be safely performed.
C: Instilling 15 mL of irrigation fluid with each flush may not be appropriate as the volume needed may vary based on the client's condition.
D: Although measuring and recording the amount of irrigant used is important for documentation purposes, it is not the immediate action to ensure the safe and effective irrigation of the catheter.
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.
Politics is a means for influencing events and the decisions of others. The nurse manager who consistently reminds the staff that 'there is no I in team' and periodically brings treats for the staff is using:
- A. Image enhancement
- B. Political skills
- C. Reward power
- D. Expert power
Correct Answer: B
Rationale: The correct answer is B: Political skills. The nurse manager is using political skills by emphasizing teamwork and building relationships through treats to influence the staff. This demonstrates an understanding of social dynamics and power structures within the team. Image enhancement (A) focuses on improving one's personal or professional reputation, not team dynamics. Reward power (C) involves using rewards or incentives to influence behavior, which is not the case here. Expert power (D) is based on knowledge and expertise, but the scenario does not indicate that the nurse manager is leveraging expertise to influence the team.
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.
What is the main purpose of a utilization review?
- A. Evaluate patient outcomes
- B. Ensure compliance with regulations
- C. Reduce hospital readmissions
- D. Assess financial impact
Correct Answer: A
Rationale: The main purpose of a utilization review is to evaluate patient outcomes. This process involves assessing the appropriateness, necessity, and quality of healthcare services provided to patients. By evaluating patient outcomes, healthcare providers can ensure that patients receive effective and efficient care, leading to better health outcomes.
Choice B (Ensure compliance with regulations) is incorrect because while utilization review may involve ensuring compliance with regulations, it is not the primary purpose of the process.
Choice C (Reduce hospital readmissions) is incorrect as reducing hospital readmissions is a specific goal within healthcare quality improvement initiatives, but it is not the main purpose of utilization review.
Choice D (Assess financial impact) is incorrect as while financial considerations may play a role in utilization review, the primary focus is on evaluating patient outcomes rather than financial implications.
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