Nokea
A community health nurse has witnessed significant shifts in patterns of disease over the course of a four-decade career. Which of the following focuses most clearly demonstrates the changing pattern of disease in the United States?
- A. Type 1 diabetes management
- B. Treatment of community-acquired pneumonia
- C. Rehabilitation from traumatic brain injuries
- D. Management of acute Staphylococcus aureus infections
Correct Answer: A
Rationale: Management of chronic diseases such as diabetes is a priority focus of the current health care environment. This supersedes the treatment of acute infections and rehabilitation needs.
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A nurse is planning a medical patients care with consideration of Maslows hierarchy of needs. Within this framework of understanding, what would be the nurses first priority?
- A. Allowing the family to see a newly admitted patient
- B. Ambulating the patient in the hallway
- C. Administering pain medication
- D. Teaching the patient to self-administer insulin safely
Correct Answer: C
Rationale: In Maslows hierarchy of needs, pain relief addresses the patients basic physiologic need. Activity, such as ambulation, is a higher level need above the physiologic need. Allowing the patient to see family addresses a higher level need related to love and belonging. Teaching the patient is also a higher level need related to the desire to know and understand and is not appropriate at this time, as the basic physiologic need of pain control must be addressed before the patient can address these higher level needs.
A nurse is providing care for a patient who is postoperative day one following a bowel resection for the treatment of colorectal cancer. How can the nurse best exemplify the QSEN competency of quality improvement?
- A. By liaising with the members of the interdisciplinary care team
- B. By critically appraising the outcomes of care that is provided
- C. By integrating the patients preferences into the plan of care
- D. By documenting care in the electronic health record in a timely fashion
Correct Answer: B
Rationale: Evaluation of outcomes is central to the QSEN competency of quality improvements. Each of the other listed activities is a component of quality nursing care, but none clearly exemplifies quality improvement activities.
The home health nurse is assisting a patient and his family in planning the patients return to work after surgery and the development of postsurgical complications. The nurse is preparing a plan of care that addresses the patients multifaceted needs. To which level of Maslows hierarchy of basic needs does the patients need for self-fulfillment relate?
- A. Physiologic
- B. Transcendence
- C. Love and belonging
- D. Self-actualization
Correct Answer: D
Rationale: Maslows highest level of human needs is self-actualization, which includes self-fulfillment, desire to know and understand, and aesthetic needs. The other answers are incorrect because self-fulfillment does not relate directly to them.
Nurses in acute care settings must work with other health care team members to maintain quality care while facing pressures to care for patients who are hospitalized for shorter periods of time than in the past. To ensure positive health outcomes when patients return to their homes, what action should the nurse prioritize?
- A. Promotion of health literacy during hospitalization
- B. Close communication with insurers
- C. Thorough and evidence-based discharge planning
- D. Participation in continuing education initiatives
Correct Answer: C
Rationale: Following discharges that occur after increasingly short hospital stays, nurses in the community care for patients who need high-technology acute care services as well as long-term care in the home. This is dependent on effective discharge planning to a greater degree than continuing education, communication with insurers, or promotion of health literacy.
Advanced practice nursing roles have grown in number and in visibility in recent years. What characteristic sets these nurses apart from the registered nurse?
- A. Collaboration with other health care providers
- B. Education that goes beyond that of the RN
- C. Advanced documentation skills
- D. Ability to provide care in the surgical context
Correct Answer: B
Rationale: There is wide variety in APRN roles. However, a commonality is that they require education beyond that of the professional RN. All nurses collaborate with other health care providers to provide nursing care to their patients. Advanced documentation skills are not what sets advanced practice nurses apart from the staff nurse. RNs have the ability to provide care in the operating room.