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A newly graduated nurse at the hospital states that, since she is so new, she cannot participate in quality improvement (QI) projects. What response by the precepting nurse is best?
- A. All staff nurses are required to participate in quality improvement here
- B. Even being new, you can implement activities designed to improve care
- C. You are to identify what indicators should be used to measure quality
- D. You should ask to be assigned to the research and quality committee
Correct Answer: B
Rationale: The preceptor should reassure the nurse that implementing QI measures is not out of line for a newly graduated nurse. Even new nurses can contribute to quality improvement by implementing activities designed to enhance care, such as following evidence-based protocols or suggesting small process improvements. Requiring participation, assigning specific tasks like identifying indicators, or suggesting committee assignment may not address the nurse's concern about their capability as a new graduate.
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A student nurse asks the faculty to explain best practices when communicating with a person from the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community. What answer by the faculty is most accurate?
- A. Avoid embarrassing the client by asking questions
- B. Use open-ended questions and attentive listening
- C. Most LGBTQ people do not want to share information
- D. No differences exist in communicating with this population
Correct Answer: B
Rationale: Many members of the LGBTQ community have faced discrimination from health care providers and may be reluctant to seek health care. Using open-ended questions and attentive listening fosters trust and encourages honest communication. Avoiding questions may miss critical health information, and assuming no differences or reluctance to share ignores the unique needs and experiences of this population.
A nurse wishes to provide client-centered care in all interactions. Which action by the nurse best demonstrates this concept?
- A. Assesses for cultural influences affecting health care
- B. Ensures that all the clients basic needs are met
- C. Tells the client and family about all upcoming tests
- D. Thoroughly orients the client and family to the room
Correct Answer: A
Rationale: Competency in client-focused care is demonstrated when the nurse focuses on communication, culture, respect, compassion, client education, and empowerment. By assessing the effect of the client's culture on health care, the nurse best demonstrates this concept. Simply telling the client about all upcoming tests is not providing empowering education. Orienting the client and family to the room is an important safety measure, but not directly related to demonstrating client-centered care.
The nurse utilizing evidence-based practice (EBP) considers which factors when planning care? (Select all that apply.)
- A. Cost-saving measures
- B. Nursing expertise
- C. Client preferences
- D. Research findings
- E. Values of the client
Correct Answer: B,C,D,E
Rationale: The IOM reports utilizing current evidence, the client's values and preferences, and the nurse's expertise when planning care. It does not include cost-saving measures, as these are not a primary focus of evidence-based practice.
A nurse is talking with a client who is moving to a new state and needs to find a new doctor and hospital there. What advice by the nurse is best?
- A. Ask the hospitals there about standard nurse-client ratios
- B. Choose the hospital that has the newest technology
- C. Find a hospital that is accredited by The Joint Commission
- D. Use a facility affiliated with a medical or nursing school
Correct Answer: C
Rationale: Accreditation by The Joint Commission (TJC) or other accrediting body gives assurance that the facility has a focus on safety. Nurse-client ratios differ by unit type and change over time. New technology doesn't necessarily mean the hospital is safe. Affiliation with a health professions school has several advantages, however safety is most important.
A nurse is calling the on-call physician about a client who had a hysterectomy 2 days ago and has pain that is unrelieved by the prescribed narcotic pain medication. Which statement is part of the SBAR format for communication?
- A. Provide the client's current pain level and history
- B. Administer additional pain medication as needed
- C. Document the client's pain in the medical record
- D. Schedule a follow-up visit with the physician
Correct Answer: A
Rationale: The SBAR format (Situation, Background, Assessment, Recommendation) is used for clear and concise communication with healthcare providers. Providing the client's current pain level and history is part of the Background and Assessment components of SBAR, ensuring the physician has relevant information to make informed decisions. The other options are not part of the SBAR communication process.