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The nurse is interviewing a new patient with diabetes who receives rosiglitazone (Avandia)
through a restricted access medication program. What is most important for the nurse to report
immediately to the health care provider?
- A. The patient's blood pressure is 154/92.
- B. The patient has a history of emphysema
- C. The patient's blood glucose is 86 mg/dL.
- D. The patient has chest pressure when walking
Correct Answer: D
Rationale: The correct answer is D: The patient has chest pressure when walking. This symptom could indicate cardiac issues, a known side effect of rosiglitazone. Reporting this immediately is crucial to prevent potential serious complications.
A: The patient's blood pressure is 154/92. While high, it is not an immediate concern unless accompanied by other symptoms.
B: The patient has a history of emphysema. Relevant but not urgent in this scenario.
C: The patient's blood glucose is 86 mg/dL. Within the normal range and not a priority compared to chest pressure.
In summary, choice D is correct as it addresses a potentially severe side effect of the medication that requires immediate attention. Choices A, B, and C are not as urgent or directly related to the medication's side effects.
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After a violent incident, staff needs to discuss what occurred. Several actions need to be taken following the incident:
- A. Debrief the staff and complete incident reports and verify that all staff are safe
- B. Reassure the violent patient that hurting staff when ill is not cause for concern
- C. Avoid any interactions
- D. Standing close to the patient while talking
Correct Answer: A
Rationale: The correct answer is A because it ensures the safety and well-being of staff by debriefing them, completing incident reports, and verifying their safety. This action promotes communication, support, and documentation after a violent incident. Reassuring the patient (B) is important but not the immediate priority. Avoiding interactions (C) is counterproductive as addressing the incident is necessary. Standing close to the patient (D) can potentially escalate the situation and compromise safety.
Which of the following is an example of a clinical decision support system (CDSS)?
- A. Electronic health record (EHR)
- B. Barcode medication administration
- C. Smart infusion pumps
- D. Automated drug dispensing system
Correct Answer: C
Rationale: The correct answer is C: Smart infusion pumps. A smart infusion pump is an example of a CDSS as it helps healthcare providers in administering medications accurately by providing alerts, dosage calculations, and other decision support tools. This system enhances patient safety and clinical outcomes.
Incorrect choices:
A: Electronic health record (EHR) - While EHRs store and manage patient health information, they do not provide decision support features like CDSS.
B: Barcode medication administration - While barcoding helps in verifying medication administration, it is not a CDSS that provides clinical decision support.
D: Automated drug dispensing system - While these systems help in dispensing medications accurately, they do not provide clinical decision support tools like smart infusion pumps do.
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.
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.
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.