Nokea
A nurse is comparing the rate of medication errors on the medical unit to the rate from a medical unit in a magnet hospital. Which of the following quality improvement methods is the nurse using?
- A. Structure audit
- B. Benchmarking
- C. Risk benefit analysis
- D. Root cause analysis
Correct Answer: B
Rationale: The correct answer is B: Benchmarking. Benchmarking involves comparing performance metrics with those from other units or institutions, which is exactly what the nurse is doing by comparing the rate of medication errors on their medical unit to the rate from a medical unit in a magnet hospital. Choice A, Structure audit, is not relevant to this scenario as it focuses on assessing the physical, organizational, or procedural structures in a healthcare setting. Choice C, Risk benefit analysis, involves weighing the potential risks and benefits of a particular course of action, not comparing performance metrics. Choice D, Root cause analysis, is a method used to identify the underlying causes of problems or adverse events, not to compare performance metrics between units.
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Serge, who has diabetes mellitus, is taking oral agents and is scheduled for a diagnostic test that requires him to be NPO. What is the best plan of action for the nurse regarding Serge's oral medications?
- A. Administer the oral agents immediately after the test.
- B. Notify the diagnostic department and request orders.
- C. Notify the physician and request orders.
- D. Administer the oral agents with a sip of water before the test.
Correct Answer: C
Rationale: The best plan of action for the nurse is to notify the physician and request orders regarding Serge's oral medications. By involving the physician, the nurse ensures that appropriate instructions are obtained, considering Serge's medical condition and the need for NPO status for the diagnostic test. Administering the medications without medical guidance (choice A) can be risky, as it may affect the test results. Notifying the diagnostic department (choice B) is not the most direct and appropriate action; the physician is the primary healthcare provider responsible for medication orders. Administering the medications with water before the test (choice D) is not advisable when the patient is supposed to be NPO, as it can interfere with the test requirements.
A nurse reviews the electrolyte results of an assigned client and notes that the potassium level is 5.4 mEq/L. Which of the following would the nurse expect to note on the electrocardiogram as a result of the laboratory value?
- A. ST depression
- B. Inverted T wave
- C. Prominent U wave
- D. Tall peaked T waves
Correct Answer: D
Rationale: The correct answer is 'Tall peaked T waves.' Tall peaked T waves are characteristic ECG changes associated with hyperkalemia. In hyperkalemia, the elevated potassium levels affect the myocardium, leading to changes in the ECG. ST depression (Choice A) is more commonly associated with myocardial ischemia or infarction. Inverted T wave (Choice B) is seen in conditions like myocardial ischemia or CNS events. Prominent U wave (Choice C) is typically associated with hypokalemia or certain medications. Therefore, in this scenario, the nurse would expect to note tall peaked T waves on the electrocardiogram due to the elevated potassium level.
Although there is projected to be a small surplus of nurses by 2030, some states will continue to see nursing shortages. Which of the following is the best explanation for this situation?
- A. Healthcare legislation that impacts nursing salaries in some states
- B. Workforce availability
- C. Aging of the baby boomers, resulting in a younger nursing workforce
- D. Population declines
Correct Answer: B
Rationale: The best explanation for the continued nursing shortages in some states despite an overall projected surplus by 2030 is workforce availability. This factor directly impacts the number of nurses available in certain regions. Choice A about healthcare legislation affecting nursing salaries does not directly address the availability of nurses. Choice C is incorrect as the aging of the baby boomers would typically imply an older nursing workforce instead of a younger one. Choice D regarding population declines does not necessarily relate to the availability of nurses in specific states.
Which anatomic malformations are associated with Tetralogy of Fallot?
- A. A sub-aortic septal defect, an overriding aorta, left ventricular hypertrophy, and right ventricular outflow
- B. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and left ventricular outflow
- C. A sub-aortic septal defect, an overriding aorta, pulmonary atresia, and right ventricular outflow
- D. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and right ventricular outflow
Correct Answer: D
Rationale: Tetralogy of Fallot is characterized by a combination of four heart defects: a sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and right ventricular outflow obstruction. This leads to mixing of oxygen-poor and oxygen-rich blood, resulting in cyanosis. Therefore, the correct answer is D. Choices A, B, and C are incorrect because they do not accurately describe the specific combination of anatomic malformations seen in Tetralogy of Fallot.
A clinical instructor teaches a class for the public about diabetes mellitus. Which individual does the nurse assess as being at highest risk for developing diabetes?
- A. The 50-year-old client who does not engage in any physical exercise
- B. The 56-year-old client who drinks three glasses of wine daily
- C. The 42-year-old client who is 50 pounds overweight
- D. The 38-year-old client who smokes one pack of cigarettes daily
Correct Answer: C
Rationale: The 42-year-old client who is 50 pounds overweight is at the highest risk for developing diabetes. Excess weight is a significant risk factor for diabetes as it can lead to insulin resistance and metabolic abnormalities. Choices A, B, and D are also risk factors for diabetes, but being overweight has a stronger association with the development of the condition compared to lack of exercise, excessive alcohol consumption, or smoking.