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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.
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A nurse on a postsurgical unit is providing care based on a clinical pathway. When performing assessments and interventions with the aid of a pathway, the nurse should prioritize what goal?
- A. Helping the patient to achieve specific outcomes
- B. Balancing risks and benefits of interventions
- C. Documenting the patients response to therapy
- D. Staying accountable to the interdisciplinary team
Correct Answer: A
Rationale: Pathways are an EBP tool that is used primarily to move patients toward predetermined outcomes. Documentation, accountability, and balancing risks and benefits are appropriate, but helping the patient achieve outcomes is paramount.
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.
A hospitals current quality improvement program has integrated the principles of the Institute for Healthcare Improvement (IHI) 5 Million Lives Campaign. How can the hospital best achieve the campaign goals of reducing preventable harm and death?
- A. By adhering to EBP guidelines
- B. By reducing nurse-to-patient ratios and increasing accountability
- C. By having researchers from outside the facility evaluate care
- D. By involving patients and families in their care planning
Correct Answer: A
Rationale: The 5 Million Lives Campaign posits that if evidence-based guidelines it advocated were voluntarily implemented by U.S. hospitals, 5 million lives would be saved from either harm or death over a two-year period. Nurse-to-patient ratios, family participation, and independent evaluation are not stated components of the campaign.
Professional nursing expands and grows because of factors driven by the changing needs of health care consumers. Which of the following is a factor that nurses should reflect in the planning and provision of health care?
- A. Decreased access to health care information by individuals
- B. Gradual increases in the cultural unity of the American population
- C. Increasing mean and median age of the American population
- D. Decreasing consumer expectations related to health care outcomes
Correct Answer: C
Rationale: The decline in birth rate and the increase in lifespan due to improved health care have resulted in fewer school-age children and more senior citizens, many of whom are women. The population has become more culturally diverse as increasing numbers of people from different national backgrounds enter the country. Access to information and consumer expectations continue to increase.
A case manager has been hired at a rural hospital that has a combined medical-surgical unit. When defining this new role, which of the following outcomes should be prioritized by the hospitals leadership?
- A. Decreased need for physician services
- B. Improved patient and family education
- C. Increased adherence to the principles of EBP
- D. Increased coordination of health services
Correct Answer: D
Rationale: Case management is a system of coordinating health care services to ensure cost-effectiveness, accountability, and quality care. The case manager coordinates the care of a caseload of patients through facilitating communication between nurses, other health care personnel who provide care, and insurance companies. Reducing the need for physician services is not a central goal. Education and EBP are consistent with case management, but they are not central to this particular role.