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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.
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A nurse is caring for a postoperative client on the surgical unit. The client's blood pressure was 142/76 mm Hg 30 minutes ago, and now is 89/50 mm Hg. What action by the nurse is best?
- A. Call the Rapid Response Team
- B. Document and continue to monitor
- C. Notify the primary care provider
- D. Repeat blood pressure measurement in 15 minutes
Correct Answer: A
Rationale: The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating before they suffer respiratory or cardiac arrest. Since the client has experienced a significant change in blood pressure, the nurse should call the RRT. Changes in blood pressure, mental status, heart rate, and pain are particularly significant. Documentation is vital, but the nurse must do more than document. Notifying the primary care provider is important but does not address the immediate need for intervention. Repeating the blood pressure measurement delays necessary action.
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 new nurse is working with a preceptor on an inpatient medical-surgical unit. The preceptor advises the student that which is the priority when working as a professional nurse?
- A. Attending to holistic client needs
- B. Ensuring client safety
- C. Attending to medical-surgical errors
- D. Providing client-focused care
Correct Answer: B
Rationale: All actions are appropriate for the professional nurse. However, ensuring client safety is the priority. Up to 98,000 deaths result each year from errors in hospital care, according to the 2000 Institute of Medicine report. Many more clients have suffered injuries and less serious outcomes. Every nurse has the responsibility to ensure the client's safety.