Nokea
A nurse providing care at the bedside receives an "alert" that a patient's stat potassium level is 5 and digoxin (Lanoxin) is scheduled. The nurse holds the medication and prevents a possible complication. This feature of the Electronic Health Record is available through which core function of EHR?
- A. Order entry/order management
- B. Decision support
- C. Patient support
- D. Administrative support
Correct Answer: B
Rationale: The correct answer is B: Decision support. In this scenario, the nurse received an alert regarding a potential drug interaction between the patient's potassium level and the scheduled digoxin. Decision support in EHR provides real-time clinical guidance to healthcare providers, helping them make informed decisions to improve patient safety. Holding the medication in response to the alert demonstrates the effective use of decision support to prevent adverse drug events. Choices A, C, and D do not directly relate to the situation described and do not involve the clinical decision-making support provided by EHRs.
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The use of research to guide nursing practice is called:
- A. utilization.
- B. dissemination.
- C. generalizability.
- D. analysis.
Correct Answer: A
Rationale: The correct answer is A: utilization. Research utilization refers to the application of research findings in nursing practice to improve patient outcomes. Utilization involves integrating research evidence into clinical decision-making. Dissemination (B) refers to sharing research findings. Generalizability (C) pertains to the extent to which research findings can be applied to different populations or settings. Analysis (D) involves examining data to draw conclusions, but it does not specifically relate to using research in practice like utilization does.
Time is becoming crucial for the nurse to address issues related to sponsoring programs to include hearing aid costs as part of Medicare coverage. The nurse involved in grassroots political actions realizes that the least timely method of reaching elected officials would be via:
- A. letter.
- B. telephone.
- C. e-mail.
- D. facsimile (fax).
Correct Answer: A
Rationale: The correct answer is A: letter. Writing a physical letter and sending it through traditional mail is the least timely method of reaching elected officials. It takes longer for letters to be delivered and processed compared to other electronic forms of communication like telephone, email, and fax. Elected officials may not receive and respond to letters in a timely manner, especially when time is crucial. Telephone, email, and fax offer quicker and more direct communication, allowing for faster responses and action. Therefore, choosing to reach out to elected officials via a letter would be the least timely method in this scenario.
A nurse is delegating to the newly hired nursing unlicensed assistive personnel (UAP) the task of assisting with oral hygiene, knowing that this assignment "does not require decisions based on the nursing process." The nurse is correctly using which of the five rights of delegation?
- A. Supervision
- B. Communication
- C. Person
- D. Circumstance
Correct Answer: C
Rationale: Correct Answer: C - Person
Rationale:
- The five rights of delegation are Right Task, Right Circumstances, Right Person, Right Direction/Communication, and Right Supervision.
- In this scenario, choosing the Right Person means delegating tasks to individuals with appropriate skills and abilities, such as UAP assisting with oral hygiene.
- This choice is correct as the nurse is delegating a task that falls within the UAP's scope of practice without requiring nursing process decisions.
An RN is counseled by the nurse manager regarding inappropriate delegation when the:
- A. RN instructs the nursing assistant to greet ambulatory surgery patients and show them to their rooms.
- B. nursing assistant informs the RN that she has not been trained to collect a sputum specimen and the RN states, "I will show you this time and you can show me the next time."
- C. RN assigns the float LPN/LVN the task of completing a plan of care for a stable patient who was admitted for routine replacement of a feeding tube.
- D. LPN/LVN who has demonstrated competence is asked to perform a dressing change for a patient before she is discharged home.
Correct Answer: C
Rationale: The correct answer is C because delegating the task of completing a plan of care to a float LPN/LVN for a stable patient is inappropriate. LPNs/LVNs have a different scope of practice compared to RNs and should not be assigned tasks related to developing care plans. This task requires critical thinking skills and assessment that are within the RN's scope of practice.
A: A is incorrect because delegating the task of greeting and showing ambulatory surgery patients to their rooms is appropriate for a nursing assistant.
B: B is incorrect because delegating the task of collecting a sputum specimen, once trained, is appropriate for a nursing assistant under the supervision of an RN.
D: D is incorrect because delegating the task of performing a dressing change to a competent LPN/LVN is appropriate, as long as it falls within their scope of practice.
The RN who identifies the best resources at the lowest cost to achieve optimal health outcomes for the client is fulfilling the role of:
- A. informatics specialist.
- B. educator.
- C. case manager.
- D. quality manager.
Correct Answer: C
Rationale: The correct answer is C: case manager. A case manager coordinates resources to achieve optimal health outcomes for clients efficiently. They assess, plan, implement, and evaluate care while considering cost-effectiveness. Informatics specialists focus on data and technology, educators provide knowledge, and quality managers ensure high standards. In this scenario, the key role is coordinating resources, making C the best choice.