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A peaceful death is best characterized by which terminally ill patient?
- A. One who is surrounded by family
- B. One who uses meditation to help manage pain
- C. One who has advanced directives in place
- D. One who has drifted from lethargy to coma
Correct Answer: A
Rationale: The correct answer is A because being surrounded by family provides emotional support, comfort, and a sense of closure. Family presence can alleviate fear, anxiety, and loneliness, contributing to a peaceful death experience. Choice B focuses on pain management but does not address emotional well-being. Choice C, while important for end-of-life care, does not directly impact the patient's immediate comfort. Choice D indicates a decline in consciousness, which may not necessarily lead to a peaceful death experience as the patient may not be aware of their surroundings or loved ones.
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According to the Quality Chasm report:
- A. health care providers should be proactive rather than reactive to patient needs.
- B. common needs rather than individual preferences should be the priority.
- C. medical information should be confined to the primary care provider.
- D. specialized providers or case managers should control health care decisions.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Proactive care emphasizes prevention and early intervention.
2. The Quality Chasm report advocates for patient-centered care.
3. Being proactive ensures better health outcomes and lower costs.
4. Reactive care may lead to delayed diagnosis and treatment.
Summary:
B: Focusing on common needs ignores individual preferences, contradicting patient-centered care.
C: Limiting medical information to one provider is not patient-centered and hinders care coordination.
D: Allowing specialized providers to control decisions may not consider the holistic needs of the patient.
Which functions can be delegated only to another RN with appropriate experience and training? (select all that apply)
- A. Assessment of skin integrity on third day of hospitalization
- B. Evaluation of patient teaching related to turn, cough, and deep breathing exercises
- C. Nursing judgment related to withholding medication based on vital signs
- D. RNs do not delegate to other RNs, they delegate only to licensed practical nurses or unlicensed assistive personnel
Correct Answer: C
Rationale: The correct answer is C because nursing judgment related to withholding medication based on vital signs requires critical thinking, clinical knowledge, and experience. This decision-making process involves assessing the patient's condition, interpreting vital signs, and determining if medication should be given or withheld to ensure patient safety. This function cannot be delegated to someone without the appropriate training and expertise.
A: Assessment of skin integrity on the third day of hospitalization can be delegated to other healthcare team members such as LPNs or nursing assistants, as long as they have been trained and deemed competent.
B: Evaluation of patient teaching related to turn, cough, and deep breathing exercises can be delegated to other healthcare team members, as long as they have the appropriate training and supervision.
D: The statement that RNs do not delegate to other RNs is incorrect. RNs can delegate certain tasks to other RNs based on their scope of practice and level of experience. It is not limited to LPNs or unlicensed assistive personnel.
A qualitative researcher reviews data collected with a grief support group to develop a theory of how widows and widowers mourn. The researcher is using which qualitative research design?
- A. Phenomenology
- B. Grounded theory
- C. Case study
- D. Hypothesis generation
Correct Answer: B
Rationale: Grounded theory is the correct answer because it involves developing a theory based on analyzing data collected from participants. In this case, the researcher is reviewing data from a grief support group to identify patterns and themes, ultimately leading to the development of a theory on how widows and widowers mourn. Phenomenology focuses on understanding individuals' lived experiences, not developing theories. Case study involves an in-depth analysis of a single case, not suitable for developing a theory. Hypothesis generation is part of quantitative research, not qualitative research design.
An interdisciplinary team is evaluating the hospital's care of patients admitted with a myocardial infarction (heart attack) compared to national standards. The team analyzes the hospital's clinical indicator, which would be: (select all that apply)
- A. aspirin order within 24 hours of discharge.
- B. patient teaching related to stopping smoking completed prior to discharge.
- C. beta blocker administered upon arrival.
- D. support of employer to modify stress in workplace.
Correct Answer: A
Rationale: The correct answer is A: aspirin order within 24 hours of discharge. This is a key clinical indicator for evaluating care of heart attack patients as aspirin is a standard treatment to prevent further cardiac events. It is crucial for patient safety and adherence to national guidelines.
Choice B is incorrect as patient teaching on smoking cessation, although important, is not a direct clinical indicator for evaluating care of heart attack patients.
Choice C is incorrect as beta blocker administration upon arrival is important for heart attack patients, but it is not specific to evaluating the hospital's care compared to national standards.
Choice D is incorrect as employer support for stress modification is not a clinical indicator relevant to evaluating care of heart attack patients.
An RN recently relocated to another region of the country and immediately assumed the role of charge nurse. When determining the appropriate person to whom to delegate, the RN knows that:
- A. the role of the LPN/LVN is the same from state to state.
- B. the LPN/LVN can be taught to perform all the duties of an RN if approved by the employer and if additional on-the-job training is provided.
- C. he or she must review the state's nurse practice act for LPN/LVNs, because each state defines the role and scope of practice of the LPN/LVN.
- D. The Joint Commission has certified and established roles for the LPN/LVN.
Correct Answer: C
Rationale: The correct answer is C. When delegating tasks to an LPN/LVN, the RN must review the state's nurse practice act because each state defines the role and scope of practice of the LPN/LVN. This is crucial as the LPN/LVN scope of practice can vary significantly from state to state. By reviewing the nurse practice act, the RN ensures that the tasks being delegated fall within the legal scope of practice for the LPN/LVN in that specific state, promoting safe and effective patient care.
Choice A is incorrect because the role of the LPN/LVN can differ between states.
Choice B is incorrect because LPN/LVNs cannot perform all duties of an RN, and additional training does not change their scope of practice.
Choice D is incorrect because the Joint Commission does not establish roles for LPN/LVNs; it focuses on accreditation standards for healthcare organizations.