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Which of the following is an example of a sentinel event in healthcare?
- A. A patient falling in the hospital without injury
- B. A near-miss medication error
- C. An unexpected patient death unrelated to the natural course of illness
- D. A patient developing an infection during a hospital stay
Correct Answer: C
Rationale: The correct answer is C. A sentinel event in healthcare is an unexpected patient death unrelated to the natural course of illness. These events are serious occurrences that warrant immediate investigation and response to prevent their recurrence and ensure patient safety. Choices A, B, and D do not fit the definition of a sentinel event. A patient falling without injury, a near-miss medication error, and a patient developing an infection, while concerning, do not meet the criteria of an unexpected patient death unrelated to the natural course of illness.
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Which of the following should be included in a discussion of advance directives with new nurse graduates?
- A. According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.
- B. The advance directive designates an individual who will make financial decisions for the client if he or she is unable to do so.
- C. A living will designates who will make health-care decisions for an individual in the event the individual is unable or incompetent to make his or her own decisions.
- D. The advance directive designates a health-care surrogate who will make known the client’s wishes regarding medical treatment if the client is unable to do so.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
When should the nurse initiate discharge planning for a client experiencing an exacerbation of heart failure?
- A. During the admission process
- B. As soon as the client's condition is stable
- C. After consulting with the client's family
- D. During the initial team conference
Correct Answer: B
Rationale: The correct time for the nurse to initiate discharge planning for a client experiencing an exacerbation of heart failure is as soon as the client's condition is stable. Discharge planning should begin early in the admission process to ensure a smooth transition and continuity of care. While involving the client's family in the planning process is crucial, the primary focus should be on starting the preparations for discharge once the client's immediate health concerns are addressed and their condition is stable. Waiting for a team conference or after consulting with the family may delay the planning process, which is not ideal in ensuring a timely and effective discharge plan.
A new manager is implementing an initiative with the desired outcome to have the unit run more smoothly. What quality is the manager demonstrating?
- A. Being unrealistic
- B. Being a change agent
- C. Being democratic
- D. Being authoritarian
Correct Answer: B
Rationale: The correct answer is B: Being a change agent. The manager is demonstrating the quality of being a change agent by implementing an initiative aimed at improving the unit's operations. A change agent initiates and drives changes to enhance effectiveness and efficiency within the unit. Choice A is incorrect because the manager's actions are not described as unrealistic but rather proactive. Choice C, being democratic, is incorrect as it does not relate to the manager's initiative to improve unit operations. Choice D, being authoritarian, is also incorrect as the manager is not described as enforcing changes through strict control and power.
What is the process of helping an employee to improve performance called?
- A. Coaching
- B. Disciplining
- C. Mentoring
- D. Peer reviewing
Correct Answer: A
Rationale: The correct answer is A: Coaching. Coaching involves providing guidance and support to help an employee enhance their performance. It focuses on developing skills, addressing weaknesses, and achieving professional growth. Mentoring (choice C) involves guiding and nurturing a less experienced individual. Peer reviewing (choice D) is when colleagues evaluate the performance of their peers. Disciplining (choice B) refers to taking corrective actions in response to policy violations or performance issues.
A client is receiving pain medication through a PCA pump. Which of the following actions should the nurse take?
- A. Educate the family not to push the button for the client while the client is asleep.
- B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
- C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
- D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.
Correct Answer: D
Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.