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An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?
- A. Use shortcuts in documentation.
- B. Only use approved abbreviations.
- C. Documentation should be subjective.
- D. Document after care is provided.
Correct Answer: B
Rationale: The correct answer is B: Only use approved abbreviations. Using approved abbreviations in nursing documentation helps ensure clarity, accuracy, and consistency, which are crucial for legal credibility. Abbreviations can lead to misunderstandings or errors if not standardized.
Explanation for other choices:
A: Using shortcuts in documentation can compromise accuracy and lead to incomplete or unclear information, which could result in legal issues.
C: Documentation should be objective, not subjective, to provide an accurate portrayal of the patient's condition and care. Subjective documentation can be challenged legally.
D: Documenting after care is provided is important, but documenting in a timely manner is crucial for legal credibility. Delayed documentation can raise questions about the accuracy and reliability of the information.
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What is the primary goal of a root cause analysis (RCA) in healthcare?
- A. To assign blame for errors
- B. To prevent future errors by identifying underlying causes
- C. To improve patient satisfaction
- D. To analyze the financial impact of errors
Correct Answer: B
Rationale: The primary goal of a root cause analysis (RCA) in healthcare is to prevent future errors by identifying underlying causes. This is because RCA focuses on understanding the fundamental reasons behind incidents to implement effective preventive measures. By identifying root causes, healthcare providers can implement strategies to mitigate risks and enhance patient safety. The other choices are incorrect because RCA is not about assigning blame (A), improving patient satisfaction (C), or analyzing financial impact (D), but rather about understanding and addressing the core issues to prevent recurrence.
In which order will the nurse take these steps to prepare NPH 20 units and regular insulin 2 units using the same syringe? (Put a comma and a space between each answer choice [A, B, C, D, E]).
- A. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw regular insulin, Inject 2 units of air into regular insulin vial, Withdraw 20 units of NPH.
- B. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw regular insulin, Inject 2 units of air into regular insulin vial, Withdraw 20 units of NPH.
- C. Rotate NPH vial, Inject 20 units of air into NPH vial, Inject 2 units of air into regular insulin vial, Withdraw regular insulin, Withdraw 20 units of NPH.
- D. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw 20 units of NPH, Inject 2 units of air into regular insulin vial, Withdraw regular insulin.
Correct Answer: C
Rationale: The correct order is C. First, rotate the NPH vial to mix the insulin. Then, inject 20 units of air into the NPH vial to prevent a vacuum. Next, inject 2 units of air into the regular insulin vial to maintain pressure. After that, withdraw the regular insulin to avoid contamination. Finally, withdraw 20 units of NPH, ensuring the correct dosage. This order ensures proper mixing, prevents contamination, and maintains accurate dosing. Other choices have incorrect sequences that may result in inaccurate dosing or contamination.
Which of the following is an example of a secondary prevention strategy?
- A. Administering flu vaccinations
- B. Screening for hypertension
- C. Performing a mastectomy
- D. Providing rehabilitation after surgery
Correct Answer: B
Rationale: The correct answer is B: Screening for hypertension. Secondary prevention aims to detect and treat a disease in its early stages to prevent further progression. Screening for hypertension helps identify individuals at risk and enables timely intervention to prevent complications. Administering flu vaccinations (A) is an example of primary prevention. Performing a mastectomy (C) is a treatment method for existing breast cancer, falling under tertiary prevention. Providing rehabilitation after surgery (D) focuses on restoring function post-treatment, also part of tertiary prevention.
A nurse is considering employment at a long-term care facility that has a functional nursing delivery system. Knowing this, the nurse could expect that:
- A. Each RN would coordinate care for a group of clients.
- B. One RN would pass meds for all clients on a unit.
- C. Each RN would deliver total care to an assigned group of clients.
- D. One RN, one LPN, and one unlicensed assistive personnel would share responsibility for a group of clients.
Correct Answer: B
Rationale: The correct answer is B because in a functional nursing delivery system, one RN typically administers medications for all clients on a unit. This system allows for efficient distribution of tasks, ensuring that medications are given safely and accurately.
A: Incorrect. Functional nursing does not involve each RN coordinating care for a group of clients.
C: Incorrect. In this system, care tasks are divided among team members, not each RN providing total care to a group of clients.
D: Incorrect. Functional nursing typically does not involve sharing responsibility among different roles like RN, LPN, and unlicensed assistive personnel.
A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?
- A. Blood pressure 144/82 mm Hg
- B. Urine specific gravity 1.03
- C. Neck vein distention
- D. Urine specific gravity 1.01
Correct Answer: A
Rationale: The correct answer is A. The elevated blood pressure of 144/82 mm Hg indicates dehydration due to vomiting and diarrhea, leading to hypovolemia. This is a compensatory mechanism by the body to maintain perfusion. Option B, urine specific gravity of 1.03, indicates concentrated urine and dehydration, but not as specific as elevated blood pressure. Option C, neck vein distention, is more indicative of heart failure or fluid overload rather than dehydration. Option D, urine specific gravity of 1.01, indicates diluted urine and is not consistent with dehydration. Therefore, based on the symptoms and the compensatory mechanism of the body, an elevated blood pressure is the most likely finding in a client with vomiting and diarrhea.