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Each month data on admission assessments that are based on the following standard are entered: "All patients will be assessed by an RN within 2 hours of admission." The target goal for this standard is 97% compliance. Data are displayed on a graph that shows number and time of admission assessments and compliance variation limits. This pictorial representation is:
- A. Pareto chart.
- B. control chart.
- C. deployment chart.
- D. top-down flowchart.
Correct Answer: B
Rationale: The correct answer is B: control chart. A control chart is used to display data over time and indicate variations within set limits, making it ideal for monitoring compliance with a standard like "All patients will be assessed by an RN within 2 hours of admission." The control chart allows for easy identification of trends, shifts, or patterns that may indicate a need for corrective action to maintain the 97% compliance goal.
A: Pareto chart is used to identify the most significant factors contributing to a problem, not to monitor compliance over time.
C: Deployment chart is not a standard tool in quality control or process monitoring.
D: A top-down flowchart is used to depict the sequence of steps in a process, not to monitor compliance with a standard over time.
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A nursing student scores 95% on the written examination for the adult health course. To be successful in this course, this same student must then perform an indwelling catheter insertion and wound care in a simulated environment meeting core competencies. The student asks, "What are core competencies?" The nursing instructor replies, "Core competencies are:
- A. a trend used in nursing education to reduce attrition in prelicensure students."
- B. those skills necessary for safe, competent nursing practice."
- C. educational opportunities that provide remediation when student is unable to perform psychomotor skills correctly."
- D. critical thinking exercises aimed to improve reading and math skills."
Correct Answer: B
Rationale: The correct answer is B: those skills necessary for safe, competent nursing practice. Core competencies refer to the essential skills and knowledge required for safe and competent nursing practice. In the scenario provided, the nursing student needs to demonstrate proficiency in indwelling catheter insertion and wound care to meet these core competencies. These skills are crucial for providing quality patient care and ensuring patient safety.
Choice A is incorrect because core competencies are not about reducing attrition but rather about ensuring students possess the necessary skills for nursing practice. Choice C is incorrect as core competencies focus on skills required for practice, not on educational remediation. Choice D is incorrect because core competencies are not about improving reading and math skills but about the specific nursing skills needed for practice.
A care provider sacrifices an animal and waves an herb-filled sack over a client who is complaining of painful joints and chest pain with exertion. This ritual represents health care during:
- A. the prehistoric period.
- B. early civilization in Egypt.
- C. the Renaissance.
- D. the Middle Ages.
Correct Answer: A
Rationale: The correct answer is A: the prehistoric period. During this time, people relied heavily on spiritual beliefs and rituals for healing. Sacrificing animals and using herbs in rituals to treat ailments was common practice. In contrast, early civilization in Egypt (B) had more advanced medical practices, the Renaissance (C) saw a shift towards scientific medicine, and the Middle Ages (D) had a mix of spiritual and medical practices, but not as primitive as the prehistoric period.
A novice nurse is stressed due to always being behind with her assignments. She is overheard saying, "No one here worries about checking nasogastric tube placement before they give medications and hang feedings. Skipping that step would save me an extra 30 minutes to be used for charting. If they can do it, so can I." This nurse is experiencing which stage of reality shock?
- A. loner.
- B. "rutter."
- C. change agent.
- D. "native."
Correct Answer: D
Rationale: The correct answer is D, "native." In this scenario, the nurse is rationalizing skipping a crucial safety step by justifying it with the actions of others, indicating a lack of understanding regarding the importance of the procedure. The "native" stage of reality shock occurs when individuals start to adopt the norms and behaviors of their workplace without questioning or critically evaluating them. This nurse is displaying a mindset of conforming to unsafe practices to fit in with her colleagues, which aligns with the characteristics of the "native" stage.
Incorrect choices:
A: "loner" does not apply as the nurse is not isolating herself but rather seeking to emulate the actions of others.
B: "rutter" does not fit as this stage involves feeling overwhelmed by the demands of the job, not justifying unsafe practices.
C: "change agent" is not relevant as the nurse is not actively seeking to instigate change but rather conforming to existing practices.
A nurse responsible for staffing a medical-surgical unit must consider: (select all that apply)
- A. the patient census.
- B. physical layout of the unit.
- C. complexity of care required.
- D. educational level of all staff.
Correct Answer: A
Rationale: The correct answer is A: the patient census. This is crucial for determining the appropriate number of staff needed to provide safe and effective care based on the current number of patients. The patient census directly impacts workload and patient acuity levels. Choices B, C, and D are incorrect because although they may be important factors to consider when staffing a medical-surgical unit, they are not as directly related to determining the immediate staffing needs based on the current patient load. The physical layout of the unit, complexity of care required, and educational level of staff are important for overall unit operations and quality of care but do not have the same immediate impact on staffing decisions as the patient census.
A nurse learns in orientation that an incident report does not "blame" anyone but concisely documents the events leading up to an occurrence. Which events would warrant completion of an incident report? (select all that apply)
- A. The client is crying and distraught when he learns of a diagnosis of cancer.
- B. An intravenous antibiotic given preoperatively does not infuse because of a faulty pump.
- C. The nurse is unable to carry out orders written by the specialist because of illegibility.
- D. A client falls while in the shower, although she was told not to get up alone.
Correct Answer: B
Rationale: The correct answer is B because it involves a medical error that could potentially harm the patient. An incident report is necessary to document such events for quality improvement and patient safety. Choice A does not involve a preventable adverse event, so it does not require an incident report. Choice C is related to communication issues and can be resolved without an incident report. Choice D involves a patient fall, which is a reportable event, but the client was informed not to get up alone, making it less urgent for an incident report compared to a medication error.