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Leadership of a medical unit have been instructed to integrate the principles of the Quality and Safety Education for Nurses (QSEN) competency of quality improvement. What action should the units leaders take?
- A. Provide access to online journals and Web-based clinical resources for nursing staff.
- B. Use flow charts to document the processes of care that are used on the unit.
- C. Enforce continuing education requirements for all care providers.
- D. Reduce the use of chemical and physical restraints on the unit.
Correct Answer: B
Rationale: One of the quality improvement skills is to use tools, such as flow charts and cause-effect diagrams, to make processes of care explicit. Each of the other listed actions has the potential to benefit patients and care givers, but none is an explicit knowledge, skill, or attitude associated with this QSEN competency.
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Nurses now have the option to practice in a variety of settings and one of the fastest growing venues of practice for the nurse in todays health care environment is home health care. What is the main basis for the growth in this health care setting?
- A. Chronic nursing shortage
- B. Western focus on treatment of disease
- C. Nurses preferences for day shifts instead of evening or night shifts
- D. Discharge of patients who are more critically ill
Correct Answer: D
Rationale: With shorter hospital stays and increased use of outpatient health care services, more nursing care is provided in the home and community setting. The other answers are incorrect because they are not the basis for the growth in nursing care delivered in the home setting.
A hospice nurse is caring for a patient who is dying of lymphoma. According to Maslows hierarchy of needs, what dimension of care should the nurse consider primary in importance when caring for a dying patient?
- A. Spiritual
- B. Social
- C. Physiologic
- D. Emotional
Correct Answer: C
Rationale: Maslow ranked human needs as follows: physiologic needs; safety and security; sense of belonging and affection; esteem and self-respect; and self-actualization, which includes self-fulfillment, desire to know and understand, and aesthetic needs. Such a hierarchy of needs is a useful framework that can be applied to the various nursing models for assessment of a patients strengths, limitations, and need for nursing interventions. The other answers are incorrect because they are not of primary importance when caring for a dying patient, though each should certainly be addressed.
The public health nurse is presenting a health promotion class to a group of new mothers. How should the nurse best define health?
- A. Health is being disease free.
- B. Health is having fulfillment in all domains of life.
- C. Health is having psychological and physiological harmony.
- D. Health is being connected in body, mind, and spirit.
Correct Answer: D
Rationale: The World Health Organization (WHO) defines health in the preamble to its constitution as a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity. The other answers are incorrect because they are not congruent with the WHO definition of health.
The view that health and illness are not static states but that they exist on a continuum is central to professional health care systems. When planning care, this view aids the nurse in appreciating which of the following?
- A. Care should focus primarily on the treatment of disease.
- B. A persons state of health is ever-changing.
- C. A person can transition from health to illness rapidly.
- D. Care should focus on the patients compliance with interventions.
Correct Answer: B
Rationale: By viewing health and illness on a continuum, it is possible to consider a person as being neither completely healthy nor completely ill. Instead, a persons state of health is ever-changing and has the potential to range from high-level wellness to extremely poor health and imminent death. The other answers are incorrect because patient care should not focus just on the treatment of disease. Rapid declines in health and compliance with treatment are not key to this view of health.
Nurses in acute care settings must work with other health care team members to maintain quality care while facing pressures to care for patients who are hospitalized for shorter periods of time than in the past. To ensure positive health outcomes when patients return to their homes, what action should the nurse prioritize?
- A. Promotion of health literacy during hospitalization
- B. Close communication with insurers
- C. Thorough and evidence-based discharge planning
- D. Participation in continuing education initiatives
Correct Answer: C
Rationale: Following discharges that occur after increasingly short hospital stays, nurses in the community care for patients who need high-technology acute care services as well as long-term care in the home. This is dependent on effective discharge planning to a greater degree than continuing education, communication with insurers, or promotion of health literacy.