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Since losing a leg years ago, the client and their spouse have formed a community walking group to raise money for the homeless in their area. Which of the following has contributed to the client being viewed as 'healthy'?
- A. The client is married and is moving on.
- B. The client is experiencing high quality of life within the limits of the physical condition.
- C. The client is facing various states of health and illness.
- D. The client is physiologically and psychologically stable.
Correct Answer: B
Rationale: Clients adapt physically, emotionally, and socially, enabling them to maintain comfort, stability, and self-expression. Clients with chronic illness can achieve a high level of wellness and experience high quality of life. Marriage is an aspect that contributes to quality of life but does not by itself define the quality of the client's life. All clients experience various states of health and illness.
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A nurse is providing care for a client who has had a hip replacement and is going to be discharged in 2 days. The nurse has provided the client instructions for care after discharge. Which instruction would be considered accessing tertiary care?
- A. Begin physical therapy in 1 week.'
- B. Follow up with your primary health care provider in 2 days to discuss laboratory results.'
- C. Go to the outpatient laboratory for blood studies in 3 days.'
- D. Report to the emergency department for signs of infection, shortness of breath, or chest pain.'
Correct Answer: A
Rationale: Starting physical therapy, a type of rehabilitation, is a form of tertiary care. Tertiary care focuses on complex medical and surgical interventions, and specialized services such as cancer care and rehabilitative services. Encouraging the client to see a family health care provider would be promoting primary care. Sending the client for lab studies or instructing them to go to the emergency department would be directing the client to seek secondary care, which includes additional testing and emergency care.
The nurse has been asked to assist in gathering data regarding the incidence of falls in the hospital as part of a project that is geared toward identifying avoidable contributing factors and their effects. What type of quality indicators (QI) is this considered?
- A. Prevention QI
- B. Inpatient QI
- C. Client safety QI
- D. Pediatric QI
Correct Answer: C
Rationale: Client safety QIs reflect quality of care within hospitals but focus on potentially avoidable complications and adverse effects. Prevention QIs identify hospital admissions that could be avoided through high-quality outpatient care. Inpatient QIs reflect quality of care inside hospitals, including inpatient mortality for medical conditions and surgical events. The question does not indicate that client age is considered when gathering data, so Pediatric QIs would not be relevant here.
What method for financing healthcare is based on the ability to keep clients healthy and out of the hospital through periodic screening, health education, and preventive services?
- A. Managed care
- B. Preferred provider organization
- C. Health maintenance organization
- D. Point-of-service organization
Correct Answer: C
Rationale: Health maintenance organizations strive to keep their costs low and members out of the hospital through periodic screenings, health education, and preventive services. Managed care organizations are insurers who carefully plan and closely supervise the distribution of healthcare services. Preferred provider organizations are a community network of providers who are willing to discount their fees for service in exchange for a steady stream of referral customers. Point-of-service organizations involve a network of providers; clients select a primary care physician within the group who then serves as the gatekeeper for other healthcare services.
The nurse is leading a cardiac rehabilitation support group. How can the nurse best demonstrate meeting the client's needs holistically?
- A. Lead an exercise, show a video about healthy lifestyle changes, and invite a spiritual leader to talk with the group.
- B. Have the clients share various healthy low-cholesterol recipes and participate in a cooking class.
- C. Have the clients discuss ways to relieve stress and practice stress reduction.
- D. Demonstrate low-impact aerobic exercise to the group and bring in a lecturer on Tai Chi.
Correct Answer: A
Rationale: Nurses practice from the perspective of holism, which is viewing a person's health as a state balance between body, mind, and spirit. Leading an exercise, showing a video about healthy lifestyle changes, and inviting a spiritual leader to talk with the support group are all ways the nurse can meet the clients' needs holistically. By combining these activities, the nurse addresses the needs of the body, mind, and spirit. Cooking classes, having clients discuss stress reduction, and demonstrating exercise techniques are each only addressing one type of need, and therefore are not on their own holistic methods.
A client undergoing a surgical procedure at the hospital died related to complications during the procedure. The nurse is required to collect data about the event so that a cause can be determined. What type of quality indicators would be used in this incident?
- A. Prevention QIs
- B. Inpatient QIs
- C. Client safety QIs
- D. Pediatric QIs
Correct Answer: B
Rationale: Inpatient QIs reflect quality of care inside hospitals, including inpatient mortality for medical conditions and surgical procedures. Prevention QIs identify hospital admissions that could be avoided through high-quality outpatient care. Client safety QIs also reflect quality of care within hospitals but focus on potentially avoidable complications and adverse events. Pediatric QIs reflect quality of care inside hospitals and identify potentially avoidable hospitalization among children.