Nokea
The nurse is planning a continuous quality improvement (CQI) process to decrease the infection rate on the nursing unit. The nurse should consider which of the following when planning the process? Select all that apply.
- A. CQI processes are required by accrediting agencies
- B. The approach to CQI can be retrospective or concurrent
- C. Institutional Review Board (IRB) approval is required
- D. CQI is conducted by people who are not part of the process
- E. The CQI process has a fixed endpoint
Correct Answer: A,B
Rationale: CQI is often required by accrediting agencies and can be retrospective or concurrent. IRB approval is not typically needed, CQI involves unit staff, and it is ongoing without a fixed endpoint.
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The nurse is caring for a client with a new tracheostomy. Which action is the priority during routine care?
- A. Suction the tracheostomy every 4 hours.
- B. Clean the stoma site with sterile saline.
- C. Change the tracheostomy ties daily.
- D. Monitor for signs of infection.
Correct Answer: B
Rationale: Cleaning the stoma site with sterile saline prevents infection and maintains skin integrity, making it the priority during routine tracheostomy care.
The nurse is obtaining a nursing history of a client suspected of having hepatitis C. The nurse should ask the client if he has:
- A. Drunk contaminated water.
- B. Traveled to India.
- C. Had a tattoo.
- D. Eaten shellfish.
Correct Answer: C
Rationale: Hepatitis C is commonly transmitted through blood exposure, such as via tattoos with unsterile equipment. The other options are more associated with hepatitis A.
A client is receiving spironolactone (Aldactone) for treatment of bilateral lower extremity edema. The nurse should instruct the client to make which of the following nutritional modifications to prevent an electrolyte imbalance?
- A. Increase intake of milk and milk products.
- B. Restrict fluid intake to 1000 mL per day.
- C. Decrease foods high in potassium.
- D. Decrease foods high in sodium.
Correct Answer: C
Rationale: Spironolactone is a potassium-sparing diuretic, so decreasing potassium-rich foods prevents hyperkalemia. Sodium restriction may help edema but is less critical for electrolyte balance in this context.
When assessing speech development, which of the following children should the nurse refer for further examination?
- A. A 4-month-old who laughs out loud.
- B. A 10-month-old who says 'dada' and 'mama.'
- C. A 1-year-old who says 3 to 5 words.
- D. An 18-month-old who only says 'no.'
Correct Answer: D
Rationale: An 18-month-old should have a vocabulary of about 15-20 words and start forming simple phrases. Only saying 'no' indicates a potential delay, warranting further evaluation. The other options reflect age-appropriate speech milestones.
A primary health care provider has written a prescription for a client diagnosed with diabetic gastroparesis to receive metoclopramide four times a day. The nurse schedules this medication to be given at which times?
- A. With each meal and at bedtime
- B. Thirty minutes before meals and at bedtime
- C. One hour after each meal and at bedtime
- D. Every 6 hours spaced evenly around the clock
Correct Answer: B
Rationale: Metoclopramide stimulates the motility of the upper gastrointestinal tract and is used to treat gastroparesis (nausea, vomiting, and persistent fullness after meals). The client should be taught to take this medication 30 minutes before meals and at bedtime. The before-meals administration allows the medication time to begin working before the client consumes food that requires digestion. The other options suggest information that is incorrect.