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The nurse is reviewing the core competencies for health care providers outlined by the Institute of Medicine (IOM). Which of the following are included? (Select all that apply.)
- A. Collaborating with an interdisciplinary team
- B. Implementing evidence-based care
- C. Providing family-focused care
- D. Routinely using informatics in practice
- E. Using quality improvement in client care
Correct Answer: A,B,D,E
Rationale: The IOM report lists five broad core competencies that all health care providers should practice. These include collaborating with the interdisciplinary team, implementing evidence-based practice, providing client-focused care, using informatics in client care, and using quality improvement in client care. Providing family-focused care is not explicitly listed as a core competency.
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A nurse manager wants to improve hand-off communication among the staff. What actions by the manager would best achieve this goal? (Select all that apply.)
- A. Attend hand-off rounds to coach and mentor
- B. Conduct audits of staff using a new template
- C. Hand-off rounds to coach and mentor
- D. Encourage staff to ask questions during hand-off
- E. Give raises based on compliance with reporting
Correct Answer: A,B,C,D
Rationale: A protocol for standardizing hand-off reports and other critical communication is the SHARE model. Attending hand-off rounds gives the manager opportunities to educate and coach. Conducting audits is part of reinforcing quality. Creating a template is standardizing within the system. Encouraging staff to ask questions and think critically about the information is allowing opportunities to ask questions. Giving raises based on compliance is not part of the SHARE model.
A nurse is talking with a client who is moving to a new state and needs to find a new doctor and hospital there. What advice by the nurse is best?
- A. Ask the hospitals there about standard nurse-client ratios
- B. Choose the hospital that has the newest technology
- C. Find a hospital that is accredited by The Joint Commission
- D. Use a facility affiliated with a medical or nursing school
Correct Answer: C
Rationale: Accreditation by The Joint Commission (TJC) or other accrediting body gives assurance that the facility has a focus on safety. Nurse-client ratios differ by unit type and change over time. New technology doesn't necessarily mean the hospital is safe. Affiliation with a health professions school has several advantages, however safety is most important.
The nurse utilizing evidence-based practice (EBP) considers which factors when planning care? (Select all that apply.)
- A. Cost-saving measures
- B. Nursing expertise
- C. Client preferences
- D. Research findings
- E. Values of the client
Correct Answer: B,C,D,E
Rationale: The IOM reports utilizing current evidence, the client's values and preferences, and the nurse's expertise when planning care. It does not include cost-saving measures, as these are not a primary focus of evidence-based practice.
A nurse wishes to provide client-centered care in all interactions. Which action by the nurse best demonstrates this concept?
- A. Assesses for cultural influences affecting health care
- B. Ensures that all the clients basic needs are met
- C. Tells the client and family about all upcoming tests
- D. Thoroughly orients the client and family to the room
Correct Answer: A
Rationale: Competency in client-focused care is demonstrated when the nurse focuses on communication, culture, respect, compassion, client education, and empowerment. By assessing the effect of the client's culture on health care, the nurse best demonstrates this concept. Simply telling the client about all upcoming tests is not providing empowering education. Orienting the client and family to the room is an important safety measure, but not directly related to demonstrating client-centered care.
A student nurse asks the faculty to explain best practices when communicating with a person from the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community. What answer by the faculty is most accurate?
- A. Avoid embarrassing the client by asking questions
- B. Use open-ended questions and attentive listening
- C. Most LGBTQ people do not want to share information
- D. No differences exist in communicating with this population
Correct Answer: B
Rationale: Many members of the LGBTQ community have faced discrimination from health care providers and may be reluctant to seek health care. Using open-ended questions and attentive listening fosters trust and encourages honest communication. Avoiding questions may miss critical health information, and assuming no differences or reluctance to share ignores the unique needs and experiences of this population.