Nokea
The nurse manager plans to establish quality metrics for the nursing unit based on national metrics and compare them to other healthcare organizations. This process is identified as
- A. benchmarking.
- B. continuous quality improvement.
- C. performance improvement.
- D. quality management.
Correct Answer: A
Rationale: Comparing unit metrics to national standards (A) is benchmarking, a process to measure performance against external standards. Continuous quality improvement (B), performance improvement (C), and quality management (D) are broader processes, but benchmarking is specific to this action.
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The charge nurse is planning client care assignments for a licensed practical/vocational nurse (LPN/VN). Which of the following would be an appropriate assignment(s) for the LPN? Select all that apply.
- A. A 67-year-old one-hour post-procedure from a cardiac catheterization.
- B. An 88-year-old client who was just admitted for intractable pain secondary to metastatic cancer.
- C. A 42-year-old being discharged following a diagnosis of type 2 diabetes mellitus.
- D. A 75-year-old inpatient client with colon cancer needing colostomy care.
- E. A 50-year-old client being treated for herpes zoster with prescribed oral antivirals.
Correct Answer: B, D, E
Rationale: LPNs can manage stable clients with pain (B), colostomy care (D), and oral antivirals (E) within their scope. A client one-hour post-cardiac catheterization (A) requires RN monitoring for complications, and discharge teaching for diabetes (C) involves complex education best suited for an RN.
The nurse is precepting a newly hired nurse on the medical-surgical unit. Which of the following actions, if performed first by the newly hired nurse, would demonstrate appropriate prioritization?
- A. Initiates a referral for a client needing home health care.
- B. Performs a central line dressing change on a client receiving 0.9% saline infusion.
- C. Collects a urine specimen from a client's indwelling urinary catheter.
- D. Obtains capillary blood glucose for a client receiving continuous regular insulin.
Correct Answer: D
Rationale: Obtaining blood glucose for a client on continuous insulin (D) is the priority to prevent hypo- or hyperglycemia, which can be life-threatening. Home health referral (A), dressing change (B), and urine collection (C) are important but less urgent, as they do not address immediate physiological risks.
The nurse is admitting a client who is blind and deaf. The nurse should prioritize which action?
- A. Review the plan of care with the client
- B. Communicate with the nursing supervisor with any safety concerns
- C. C. Update the client on the social activities
- D. D. Provide a safe environment for the client
Correct Answer: D
Rationale: Providing a safe environment (D) is the priority for a blind and deaf client to prevent injury, using tactile communication and clear pathways. Reviewing care plans (A), addressing concerns (B), or social updates (C) are secondary to immediate safety.
The nurse is caring for the following assigned clients. The nurse should initially follow-up on the client who
- A. is taking lithium that reports nausea and vomiting.
- B. is refusing their prescribed quetiapine.
- C. is reporting a headache following the first dose of citalopram.
- D. gets drowsy following a dose of alprazolam.
Correct Answer: A
Rationale: Nausea and vomiting with lithium (A) suggest potential toxicity, requiring immediate follow-up. Quetiapine refusal (B), headache with citalopram (C), and drowsiness with alprazolam (D) are less urgent or expected side effects.
The nurse has been made aware of the following client situations. The nurse should first follow up with the client
- A. receiving a chemotherapy infusion who reports nausea and vomiting.
- B. newly diagnosed with polycystic kidney disease reporting hematuria and flank pain.
- C. being treated for aplastic anemia and has a temperature of 101.1°F (38.4°C).
- D. being treated for pulmonary tuberculosis and ambulating in the hallway wearing a surgical mask.
Correct Answer: C
Rationale: A fever in a client with aplastic anemia (C) indicates potential infection, a life-threatening complication due to low white blood cells, requiring immediate attention. Nausea from chemotherapy (A), hematuria with kidney disease (B), and TB with a mask (D) are less urgent.