Nokea
Which of the following best describes the concept of total quality management (TQM)?
- A. Top-down management
- B. Employee-centered approach
- C. Continuous improvement
- D. Quality control
Correct Answer: C
Rationale: The correct answer is C: Continuous improvement. Total Quality Management (TQM) focuses on constantly improving processes, products, and services to meet or exceed customer expectations. TQM involves all employees in identifying and solving problems, emphasizing continuous learning and innovation.
A: Top-down management is incorrect because TQM encourages involvement and empowerment of employees at all levels, not just top management.
B: Employee-centered approach is incorrect because while TQM values employees and their contributions, it is primarily focused on improving overall quality and processes, not solely centered on employees.
D: Quality control is incorrect because TQM goes beyond traditional quality control methods to encompass a holistic approach to quality management through continuous improvement efforts.
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A resident on night call refuses to answer pages from the staff nurse on the night shift and complains that she calls too often with minor problems. The nurse feels offended and reacts with frequent, middle-of-the-night phone calls to 'get back' at him. The behavior displayed by the resident and the nurse is an example of what kind of conflict?
- A. Perceived conflict
- B. Disruptive conflict
- C. Competitive conflict
- D. Felt conflict
Correct Answer: B
Rationale: The correct answer is B: Disruptive conflict. This type of conflict occurs when individuals are unwilling to cooperate or communicate effectively, leading to negative consequences. In this scenario, the resident and nurse are engaging in disruptive conflict by refusing to answer calls and retaliating with more calls. This behavior disrupts the communication and collaboration necessary for effective patient care.
A: Perceived conflict is when individuals believe there is a conflict, even if it may not exist. In this case, the conflict is real and not just perceived.
C: Competitive conflict involves individuals trying to outdo each other or win at the expense of the other party. This is not evident in the scenario provided.
D: Felt conflict refers to the emotional response to a conflict situation. While there are emotions involved in the scenario, the main issue is the disruption in communication rather than just feelings.
Which information will the nurse include when teaching a 50-year-old patient who has type 2 diabetes about glyburide (Micronase, DiaBeta, Glynase)?
- A. Glyburide decreases glucagon secretion from the pancreas.
- B. Glyburide stimulates insulin production and release from the pancreas.
- C. Glyburide should be taken even if the morning blood glucose level is low.
- D. Glyburide should not be used for 48 hours after receiving IV contrast media.
Correct Answer: B
Rationale: The correct answer is B: Glyburide stimulates insulin production and release from the pancreas.
1. Glyburide belongs to the sulfonylurea class of drugs, which works by stimulating the pancreas to produce and release more insulin.
2. This action helps to lower blood glucose levels in patients with type 2 diabetes.
3. By increasing insulin secretion, glyburide helps improve glucose utilization in the body.
Incorrect choices:
A: Glyburide does not decrease glucagon secretion from the pancreas; it primarily affects insulin production.
C: Glyburide should not be taken if the morning blood glucose level is low to prevent hypoglycemia.
D: Glyburide does not have a specific interaction with IV contrast media; caution is needed with other medications that may interact.
What information will the nurse include in teaching a female patient who has peripheral arterial disease, type 2 diabetes, and sensory neuropathy of the feet and legs?
- A. Select flat-soled leather shoes
- B. Apply heating pads on a low temperature.
- C. Avoid using callus remover for corns or calluses.
- D. Refrain from soaking feet in warm water for an hour each day.
Correct Answer: A
Rationale: The correct answer is A: Select flat-soled leather shoes. This choice is important for a patient with peripheral arterial disease, type 2 diabetes, and sensory neuropathy as it helps prevent skin breakdown, reduce pressure on the feet, and minimize the risk of injury due to decreased sensation. Flat-soled leather shoes provide good support and protection.
Explanation for why the other choices are incorrect:
B: Apply heating pads on a low temperature - This can be dangerous for a patient with sensory neuropathy as they may not be able to feel if the heating pad is too hot, leading to burns.
C: Avoid using callus remover for corns or calluses - While it is important to avoid injuring the skin, addressing foot care is not as critical as selecting appropriate footwear.
D: Refrain from soaking feet in warm water for an hour each day - Prolonged soaking can increase the risk of skin breakdown and infections, so it is important to avoid this practice.
What is the primary goal of a root cause analysis (RCA) in healthcare?
- A. To assign blame for errors
- B. To prevent future errors by identifying underlying causes
- C. To improve patient satisfaction
- D. To analyze the financial impact of errors
Correct Answer: B
Rationale: The primary goal of a root cause analysis (RCA) in healthcare is to prevent future errors by identifying underlying causes. This is because RCA focuses on understanding the fundamental reasons behind incidents to implement effective preventive measures. By identifying root causes, healthcare providers can implement strategies to mitigate risks and enhance patient safety. The other choices are incorrect because RCA is not about assigning blame (A), improving patient satisfaction (C), or analyzing financial impact (D), but rather about understanding and addressing the core issues to prevent recurrence.
A client experiences an air emboli, resulting in a stroke, during an IV start. This can be classified as which type of risk?
- A. Patient dissatisfaction
- B. Medical-legal incident
- C. Medication error
- D. Diagnostic procedure
Correct Answer: D
Rationale: The correct answer is D: Diagnostic procedure. Air emboli during an IV start can lead to a stroke, making it a risk associated with a diagnostic procedure. The air emboli occurred during the IV start, which is a diagnostic procedure aimed at obtaining information about the patient's health status. Patient dissatisfaction (A) is not the main concern here, as the focus is on the medical outcome. While a medical-legal incident (B) may result from this situation, the primary classification is related to the diagnostic nature of the procedure. This incident is not primarily a medication error (C) as the main issue is the introduction of air into the bloodstream during the IV start, rather than a mistake in medication administration.