Nokea
Which quality of care measures influence the payment for health care services by third-party payers (select all that apply)?
- A. Clinical outcomes
- B. Regulatory agencies
- C. Use of evidence-based practice
- D. Occurrence of preventable conditions
Correct Answer: A
Rationale: Third-party payers prioritize clinical outcomes, evidence-based practice adoption, and minimizing preventable conditions to ensure value-based care.
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A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?
- A. The client who has been NPO since midnight for endoscopy
- B. The client who has left-sided heart failure and has a brain natriuretic peptide (BNP) level of 600 pg/mL
- C. The client who has end-stage renal failure and is scheduled for dialysis today
- D. The client who has gastroenteritis and is febrile
Correct Answer: D
Rationale: Step 1: The client with gastroenteritis is at risk for fluid volume deficit due to vomiting and diarrhea, leading to loss of fluids.
Step 2: Febrile state increases fluid loss through sweating.
Step 3: Combining gastroenteritis and fever exacerbates fluid loss, making this client at high risk.
Step 4: Clients A, B, and C do not have immediate factors contributing to fluid volume deficit as evident from their conditions.
Summary: Client D is at risk due to gastroenteritis and fever causing significant fluid loss. Clients A, B, and C do not have conditions directly leading to fluid deficit.
In assessing the healing of a client's wound during a home visit, which of the following is the best indicator of good healing?
- A. White patches.
- B. Green drainage.
- C. Reddened tissue.
- D. Eschar development.
Correct Answer: C
Rationale: Reddened tissue indicates healthy granulation tissue.
What is contraindicated for a client being treated for Ménière’s disease?
- A. Alcohol
- B. Smoking
- C. A high-protein diet
- D. Cough syrups and other CNS depressants
Correct Answer: D
Rationale: CNS depressants can worsen dizziness and imbalance associated with Ménière’s disease.
What does weight gain during the postoperative period indicate?
- A. Urine retention
- B. Healthy recovery
- C. Paralytic ileus
- D. Hypoxia
Correct Answer: C
Rationale: The correct answer is C because weight gain can indicate fluid retention due to paralytic ileus.
A client has periodic outbreaks of cold sores long after the initial infection of herpes simplex virus. Why does this occur?
- A. The client has low resistance.
- B. The client has not received proper treatment.
- C. The viruses are dormant in the client.
- D. The viruses are immune to the therapy.
Correct Answer: C
Rationale: The correct answer is C because the herpes simplex virus can become dormant in nerve cells and reactivate periodically, leading to recurrent outbreaks.