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Which statement made by a nurse about the goal of total quality management or continuous quality improvement in a health care setting is correct?
- A. It is to observe reactive service and product problem solving
- B. Improvement of the processes in a proactive, preventive mode is paramount
- C. A chart audits to find to the process in a proactive, preventive mode is paramount
- D. A flow chart to organize daily tasks is critical to the initial stages
Correct Answer: B
Rationale: Improvement of the processes in a proactive, preventive mode is paramount. Total quality management and continuous quality improvement have a major goal of identifying ways to do the right thing at the right time in the right way by proactive problem-solving.
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What principle of HIV disease should the nurse keep in mind when planning care for a newborn who was infected in utero?
- A. The disease will incubate longer and progress more slowly in this infant
- B. The infant is very susceptible to infections
- C. Growth and development patterns will proceed at a normal rate
- D. Careful monitoring of renal function is indicated
Correct Answer: B
Rationale: The infant is very susceptible to infections. HIV compromises the immune system, increasing susceptibility to opportunistic infections.
The nurse is reinforcing teaching on oral care and symptom management to a client with head and neck cancer who has developed mouth sores related to external radiation therapy. Which of the following instructions should the nurse include? Select all that apply.
- A. Apply a water-soluble lubricating agent to moisturize mouth tissue
- B. Avoid hot liquids and foods that are spicy or acidic
- C. Brush your teeth with a soft-bristle toothbrush
- D. Cleanse the mouth with saline after meals and at bedtime
- E. Rinse with alcohol-based antiseptic mouthwash to decrease mouth odor
Correct Answer: A,B,C,D
Rationale: Water-soluble lubricant , avoiding irritants , soft brushing , and saline rinses promote comfort. Alcohol-based mouthwash irritates sores.
The nurse reinforces discharge teaching to a client who had a total knee replacement 4 days ago. Which client statement indicates the need for additional teaching?
- A. I have to give myself shots in the belly because my spouse is afraid of needles?
- B. I have to use a walker because I cant bear any weight on this knee yet.
- C. I will call my health care provider if I get short of breath or sore or swollen below my knee
- D. The raised toilet seat makes it easier for me to get on and off the toilet by myself.
Correct Answer: A
Rationale: Self-administered anticoagulant injections require confirmation of correct technique, not spousal fear, indicating misunderstanding. Walker use , symptom reporting , and toilet aids are correct.
The nurse is caring for a client with acute pancreatitis. After pain management, which intervention should be included in the plan of care?
- A. Encourage the client to cough and deep breathe every 2 hours
- B. Place the client in contact isolation
- C. Provide a diet high in protein
- D. Institute seizure precautions
Correct Answer: A
Rationale: Encourage the client to cough and deep breathe every 2 hours. Coughing and deep breathing prevent respiratory infections due to shallow respirations.
A throat culture is ordered for an adult who has a sore throat. The nurse asks the client if he has taken any medications to treat himself. Which medication, if reported by the client, would be of greatest concern to the nurse?
- A. Aspirin
- B. A throat lozenge
- C. Acetaminophen
- D. An antibiotic
Correct Answer: D
Rationale: Antibiotics can alter throat culture results by reducing bacterial growth, potentially leading to a false negative, the greatest concern.