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With the changing population of health care consumers, it has become necessary for nurses to work more closely with other nurses, as when acute care nurses collaborate with public health and home health nurses. What nursing function has increased in importance because of this phenomenon?
- A. Prescribing medication
- B. Performing discharge planning
- C. Promoting family involvement
- D. Forming collegial relationships
Correct Answer: B
Rationale: The importance of effective discharge planning and quality improvement cannot be overstated. The other answers are incorrect because giving medication and family involvement in the patients care have not grown in importance. Making and maintaining collegial relationships has become a necessity in working in the health care delivery system. Effective discharge planning aids in getting patients out of the inpatient setting sooner, cutting costs, and making rehabilitation in the community and home setting possible.
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You are admitting a patient to your medical unit after the patient has been transferred from the emergency department. What is your priority nursing action at this time?
- A. Identifying the immediate needs of the patient
- B. Checking the admitting physicians orders
- C. Obtaining a baseline set of vital signs
- D. Allowing the family to be with the patient
Correct Answer: A
Rationale: Among the nurses important functions in health care delivery, identifying the patients immediate needs and working in concert with the patient to address them is most important. The other nursing functions are important, but they are not the most important functions.
A hospitals current quality improvement program has integrated the principles of the Institute for Healthcare Improvement (IHI) 5 Million Lives Campaign. How can the hospital best achieve the campaign goals of reducing preventable harm and death?
- A. By adhering to EBP guidelines
- B. By reducing nurse-to-patient ratios and increasing accountability
- C. By having researchers from outside the facility evaluate care
- D. By involving patients and families in their care planning
Correct Answer: A
Rationale: The 5 Million Lives Campaign posits that if evidence-based guidelines it advocated were voluntarily implemented by U.S. hospitals, 5 million lives would be saved from either harm or death over a two-year period. Nurse-to-patient ratios, family participation, and independent evaluation are not stated components of the campaign.
Leadership of a medical unit have been instructed to integrate the principles of the Quality and Safety Education for Nurses (QSEN) competency of quality improvement. What action should the units leaders take?
- A. Provide access to online journals and Web-based clinical resources for nursing staff.
- B. Use flow charts to document the processes of care that are used on the unit.
- C. Enforce continuing education requirements for all care providers.
- D. Reduce the use of chemical and physical restraints on the unit.
Correct Answer: B
Rationale: One of the quality improvement skills is to use tools, such as flow charts and cause-effect diagrams, to make processes of care explicit. Each of the other listed actions has the potential to benefit patients and care givers, but none is an explicit knowledge, skill, or attitude associated with this QSEN competency.
Nurses in acute care settings must work with other health care team members to maintain quality care while facing pressures to care for patients who are hospitalized for shorter periods of time than in the past. To ensure positive health outcomes when patients return to their homes, what action should the nurse prioritize?
- A. Promotion of health literacy during hospitalization
- B. Close communication with insurers
- C. Thorough and evidence-based discharge planning
- D. Participation in continuing education initiatives
Correct Answer: C
Rationale: Following discharges that occur after increasingly short hospital stays, nurses in the community care for patients who need high-technology acute care services as well as long-term care in the home. This is dependent on effective discharge planning to a greater degree than continuing education, communication with insurers, or promotion of health literacy.
A team of community health nurses are planning to draft a proposal for a program that will increase the communitys alignment with the principles contained in the Healthy People 2020 report. Which of the following activities would best demonstrate the priorities identified in this report?
- A. Addressing determinants of health such as clean environments and safety in the community
- B. Lobbying for increased funding to the county hospital where many residents receive primary care
- C. Collaborating with health professionals in neighboring communities to pool resources and increase efficiencies
- D. Creating clinical placements where nursing students and members of other health disciplines can gain experience in a community setting
Correct Answer: A
Rationale: Healthy People 2020 addresses social determinants of health such as safety and the state of the environment. This report does not specifically address matters such as hospital funding, nursing education, or resource allocation.