Nursing Elites

1. A nurse is reviewing the laboratory results of a female client who has hypovolemia. Which of the following laboratory results would be a priority for the nurse to report to the provider?

• A. BUN 21 mg/dL (10 to 20 mg/dL)
• B. Potassium 5.8 mEq/L (3.5 to 5 mEq/L)
• C. Creatinine 1.4 mg/dL (0.5 to 1.1 mg/dL)
• D. Sodium 132 mEq/L (136 to 145 mEq/L)

Correct answer: B

Rationale: In a client with hypovolemia, the nurse should prioritize reporting the elevated potassium level of 5.8 mEq/L to the provider. Hypovolemia can lead to electrolyte imbalances, and hyperkalemia (potassium level above 5.0 mEq/L) is a serious condition that can result in cardiac arrhythmias and requires immediate attention. The other laboratory results, BUN, creatinine, and sodium, are also important in assessing renal function and fluid balance, but the priority in this case is the elevated potassium level due to its potential life-threatening complications.

2. Which of the following is a key component of patient-centered care?

• A. Provider-centered decision making
• B. Timely discharge
• C. Respect for patient preferences
• D. Focusing on clinical outcomes

Correct answer: C

Rationale: The correct answer is C: Respect for patient preferences. Patient-centered care focuses on involving patients in their care decisions and respecting their preferences. Choice A, provider-centered decision making, goes against the concept of patient-centered care as it prioritizes the provider over the patient. Timely discharge, choice B, is important but not a defining component of patient-centered care. Focusing on clinical outcomes, choice D, is essential in healthcare but does not solely represent patient-centered care, which is more about personalized care and involving patients in decision-making.

3. Which of the following is a recommendation for avoiding charges of negligence and false imprisonment for confused clients?

• A. Carefully assess and document client status.
• B. Ensure all patient information is secure and the nurse has logged out of the computer before leaving the computer station.
• C. Keep detailed notes while providing care to ensure accurate documentation later in the day.
• D. Discuss safety needs with clients.

Correct answer: A

Rationale: The correct answer is A: 'Carefully assess and document client status.' When dealing with confused clients, it is crucial to assess their status carefully and document it accurately. This helps in avoiding charges of negligence and false imprisonment by ensuring that the client's condition is well-documented and appropriate care is provided. Choice B is incorrect because it focuses on computer security rather than client care. Choice C is incorrect because it emphasizes detailed notes for accuracy but does not specifically address the confusion of clients. Choice D is incorrect as it mentions discussing safety needs but does not directly relate to avoiding charges of negligence and false imprisonment for confused clients.

4. A manager is prioritizing the following issues. Of the following issues, which should be considered urgent and important?

• A. The manager of physical therapy calls and complains about inappropriate behaviors of one of the staff nurses with one of his therapists.
• B. A staff nurse reports a pattern of malfunctioning IV pumps on the unit during her current shift, resulting in overdosing of medications.
• C. One of the staff nurses, who would have been an extra nurse for the next shift, calls in sick.
• D. A small group of staff nurses request a meeting to discuss initiating a scheduling committee.

Correct answer: B

Rationale: The correct answer is B because patient safety is a critical concern in healthcare settings. Malfunctioning IV pumps leading to medication overdosing poses a direct threat to patient safety and must be addressed urgently. Choice A involves interpersonal issues between staff members which are important but can be addressed in a less urgent manner compared to patient safety concerns. Choice C, a staff nurse calling in sick, is important for staffing but can be managed through existing protocols. Choice D, initiating a scheduling committee, is a routine operational matter that can be addressed at a later time and does not pose an immediate risk to patient safety.

5. What are the key elements essential to the implementation of case management? (Select all that apply.)

• A. Collaborative practice teams
• B. Established critical pathways
• C. Quality management system
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Established critical pathways, collaborative practice teams, and quality management systems are indeed key elements essential to the implementation of case management. Collaborative practice teams allow for multidisciplinary collaboration, established critical pathways help guide patient care, and a quality management system ensures that care provided meets established standards. Choice A, collaborative practice teams, is correct as they are fundamental for effective case management, involving various professionals working together. Choice B, established critical pathways, is also correct as they provide a structured approach to managing patient care. Choice C, quality management system, is correct as it ensures that care is delivered at high standards and continuously monitored for improvement. Therefore, all these elements are crucial for successful case management implementation.

Similar Questions