Deck 15: Health Planning for Acute Care Settings

Question 1

A nurse is reviewing the hospital's statistics in comparison with the Institute for Healthcare Improvement (IHI) "100,000 Lives Campaign" to see what the facility could do to improve safety within the organization. What statistics should the nurse look at? Select all that apply.

A)Use of rapid response teams
B)Central line infections
C)Ventilator assisted pneumonia
D)Pressure ulcers/wounds
E)Number of falls

Answer 1

Use of rapid response teams
Central line infections
Ventilator assisted pneumonia

Question 2

A nurse is teaching new nurses how to optimize post-hospital discharge outcomes for patients. Which of the following actions should the nurses take?

A)Perform a discharge assessment before patients leave the hospital.
B)Perform a home health visit before the patient is discharged to assess if it is a safe environment.
C)Make a referral for post-discharge home health visits for all patients who have been hospitalized.
D)The standardized discharge instructions for patients to follow when they return home is sufficient and no further action is needed.

Answer 2

Perform a discharge assessment before patients leave the hospital.

Question 3

A nurse is looking to develop a new policy to address the rising rate of central line infections in their medical intensive care unit (ICU). The nurse speaks with the nurse manager about utilizing the Plan-Do-Study-Act (PDSA) approach, instead of simply developing new ICU protocols. Which of the following is not a benefit of using this system?

A)New protocols can be tested before implementing them throughout the hospital ICUs.
B)The staff can work with manufacturers of the medical equipment to determine how the central line trays can be arranged more efficiently.
C)They can figure out what works on the large scale fairly quickly.
D)The nurses can figure out what other processes need to be addressed with the new policy changes.

Answer 3

They can figure out what works on the large scale fairly quickly.

Question 4

A nurse is writing a proposal for a study within the hospital that would require they obtain patient records for regular chart reviews. How should the nurse proceed?

A)Obtain the records from the EMR, or the medical records department as required by the hospital.
B)Inform the physicians caring for the patients why the nurse needs to review the records prior to conducting the medical record review.
C)Present the proposal to the hospital Institutional Review Board for review and obtain permission from them prior to doing the study.
D)The nurse is not able to use the records because it is a violation of HIPAA.

Question 5

A nurse is reviewing the Healthy People 2020 objectives related to cardiovascular disease and stroke and decides to develop an intervention to reduce hospitalizations of older people with heart failure. Which of the following is an example of an intervention at the level of secondary prevention?

A)Conducting a screening program at local senior centers to help identify persons who may have early stages of heart failure.
B)Developing a family-based discharge program for heart failure patients with a history of readmissions in less than thirty days.
C)Having patients who have been diagnosed with heart failure complete a chronic disease self-management program once they have been discharged from the hospital.
D)Conducting a good nutrition and exercise program at the local older adult housing complex.

Question 6

As part of a capstone project, a student nurse is reviewing hospital discharge data. The student nurse decides to use which group of data to track hospital discharge diagnoses for the cardiovascular system. She wants to use a taxonomy that categories diagnoses into mutually exclusive groups. Which taxonomy should she use?

A)ICD10 codes
B)Major diagnostic categories (MDCs)
C)Recidivism rates
D)ALOS statistics

Question 7

A nurse is presenting a lecture about pneumonia to a group of senior citizens in a community center. The nurse explains that people with which of the following risk factors are at a higher risk of developing the infection?

A)Tobacco use and diabetes
B)Immunosuppression and hypertension
C)Diabetes and gastritis
D)Hypertension and heart failure

Question 8

A nurse is planning specific interventions that aim to reduce the rate of complications due to uncontrolled blood sugar levels in the diabetes population. The word population is being used in the ____ context.

A)Public health
B)Hospital setting
C)Cultural
D)None of the above

Question 9

A nurse is teaching a class about the role of acute care in the nursing process. A student asks what type of prevention, if any, acute care mainly provides. The nurse replies:

A)Primary.
B)Secondary.
C)Tertiary.
D)Quaternary.

Question 10

A nurse manager is presenting an in-service to the rest of the nurses on the floor. They are discussing the recent spread of vancomycin-resistant enterococci (VRE) within the hospital and how to prevent transmission on their floor. Which of the following are recommended procedures for reducing transmission?

A)Use of disposable gloves, negative pressure rooms, the use of a disposable gown if washing or turning the patient, or changing diapers.
B)Use of disposable gloves, hand washing, reverse isolation.
C)Use of masks, hand washing, the use of a disposable gown if washing or turning the patient, or changing diapers.
D)Use of disposable gloves, hand washing, the use of a disposable gown if washing or turning the patient, or changing diapers.

Question 11

A nurse is answering telephone calls from a triage line. A call comes in from a 62-year-old woman who has complaints of unusual fatigue, abdominal pain, and nausea. She denies eating anything unusual that day. What should the nurse advise her to do?

A)Rest and take an antacid.
B)Call her physician in the morning.
C)Go to the nearest emergency department.
D)Schedule an appointment with a cardiologist next week.

Question 12

A nurse is looking to improve the care of women presenting to the emergency department (ED) with atypical symptoms of a heart attack. The nurse finds that the average door-to-balloon time-the interval starts with the patient's arrival in the emergency department, and ends when a catheter guidewire crosses the culprit lesion in the cardiac catheter lab-in their hospital is 64 minutes with the longest time being 84 minutes. How does the nurse proceed?

A)No need to address this-the average door-to-balloon time is well within the desired guidelines.
B)Perform a hospital and ED assessment to see where these patients are being held up.
C)Mandate EKGs for every patient who comes into the emergency room.
D)Create a separate wing of the ED especially for suspected cardiac patients.

Question 13

A nurse is caring for a patient in the emergency department. The physician orders hyperbaric oxygen therapy, antibiotics, and surgical debridement in the morning. The nurse knows that the physician suspects:

A)Cellulitis.
B)Necrotizing fasciitis.
C)Toxic shock syndrome.
D)Sepsis.

Question 14

A nurse working on a medical surgical unit in a large urban hospital is evaluating the hospital's discharge rate for congestive heart failure and wants to see how it compares with national statistics. Which national resource is available that specifically tracks hospital discharge data?

A)Healthcare Cost and Utilization Project
B)Healthy People 2020
C)Centers for Disease Control and Prevention
D)Institutional Review Board

Question 15

A nurse is partnering with a local television station to create a public service announcement discussing heart disease in women. The nurse explains that women often experience the symptoms of a heart attack differently than men. These symptoms can include:

A)Abdominal pain.
B)Nausea.
C)Difficulty breathing.
D)All of the above.

Question 16

A nurse is caring for a young child who is suspected of having meningitis. A spinal tap culture is pending. If it comes back positive for N. meningitidis, from a public health perspective it is important that the nurse:

A)Provide his family with information about the disease in simple to understand language.
B)Inform the public health department, the child's daycare and other caregivers so they can monitor for symptoms of the infection.
C)Promptly admit the child to the ICU.
D)Double the dose of antibiotics.