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.

Accepted Answer

A,B,C

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?

Accepted Answer

Performing a discharge assessment before patients leave the hospital helps identify any potential issues or needs that should be addressed to optimize post-discharge outcomes.

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?

Accepted Answer

The PDSA approach is typically used for small-scale testing and iterative improvements, rather than quickly determining what works on a large scale.

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?

Accepted Answer

The nurse must present the proposal to the hospital's Institutional Review Board (IRB) to ensure ethical standards are met and obtain permission before accessing patient records for research purposes.

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?

Accepted Answer

The answer of A nurse is reviewing the Healthy People...

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?

Accepted Answer

Major diagnostic categories (MDCs) group diagnoses into mutually exclusive categories based on body systems, such as the cardiovascular system, making them suitable for tracking hospital discharge diagnoses.

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?

Accepted Answer

Tobacco use and diabetes are both risk factors for developing pneumonia.

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.

Accepted Answer

The answer of A nurse is planning specific interventions that...

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:

Accepted Answer

The answer of A nurse is teaching a class about...

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?

Accepted Answer

The recommended procedures for reducing transmission of VRE include the use of disposable gloves, hand washing, and the use of a disposable gown if washing or turning the patient, or changing diapers. Reverse isolation (Option B) and the use of masks (Option C) are not specifically recommended for preventing the transmission of VRE. Negative pressure rooms (Option A) may be used for patients with airborne infections, but are not necessary for patients with VRE.

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?

Accepted Answer

Unusual fatigue, abdominal pain, and nausea can be symptoms of a serious condition such as a heart attack or appendicitis. The combination of symptoms and the patient's age make it important for her to seek immediate medical attention. Advising her to rest or take an antacid could delay necessary treatment. Similarly, waiting to call her physician or schedule an appointment with a cardiologist could be dangerous given the possible severity of the symptoms.

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?

Accepted Answer

The average door-to-balloon time of 64 minutes is within the recommended guideline of 90 minutes or less, so there is no immediate need to address this issue.

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:

Accepted Answer

Necrotizing fasciitis is a rapidly spreading bacterial infection that destroys the skin, fat, and muscle. It is a medical emergency and requires immediate treatment, including hyperbaric oxygen therapy, antibiotics, and surgical debridement.

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?

Accepted Answer

The Healthcare Cost and Utilization Project (HCUP) is a national resource that specifically tracks hospital discharge data. HCUP is sponsored by the Agency for Healthcare Research and Quality (AHRQ) and collects data on hospital stays, including discharge diagnoses and procedures. It also provides national statistics and trends for various conditions, including congestive heart failure. Healthy People 2020 is a national health promotion and disease prevention initiative that sets objectives and targets for improving the health of Americans. The Centers for Disease Control and Prevention (CDC) provides information on various health topics and diseases but does not specifically track hospital discharge data. The Institutional Review Board (IRB) is a committee that reviews research studies involving human subjects to ensure ethical and safety considerations are met.

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:

Accepted Answer

Women may experience heart attack symptoms such as abdominal pain, nausea, and difficulty breathing, which can differ from the classic symptoms often seen in men.

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:

Accepted Answer

If the spinal tap culture comes back positive for N. meningitidis, it is a reportable disease, and the nurse must inform the public health department. Additionally, it is important to inform any caregivers, including the child's daycare, to monitor for symptoms of the infection as meningitis spreads easily through contact with respiratory and throat secretions. Providing simple to understand information to the family is also important, but from a public health perspective, informing the appropriate authorities is the priority. Prompt admission to the ICU and double dosing of antibiotics may be necessary, but these decisions should be made by the healthcare provider based on the patient's clinical condition and not by the nurse.

Quiz 15: Health Planning for Acute Care Settings