Health Care Quality

The 61-year-old patient with liver cirrhosis reports extreme fatigue on a daily basis. The nurse pursues which intervention?

The nurse is instructing the unlicensed assistive personnel (UAP) on the proper care of dentures. Which actions by the UAP indicate an understanding of the teaching? Select all that apply.

The nurse is helping a woman who is 12 weeks pregnant develop a diet plan. Which initial action by the nurse is appropriate?

The 58-year-old patient asks the nurse if he is at risk of heart disease. Which response by the nurse is appropriate?

The patient is in the post-anesthesia care unit (PACU) following abdominal surgery. Which finding would prompt the nurse to delay discharge from the PACU to a hospital bed?

The patient is undergoing placement of an antibiotic-impregnated central line catheter for vancomycin infusions. Which statements are true about this type of catheter? Select all that apply.

The lab calls the nurse and reports an adult patient’s serum calcium of 5.9 mg/dL and serum potassium of 6.2 mEq/dL. Which action by the nurse is appropriate?

Which are components of informed consent? Select all that apply.

The nurse knows that a fire extinguisher with a symbol of an A is suitable for which type of fires?

The nurse is inserting a nasogastric (NG) tube. To ease the process and increase chances for success, which instruction does the nurse give the patient to perform during insertion?

The nurse is caring for the patient who is recovering from an ischemic stroke. The speech therapist recommended all liquids to be thickened to a nectar consistency. The nurse provides which information to the patient about nectar-thick liquid? Select all that apply.

The woman who delivered her first baby will be discharged tomorrow. After a bedside education program in the hospital, the patient tells the nurse that she does not have a crib, bottles, or diapers to care for her new baby. Which action is most appropriate?

The nurse is preparing for an infant’s two-month well-baby check-up. Which immunizations does the nurse prepare? Select all that apply.

The nurse is preparing a Haemophilus influenzae type b (Hib) immunization for the 2-month-old patient. The baby’s mother states, “I recently read the influenza vaccine isn’t given until at least a year. Are you sure he should be getting this now?” Which response by the nurse is most appropriate?

The nurse reviewing the vaccination record of a 12-month-old infant expects the infant to have completed which vaccine series?

The nurse is preparing for the well-baby visit of the 6-month-old who is up-to-date on vaccines. Which vaccinations does the nurse prepare for the visit? Select all that apply.

The 13-year-old female patient presents to the clinic in January to begin the vaccine series for human papillomavirus. The nurse instructs the patient’s mother to schedule an appointment for the next vaccine in the series during which month at the earliest?

The 34-week-gestation neonate is born weighing 1.7 kg to a mother who is hepatitis B surface antigen (HBsAg) positive; all other infectious disease serologies are negative. Which orders are appropriate for this patient? Select all that apply.

The 1.9 kg neonate is born precipitously via vaginal delivery to a 32-year-old mother who received no prenatal care or infectious disease serology testing before delivery. The mother has a history of intravenous drug use. Which intervention does the nurse perform first?

The patient whose mother chose not to vaccinate him presents to the clinic the day after his 18th birthday to receive all eligible vaccinations. The nurse uses which statement to counsel the patient about the hepatitis B vaccine series?

The nurse is providing discharge education to the patient regarding immunizations following a hematopoietic stem cell transplant. When does the nurse instruct the patient to visit the clinic for the Haemophilus influenzae type b (Hib) vaccine?

The public health nurse encourages which individuals to receive the hepatitis A vaccine? Select all that apply.

The 18-year-old healthy female presents to the clinic requesting to receive the vaccinations her mother refused for her when she was a child. Reviewing the chart, the nurse notes the patient never received the measles, mumps, rubella (MMR) vaccine. Prior to administering the vaccination, which test is most important?

Which initiative is a primary strategy to prevent lead toxicity?

The nurse holds the dose of propranolol and contacts the provider for which vital sign?

The nurse is assessing the patient’s ability to live independently. The patient ambulates with a cane but cannot manage stairs (lives in a one-level home). Due to advancing macular degeneration, the patient has forfeited her driving license. The patient has a daughter who is able to assist with transport to doctor appointments but cannot visit regularly. The macular degeneration is affecting the patient’s ability to tell the difference between her many pills. Which level of nursing care is appropriate for the patient?

The home care nurse visits the home of an elderly married couple who lives with their adult children. Medication bottles and loose pills are found throughout the house. The nurse provides which information about safe storage of medications? Select all that apply.

Which instruction does the nurse give the patient with epilepsy who is 6 weeks pregnant?

There are four patients with hyperglycemia in the emergency department triage. One treatment room has become available. The patient with which additional symptom is moved into the available room first?

The nurse notices that the patient’s peripheral IV insertion site is red and indurated. What action does the nurse perform first?

The nurse is providing preprocedure education to the family of the child with type 1 diabetes mellitus who must undergo a tonsillectomy. Which information does the nurse include?

Parents bring their 12-month-old baby who was born prematurely to the pediatrician for a well-baby appointment. How does the nurse judge the adequacy of the baby's weight gain?

A multidisciplinary team has been assembled to treat the patient who is hospitalized for a diabetic foot ulcer. Adherence to treatment, lifestyle, and dietary strategies has been an ongoing issue. The team includes an endocrinologist, primary care physician, a podiatrist, a registered nurse, and a dietitian. The addition of which provider to the multidisciplinary team will most positively impact outcomes for this patient?

The nurse planning care for the neonate with myelomeningocele plans interventions to ensure the child does not develop an allergy to which substance?

The charge nurse is planning room assignments during an outbreak of Shiga toxin-producing Escherichia coli (STEC). Due to the influx of patients, only one private room is available. Which patient with STEC must be placed in this private room?

The patient presents to the emergency room complaining of fever, malaise, and nuchal rigidity. Which personal protective equipment does the nurse don prior to assessing the patient? Select all that apply.

The nurse learns in shift report the 1-year-old with respiratory distress due to parainfluenza virus has had increased nasal and oral secretions and has had increased coughing fits. Which personal protective equipment does the nurse don prior to caring for the patient? Select all that apply.

The nurse observes the physician enter the room of a patient with pneumococcal pneumonia without donning personal protective equipment. Which response by the nurse is appropriate?

The nurse is caring for the patient who was admitted to the hospital in septic shock due to Escherichia coli bacteremia. Which patient assessment is most appropriate to report to the inpatient pharmacist on the patient’s medical team?

The patient admitted with asthma is receiving beclomethasone HFA PRN and nebulized albuterol PRN. Which patient assessment is most appropriate to report to the respiratory therapist assigned to care for the patient?

The nurse is riding the staff elevators with several other healthcare professionals and overhears a provider discussing the lab results for another nurse’s patient. Which response by the nurse is most appropriate?

The provider left a patient’s electronic health record (EHR) open on the computer screen in the nurse’s station when he left to assess a patient. Which action by the nurse is most appropriate?

The nurse is creating an educational class for community members who care for an older relative in the home about brain injury in the older adult. Which factors does the nurse include to impress upon the individuals the high mortality risk associated with brain injuries in the older adult? Select all that apply.

The patient is awake and alert when being admitted directly to the unit from the cardiac catheterization lab after transferring from the primary care doctor. The patient’s spouse calls the unit looking for the patient. Which response by the nurse is most appropriate?

Which situations prompt the use of four-point restraints? Select all that apply.

The LPN/LVN informs the supervising RN, “I didn’t realize until after administering the medication, but I was supposed to give the patient a half tablet of levothyroxine; I gave him a whole tablet.” Which action does the nurse take first?

The nurse is planning care for the patient who will undergo hip replacement surgery in a month. When is the best time to provide teaching about the use of a patient-controlled analgesia (PCA) pump?

The patient is admitted to the hospital with systemic syphilis infection. The patient is ordered to receive a 14-day course of penicillin G 20 million units/day intravenously. Prior to administering the medication, the nurse checks the patient’s allergies and learns the patient experienced anaphylaxis after receiving ampicillin. Which action does the nurse take?

The patient presents to the emergency department (ED) after being bitten by a friend’s dog with two puncture marks and an abrasion. Prior to dressing the wound, the nurse uses which substance to clean the wound?

To which team member does the registered nurse delegate a fecal occult blood test for the patient who requires assistance to ambulate to the restroom?