Health Care Quality

The patient is being transferred from a nursing home to an acute care facility. The receiving nurse performs which actions during the medication reconciliation process? Select all that apply.

A nurse is caring for a patient who is recovering from total hip replacement surgery. The patient has required increasing doses of IV morphine for pain control. The patient is again reporting 10/10 pain despite receiving 10 mg of morphine from the nurse, which is the top of the range ordered by the physician. The nurse monitors which of the following most closely?

A patient with gram-negative sepsis is in the ICU after cardiac arrest. He requires a vasopressor for severe hypotension. Which patient characteristic would prompt the nurse to hold the infusion and contact the provider?

The nurse mistakenly administered a long-acting benzodiazepine to the patient with end-stage liver disease, a drug that was not ordered. As a result, the patient had to remain in the hospital an extra night. The nurse wants to apologize to the patient for the mistake. Which of the following is most accurate?

The physician writes an order for diphenhydramine 250 mg PRN for sleep. Which part of the order does the nurse question?

The nurse is caring for a woman wearing a hijab. The woman does not speak English and has come to the emergency department (ED) with fever, vaginal bleeding, and abdominal pains. An interpreter is present for the interaction. Which question is appropriate for the nurse to ask first?

The nurse volunteers to be on the quality improvement team examining shift change safety and patient satisfaction. Which is the best suggestion for this quality improvement project?

The nurse is caring for a patient diagnosed with measles. Which precautions does the nurse utilize during the patient’s care? Select all that apply.

The nurse is supervising a student nurse in caring for a postoperative patient at high risk for surgical wound evisceration. The nurse prepares the student to perform which interventions if the wound eviscerates? Select all that apply.

The nurse receives report at the beginning of the shift. Which task is appropriate to delegate to the unlicensed assistive personnel?

The nurse is providing preoperative teaching to the patient who is scheduled for a total knee replacement next Tuesday at 1000. The nurse instructs the patient to have no solid food after which time?

The patient being treated for a skin wound and cellulitis is in a semi-private room with another patient; the hospital is near capacity. The culture of the wound has grown methicillin-resistant staphylococcus aureus. Which action is most appropriate? 

During an active shooter situation, the nurse closes patient’s rooms and bars entry to the unit. This is an example of which ethical principle?

The patient with severe, symptomatic anemia who is a Jehovah's Witness refuses a blood transfusion for religious reasons. The nurse instructs the provider to discontinue the order. This is an example of which ethical principle? 

After a mass casualty event, the nurse triages care of dozens of patients in the emergency department (ED) based on the severity of their injury and likelihood of survival. This is an example of which principle?

Which actions does the nurse take to prevent infection around the use of a peripheral IV? Select all that apply.

The American Cancer Society recommends the patient's initial cervical cancer screening occurs at which time?

The nurse is reviewing the medication list of the patient who wishes to become pregnant. One of the medications is listed as Category X. The nurse knows this medication poses which level of risk to the fetus?

Which is a patient responsibility?

The patient receiving sliding scale insulin requests the subcutaneous insulin to be injected into the abdomen. Immediately prior to administration, the nurse notes the site is stringy, slightly indurated, and has several fat masses. Which action by the nurse is appropriate?

Which statement is true regarding single use items?

Which situation prompts the patient to be compelled to a healthcare facility without consent?

A patient scheduled to undergo a Whipple procedure (pancreaticoduodenectomy) is extremely agitated and apprehensive, though still wants to undergo the procedure. Which interventions does the nurse employ to decrease the patient's anxiety? Select all that apply.

The single parent of the child with a severe developmental disorder confides in the nurse that caring for the child is becoming impossible to do alone. Which actions by the nurse are most appropriate? Select all that apply. 

The patient is verbally aggressive with a nurse and threatens physical violence unless he is given an IV dose of hydromorphone (Dilaudid). Which initial action by the nurse is appropriate?

During the initial home visit, the home health nurse assesses which of the elderly patient's basic activities of daily living? Select all that apply.

Body mass index (BMI) is calculated using which measurement(s)?

Which patients are seen first in the hospital following a mass casualty event?

The nurse is caring for the patient on methadone treatment as an outpatient. The provider has ordered a dose of methadone that is far higher than what the nurse has ever administered. Which action by the nurse is appropriate?

Which statements are true regarding the care of the 2-year-old with whooping cough? Select all that apply.

The nurse is discussing palliative care with the patient with metastatic colorectal cancer. The patient responds, "I'm not ready to give up. I want to keep fighting this disease." Which response from the nurse is most appropriate? 

Which patient with dyspnea is seen first in the emergency department?

Which terms are used to describe Clostridium difficile colitis? Select all that apply.

The nurse is exiting the room after providing care for the patient diagnosed with tuberculosis. In which order does the nurse remove the personal protective equipment?

The nurse intervenes if the provider attempts to remove which article of personal protective equipment first after contact with the patient with active tuberculosis?

In which order does the nurse don personal protective equipment prior to caring for the pediatric patient suspected of having the chickenpox?

The nurse in the long-term care facility is assessing a new resident who has Parkinson's disease. The nurse usually explains which group activities are available during the intake interview. Which communication technique is most helpful for the nurse to utilize with this resident?

The nurse is reviewing the chart of the patient who is scheduled for a laparoscopic cholecystectomy in one hour. Signed consent is found, as well as blood transfusion consent, anesthesia evaluation, blood type, and emergency contacts. The nurse asks the patient, “Do you have any questions about your upcoming gallbladder removal surgery?” The patient replies, “Gallbladder removal? I thought they were just taking out my gallstones. I’ll be glad to get rid of those.” Which response by the nurse is most appropriate?

The patient requires an indwelling catheter to be placed prior to surgery. Which action does the nurse take first?

A patient tells the nurse in an outpatient endocrinology clinic that he is unhappy with his diabetes care and wants to see another physician. The nurse provides which advice?

The resident of a large, long-term care facility has reactivated tuberculosis and is infectious. Which action does the nurse take?

Which practice is appropriate for a surgical scrub prior to donning a sterile gown?

Which statement describes the nurse's legal responsibility in administering regular insulin to the mentally competent adult patient? 

The nurse is visiting the home of a patient who recently underwent a trabeculectomy. Which statement improves patient safety?

The nurse receives report on the patient with acute bowel obstruction. The patient’s problem list includes controlled hypertension, uncontrolled diabetes, and presbycusis. Which action by the nurse is appropriate?

The school nurse is creating a health pamphlet to send home with the students prior to summer break on how to prevent otitis externa. Which information does the nurse include on the cause of otitis externa?

The nurse is educating the 2-year-old patient’s parents on how to instill ear drops to treat acute otitis media. Which statement indicates a need for further teaching?

The patient has undergone a right myringotomy. Which nursing intervention is appropriate?

The student nurse is preparing to perform an irrigation of the patient’s indwelling urethral catheter. Which action by the student nurse prompts the supervising nurse to intervene immediately?

Place the steps for indwelling urinary catheter irrigation into the correct order.