Navigating Patient Care: Essential Principles for
Quality Practice
:
1. Which finding is an example of a variance in the critical pathway of a
client 3 days after an above-the-knee amputation?: (A) Client reports
incisional pain of 3/10. (B) Client ambulates 20 feet with a walker. (C)
Temperature of 102° F (38.9°C). (D) Serosanguineous drainage noted at the
surgical site. Answer: (C) Temperature of 102° F (38.9°C)
2. The nurse creates a program to decrease the primary cause of disability
and death in children. What is the most important action to include in
the plan?: (A) Advocate for increased funding for pediatric trauma centers.
(B) Develop rehabilitation programs for children with disabilities. (C) Teach
health and safety practices to children and their parents. (D) Lobby for
stricter laws regarding child safety seats. Answer: (C) Teach health and
safety practices to children and their parents.
3. The nurse manager has assigned a nurse as the circulating nurse for a
surgical abortion. The nurse has a religious objection and wishes to
refuse to participate in an abortion. What should the nurse manager of
the operating room do?: (A) Insist that the nurse participate as it is part of
their job description. (B) Attempt to persuade the nurse that their personal
beliefs should not interfere with patient care. (C) Change the assignment
without comment. (D) Document the nurse's refusal in their personnel file.
Answer: (C) Change the assignment without comment.
4. The nurse is planning a continuous quality improvement (CQI) process
to decrease the infection rate on the nursing unit. The nurse should
, consider which factors when planning the process? Select all that
apply.: (A) CQI processes are required by accrediting agencies. (B) The
approach to CQI can be retrospective or concurrent. (C) Blaming individuals
for errors is an effective way to improve quality. (D) Focusing solely on
individual performance will lead to system-wide improvement. (E) Data
collection and analysis are essential components of the CQI process.
Answer: (A, B, E)
5. The charge nurse on a hematology/oncology unit is reviewing the policy
for using abbreviations with the staff. The charge nurse should
emphasize which information about why dangerous abbreviations need
to be eliminated? Select all that apply.: (A) To ensure efficient and
accurate communication. (B) To prevent medication errors. (C) To ensure
client safety. (D) To reduce the time spent documenting. (E) To comply with
hospital regulations. Answer: (A, B, C)
6. A client who just underwent a mastectomy is due to arrive at the post-
surgical care unit. Which actions should the nurse prioritize when
attempting to establish an effective relationship with the client?: (A)
Immediately begin teaching the client about wound care. (B) Focus on the
technical aspects of post-operative monitoring. (C) Recognize and address
the client's anxiety. (D) Provide detailed information about the surgical
procedure. Answer: (C) Recognize and address the client's anxiety.
7. Which documentation would indicate nursing actions were effective in
reducing breathing problems for a client? Select all that apply.: (A)
Anxiety decreased. (B) Oxygen saturation levels at 94%. (C) Nonproductive
cough. (D) Respirations at 22 breaths/min. (E) Lung sounds clear bilaterally
with non-labored respirations noted. Answer: (A, B, E)
,8. A nurse is admitting a client to the palliative unit and discussing
advanced directives. Which of the following statements made by the
client leads the nurse to believe the client requires clarification around
advanced directives?: (A) "I have a living will that outlines my wishes for
end-of-life care." (B) "I've appointed my spouse as my health care proxy."
(C) "This will stop my daughter-in-law from putting me in a home." (D) "I
understand that I can change these documents at any time." Answer: (C)
"This will stop my daughter-in-law from putting me in a home."
9. A nurse wants to ensure inclusiveness in language regarding family
when developing a plan of care for a client. Which action is the most
important for the nurse to take to ensure that the plan is inclusive?: (A)
Use the term "family" broadly in all documentation. (B) Refer to the client's
legal next of kin as family. (C) Ask the client to identify who is considered
family. (D) Include all individuals who visit the client as family. Answer:
(C) Ask the client to identify who is considered family.
10.The nurse assists the client to the operating room table and supervises
the operating room technician preparing the sterile field. Which action,
completed by the surgical technician, indicates to the nurse that a sterile
field has been contaminated?: (A) The technician's gloved hand briefly
touches the edge of the sterile drape. (B) Sterile instruments are placed
within the one-inch border of the sterile field. (C) Wetness in the sterile
cloth on top of the nonsterile table has been noted. (D) The technician turns
their back to the sterile field to retrieve an item. Answer: (C) Wetness in
the sterile cloth on top of the nonsterile table has been noted.
11.Which intervention is an example of primary prevention?: (A) Providing
blood glucose monitoring for a client with diabetes. (B) Administering a
measles, mumps, and rubella immunization to an infant. (C) Conducting a
, Pap smear for early detection of cervical cancer. (D) Implementing a
rehabilitation program for a client after a stroke. Answer: (B)
Administering a measles, mumps, and rubella immunization to an
infant.
12.A nurse on the mental health unit tells the nurse manager, "Kids with
conduct disorders might as well be jailed because they all end up as
adults with antisocial personality disorder anyway." What is the best
reply by the nurse manager?: (A) "That's a very negative attitude to have
towards our young clients." (B) "You sound really frustrated. Let's talk about
the meaning of their behavior." (C) "Actually, many children with conduct
disorders learn to manage their behavior as they mature." (D) "We need to
focus on providing the best care possible, regardless of their future."
Answer: (B) "You sound really frustrated. Let's talk about the meaning
of their behavior."
13.Under which circumstance may a nurse communicate medical
information without the client's consent?: (A) When discussing the
client's condition with family members who are concerned. (B) When
treating the client with a sexually transmitted disease and mandated
reporting is required by law. (C) When sharing information with colleagues
for educational purposes, ensuring client anonymity. (D) When the client's
insurance company requests details about the treatment plan. Answer: (B)
when treating the client with a sexually transmitted disease and
mandated reporting is required by law.
14.A nurse has made a medication error. Which information is
appropriate to include in the incident report?: (A) The nurse's personal
feelings about the error. (B) A detailed account of the client's past medical
Quality Practice
:
1. Which finding is an example of a variance in the critical pathway of a
client 3 days after an above-the-knee amputation?: (A) Client reports
incisional pain of 3/10. (B) Client ambulates 20 feet with a walker. (C)
Temperature of 102° F (38.9°C). (D) Serosanguineous drainage noted at the
surgical site. Answer: (C) Temperature of 102° F (38.9°C)
2. The nurse creates a program to decrease the primary cause of disability
and death in children. What is the most important action to include in
the plan?: (A) Advocate for increased funding for pediatric trauma centers.
(B) Develop rehabilitation programs for children with disabilities. (C) Teach
health and safety practices to children and their parents. (D) Lobby for
stricter laws regarding child safety seats. Answer: (C) Teach health and
safety practices to children and their parents.
3. The nurse manager has assigned a nurse as the circulating nurse for a
surgical abortion. The nurse has a religious objection and wishes to
refuse to participate in an abortion. What should the nurse manager of
the operating room do?: (A) Insist that the nurse participate as it is part of
their job description. (B) Attempt to persuade the nurse that their personal
beliefs should not interfere with patient care. (C) Change the assignment
without comment. (D) Document the nurse's refusal in their personnel file.
Answer: (C) Change the assignment without comment.
4. The nurse is planning a continuous quality improvement (CQI) process
to decrease the infection rate on the nursing unit. The nurse should
, consider which factors when planning the process? Select all that
apply.: (A) CQI processes are required by accrediting agencies. (B) The
approach to CQI can be retrospective or concurrent. (C) Blaming individuals
for errors is an effective way to improve quality. (D) Focusing solely on
individual performance will lead to system-wide improvement. (E) Data
collection and analysis are essential components of the CQI process.
Answer: (A, B, E)
5. The charge nurse on a hematology/oncology unit is reviewing the policy
for using abbreviations with the staff. The charge nurse should
emphasize which information about why dangerous abbreviations need
to be eliminated? Select all that apply.: (A) To ensure efficient and
accurate communication. (B) To prevent medication errors. (C) To ensure
client safety. (D) To reduce the time spent documenting. (E) To comply with
hospital regulations. Answer: (A, B, C)
6. A client who just underwent a mastectomy is due to arrive at the post-
surgical care unit. Which actions should the nurse prioritize when
attempting to establish an effective relationship with the client?: (A)
Immediately begin teaching the client about wound care. (B) Focus on the
technical aspects of post-operative monitoring. (C) Recognize and address
the client's anxiety. (D) Provide detailed information about the surgical
procedure. Answer: (C) Recognize and address the client's anxiety.
7. Which documentation would indicate nursing actions were effective in
reducing breathing problems for a client? Select all that apply.: (A)
Anxiety decreased. (B) Oxygen saturation levels at 94%. (C) Nonproductive
cough. (D) Respirations at 22 breaths/min. (E) Lung sounds clear bilaterally
with non-labored respirations noted. Answer: (A, B, E)
,8. A nurse is admitting a client to the palliative unit and discussing
advanced directives. Which of the following statements made by the
client leads the nurse to believe the client requires clarification around
advanced directives?: (A) "I have a living will that outlines my wishes for
end-of-life care." (B) "I've appointed my spouse as my health care proxy."
(C) "This will stop my daughter-in-law from putting me in a home." (D) "I
understand that I can change these documents at any time." Answer: (C)
"This will stop my daughter-in-law from putting me in a home."
9. A nurse wants to ensure inclusiveness in language regarding family
when developing a plan of care for a client. Which action is the most
important for the nurse to take to ensure that the plan is inclusive?: (A)
Use the term "family" broadly in all documentation. (B) Refer to the client's
legal next of kin as family. (C) Ask the client to identify who is considered
family. (D) Include all individuals who visit the client as family. Answer:
(C) Ask the client to identify who is considered family.
10.The nurse assists the client to the operating room table and supervises
the operating room technician preparing the sterile field. Which action,
completed by the surgical technician, indicates to the nurse that a sterile
field has been contaminated?: (A) The technician's gloved hand briefly
touches the edge of the sterile drape. (B) Sterile instruments are placed
within the one-inch border of the sterile field. (C) Wetness in the sterile
cloth on top of the nonsterile table has been noted. (D) The technician turns
their back to the sterile field to retrieve an item. Answer: (C) Wetness in
the sterile cloth on top of the nonsterile table has been noted.
11.Which intervention is an example of primary prevention?: (A) Providing
blood glucose monitoring for a client with diabetes. (B) Administering a
measles, mumps, and rubella immunization to an infant. (C) Conducting a
, Pap smear for early detection of cervical cancer. (D) Implementing a
rehabilitation program for a client after a stroke. Answer: (B)
Administering a measles, mumps, and rubella immunization to an
infant.
12.A nurse on the mental health unit tells the nurse manager, "Kids with
conduct disorders might as well be jailed because they all end up as
adults with antisocial personality disorder anyway." What is the best
reply by the nurse manager?: (A) "That's a very negative attitude to have
towards our young clients." (B) "You sound really frustrated. Let's talk about
the meaning of their behavior." (C) "Actually, many children with conduct
disorders learn to manage their behavior as they mature." (D) "We need to
focus on providing the best care possible, regardless of their future."
Answer: (B) "You sound really frustrated. Let's talk about the meaning
of their behavior."
13.Under which circumstance may a nurse communicate medical
information without the client's consent?: (A) When discussing the
client's condition with family members who are concerned. (B) When
treating the client with a sexually transmitted disease and mandated
reporting is required by law. (C) When sharing information with colleagues
for educational purposes, ensuring client anonymity. (D) When the client's
insurance company requests details about the treatment plan. Answer: (B)
when treating the client with a sexually transmitted disease and
mandated reporting is required by law.
14.A nurse has made a medication error. Which information is
appropriate to include in the incident report?: (A) The nurse's personal
feelings about the error. (B) A detailed account of the client's past medical
