Ignatavicius Chapter 1 (Evolve) Question with complete solution 2023

Ignatavicius Chapter 1 (Evolve) Question with complete solution 2023Which important aspect of coordinating care with the interdisciplinary team is facilitated by use of the "SBAR" and "PACE" procedures? A. Communication B. Implementation C. Policymaking D. Protocol development A. Communication SBAR and PACE are acronyms for "hand-off" methods of communication used by health care organizations to share information between shifts and between departments. SBAR and PACE are not types of implementation [of client care]. Implementation, the fourth step of the nursing process, is an action rather than a coordination of care. SBAR and PACE are not types of policymaking or protocol development. The nurse educator is instructing newly hired registered nurses about patient-centered care. Which competency categories are included in this content? (Select all that apply) A. Attitudes B. Environments C. Judgments D. Knowledge E. Skills F. Values A. Attitudes D. Knowledge E. Skills Attitudes, knowledge, and skills are the patient-centered care competencies needed to ensure quality care. These characteristics, which were developed by the Institute of Medicine and the Quality and Safety Education for Nurses (QSEN) groups, are the areas cited and enumerated by both groups. A delineation (and examples of each) of knowledge, skills, and attitudes constitutes competent nursing practice. Environment, sound nursing judgments, and values are important to the client's care but are not included in the patient-centered care competencies. Bedside computers are an example of informatics used in health care primarily for which purpose? A. Documenting interdisciplinary care B. Enhancing collaboration and coordination of care C. Offering clients access to e-mail and the internet D. Retrieving data for evidence-based practice A. Documenting interdisciplinary care The largest application of health care informatics is the growing trend of the use of electronic medical records (EMRs) for documenting interdisciplinary care. Computers may be located at the client's bedside or in the treatment room for ease of access for documentation. Computers allow quick communication among health care professionals to enhance collaboration and coordination of care; however, this type of communication typically would not take place at the client's bedside. Bedside computers in the health care setting are not intended for client use. The Internet provides ways to search multiple sources of information and retrieve data efficiently; however, this would not be done at the client's bedside. A nurse has recently been assigned to a medical-surgical clinical rotation. According to the scope of medical-surgical nursing, what type of client assignments does the nurse expect to see? A. Hospitalized children with acute and chronic illnesses B. Hospitalized adults with acute and chronic illnesses C. Older adults in a nursing home D. Working adults in a corporate setting B. Hospitalized adults with acute and chronic illnesses The scope of medical-surgical nursing, sometimes called adult health nursing, is to promote health and prevent illness or injury in clients from 18 to 100 years of age or older. The most common practice setting is the acute care hospital. Hospitalized children with acute and chronic illnesses are commonly seen in pediatric nursing. Older adults in a nursing home are commonly seen in geriatric nursing. Working adults in a corporate setting are commonly seen by occupational health nurses. Which of these hospital staff members will the nurse manager assign to coordinate the discharge of a client who will need community-based rehabilitation services after a traumatic injury? A. The nurse who is responsible for the client's case management B. The physical therapist who developed the client's exercise program C. The physician who is assigned as the client's medical resident D. The unit-based RN who has cared for the client during the hospital stay A. The nurse who is responsible for the client's case management The case manager role includes coordination of acute care and post-discharge community services for the client. The physical therapist, health care provider, and unit-based RN will have input into planning for rehabilitation for the client, but are not the best choice to coordinate a smooth transition from acute care to community rehabilitation services. The nurse is asked to collaborate with others to implement an interdisciplinary plan of care for a client. Which health care team members are essential for the client's daily care regimen? (Select all that apply) A. Anesthesiologist B. Case manager C. Health care provider D. Occupational therapist E. Chaplain B. Case manager C. Health care provider The case manager and the health care provider must see the client on a daily basis to collaborate with the nurse caring for the client. The anesthesiologist, occupational therapist, and chaplain are not needed on a daily basis. Which principal nursing actions best support a focus on client safety? (Select all that apply) A. Client restraints B. Handwashing C. Preoperative checklists D. Respect for others E. Five rights of drug administration B. Handwashing C. Preoperative checklists E. Five rights of drug administration Handwashing is the number-one way to prevent infection in clients. Checklists can help prevent mistakes in care for a surgical client, thus ensuring a safe environment. Adhering to the five rights of medication administration helps to prevent errors in this important nursing care activity, providing for increased safety in client care. Although restraints may help clients who are confused to keep from hurting themselves, they are potentially risky and are used infrequently because of the harm they can cause. Respect is an important element in client care, but it is not directly tied to the provision of a safe care setting. A nurse is appointed to a hospital committee whose goal is to "improve nursing practice." Which areas of practice are included in the committee's task? (Select all that apply) A. Attentiveness/surveillance of clients B. Mandatory reporting C. Medication administration D. Participation in professional organizations E. Prevention of errors or complications F. Teaching clients about their care regimens A. Attentiveness/surveillance of clients B. Mandatory reporting C. Medication administration E. Prevention of errors or complications Attentiveness/surveillance of clients, mandatory reporting, medication administration, and prevention of errors or complications are initiatives of the National Council of State Boards of Nursing (NCSBN) published findings about breakdowns in nursing practice. Participation in professional organizations and teaching clients about their care regimens are not initiatives of the NCSBN. An older client who has had a total hip replacement will be transferred to a rehabilitation center for continuing care before going home. The Joint Commission, along with National Patient Safety Goal standards, mandates communication between hospital nurses and other providers to ensure adequate transition management. Which aspects of this client's care plan are most important for the nurse to communicate to the rehabilitation center care team? A. Third-party payer information B. Pain medication needs C. Primary care provider D. Medical history of osteoarthritis B. Pain medication needs The goal of communication between the hospital nurse and the outside health agency is to provide safe transition of care. Important aspects of care, such as pain medications, oxygen needs, and fall risks must be communicated. Third-party payer information and the name of the primary care provider are listed in client demographic data and are included when medical records are shared. The medical history of osteoarthritis is also communicated, but is not the most important to provide safe transition of care. The nurse support the client and family in deciding on a "Do Not Resuscitate" order. Which ethical principle that guides nursing clinical decision making is demonstrated in this situation? A. Beneficence B. Justice C. Legality D. Self-determination D. Self-determination Self-determination refers to the idea that clients are autonomous individuals capable of making informed decisions about their care. When the client is not capable of self-determination, the nurse is ethically obligated to protect the client as an advocate in the professional scope of practice. Beneficence emphasizes the importance of preventing harm and ensuring the client's well-being. Justice refers to equality (i.e., all clients should be treated equally and fairly). Legality is not one of the ethical principles. The nursing student asks the supervising nurse whether a certain fall protocol used on the nursing unit is effective. To demonstrate effectiveness, what does the supervising nurse identify? A. Information about how to implement a fall protocol and what nurses need to document B. Data about the number of falls after the protocol was introduced compared with previous fall rates C. The number of clients who currently have a fall protocol in place D. National statistics about the use of fall protocols to prevent serious injury from falls B. Data about the number of falls after the protocol was introduced compared with previous fall rates Medical-surgical nurses, as part of the Quality and Safety Education for Nurses (QSEN) and evidence-based practice improvement (EBPI) quality improvement competency, are expected to be able to identify indicators to monitor quality and effectiveness of health care. Data that demonstrate evidence of improvement in falls after implementation of a protocol is a type of indicator of quality and effectiveness of care. Information about implementation and documentation of the protocol is part of a procedure and not an indicator of quality. The number of clients with a fall monitor in place is not an outcome measure. National statistics provide valuable information when implementing a new strategy, but do not yield outcome data for a particular protocol in that unit. A previously stable postoperative client on the medical-surgical unit now has a blood pressure of 88/40 mm Hg and a heart rate of 124 beats/min. After placing the client in Trendelenburg position, which action does the nurse perform next? A. Activate the Rapid Response Team B. Call for a Code Blue C. Determine the cause of the changes D. Re-check the vital signs in 5 minutes A. Activate the Rapid Response Team Because Rapid Response Teams (RRTs) have been demonstrated to reduce the number of cardiac or respiratory arrests, the nurse's first action should be to call the RRT. The client is not experiencing a cardiac or respiratory arrest, so calling a Code Blue is not appropriate. Re-checking and determining the cause of the vital sign changes are needed actions, but they are not the first action that the nurse should take because the client's mean arterial pressure is 56, which is below the threshold required for organ perfusion. A 5-minute delay in the client's care could be life-threatening!