Management of Care (MC)
What is: CHOOSE ALL THAT APPLY
1) Use aggressive communication when addressing the team
2) Recognize the knowledge and skills of each team member
3) Ensure that a NURSE is assigned as the group facilitator for all of the interprofessional meetings
4) Encourage patient and family participation
5) Support team member requests for referrals
See NEXT Column to right for CORRECT ANSWERS
A nurse manager is organizing an interprofessional collaboration for a patient. She should do these things to be successful.
What is: CHOOSE ALL THAT APPLY 1) Use aggressive communication when addressing the team 2) Recognize the knowledge and skills of each team member 3) Ensure that a NURSE is assigned as the group facilitator for all of the interprofessional meetings 4) Encourage patient and family participation 5) Support team member requests for referrals
CORRECT ANSWER: ALL EXCEPT 1 and 3
nurse manger should use ASSERTIVE communication and a NURSE does not have to be the leader at all interprofessional meetings.
What is: CHOOSE ALL THAT APPLY
1) Assume that the patient does not want resuscitated and take no action if he codes
2) Write a note on the chart that the DNR needs to be renewed
3) Anticipate that CPR will be instituted if patient codes
4) Call provider to determine if the DNR should be immediately reinstated
See NEXT Column to right for CORRECT ANSWERS
In reviewing his patient's record an RN discovers that the DNR status has expired. The patient is unstable. The RN should take these actions.
What is: CHOOSE ALL THAT APPLY 1) Assume that the patient does not want resuscitated and take no action if he codes 2) Write a note on the chart that the DNR needs to be renewed 3) Anticipate that CPR will be instituted if patient codes 4) Call provider to determine if the DNR should be immediately reinstated
CORRECT ANSWER: 4 - this should be done right away because if the patient codes before DNR status is reinstated CPR must be performed #3.
What is: CHOOSE ALL THAT APPLY
1) Reviewing the EMR of a patient assigned to another nurse
2) Making a copy of a patients lab results to share on rounds
3) Provide information about a patient's condition to hospital clergy
4) Discussing patient condition on the phone with someone who has given the clients information code
5) participating in hallway rounds - discussing the patient outside of the patient room
See NEXT Column to right for CORRECT ANSWERS
A nurse manager is observing a new RN. The nurse manager should intervene when she sees the new RN do these things.
What is: CHOOSE ALL THAT APPLY 1) Reviewing the EMR of a patient assigned to another nurse 2) Making a copy of a patients lab results to share on rounds 3) Provide information about a patient's condition to hospital clergy 4) Discussing patient condition on the phone with someone who has given the clients information code 5) participating in hallway rounds - discussing the patient outside of the patient room
CORRECT ANSWER: ALL EXCEPT for 4 - the others are potential patient confidentiality breaches
What is:
1) Mom says she doesn't have insurance for follow up visit
2) The child says his head hurts and he wants to go home
3) The RN smells alcohol on mom's breath
4) Mom says she is nervous about taking the patient home and would like to stay the night
See NEXT Column to right for CORRECT ANSWERS
An RN is caring for a 2 yo with a concussion. The discharge instructions include waking the child every hour during the night. The RN should intervene to prevent discharge if this occurs.
What is: 1) Mom says she doesn't have insurance for follow up visit 2) The child says his head hurts and he wants to go home 3) The RN smells alcohol on mom's breath 4) Mom says she is nervous about taking the patient home and would like to stay the night
CORRECT ANSWER 3 - mom may not be able to wake up to check on child every hour if she is impaired.
Consult social services for resources for 1, 2 the child is likely to have a headache with concussion, 4 educate mom and give resources such as phone number to help anxiety
What is: CHOOSE ALL THAT APPLY
1) Return papers to admitting with a note saying the patient doesn't want to fill out at this time
2) Explain to the patient that you never know what can happen in surgery so she should fill them out just in case
3) Contact a patient rep to talk to the patient to explain and offer additional information about Advance Directives
4) Inform the patient that she cannot have surgery unless she fills the paperwork out.
See NEXT Column to right for CORRECT ANSWERS
An RN is caring for a patient who thinks she is too young to worry about filling out Advance Directives before surgery. The RN should take these actions.
What is: CHOOSE ALL THAT APPLY 1) Return papers to admitting with a note saying the patient doesn't want to fill out at this time 2) Explain to the patient that you never know what can happen in surgery so she should fill them out just in case 3) Contact a patient rep to talk to the patient to explain and offer additional information about Advance Directives 4) Inform the patient that she cannot have surgery unless she fills the paperwork out.
CORRECT ANSWER: 3 ONLY
1 is not appropriate, 2 is threatening and may increase patients anxiety (Assault), 4 is not true
What is: CHOOSE ALL THAT APPLY
1) Verifying that a client knows what to expect with an upcoming procedure
2) Discussing treatment options for a terminal illness
3) Informing members of the health care team that a patient is a DNR
4) Reporting that an AP did not provide care as prescribed on the previous shift
5) Assisting a patient to make decisions about his care based on the nurse's recommendations
See NEXT Column to right for CORRECT ANSWERS
The new RN is being a patient advocate. These are appropriate actions that are reflective of patient advocacy.
What is: CHOOSE ALL THAT APPLY 1) Verifying that a client knows what to expect with an upcoming procedure 2) Discussing treatment options for a terminal illness 3) Informing members of the health care team that a patient is a DNR 4) Reporting that an AP did not provide care as prescribed on the previous shift 5) Assisting a patient to make decisions about his care based on the nurse's recommendations
CORRECT ANSWER: 1, 3, and 4
2 treatment options are out of the RNs scope, 5 does not support autonomy - patient's right to make his own choices
What is:
1) Assault
2) Battery
3) False Imprisonment
4) Invasion of privacy
See NEXT Column to right for CORRECT ANSWERS
An RN witnesses an AP threatening to put a diaper on a patient if she has to change his linens again. The AP is committing this tort.
What is: 1) Assault 2) Battery 3) False Imprisonment 4) Invasion of privacy
CORRECT ANSWER:
1. Assault - conduct that makes a person fear he or she will be harmed
What is: CHOOSE ALL THAT APPLY
1) History of previous fall
2) Reduced vision
3) Impaired memory
4) Takes rosuvastatin
5) Uses a night light
6) Kyphosis
See NEXT Column to right for CORRECT ANSWERS
An RN is assessing a patient for fall risk. He knows that all of these factors increase the patient's risk of falling.
What is: CHOOSE ALL THAT APPLY 1) History of previous fall 2) Reduced vision 3) Impaired memory 4) Takes rosuvastatin 5) Uses a night light 6) Kyphosis
CORRECT ANSWER: ALL EXCEPT for 4 (this med does not increase risk of falling) and 5 (nightlight decreases risk of falling)
What is: 1) Website
2) Institutional policy and procedure manual
3) More experienced nurse
4) State nurse practice act
See NEXT Column to right for CORRECT ANSWERS
A new RN is getting ready to start an IV. She should consult with this in order to review the standard at which this procedure should be performed.
What is: 1) Website 2) Institutional policy and procedure manual 3) More experienced nurse 4) State nurse practice act
CORRECT ANSWER: 2
1 and 4 are too broad a resource and 3 the experienced nurse may not do procedure according to protocol
What is:
1) Recheck patients BS
2) Complete an incident report
3) Inform the AP to give the patient 120 ml of Juice
4) Administer insulin as prescribed
See NEXT Column to right for CORRECT ANSWERS
An RN is caring for a DM patient. His am BS was 285 mg/dL this am. The AP reports that his 30 min prior to lunch BS is 58 mg/dL. The RN knows that this is the action to take.
What is: 1) Recheck patients BS 2) Complete an incident report 3) Inform the AP to give the patient 120 ml of Juice 4) Administer insulin as prescribed
CORRECT ANSWER:
1 - recheck BS
2 is not correct because an incident report is not necessary unless action was taken on an incorrect reading, 3 is not correct becaue you would not want to give juice until you are sure BS is low, and 4 is not correct because you would not want to give insulin until recheck BS
What is R.A.C.E.?
Remove patient/people from area
Activate or Alarm
Confine - close doors
Extinguish (PASS Pull, Aim, Squeeze, Sweep) and Evacuate if told to do so