Nursing Elites

1. A nurse is admitting a client who has an abdominal wound with a large amount of purulent drainage. Which of the following types of transmission precautions should the nurse initiate?

• A. Droplet precautions
• B. Protective environment
• C. Airborne precautions
• D. Contact precautions

Correct answer: D

Rationale: The correct answer is D: Contact precautions. Contact precautions are used when there is a risk of transmission of infections through direct or indirect contact. In this scenario, the client has an abdominal wound with purulent drainage, indicating a potential for infection transmission through contact. Droplet precautions (choice A) are used for infections transmitted through respiratory droplets, such as influenza. Protective environment (choice B) is used for immunocompromised clients. Airborne precautions (choice C) are used for infections transmitted through small droplets that remain in the air, like tuberculosis. Therefore, in this case, the nurse should initiate contact precautions to prevent the spread of infection.

2. Which of the following are significant benefits to an organization that is considering adoption of a practice partnership model? (Select all that apply.)

• A. Clients express reduced satisfaction.
• B. It is less expensive to implement than other models.
• C. Continuity of care is facilitated.
• D. Leadership is well accepted.

Correct answer: C

Rationale: The correct answer is C: Continuity of care is facilitated. One of the significant benefits of a practice partnership model is that it facilitates continuity of care, which can lead to better outcomes for clients. Choice A is incorrect as clients would not express reduced satisfaction with this model; in fact, greater client satisfaction is a benefit. Choice B is incorrect because the cost-effectiveness of the model is not specified or guaranteed. Choice D is incorrect as the acceptance of leadership is not explicitly mentioned as a significant benefit of this model.

3. A client is admitted to a medical-surgical unit after six hours in the emergency room. He requests that his AM care be delayed to allow him to rest. The nurse complies with his request. This is an example of which type of management philosophy?

• A. Continuous quality improvement
• B. Total quality management
• C. Six Sigma
• D. Quality management

Correct answer: B

Rationale: Total Quality Management (TQM) emphasizes meeting customer needs and satisfaction. In this scenario, by honoring the client's request to delay care to allow for rest, the nurse is aligning with the customer-focused approach of TQM. TQM seeks to continuously improve processes and services to enhance customer experiences and outcomes. Continuous Quality Improvement focuses on incremental improvements in processes and outcomes over time. Six Sigma is a data-driven approach to process improvement that aims to reduce defects and errors. Quality Management is a broader concept that encompasses various strategies to ensure quality standards are met.

4. Which of the following are considered part of the operating expenses within health care organizations? (EXCEPT)

• A. Maintenance costs
• B. Rental fees
• C. Renovation costs
• D. Supplies

Correct answer: C

Rationale: Operating expenses in health care organizations typically include costs like maintenance, rental fees, and supplies as they are necessary for the day-to-day operations. Renovation costs, on the other hand, are considered capital expenses as they involve significant improvements to facilities rather than routine operational expenses. Therefore, the correct answer is C. Choices A, B, and D are part of operating expenses in health care organizations because they directly contribute to the ongoing operational needs.

5. Which of the following is a recommendation for avoiding charges of negligence and false imprisonment for confused clients?

• A. Carefully assess and document client status.
• B. Ensure all patient information is secure and the nurse has logged out of the computer before leaving the computer station.
• C. Keep detailed notes while providing care to ensure accurate documentation later in the day.
• D. Discuss safety needs with clients.

Correct answer: A

Rationale: The correct answer is A: 'Carefully assess and document client status.' When dealing with confused clients, it is crucial to assess their status carefully and document it accurately. This helps in avoiding charges of negligence and false imprisonment by ensuring that the client's condition is well-documented and appropriate care is provided. Choice B is incorrect because it focuses on computer security rather than client care. Choice C is incorrect because it emphasizes detailed notes for accuracy but does not specifically address the confusion of clients. Choice D is incorrect as it mentions discussing safety needs but does not directly relate to avoiding charges of negligence and false imprisonment for confused clients.

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