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1. What is the primary purpose of a patient-centered medical home (PCMH)?
- A. To coordinate all aspects of patient care
- B. To reduce healthcare costs
- C. To implement the latest clinical guidelines
- D. To provide financial incentives for providers
Correct answer: A
Rationale: The correct answer is A: 'To coordinate all aspects of patient care.' A patient-centered medical home (PCMH) aims to provide comprehensive and continuous care by coordinating various aspects of a patient's healthcare needs. While reducing healthcare costs and implementing clinical guidelines are important goals in healthcare, the primary focus of a PCMH is on enhancing patient care coordination to improve outcomes and patient satisfaction. Providing financial incentives for providers is not the primary purpose of a PCMH, although it can be a component of some models to encourage quality care delivery.
2. When a client is receiving pain medication through a PCA pump, which of the following actions should the nurse take?
- A. Educate the family not to push the button for the client while the client is asleep.
- B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
- C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
- D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.
Correct answer: D
Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.
3.
- A. The RN tells the client he is not allowed to leave until the physician has released him.
- B. The RN asks the client why he wishes to leave.
- C. The RN asks the client to explain what he understands about his medical diagnosis.
- D. The RN asks the client to sign an against medical advice discharge form.
Correct answer: A
Rationale: Verbal or physical detainment of a client who desires to leave the institution is false imprisonment.
4. What is the process of helping an employee to improve performance called?
- A. Coaching
- B. Disciplining
- C. Mentoring
- D. Peer reviewing
Correct answer: A
Rationale: The correct answer is A: Coaching. Coaching involves providing guidance and support to help an employee enhance their performance by focusing on skill development, addressing weaknesses, and achieving professional growth. Mentoring (choice C) is about guiding and nurturing a less experienced individual, not specifically aimed at improving performance. Peer reviewing (choice D) involves colleagues evaluating each other's performance, not necessarily focused on improvement. Disciplining (choice B) is taking corrective actions in response to policy violations or performance issues, which is different from the process of helping an employee improve their performance.
5. A healthcare professional is preparing to delegate client care tasks to an assistive personnel (AP). Which of the following tasks should the healthcare professional delegate?
- A. Confirming that a client's pain has decreased after receiving an analgesic
- B. Ambulating a client who is postoperative
- C. Inserting an indwelling urinary catheter for a client
- D. Demonstrating the use of an incentive spirometer to a client
Correct answer: A
Rationale: The correct answer is option A: 'Confirming that a client's pain has decreased after receiving an analgesic.' This task involves assessing the effectiveness of the medication, which can be delegated to the assistive personnel. Options B, C, and D involve skills that should be performed by licensed healthcare professionals due to their complexity and potential risks if not done correctly. Ambulating a postoperative client requires monitoring for signs of distress or complications, inserting a urinary catheter involves an invasive procedure with infection risks, and demonstrating the use of medical devices like an incentive spirometer requires specialized knowledge to ensure correct usage.
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