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1. Which of the following best describes the concept of total quality management (TQM)?
- A. Top-down management
- B. Employee-centered approach
- C. Continuous improvement
- D. Quality control
Correct answer: C
Rationale: The correct answer is C: Continuous improvement. Total quality management (TQM) focuses on continuously improving all aspects of healthcare delivery to enhance patient care, safety, and overall quality. Choice A, 'Top-down management,' does not capture the essence of TQM, which involves involvement at all levels of an organization. Choice B, 'Employee-centered approach,' while important, is not the defining characteristic of TQM. Choice D, 'Quality control,' is a component of TQM but does not fully encompass its comprehensive approach to quality improvement.
2. When should a critical pathway be revised?
- A. When variances show a new trend.
- B. When the variances show a new trend.
- C. When a member of the team retires.
- D. When the client leaves the hospital.
Correct answer: B
Rationale: A critical pathway should be revised when variances in the patient's progress indicate a new trend or deviation from the expected course of treatment. This allows healthcare providers to adjust the pathway to ensure optimal patient care and outcomes. Changes in the critical pathway are not typically driven by its length or external factors like team member retirements or client discharges. Therefore, the correct answer is B. Choice A is a better phrasing of the correct answer, emphasizing the importance of variances showing a new trend. Choices C and D are irrelevant to the patient's progress and treatment plan, making them incorrect.
3. A nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. The nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min and to report back in 1 hour. Which of the following actions should the nurse take next?
- A. Document the surgeon's instructions in the client's medical record.
- B. Complete an incident report.
- C. Consult the charge nurse.
- D. Notify the nursing manager.
Correct answer: D
Rationale: In this scenario, the nurse should notify the nursing manager next. The surgeon's instructions are related to the client's condition, and it is crucial to inform the nursing manager about the situation. Option A is incorrect because documenting the surgeon's instructions in the medical record is not the immediate next step. Option B is also incorrect as completing an incident report is not warranted in this situation. Option C is not the best choice as consulting the charge nurse may cause a delay in escalating the situation to higher management, which is necessary in cases of emergency like hemorrhagic shock.
4. A nurse is caring for a client who is scheduled to be transferred to a long-term care facility. The client's family questions the nurse about the reasons for the transfer. Which of the following responses made by the nurse is appropriate?
- A. The transfer of your family member is being done because the provider knows what's best.
- B. Would you like us to discuss the transfer with your family member?
- C. Why are you so concerned about this transfer?
- D. I know how you feel. My parent had to be transferred to a long-term care facility.
Correct answer: A
Rationale: The correct response is A because it provides a professional and reassuring explanation for the transfer, focusing on the expertise of the healthcare provider. Choice B offers to include the family member in the discussion, which may not address their concerns directly. Choice C appears defensive and does not address the family's inquiry. Choice D shifts the focus to the nurse's personal experience, which may not be relevant or helpful to the family seeking information about their own situation.
5. Which question during the assessment of a diabetic patient will help the nurse identify autonomic neuropathy?
- A. �Do you feel bloated after eating?�
- B. �Have you seen any skin changes?�
- C. �Do you need to increase your insulin dosage when you are stressed?�
- D. �Have you noticed any painful new ulcerations or sores on your feet?�
Correct answer: A
Rationale:
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