A nurse is assessing a client who has heart failure two months after the implementation of a quality improvement initiative to reduce the hospital readmission rate. Which of the following findings should the nurse identify as an indication the quality improvement initiative is successful?

Presence of jugular vein distention

Increased weight of 2.27 kg (5 lb) in one week

Decreased brain natriuretic peptide levels

Development of S3 heart sounds

Answer and Explanation

The Correct Answer is C

A. The presence of jugular vein distention indicates fluid overload and is a sign of worsening heart failure, which would not suggest a successful initiative.

B. An increased weight of 2.27 kg (5 lb) in one week is indicative of fluid retention, a common sign of heart failure exacerbation, suggesting the initiative is not effective.

C. Decreased brain natriuretic peptide (BNP) levels indicate improved cardiac function and a reduction in heart failure symptoms, reflecting the success of the quality improvement initiative aimed at reducing hospital readmissions.

D. The development of S3 heart sounds is often associated with heart failure and fluid overload, indicating a worsening condition rather than improvement.

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Correct Answer is A

Explanation

A. Submitting a written request is a standard procedure for obtaining medical records, as it ensures proper documentation and compliance with privacy regulations. This response is appropriate and follows legal protocols.

B. Making a copy of the medical records immediately may violate facility policy, as proper authorization and procedures are typically required before releasing any medical documents.

C. Questioning the client's intentions can be seen as invasive and does not facilitate the process of obtaining their medical records. The nurse should not pry into the client’s personal reasons.

D. Stating that the facility is unable to release the records is incorrect, as clients have the right to access their medical records as long as they follow the proper protocol.

A. "I will run on a treadmill during this test." B. "I will be given contrast dye during this test." C. "I might have to wear a nose clip during this test." D. "I might have a tube inserted into my airway during this test."

Correct Answer is C

Explanation

A. The pulmonary function test does not typically involve running on a treadmill; that statement indicates a misunderstanding of the test.

B. Contrast dye is not used in pulmonary function tests; this reflects a lack of understanding of the procedure.

C. Wearing a nose clip is a common practice during pulmonary function tests to ensure that the client breathes only through the mouth, indicating the client understands the procedure.

D. Inserting a tube into the airway is not a standard part of pulmonary function tests, and this statement shows a misunderstanding of the procedure.

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A nurse is assessing a client who has heart failure two months after the implementation of a quality improvement initiative to reduce the hospital readmission rate. Which of the following findings should the nurse identify as an indication the quality improvement initiative is successful?

Nursing Test Bank

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A nurse is caring for a client who requests a copy of their medical records immediately. Which of the following responses should the nurse make?

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Explanation

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Correct Answer is C

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