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 D

Explanation

A. Restraints should be tied using a quick-release knot, not a square knot. A quick-release knot allows for easy removal in emergencies.

B. A provider cannot write a prescription for restraints "as needed" because restraints must be prescribed for a specific duration and reason, ensuring they are used safely and appropriately.

C. Restraints should be removed as soon as they are no longer necessary, typically every 2 hours, not every 4 hours, to ensure the client's comfort and safety.

D. Restraints should always be secured to a part of the bed frame that moves with the client’s position. This prevents excessive tightening or loosening of the restraint, which could cause injury or compromise circulation. Restraints should never be tied to side rails, as this can lead to serious harm if the rails are moved.

A. Structure audit B. Benchmarking C. Outcome audit D. Process audit

Correct Answer is C

Explanation

A. A structure audit examines the resources, facilities, and organizational structure in place rather than specific patient outcomes or interventions.

B. Benchmarking involves comparing performance metrics to industry standards or best practices but does not specifically apply to this situation.

C. An outcome audit focuses on the results of care, specifically looking at the effectiveness of care practices, such as the timely removal of urinary catheters, to prevent complications.

D. A process audit evaluates the methods and processes of care rather than the outcomes, which is not applicable in this context.

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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

Naxlex Comprehensive Predictor Exams

A nurse is orienting a newly licensed nurse about the use of restraints. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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