A nurse is on the hospital quality and performance Improvement committee. The committee is reviewing compliance with prevention measures related to posterior cervical surgical site infections over the first 3 quarters of the year. Glucose Control
Benchmark: 90 %
Quarter 1-75.29%
Quarter 2-85.5%
Quarter 3-82%
Post Operative Normothermia
Bench mark- 85%
Quarter 1-69%
Quarter 2-85%
Quarter 3-86.2%
Perioperative Antibiotics
Benchmark 100%
Quarter 1-90.4%
Quarter 2-88.2%
Quarter 3-92.6 %
Smoking Cessation
Smoking cessation education 4 weeks prior to surgery.
Benchmark 75%
Quarter 1-70.6%
Quarter 2-100%
Quarter 3-74%
Intrawound Vancomycin Powder
Benchmark 80.2%
Quarter 1-75.79%
Quarter 2-80.5%
Quarter 3-92%
Which measures should the nurse recognize that indicate the need for improvement compared to benchmarks? Select all that apply.

Glucose control

Intraoperative vancomycin

Post operative normothermia

Perioperative antibiotics

Smoking cessation

Answer and Explanation

Correct Answer : A,D,E

Rationale:

A. The benchmark for glucose control is 90%, but the percentages reported are consistently below this threshold: 75.29% in Quarter 1, 85.5% in Quarter 2, and 82% in Quarter 3. Improvement is needed to meet or exceed the benchmark.

B. The benchmark is 80.2%, and the percentages are above this threshold: 75.79% in Quarter 1, 80.5% in Quarter 2, and 92% in Quarter 3. No improvement needed as the measure is above the benchmark.

C. The benchmark is 85%, and the percentages reported are: 69% in Quarter 1, 85% in Quarter 2, and 86.2% in Quarter 3. Although Quarter 1 is below the benchmark, Quarter 2 and Quarter 3 meet or exceed the benchmark. Overall, the trend shows improvement.

D. The benchmark is 100%, and the percentages reported are: 90.4% in Quarter 1, 88.2% in Quarter 2, and 92.6% in Quarter 3. Although the percentages are below the benchmark, there is a trend of improvement. However, the measure still requires further enhancement to meet the benchmark.

E. The benchmark for smoking cessation education 4 weeks prior to surgery is 75%. The percentages are below this benchmark in Quarter 1 (70.6%) and Quarter 3 (74%), although it meets the benchmark in Quarter 2 (100%). Consistent adherence to the benchmark needs to be improved.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Rationale:

A. Call the provider for a stat DNR order is not appropriate as the client is already in a critical state requiring immediate action.

B. Call the emergency response team is necessary as the client is pulseless, and resuscitation should be initiated according to standard procedures until a DNR order is confirmed.

C. Seek immediate help from the risk manager is not appropriate at this moment; the immediate concern is the client's emergency situation.

D. Respect the family's wishes and do nothing is not appropriate as immediate life-saving measures should be taken until a formal DNR order is in place.

A. A client who was administered erythromycin for acute glomerulonephritis and reports reddish-brown urinary output B. A client who was administered glipizide for type 2 diabetes mellitus and has a blood glucose of 68 mg/dL C. A client who was administered adalimumab for Crohn's disease, has a serum calcium level of 10 mg/dL, and reports a headache D. A client who was administered acyclovir for cellulitis reports pain in the affected leg

Correct Answer is B

Explanation

Rationale:

A. A client who was administered erythromycin for acute glomerulonephritis and reports reddish-brown urinary output requires assessment for possible drug reaction or hematuria, but this may not be immediately life-threatening compared to hypoglycemia.

B. A client who was administered glipizide for type 2 diabetes mellitus and has a blood glucose of 68 mg/dL is at risk for hypoglycemia, which requires prompt assessment and intervention to prevent severe complications.

C. A client who was administered adalimumab for Crohn's disease, has a serum calcium level of 10 mg/dL, and reports a headache should be assessed, but the calcium level and headache are less urgent compared to immediate treatment needs for hypoglycemia.

D. A client who was administered acyclovir for cellulitis reports pain in the affected leg may require assessment for infection or medication side effects, but this is less critical than addressing hypoglycemia.

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Naxlex Comprehensive Predictor Exams

A nurse enters a client's room and finds the client pulseless. The family has requested a do-not-resuscitate (DNR) order from the provider, but he has not written the order yet. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A nurse has received morning report on the following four clients. Which of the following clients should the nurse assess first?

Correct Answer is B

Explanation

A nurse manager is preparing an inservice program about managing conflict for the nurses on the unit. The nurse manager should identify which of the following examples as interpersonal conflict?

A nurse is caring for a client who is dying. The nurse should incorporate the principle of nonmaleficence into practice by taking which of the following actions?

A coworker puts an arm around a nurse and says, "I bet you are a great lover." Which of the following is an appropriate response by the nurse?

A nurse is teaching a class on torts. The nurse should instruct the class that administering an antibiotic medication to a competent client after the client has refused it is an example of which of the following torts?

A nurse tells another nurse that she thinks he did not provide adequate care for a client who underwent hip arthroplasty. Which of the following responses by the nurse demonstrates assertiveness?

An assistive personnel (AP) comes to work with a new set of artificial nails. The nurse takes the AP to a private location to discuss the issue. Which of the following statements by the nurse is appropriate?

A nurse checks with assistive personnel on the unit throughout the shift to determine if they are completing tasks. The nurse is demonstrating which of the following rights of delegation?

A nurse manager has received information from the facility's risk management department that a former client is pursuing a lawsuit. The nurse manager should anticipate a deposition will be required during which phase of the legal process?