A nurse is preparing to discharge a client who is a status post-operative laryngectomy. The nurse should recognize which of the following discharge teaching is the highest priority?

Use of Passy Muir speaking valve

Phone number of healthcare provider to report complications

Emergency personal identification that client is unable to speak

Ability to perform tracheostomy care

Answer and Explanation

The Correct Answer is C

A. Use of Passy Muir speaking valve: While this is an important aspect of communication for a client who has undergone a laryngectomy, it is not the highest priority at the time of discharge. The use of the speaking valve can be addressed after ensuring that the client is equipped to handle immediate safety concerns and emergencies related to their condition.
B. Phone number of healthcare provider to report complications: Providing the client with contact information for their healthcare provider is essential for ongoing support and to address any concerns that may arise after discharge. However, this information is secondary to ensuring the client can effectively communicate their condition and limitations, particularly in an emergency situation.
C. Emergency personal identification that client is unable to speak: This is the highest priority for discharge teaching because it directly addresses the client’s safety. Having emergency identification is crucial for informing healthcare providers and first responders about the client's inability to speak, especially in situations where communication may be vital for receiving appropriate care. Ensuring that the client can communicate their condition in emergencies takes precedence over other aspects of post-operative care.
D. Ability to perform tracheostomy care: While it is important for the client to be educated on tracheostomy care to ensure ongoing health and safety, this teaching can be considered after addressing immediate safety needs. The ability to care for the tracheostomy is vital but does not take priority over having emergency identification that communicates the client’s needs to others who may not be aware of their condition.

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Correct Answer is B

Explanation

A. The number of medication errors committed by another nurse. Quality improvement focuses on systemic issues rather than individual performance. Addressing medication errors should involve evaluating factors such as workflow inefficiencies, high workloads, or unclear protocols rather than singling out a specific nurse. Identifying system-wide improvements enhances patient safety more effectively.
B. Systems that make it difficult for the nurses to do their job. Quality improvement initiatives aim to identify and correct systemic barriers that hinder nursing efficiency and patient care. Issues such as inadequate staffing, poor communication, or outdated technology can lead to errors and inefficiencies. Addressing these barriers can improve workflow, reduce mistakes, and enhance patient outcomes.
C. Collective bargaining activity at a nearby hospital. Discussions about union activities or labor disputes are not directly related to quality improvement. While working conditions can impact patient care, this topic is more relevant to human resources or labor relations than a quality improvement committee focused on systemic patient safety issues.
D. How unhappy the nurses are with their current pay. While job satisfaction is important, a quality improvement committee focuses on patient safety, workflow efficiency, and care outcomes. Salary concerns are best addressed through administration or labor negotiations rather than a committee designed to implement clinical and operational improvements.

Correct Answer is ["15"]

Explanation

Formula:

Volume to administer (mL) = (Desired dose (mEq) / Available concentration (mEq/mL))

Desired dose = (40 mEq / 2 doses)

=20mEq

Available concentration = 6.7 mEq / 5 mL

Calculate the concentration per mL:

6.7 mEq / 5 mL = 1.34 mEq/mL

Volume to administer = 20 mEq / 1.34 mEq/mL

= 14.925... mL

Round to the nearest whole number:

Volume to administer = 15 mL

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A nurse is preparing to discharge a client who is a status post-operative laryngectomy. The nurse should recognize which of the following discharge teaching is the highest priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assigned to a quality improvement committee to decide on a quality improvement project for the unit. Which issues should the nurse discuss at the committee meeting?

Correct Answer is B

Explanation

A nurse is preparing to administer potassium chloride elixir 40 mEq divided into 2 equal doses every 12 hr. Available is 6.7 mEq/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["15"]

Explanation

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