A nurse is reviewing the electronic medical record on clients following the implementation of a quality improvement plan to reduce health care associated infections on a medical surgical unit.

Exhibits

Select the 3 clients whose findings indicate the program is effective.

Client 1

Client 2

Client 3

Client 4

Client 5

Answer and Explanation

Correct Answer : B,D,E

A. Client 1 - The findings for this client indicate a worsening of the pressure injury, with an increase in size from 2.5 cm x 2.5 cm to 3 cm x 3 cm. Additionally, the presence of purulent drainage suggests an infection rather than improvement, indicating that the quality improvement plan is not effective for this client.

B. Client 2 - The white blood cell (WBC) count for this client decreased from 11,500/mm³ to 9,500/mm³, which falls within the normal range. This reduction in WBC count suggests an improvement in the client's pneumonia, indicating that the quality improvement initiative to reduce healthcare-associated infections is effective in this case.

C. Client 3 - Although the WBC count increased from 2 to 6, it remains within the acceptable range of 0 to 4 per low-power field for urinary tract infections (UTIs). There are no significant improvements in the urinalysis results, which suggests that the program may not be effectively addressing the client's condition.

D. Client 4 - This client's urinalysis results remained consistent with no significant changes in urine pH and specific gravity. The WBC count remains unchanged at 2, indicating stability and no evidence of infection progression. This lack of worsening suggests that the quality improvement plan is effectively managing the client's UTI.

E. Client 5 - This client shows improvement, with a decrease in the size of the pressure injury from 3.5 cm x 2.5 cm to 2.8 cm x 2 cm and the absence of purulent drainage. These findings indicate that the quality improvement plan is effective in preventing further infection and promoting healing in this client.

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Correct Answer is ["A","B","D","F"]

Explanation

A. Client 1 - Lyme disease is a reportable infectious disease in many jurisdictions due to its potential public health implications. Given that it is transmitted by tick bites, it is crucial to notify the health department to help track the incidence and potential outbreaks in the area.

B. Client 2 - Acute hepatitis C is also a reportable disease, especially given the client's history of IV substance use. Reporting aids in monitoring and controlling the spread of the disease, as it can be transmitted through blood and sharing of needles.

C. Client 3 - Clostridium difficile infections are typically not reported to the health department, as they are often linked to healthcare settings and do not pose a public health threat in the same way as other infectious diseases.

D. Client 4 - Salmonellosis is a reportable illness as it can be associated with outbreaks linked to foodborne transmission. Reporting is essential for investigating sources of infection and preventing further cases.

E. Client 5 - While Streptococcal pharyngitis is common and can cause outbreaks, it is generally not classified as a reportable disease to public health departments. Instead, treatment and monitoring are usually managed within healthcare settings.

F. Client 6 - Pertussis (whooping cough) is highly contagious and considered a reportable disease due to its potential to cause outbreaks, especially among vulnerable populations. Reporting allows for monitoring and preventive measures to be implemented in the community.

A. Refer the AP to the facility procedure manual. B. Instruct the AP to request assistance when unsure about a task. C. Demonstrate the proper client transfer technique for the AP. D. Help the AP assist the client with the transfer.

Correct Answer is D

Explanation

A. Referring the AP to the facility procedure manual does not provide immediate support or correct the unsafe practice observed. It may not address the situation in real-time.

B. While instructing the AP to request assistance is important for future situations, it does not immediately rectify the incorrect technique being used at that moment.

C. While demonstrating the correct technique is valuable, the immediate priority is ensuring the client’s safety by assisting with the current transfer. A demonstration should follow after the immediate risk has been managed.

D. The first priority is client safety. If the nurse manager observes an incorrect transfer technique, the immediate response should be to intervene to prevent injury to the client or the AP. Assisting with the transfer ensures that the client is safely positioned while also providing an opportunity to correct the AP's actions in real time.

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A nurse is reviewing the electronic medical record on clients following the implementation of a quality improvement plan to reduce health care associated infections on a medical surgical unit. Exhibits Select the 3 clients whose findings indicate the program is effective.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An infectious disease nurse is reviewing electronic medical records on a group of clients. Exhibits Select the 4 clients whose diagnosis should be reported to the health department.

Correct Answer is ["A","B","D","F"]

Explanation

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Correct Answer is D

Explanation

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A nurse is reviewing the electronic medical record on clients following the implementation of a quality improvement plan to reduce health care associated infections on a medical surgical unit.

Exhibits

Select the 3 clients whose findings indicate the program is effective.