A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?

Require staff nurses to demonstrate competency by passing a medication administration examination

Provide an in-service on medication administration to at the nurses

Develop a quality improvement program for nurses involved in medication administration errors

Renew the events lead up to each medication administration error

Answer and Explanation

The Correct Answer is D

A. Requiring staff nurses to demonstrate competency by passing a medication administration examination: While competency assessments are essential, initiating this as the first strategy may not address the root causes of medication administration errors. It's important to first understand the specific factors contributing to errors by reviewing the events leading up to each error before implementing competency assessments. This allows for a targeted approach to addressing gaps in knowledge or skills related to medication administration.
B. Providing an in-service on medication administration to all nurses: While education and training are valuable components of error reduction strategies, providing an in-service as the first step may not address the underlying system issues contributing to medication errors. Education should complement other interventions aimed at improving the medication administration process, such as system redesign or standardization of practices.
C. Developing a quality improvement program for nurses involved in medication administration errors: Implementing a quality improvement program for nurses involved in errors is important for learning from mistakes and preventing recurrence. However, developing such a program should be informed by a thorough analysis of the events leading to errors. Without understanding the root causes, it may be challenging to develop effective improvement initiatives.
D. Reviewing the events leading up to each medication administration error: This strategy is the most appropriate initial step. Conducting a detailed review of each error allows the committee to identify patterns, common factors, and system issues contributing to medication errors. By understanding the specific circumstances surrounding each error, the committee can develop targeted interventions to address root causes and prevent future errors. This approach aligns with the principles of continuous quality improvement, focusing on data-driven analysis and proactive problem-solving.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. Provide reassurance to the client and parents: While reassurance is important, it is not the priority action when caring for an adolescent client with a newly applied fiberglass cast for a fractured tibia. Ensuring adequate neurovascular status is critical to prevent complications associated with impaired circulation or nerve function.
B. Perform a neurovascular assessment: This is the correct action and the priority when caring for a client with a newly applied cast. The nurse should assess the client's neurovascular status by evaluating circulation, sensation, and movement distal to the casted limb. Changes in color, temperature, sensation, or movement could indicate impaired circulation or nerve function, which require immediate intervention to prevent complications such as compartment syndrome.
C. Apply an ice pack to the casted leg: While applying ice may help reduce swelling and discomfort, it is not the priority action when caring for a client with a newly applied cast. Additionally, applying ice directly to the cast may not effectively reach the skin and underlying tissues, potentially causing discomfort without providing significant benefit.
D. Explain the discharge instructions to the client and parents: Providing discharge instructions is important for client education, but it is not the priority action immediately after applying a cast. Ensuring the client's safety and well-being by performing a neurovascular assessment takes precedence to identify and address any potential complications associated with the cast.

A. Polyuria B. Hypotension C. Weakened gag reflex D. Hyperthermia E. Absence of bowel sounds

Correct Answer is ["B","C","E"]

Explanation

A. Polyuria: Polyuria, or excessive urination, is not typically associated with cervical spinal cord injury. In fact, urinary retention or neurogenic bladder is more commonly observed due to disruption of bladder control. Clients with cervical spinal cord injury often experience bladder dysfunction, which can lead to urinary retention rather than polyuria.
B. Hypotension: Hypotension is a common complication of cervical spinal cord injury, particularly in cases involving injury above the level of T6. Damage to the sympathetic nervous system can result in neurogenic shock, characterized by vasodilation and bradycardia, leading to hypotension. Monitoring for signs of hypotension, such as decreased blood pressure and altered mental status, is essential for early intervention and prevention of complications.
C. Weakened gag reflex: Cervical spinal cord injury can impair the gag reflex due to disruption of the glossopharyngeal nerve (CN IX) and vagus nerve (CN X) function. This impairment can lead to difficulty swallowing, aspiration risk, and increased susceptibility to respiratory complications such as aspiration pneumonia. Therefore, monitoring the gag reflex and assessing for signs of dysphagia are crucial in clients with cervical spinal cord injury to prevent respiratory compromise and aspiration-related complications.
D. Hyperthermia: Hyperthermia is less commonly associated with cervical spinal cord injury. However, in some cases, autonomic dysreflexia—a potentially life-threatening condition—can occur, leading to increased body temperature among other symptoms. This is more common in injuries above the T6 level.
E. Absence of bowel sounds: Neurogenic bowel dysfunction, including the absence of bowel sounds, is a common complication of cervical spinal cord injury. Disruption of autonomic nervous system function can lead to decreased peristalsis and absent bowel sounds.

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A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an adolescent client who has a newly applied fiberglass cast for a fractured tibia. Which of the following is the priority action for the nurse to take?

Correct Answer is B

Explanation

A nurse in the emergency department is monitoring a client who has a cervical spinal cord injury from a fall. The nurse should monitor the client for which of the following complications? (Select all that apply)

Correct Answer is ["B","C","E"]

Explanation

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