The charge nurse is responsible for making the patient assignments on the critical care unit. An experienced, certified nurse is assigned to care for the acutely ill patient with sepsis who also requires continuous renal replacement therapy and mechanical ventilation. The nurse with less than 1 year of experience is assigned to two patients who are more stable. This assignment reflects implementation of the
Quality and Safety Education for Nurses (QSEN) model.
National Patient Safety Goals
Synergy Model of Practice
Crew resource management model.
The Correct Answer is C
A. QSEN focuses on preparing nurses with knowledge, skills, and attitudes to improve patient safety and quality of care. While relevant to overall safety, it does not specifically guide matching nurse competencies to patient acuity in assignments.
B. These goals, established by The Joint Commission, provide specific safety standards for areas such as medication administration, infection control, and patient identification. They do not address individualized nurse-patient assignments based on skill and patient acuity.
C. The Synergy Model links patient needs with nurse competencies, emphasizing that patient outcomes are optimized when the nurse’s experience, expertise, and certification match patient complexity and acuity. In this scenario, the most experienced nurse is assigned the most critically ill patient, while the less experienced nurse cares for more stable patients, reflecting synergy between patient needs and nurse competencies.
D. Crew resource management focuses on team communication, decision-making, and error reduction, originally in aviation and applied in healthcare to improve safety. It does not specifically guide nurse-patient assignment based on competency.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. While consulting with advanced practice nurses can provide guidance and expertise, this does not guarantee that care is evidence-based or consistently aligned with research. It depends on individual knowledge and experience rather than standardized research-based protocols.
B. Following a physician’s personal preferences may guide care, but these preferences may not always reflect current evidence or best practices. Relying solely on provider preference risks variability and inconsistency in patient care.
C. Clinical practice guidelines are systematically developed recommendations based on rigorous review of current research and evidence. Following these guidelines helps critical care nurses provide care that is consistent, safe, and supported by research, reducing variability and improving patient outcomes.
D. While computerized order entry helps reduce errors in transcription and ensures legible orders, it does not ensure that the interventions themselves are evidence-based. The tool supports safety and efficiency but is not a substitute for evidence-based practice.
Correct Answer is D
Explanation
A. Premature junctional contractions are incorrect because while they can occur postoperatively, they are not the most common dysrhythmia following coronary artery bypass grafting (CABG). These are usually transient and less clinically significant.
B. Ventricular ectopy is incorrect as isolated premature ventricular contractions may appear after surgery, but they are not the most frequently encountered dysrhythmia in this patient population. Ventricular arrhythmias can be serious, but they are less common than atrial arrhythmias post-CABG.
C. Second degree heart block is incorrect because this type of conduction disturbance is less common after CABG. It may occur in patients with preexisting conduction system disease but is not the usual postoperative dysrhythmia.
D. Atrial fibrillation or flutter is correct because these are the most common dysrhythmias following CABG, occurring in up to 30–40% of patients. The atrial tissue is often irritated by surgical manipulation, inflammation, and electrolyte shifts, making the patient prone to atrial arrhythmias. Monitoring for these dysrhythmias is crucial as they can increase the risk of thromboembolism, hemodynamic instability, and prolonged hospitalization. Management may include rate control, rhythm control, anticoagulation, and addressing reversible causes such as electrolyte imbalances.
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