Prioritizing Care EAQ

What type of delivery method is used when the nurse provides care to the same client for the entire work period? 1. Primary 2. Case method 3. Case management 4. Practice partnership

Case Method The premise of the case method is that one nurse provides total care for one client during the entire work period. In primary nursing, the primary nurse is accountable for the clients' care 24 hours a day from admission through discharge. Case management is the process of coordinating health care by planning, facilitating, and evaluating interventions across levels of care to achieve measurable cost and quality outcomes. In the practice partnership model an RN is paired with a technical assistant. The partner works with the RN consistently.

Which nursing intervention for opening the airway should be performed in an unconscious client with a spinal injury? 1. Performing a jaw thrust maneuver 2. Preparing for a needle thoracostomy 3. Initiating cardiopulmonary resuscitation 4. Providing oxygen via a nonrebreather mask

1 The jaw thrust maneuver is the recommended procedure for opening the airway of an unconscious client with a possible spinal or neck injury. Needle thoracostomy should be performed in a client with absent breath sounds. Cardiopulmonary resuscitation should be initiated in a client when there is no pulse. Providing oxygen via a nonrebreather mask is mainly performed when the client is conscious.

Which are considered as nurse competencies within the synergy model of care delivery? Select all that apply. 1. Collaboration 2. Care planning 3. Communication 4. Clinical judgment 5. Cultural competency

1, 4, 5 The Synergy Model describes eight nurse competencies, which include collaboration, clinical judgment, advocacy and moral agency, caring practices, facilitation of learning, systems thinking, response to diversity (cultural competency), and clinical inquiry. Care planning and communication are skills that every nurse should demonstrate regardless of the care delivery system being implemented.

What is an expectation of a primary nurse? 1. Identify associate nurses. 2. Provide all direct client care. 3. Coordinate all aspects of a client's care. 4. Report the client's status to the charge nurse

3 The primary nurse coordinates all aspects of client care with other nurses as well as other disciplines. The primary nurse does not identify associate nurses. The primary nurse will provide direct care but will not provide all care since the nurse will have scheduled days off from work. Reporting the status of a client to the charge nurse is a feature of team nursing, not primary nursing.

A nurse receives a shift report on four adult clients who are between the ages of 25 and 55. Which client should the nurse assess first? 1. Male client with a hemoglobin of 15.9 (160 mmol/L) 2. Female client on warfarin (Coumadin) with an international normalized ratio (INR) of 7.5 3. Female client taking daily calcium supplements with a serum calcium level of 9.4 (2.35 mmol/L) 4. Male client with a blood urea nitrogen (BUN) of 20 (7.1 mmol/L) and a creatinine of 1 (96 mcmol/L)

4 The client on warfarin (Coumadin) with an INR of 7.5 should be assessed first by the nurse, because this is an elevated result. Normal is considered between 2 and 3. This result is not therapeutic, and the nurse should assess for bleeding and hemodynamic stability. The nurse should report the result to the physician and implement bleeding precautions. The other results are within normal ranges: hemoglobin for a male is 14 to 18 g/dL (140 to 180 mmol/L); serum calcium is 9.0 to 10.5 mg/dL (2.25 to 2.75 mmol/L); BUN is 5 to 20 mg/dL (3.6 to 7.1 mmol/L); and creatinine is 0.7 to 1.5 mg/dL (53 to 106 mcmol/L).

Which level of emergency severity index (ESI) should be considered the lowest priority while a nurse is caring for the clients in the emergency department? 1. ESI-1 2. ESI-2 3. ESI-3 4. ESI-4

ESI-4

Which health care provider would best help a homeless client receive needed medication for a communicable disease? 1. Navigator 2. Case manager 3. Primary nurse 4. Unlicensed assistive personnel

Navigator The navigator role was conceived to reduce barriers to care for vulnerable clients who may cope with delays in access, diagnosis, treatment, and/or fragmented and uncoordinated care. A homeless person would be appropriately cared for by a navigator. The case manager, primary nurse, or unlicensed assistive personnel (UAP) would not be appropriate to aid the homeless client receive medication for a communicable disease.

Which member of the healthcare team, when using the team nursing approach, is responsible for prioritizing client care? 1. Team leader 2. Charge nurse 3. Licensed practical nurse 4. Unlicensed assistive personnel

Team leader