EAQ Informatics/Technology
Which radiographic test is used to view the entire skeleton? 1. Bone scan 2. Gallium and thallium scan 3. Computed tomography (CT) 4. Magnetic resonance imaging (MRI) scan
Correct Answer 1. Bone scan A bone scan is a radionuclide test in which radioactive material is injected so that the client's entire skeleton can be viewed. Gallium and thallium scans are similar to bone scans but are more specific and sensitive in detecting bone disorders. A CT scan is used to detect musculoskeletal problems, primarily in the vertebral column and joints. An MRI scan is used to diagnose musculoskeletal disorders.
A client is receiving warfarin. Which test result should the nurse use to determine whether the daily dose of this anticoagulant is therapeutic? 1. International normalized ratio (INR) 2. Accelerated partial thromboplastin time (APTT) 3. Bleeding time 4. Sedimentation rate
Correct Answer 1. International normalized ratio (INR) Warfarin initially is prescribed day by day, based on INR blood test results. This test provides a standard system to interpret prothrombin times. APTT is used to evaluate the effects of heparin, which acts on the intrinsic pathway. Bleeding time is the time required for blood to cease flowing from a small wound; it is not used for warfarin dosage calculation. Sedimentation rate is a test used to determine the presence of inflammation or infection; it does not indicate clotting ability.
A client with diabetes mellitus experiences a sudden fall in blood glucose levels while travelling by air. The client is not carrying any medications or a copy of a personal medical record. Which type of health information technology would be beneficial for this client? 1. Personal health record (PHR) 2. Clinical health care informatics 3. Electronic medical record (EMR) 4. Regional health information organization (RHIO)
Correct Answer 1. Personal health record (PHR) The PHR is an electronic health record which consists of health data and the treatment provided for the client. The client can enter the data and maintain these health records. It is easy to carry and helps healthcare providers provide treatment in emergency conditions. Health care facilities maintain an EMR for each client. The client does not have access to these records in the air. Clinical health care informatics seeks to transform client health by educating and training health care professionals. It does not help to provide emergency treatment to the client while traveling. RHIO oversees the exchange of client's information among the client's healthcare providers and across geographic areas.
What does a nurse understand by the Quality and Safety Education for Nurses (QSEN) competency called informatics? 1. A nurse should ensure that the risk of harm to clients and healthcare workers is decreased by improving professional performance. 2. A nurse should use information and technology to communicate, manage knowledge, mitigate error, and support decision-making. 3. A nurse should integrate best current evidence with clinical expertise and client preferences and values to deliver quality health care. 4. A nurse should use data to monitor the outcomes of health care processes and implement improvement methods to design and test changes to improve quality of health care.
Correct Answer 2. A nurse should use information and technology to communicate, manage knowledge, mitigate error, and support decision-making. According to informatics, a nurse should use information and technology to communicate, manage knowledge, mitigate errors, and support decision-making. According to the Quality and Safety Education for Nurses (QSEN) competency called safety, a nurse should ensure that the risk of harm to clients and healthcare workers is decreased by improving professional performance. The QSEN competency called evidence-based practice states that a nurse should integrate best current evidence with clinical expertise along with client preferences and values to deliver quality healthcare. The QSEN competency called quality improvement states that a nurse should use data to monitor the outcomes of healthcare processes and implement improvement methods to design and test changes to improve quality of health care.
A nurse is reviewing a newly admitted client's medication administration record (MAR). Which element, if missing, makes the record incomplete? 1. Height 2. Allergies 3. Vital signs 4. Body weight
Correct Answer 2. Allergies Allergies should be listed on all MARs to prevent the administration of drugs to which the client is allergic. Height is part of the initial health history/physical assessment data. Weight is part of the initial health history/physical assessment data. The vital signs are part of the initial health history/physical assessment data.
While entering data for a client in the electronic health record (EHR), the nurse uses North American Nursing Diagnosis Association (NANDA) International terminology to document which part of the nursing process? 1. Planning 2. Diagnosis 3. Outcomes 4. Interventions
Correct Answer 2. Diagnosis The NANDA International terminology provides code numbers for the diagnosis of various diseases. Therefore the nurse would use NANDA International for entering the client's diagnosis. The NANDA International terminology does not give codes for planning, outcomes, and interventions. The nurse would document planning under the planning portion of the electronic health record. The nurse would use nursing interventions classification for entering interventions in the client's EHR. The nurse would use nursing outcomes classification for documenting the outcomes of the treatment in the EHR.
A visitor in the waiting room of the emergency department has a syncopal episode and collapses on the floor. The event is witnessed by a nurse on her way into the hospital for her shift, who provides initial care. The nurse assessed the client, maintained safety of the environment, and gave a report to the emergency department nurse, who will provide ongoing care. What should the nurse who witnessed the event do next? 1. Contact the family. 2. Document the incident. 3. Report the incident to the nurse manager. 4. Escort the client to the radiology department.
Correct Answer 2. Document the incident. Documenting the event on an incident report (Canada: adverse event) form provides a legal record and is critical in providing appropriate care and follow-up. Calling the family is the responsibility of the healthcare provider and nurse providing ongoing care. Reporting the incident to the nurse manager should be done, but it is not as critical as documenting the incident. Escorting the client to radiology is not the responsibility of the witnessing nurse. Once care is transferred to the emergency department nurse, it is the emergency department nurse's responsibility to arrange for or to escort the client to radiology.
After a cerebrovascular accident (also known as brain attack) a client is unable to differentiate between heat or cold and sharp or dull sensory stimulation. What lobe of the brain should the nurse conclude is likely affected? 1. Frontal 2. Parietal 3. Occipital 4. Temporal
Correct Answer 2. Parietal Sensory impulses from temperature, touch, and pain travel via the spinothalamic pathway to the thalamus and then to the postcentral gyrus of the parietal lobe, the somatosensory area. The frontal area is the area of abstract thinking and muscular movements. The occipital area is the area where nerve impulses are translated into sight. The temporal area is the area where nerve impulses are translated into sound.
After a cerebrovascular accident (also known as brain attack) a client is unable to differentiate between heat or cold and sharp or dull sensory stimulation. What lobe of the brain should the nurse conclude is likely affected? 1. Frontal 2. Parietal 3. Occipital 4. Temporal
Correct Answer 2. Parietal Sensory impulses from temperature, touch, and pain travel via the spinothalamic pathway to the thalamus and then to the postcentral gyrus of the parietal lobe, the somatosensory area. The frontal area is the area of abstract thinking and muscular movements. The occipital area is the area where nerve impulses are translated into sight. The temporal area is the area where nerve impulses are translated into sound.
A nurse identifies 12 mm of induration at the site of a tuberculin purified protein derivative (PPD) test when a client returns to the health office to have it read. What does the nurse explain to the client about this test? 1. Test result is negative and no follow-up is needed 2. Result indicates a need for further tests and a chest x-ray 3. Test was used for screening and a Tine test now will be given 4. Skin test is inconclusive and will have to be repeated in 6 weeks
Correct Answer 2. Result indicates a need for further tests and a chest x-ray The tuberculin PPD is injected intradermally; it is the most accurate skin test for tuberculosis (TB) because of the testing material and the intradermal method used. No other skin test is appropriate as a follow-up; further tests are now warranted, including a chest x-ray film. The test result is positive, not negative; thus further testing is necessary. The Tine test is less accurate than the tuberculin PPD and is not used as a follow-up test. More than 10 mm of induration is a positive test result, not a doubtful test result.
A client's monitor shows a PQRST wave for each beat and indicates a rate of 120 beats/minute. The rhythm is regular. What does the nurse conclude that the client is experiencing? 1. Atrial fibrillation 2. Sinus tachycardia 3. Ventricular fibrillation 4. First-degree atrioventricular block
Correct Answer 2. Sinus tachycardia The presence of a P wave before each QRS complex indicates a sinus rhythm. A heart rate greater than 100 beats per minute indicates tachycardia. Atrial fibrillation causes an irregular rhythm, and P waves are not identifiable. Ventricular fibrillation is irregular and shows no PQRST configurations. A first-degree atrioventricular block pattern has a prolonged PR interval and is regular.
A nurse is monitoring a client who is having a computed tomography (CT) scan of the brain with contrast. Which response indicates that the client is having a reaction to the contrast medium? 1. Pelvic warmth 2. Feeling flushed 3. Shortness of breath 4. Salty taste in the mouth
Correct Answer 3. Shortness of breath An untoward response to the iodinated dye used as a contrast is anaphylaxis, a life-threatening allergic response. Anaphylaxis is manifested by respiratory distress, hypotension, and shock; counteractive measures must be instituted. A feeling of warmth or flushing is an expected minor side effect. A salty taste is an expected minor side effect.
A nurse is caring for an older adult with a history of recent memory loss. Which action should the nurse take? 1. Instruct the client to move slowly when changing positions 2. Remind the client to look where places feet while walking 3. Adjust the daily schedule to accommodate sleep pattern 4. Employ electronic devices that provide alerts
Correct Answer 4. Employ electronic devices that provide alerts Providing electronic devices that give alerts can help an older adult who has developed recent memory loss. Adjusting the daily schedule can aid older adults who have changes in their sleep pattern. Instructing the client to move slowly when changing positions can prevent dizziness and falls caused by orthostatic blood pressure changes or altered balance/coordination. Reminding the client to check where feet are placed can help older adults with a decreased sensory perception of touch.
Which technology would the nurse use to reduce chronic ulcers by removing fluids from the wound? 1. Electrical stimulation 2. Topical growth factors 3. Hyperbaric oxygen therapy 4. Negative pressure wound therapy
Correct Answer 4. Negative pressure wound therapy Negative pressure wound therapy is a new technology used to reduce chronic ulcers by removing fluids from the wound and enhancing granulation. Electrical stimulation is done by the application of low-voltage current to a wound area to increase blood vessel growth and promote granulation. Topical growth factors are the normal body substances that stimulate cell movement and growth. Hyperbaric oxygen therapy is the administration of oxygen under pressure, raising the tissue oxygen concentration.
The student nurse is reviewing the electronic health record for clients in a health care facility. Which action by the student nurse may inhibit clients from disclosing personal information? 1. Use of clients' data for nursing research 2. Use of client data for Medicaid payment 3. Discussing a client's illness with the client 4. Sharing clients' data with family members
Correct Answer 4. Sharing clients' data with family members Clients may not want their health information shared with others and may want to maintain their privacy. If the nurse retrieves client data from the electronic health records and shares it with family members, it may lead to clients not sharing information. The nurse can use client data for research without mentioning a client's personal details. The nurse can use client data for filing insurance to receive Medicaid payments. The nurse can discuss the client's illness with the client; doing so helps to understand the client's perspective and to provide effective care.
What does a nurse understand by the quality improvement competency, according to Quality and Safety Education (QSEN)? 1. Using information and technology to communicate, manage knowledge, mitigate errors, and support decision-making 2. Integrating best current evidence with clinical expertise along with client and family preferences and values for the delivery of quality healthcare 3. Functioning effectively within nursing and interprofessional teams by fostering open communication, mutual respect, and shared decision making to achieve quality client care 4. Using data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems
Correct Answer 4. Using data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems The quality improvement competency states that a nurse should use data to monitor the outcomes of healthcare processes and uses improvement methods to design and test changes to continuously improve the quality and safety of healthcare systems. According to the competency called informatics, a nurse should use information and technology to communicate, manage knowledge, mitigate errors, and support decision-making. As per the competency called evidence-based practice, a nurse should integrate best current evidence with clinical expertise and client and family preferences and values for the delivery of quality healthcare. According to the competency called teamwork and collaboration, a nurse should function effectively within nursing and interprofessional teams by fostering open communication, mutual respect, and shared decision making to achieve quality client care.