The audit process consists of six steps. What is the sixth step?
a. Select explicit criteria for quality care.
b. Review records to determine whether criteria are met.
c. Select a topic for study.
d. Peer review all cases that do not meet the criteria.
ANS: C
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The nurse is caring for a patient admitted to the hospital with a fractured femur and possible head injury. Vital signs on admission were blood pressure 128/72 mm Hg, pulse 90 beats/min, and respirations 66 breaths/min
Four hours after admission, the nurse is checking vital signs as part of the hourly assessment. Which of the following vital signs most likely indicate the presence of increased intracranial pressure (ICP)? a. Blood pressure 172/68 mm Hg, pulse 42 beats/min, respirations 10 breaths/min b. Blood pressure 160/90 mm Hg, pulse 112 beats/min, respirations 16 breaths/min c. Blood pressure 130/72 mm Hg, pulse 50 beats/min, respirations 24 breaths/min d. Blood pressure 100/70 mm Hg, pulse 120 beats/min, respirations 30 breaths/min
A patient is receiving vancomycin (Vancocin) intravenously. The nurse will most likely administer the medication over a period of
A) 1 minute B) 10 minutes C) 30 minutes D) 60 minutes
An older client asks the nurse what they can do to live to a healthy old age. Which response by the nurse promotes healthy aging?
1. "You should not receive influenza and pneumococcal vaccines." 2. "You should decrease nutritional intake of dairy products." 3. "You should avoid any weightlifting." 4. "You should use available preventive and screening services."
Which of the following provides the nurse with the most reliable basis on which to choose a nursing diagnosis?
A) A cluster of several significant cues of data that suggest a particular health problem B) A single, definitive cue that is closely associated with a common diagnosis C) A cue that can be verified by objective, medical data D) A group of related nursing diagnoses that exist within the same NANDA-approved domain