A goal of The Joint Commission (TJC) is prevention of health care–associated pressure ulcers. In which situation would the institution fail in complying with that goal?
a. Charting of the Braden Risk Assessment Scale
b. Utilization of the Braden Risk Assessment Scale to prevent pressure ulcers from de-veloping
c. Documentation of stages of pressure ul-cers to determine appropriate action to take
d. Turning at-risk patient every 2 hours
ANS: A
The Braden Risk Assessment Scale is considered by TJC to be an accurate tool for identifying and therefore preventing pressure sores in patients, but the scale must be used to prevent the ul-cers. When the other measures are used, prevention of pressure ulcers is possible.
You might also like to view...
Nurses can enhance patient decision-making capacity by supporting all of the following except:
a. opportunities for choice. c. experiences of connection. b. reliance on authority. d. deepening self-awareness.
A nurse is reviewing the chart of a 15-year-old girl who has been sexually active since the age of 12. Which of the following findings would be of most concern?
a. She does not perform self-breast exams. b. She has never had a Pap test. c. She had one HIV test performed at the age of 13. d. She does not use birth control pills.
The nurse is collecting data for a patient with kidney disease. Which adventitious lung sound is the nurse most likely to note from fluid overload?
a. Wheezes b. Crackles c. Stridor d. Pleural friction rub
The part of the stethoscope that picks up sound is called the ____________________.
Fill in the blank(s) with the appropriate word(s).