A director of nursing in a rehabilitation facility is planning to measure the quality of care provided. Which of the following audits should the director plan to use after clients are discharged to gather information about quality of care?

Prospective audit

Outcome audit

Structure audit

Concurrent audit

Answer and Explanation

The Correct Answer is B

A. Prospective audit: A prospective audit evaluates care before it is provided, focusing on planned interventions rather than outcomes after discharge. It is not used to assess post-care quality.

B. Outcome audit: Outcome audits measure the results of care, such as client recovery, complication rates, or satisfaction, after interventions have been completed. This type of audit is appropriate for gathering information about quality of care following discharge.

C. Structure audit: Structure audits assess the resources, staffing, and organizational infrastructure used to deliver care. They do not measure client outcomes or post-discharge quality.

D. Concurrent audit: Concurrent audits evaluate care while it is being provided, allowing immediate feedback and corrections. They are performed during hospitalization, not after discharge.

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Correct Answer is {"B":{"answers":"B,C"},"D":{"answers":"C"},"E":{"answers":"A,C"}}

Explanation

Temperature: A temperature of 37.4°C is within normal limits and does not specifically support any of the three conditions. While low-grade fever may be seen in appendicitis or Crohn’s flares, the absence of fever at this time limits its diagnostic value in this case.
Vomiting: Vomiting in intussusception is common and often non-bilious in early stages, aligning with the child's light-colored emesis. Vomiting also occurs in appendicitis, especially in the early stages. However, it is not a prominent or early symptom of Crohn’s disease unless obstruction is present.
Pain rating: Severe, intermittent abdominal pain where the child draws their knees to the chest and then returns to normal behavior is a classic symptom of intussusception. Neither Crohn’s disease nor appendicitis typically presents with this pattern, appendicitis pain is usually constant and worsening, while Crohn’s pain is chronic and non-episodic.
Abdominal findings: A distended abdomen with hypoactive bowel sounds and a palpable sausage-shaped mass in the right upper quadrant is highly indicative of intussusception. These findings are not characteristic of appendicitis, which usually involves RLQ pain, or Crohn’s, which rarely presents with a discrete palpable mass.
Stool: The presence of blood and mucus in the stool ("currant jelly stool") is strongly associated with intussusception and may also occur in Crohn’s disease during flares due to colonic inflammation. Appendicitis does not typically cause bloody or mucoid stools, making this finding inconsistent with that diagnosis.

A. A blister-like area B. A cool, blanched area C. An elevated, hardened area D. An area of ecchymosis

Correct Answer is C

Explanation

Rationale:

A. A blister-like area: Blistering is not the expected reaction used to interpret a Mantoux test. The result is based on the presence and size of induration, not the formation of blisters.

B. A cool, blanched area: Coolness and blanching are not indicators of a positive test. These findings may reflect poor circulation or local skin reaction unrelated to tuberculosis screening.

C. An elevated, hardened area: Induration (elevated, firm area) at the injection site, measured in millimeters, is the basis for determining a positive result. The size threshold for positivity depends on the client’s risk factors for tuberculosis.

D. An area of ecchymosis: Bruising at the site is a local skin reaction that can occur after any injection and is unrelated to the diagnostic criteria for a positive Mantoux test.

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A director of nursing in a rehabilitation facility is planning to measure the quality of care provided. Which of the following audits should the director plan to use after clients are discharged to gather information about quality of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an acute care facility is caring for a toddler. Exhibits For each assessment finding below, click to specify if the assessment finding is consistent with Crohn's disease, appendicitis, or intussusception. Each finding may support more than 1 disease process.

Correct Answer is {"B":{"answers":"B,C"},"D":{"answers":"C"},"E":{"answers":"A,C"}}

Explanation

A nurse is assessing a client who received a Mantoux skin test 72 hr ago for tuberculosis screening. Which of the following findings indicates a positive test result?

Correct Answer is C

Explanation

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