A nurse is on the hospital quality and performance Improvement committee. The committee is reviewing compliance with prevention measures related to posterior cervical surgical site infections over the first 3 quarters of the year. Glucose Control
Benchmark: 90 %
Quarter 1-75.29%
Quarter 2-85.5%
Quarter 3-82%
Post Operative Normothermia
Bench mark- 85%
Quarter 1-69%
Quarter 2-85%
Quarter 3-86.2%
Perioperative Antibiotics
Benchmark 100%
Quarter 1-90.4%
Quarter 2-88.2%
Quarter 3-92.6 %
Smoking Cessation
Smoking cessation education 4 weeks prior to surgery.
Benchmark 75%
Quarter 1-70.6%
Quarter 2-100%
Quarter 3-74%
Intrawound Vancomycin Powder
Benchmark 80.2%
Quarter 1-75.79%
Quarter 2-80.5%
Quarter 3-92%
Which measures should the nurse recognize that indicate the need for improvement compared to benchmarks? Select all that apply.

Glucose control

Intraoperative vancomycin

Post operative normothermia

Perioperative antibiotics

Smoking cessation

Answer and Explanation

Correct Answer : A,D,E

Rationale:

A. The benchmark for glucose control is 90%, but the percentages reported are consistently below this threshold: 75.29% in Quarter 1, 85.5% in Quarter 2, and 82% in Quarter 3. Improvement is needed to meet or exceed the benchmark.

B. The benchmark is 80.2%, and the percentages are above this threshold: 75.79% in Quarter 1, 80.5% in Quarter 2, and 92% in Quarter 3. No improvement needed as the measure is above the benchmark.

C. The benchmark is 85%, and the percentages reported are: 69% in Quarter 1, 85% in Quarter 2, and 86.2% in Quarter 3. Although Quarter 1 is below the benchmark, Quarter 2 and Quarter 3 meet or exceed the benchmark. Overall, the trend shows improvement.

D. The benchmark is 100%, and the percentages reported are: 90.4% in Quarter 1, 88.2% in Quarter 2, and 92.6% in Quarter 3. Although the percentages are below the benchmark, there is a trend of improvement. However, the measure still requires further enhancement to meet the benchmark.

E. The benchmark for smoking cessation education 4 weeks prior to surgery is 75%. The percentages are below this benchmark in Quarter 1 (70.6%) and Quarter 3 (74%), although it meets the benchmark in Quarter 2 (100%). Consistent adherence to the benchmark needs to be improved.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Rationale:

A. Applying restraints to prevent an alert, oriented client from leaving AMA: This is an example of false imprisonment, not negligence.

B. Negligence is the failure to act as a reasonably prudent nurse would under similar circumstances. Notifying the provider hours after discovering absent peripheral pulses shows a delay in appropriate action, which can lead to serious complications (e.g., compartment syndrome, tissue ischemia). This failure to act promptly meets the definition of negligence.

C. Administering medication without the client’s knowledge after refusal: This constitutes battery, as it involves intentional, unauthorized physical contact.

D. Threatening to apply restraints if the client continues eating chips: This is assault, since it is a threat of harm without physical contact.

A. Agency policies for the LPN B. The documented experience level of the LPN C. The documented skill level of the LPN D. State Nurse Practice Act for the LPN

Correct Answer is D

Explanation

Rationale:

A. Agency policies for the LPN are important but secondary to ensuring the tasks fall within the scope of practice.

B. The documented experience level of the LPN is relevant but should be considered in conjunction with the scope of practice.

C. The documented skill level of the LPN is important for assigning tasks but must align with legal scope of practice.

D. State Nurse Practice Act for the LPN is the priority criterion as it defines the legal scope of practice and ensures that tasks delegated to the LPN are within their legal and professional boundaries.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a class on torts. The nurse should include which of the following situations as an example of negligence?

Correct Answer is B

Explanation

An RN is delegating care activities to a licensed practical nurse (LPN). Which of the following is the priority criterion the RN should consider when delegating?

Correct Answer is D

Explanation

A nurse manager is observing the care provided by a nurse who is in orientation to the unit. Which of the following actions by the nurse indicates the nurse manager should intervene?

A nurse and an assistive personnel (AP) are providing care for four clients who were admitted to the medical-surgical unit on the previous shift. The nurse should delegate meal assistance for which of the following clients to the AP?

A nurse is caring for a group of clients. The nurse demonstrates adherence to the ethical principle of fidelity by doing which of the following?

A nurse is planning to delegate tasks to a licensed practical nurse (LPN). Which of the following entities is important for the nurse to understand when delegating tasks to the LPN?

A nurse manager is preparing an inservice program about managing conflict for the nurses on the unit. The nurse manager should identify which of the following examples as interpersonal conflict?

A nurse has received morning report on the following four clients. Which of the following clients should the nurse assess first?

A charge nurse is observing a nurse Insert an indwelling urinary catheter into a female client. For which of the following actions by the nurse should the charge nurse intervene?

A nurse is planning to assign care activities to the assistive personnel (AP) on her team. Which of the following activities can the nurse assign to the AP? (Select all that apply.)