A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?

Require staff nurses to demonstrate competency by passing a medication administration examination

Provide an in-service on medication administration to at the nurses

Develop a quality improvement program for nurses involved in medication administration errors

Renew the events lead up to each medication administration error

Answer and Explanation

The Correct Answer is D

A. Requiring staff nurses to demonstrate competency by passing a medication administration examination: While competency assessments are essential, initiating this as the first strategy may not address the root causes of medication administration errors. It's important to first understand the specific factors contributing to errors by reviewing the events leading up to each error before implementing competency assessments. This allows for a targeted approach to addressing gaps in knowledge or skills related to medication administration.
B. Providing an in-service on medication administration to all nurses: While education and training are valuable components of error reduction strategies, providing an in-service as the first step may not address the underlying system issues contributing to medication errors. Education should complement other interventions aimed at improving the medication administration process, such as system redesign or standardization of practices.
C. Developing a quality improvement program for nurses involved in medication administration errors: Implementing a quality improvement program for nurses involved in errors is important for learning from mistakes and preventing recurrence. However, developing such a program should be informed by a thorough analysis of the events leading to errors. Without understanding the root causes, it may be challenging to develop effective improvement initiatives.
D. Reviewing the events leading up to each medication administration error: This strategy is the most appropriate initial step. Conducting a detailed review of each error allows the committee to identify patterns, common factors, and system issues contributing to medication errors. By understanding the specific circumstances surrounding each error, the committee can develop targeted interventions to address root causes and prevent future errors. This approach aligns with the principles of continuous quality improvement, focusing on data-driven analysis and proactive problem-solving.

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Correct Answer is ["A","D","E"]

Explanation

A. Clubbing of the fingers: Clubbing of the fingers is a common finding in clients with advanced emphysema. It is characterized by bulbous enlargement of the fingertips and nail changes, including increased curvature and softening of the nail beds. Clubbing results from chronic hypoxia and tissue oxygen deprivation, which leads to vascular changes and tissue proliferation in the fingertips.
B. Deep respirations: Deep respirations are not typically associated with emphysema. Instead, clients with emphysema often exhibit shallow, rapid respirations due to decreased lung elasticity and air trapping, which impair effective ventilation. As a compensatory mechanism, clients may adopt a pursed-lip breathing pattern to facilitate expiration and reduce airway collapse.
C. Bradycardia: Bradycardia is not a characteristic finding in clients with emphysema. Instead, clients with emphysema commonly experience tachycardia, which is a compensatory response to hypoxia and increased work of breathing. Tachycardia helps maintain cardiac output and tissue perfusion in the setting of impaired gas exchange.
D. Barrel chest: Barrel chest is a classic physical finding in clients with emphysema. It results from hyperinflation of the lungs and loss of lung elasticity, leading to a permanent increase in the anteroposterior diameter of the chest. This change in chest shape contributes to the characteristic appearance of a rounded, barrel-like chest.
E. Dyspnea: Dyspnea, or shortness of breath, is a hallmark symptom of emphysema. Clients with emphysema often experience dyspnea, especially with exertion, due to air trapping, decreased lung function, and impaired gas exchange. Dyspnea can significantly impact the client's quality of life and functional status, requiring careful management and symptom relief interventions.

A. Take the medication with meals. B. Check the pulse after medication administration. C. Limit caffeine intake. D. Rinse the mouth after administration.

Correct Answer is D

Explanation

A. Take the medication with meals: Beclomethasone is an inhaled corticosteroid used to prevent asthma symptoms. It should be taken as prescribed by the healthcare provider, usually inhaled at specific times each day. Taking the medication with meals is not necessary, as it does not affect its efficacy or absorption.
B. Check the pulse after medication administration: Checking the pulse is not typically indicated after administering inhaled beclomethasone. Beclomethasone is a corticosteroid inhaler used for long-term control of asthma symptoms and is not associated with significant cardiovascular effects that would necessitate pulse monitoring.
C. Limit caffeine intake: Limiting caffeine intake is not specifically related to the administration of inhaled beclomethasone. However, caffeine can exacerbate some asthma symptoms in susceptible individuals, so general advice to limit caffeine intake may be beneficial for managing asthma symptoms overall. Still, it's not directly related to the administration of this medication.
D. Rinse the mouth after administration: This is the correct action. Inhaled corticosteroids like beclomethasone can cause local side effects such as oral candidiasis (thrush) or dysphonia (hoarseness) due to deposition of the medication in the mouth and throat. Rinsing the mouth with water after each dose helps minimize these side effects by reducing the amount of medication left in the mouth, thereby decreasing the risk of oral candidiasis and other local adverse effects.

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A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client? (Select all that apply)

Correct Answer is ["A","D","E"]

Explanation

A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide?

Correct Answer is D

Explanation

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