and Answers
Am24-bedmcriticalmcaremunitmhasmexperiencedmanmincreaseminmventilator-
associatedmpneumoniam(VAP)mwithinmthempastmyear.mThemclinicalmnursemleaderm(CNL)misma
skedmtomfacilitatemamworkgroupmfocusedmonmdevelopingmamplanmtompreventmVAP.mWhichmof
mthemfollowingmbestmexhibitsmhowmthemCNLmpromotesmcommunicationmwithinmthemteam?
A.mAssignsmeachmmembermamrole,mensuringmeveryonemunderstandsmhismormhermjob.
B.mEngagesmthemteamminmsharedmdecisionmmakingmbeforemfinalizingmamplan.
C.mSharesmclearmgoals,mmessages,mandmplansmwithmthemteammthroughoutmthemprocess.
D.mSynthesizesmtheminputmfrommthemteammtomfindmcommonmthemesmandmgoals.m-
mCORRECTmANSWER-
C.mRationale:mThemCNLmcommunicatesmwithinmamteammbymfosteringmthemflowmofminformatio
nmandmservingmasmamtranslator.mThemCNLmactivelymsolicitsminputmandmsharesminformationmw
ithmthemteam.
Am28-year-
oldmpatientmwithmasthmamismrequestingmthempneumococcalmvaccine.mWhichmofmthemfollowin
gmconditionsmaremappropriatemformreceivingmthempneumococcalmvaccine?
A.mCHF,mHIV,mDM,mpregnancy
B.mCHF,mHIV,mDM,msicklemcellmdisease
C.mDM,mchemotherapy,msicklemcellmdisease,mpregnancy
D.mPregnancy,mCHF,mDM,mchemotherapym-mCORRECTmANSWER-
B.mRationale:mallmofmthesemmedicalmconditionsmrequiremthempatientmtomreceivemthempneumo
coccalmvaccination
Am40-
yearmoldmpostpartummpatientmwithmchronicmHTNmandmGDMmwhomismgravidam5mparam4mismtra
nsferredmfrommlabormandmdeliverymtomthempostpartummunitmwithmlactatedmRinger'smatm125mm
L/hr.mUponmassessmentmofmthempatient,mthemnursemnoticesmthempatient'smfundusmismthreemfi
ngermbreathsmabovemumbilicusmandmtomthemrightmofmmidlinemandmhermbladdermismpalpable.m
Themnursemalsomnotesmmoderatemtomheavymbleedingmandmamfullmbladdermandmnotifiesmthem
CNL.m
AsmamCNL,mwhatmismthemmostmimportantmintervention?
A.mEncouragemthemnursemtommassagemthemfundusmandmheplockmthempatientm
B.mEncouragemthemnursemtomcallmthemphysicianmstatmtomordermMethergine
,C.mEncouragemthemnursemtommonitormthempatientmovermthemnextmhourmb/cmtheremaremnomrisk
mfactorsmformampostpartum mhemorrhage
D.mEncouragemthemnursemtomstraightmcatherizemthempatientmtomdecreasemthemlikelihoodmofm
ampostpartummhemorrhagem-mCORRECTmANSWER-
D.mmultiparamandmfullmbladdermaremriskmfactorsmformpostpartummhemorrhage
Am6-year-
oldmboymisminmcriticalmconditionmfollowingmamcarmaccident.mThempatientmhasmheadmtraumama
ndminternalmbleeding.mThempatient'smparentsmhavemstatedmmultiplemtimesmthatmtheymaremJe
hovah'smWitnessesmandmdomnotmwantmtheirmsonmtomreceivemblood.mThemCNLmknowsmthatmth
embloodmtransfusionmismneededmimmediatelymandmcouldmsavemthemboy'smlife.m
WhichmofmthemfollowingmstatementsmismthembestmthingmformthemCNLmtomdo?
AmListenmtomthemparents,masmUSmminorsmhavemnomlegalmrightsmandmremainmundermparentalm
jurisdiction
B.mObtainmcourtmorderminmthembestminterestmofmthemchildmtomreceivemblood,mbasedmonmthema
voidancemofmphysicalmharm
C.mBasedmonmreligiousmbeliefs,mdomnotmgivemblood
D.mFollowmthemphysician'smdecisionmtomgivembloodmsincemthemphysician'smdecisionmoverride
smthemparentalmdecisionm-mCORRECTmANSWER-
B.mRationale:mchild'sminterestsmasmwellmasmstatempoliciesmoutweighmthemparentalmrights;mamc
ourtmordermismneededmtomoverridemparent'smdecision
Am65-year-
oldmwithmamhistorymofmchestmpalpittionsmwasmseenmbymhismcardiologistmformnewmonsetmpalpit
ations.mHemwasmputmonmambeta-blockermandmtoldmtomreturnmformamfollow-
upminm1mweekmaftermtakingmamstressmtest.mThembeta-blocker'smactionmincludes:
A.mIncreasingmthemconsistencymofmthemheartmrate
B.mDecreasingmthemabilitymofmthemheartmmusclemtomcontractm
C.mDecreasingmthemchancemofmdysrhymia
D.mIncreasingmcontractilitymandmdecreasingmheartmratem-mCORRECTmANSWER-
D.mRationale:mthismismthemMOAmofmBB
AmCNLmevaluatesmam17-
yearmoldmpatientmwhomhasmbeenmsexuallymassaulted.mThempatientmhasmvisiblembruisingmand
mheadmlaceration.mAftermthemCNL'smassessment,mlawmenforcementmofficialsmhavemcontacte
dmthemCNLmrequestingminformationmregardingmthemattackmandmthemvisibleminjuries.m
ThemCNLmknowsmthemprioritymismtomtakemwhatminitialmaction?
A.mThempicturesmandmcompletemthemrapemkit
B.mProvidemlawmenforcementmwithmamrecordmasmrequestedm
C.mCallmthempatient'smparentsmfirst
D.mExplainmtomthempatientminmordermtomobtainmconsentmformreleasemofmrecordsm-
mCORRECTmANSWER-D.mrationale:mHIPPA
, AmCNLminmthemNICUmismcollectingmdatamonmthemhoursmworkedmweeklymbymthemstaffmnurses.m
ThemCNLmwantsmtomseemifmtheremismamnormalmdistributionmofmhoursmworked.m
Whatmtechniquesmismthembestmtomdisplaymthemdistributionmofmthemdatamcollected?
A.mRunmchartm
B.mFishbonemchart
C.mFMEAmchart
D.mHistogrammchartm-mCORRECTmANSWER-
D.mRationale:mgraphicmillustationmformdistributionmofmdatamwithoutmtimelinesm(runmchart)morm
sentinelmeventsm(fishbone)
AmCNLmonmammedicalmunitmismfollowingmupmwithmpatientsmonmwarfarinmtherapympostdischarg
emandmconcludesmthatmpatientsmaremnotmreceivingmadequatemeducationmonmmedicationmad
ministration.mThemCNLmformulatesmanmactionmplanmandmdevelopsmamteammtomimprovemwarf
arinmdischargemeducation.mWhatmcompetencymwasmportrayedmbymthemCNL?
A.mLifelongmlearner
B.mDelegator
C.mLateralmintegration
D.mRiskmAnticipatorm-mCORRECTmANSWER-
D.mRationale:mRiskmanticipationmismcriticallymevaluatingmandmidentifyingmpotentialmthreatsmt
omclientmsafety
AmCNLmusingmRoger'smdiffusionmofminnovationmtheorymrealizesmwhilemimplementingmamnewm
healthminformationmmanagementm(HIM)msystemmthatmwhenmdealingmwithmammembermofmthe
mhealthmcaremteammshemshould:m
A.mSpendmammajoritymofmtimemeducatingmthemlaggardsmtombecomemsupportersmofmchange
B.mSpendmammajoritymofmtimemonminnovatorsmbecausemtheymwillmneedmamlotmofmconvincingmt
ommakemamchange
C.mSpendmamlotmofmtimemwithmearlymandmlatemadoptersmbecausemwhenmtheymsupportmthemch
angemitmwillmbemsuccessful.m
D.mSpendmverymlittlemtimemwithmearlymmajoritymadoptersmbecausemtheymaraemnotmadaptable
mtomchangem-mCORRECTmANSWER-
C.mRationale:mearlymandmlatemadoptersmeachmholdm34%monmRoger'smbellmcurve
Amgroupmcomposedmofmunit-
basedmcouncilmmembersmwasmputmonmamtaskmforcemtomimprovemdischargemplanningmb/cmpts
mreportedmfeelingmrushedmandmunpreparedmatmdischarge.mAmdecisionmwasmmademtomcreate
mamdischargemplanningmnursempositionmtomeducatempatientsmthemnightmbeforemthemdischarg
e.mEvenmthoughmthemnewmnursesmdidmnotmlikemthismsolution,mtheymdeferredmtomthemseniormn
ursesmofmthismgroupmwhomweremadamantmaboutmimplementingmthismposiiton.mWhichmbarrier
mtomeffectivemteamworkmdoesmthismexemplify?
A.mPhysicalmthreats
B.mGroupthink