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?

Correct Answer: C

Rationale: The correct answer is C: Review the events leading up to each medication administration error. This strategy is the most critical initial step in addressing medication administration errors. By conducting a thorough review of the events leading up to each error, the committee can identify root causes and contributing factors, allowing for targeted interventions to prevent similar errors in the future. This approach aligns with the principles of continuous quality improvement (CQI) by focusing on understanding the underlying issues before implementing solutions. Choice A: Providing an inservice on medication administration to all nurses may be beneficial, but without understanding the specific factors contributing to errors, the impact may be limited. Choice B: Requiring staff nurses to pass a medication administration examination focuses on individual competency, which is important but not as effective as addressing system issues that contribute to errors. Choice D: Developing a quality improvement program for nurses involved in errors is necessary but should come after identifying and addressing the root causes of errors through a comprehensive review process.

Correct Answer: D

Rationale: The correct answer is D, inserting a pulmonary artery catheter. This is the most appropriate action to differentiate between ARDS and pulmonary edema caused by left ventricular failure. The pulmonary artery catheter can provide valuable information such as pulmonary artery pressure, pulmonary capillary wedge pressure, and cardiac output. In ARDS, the pulmonary artery pressure and pulmonary capillary wedge pressure are typically low, whereas in pulmonary edema due to left ventricular failure, these pressures are elevated. Positioning the patient for a chest radiograph (A) would provide anatomical information but not differentiate between ARDS and pulmonary edema. Drawing blood for arterial blood gases (B) can provide information on oxygenation but may not be sufficient to differentiate between the two conditions. Obtaining a ventilation-perfusion scan (C) is not typically used to differentiate between ARDS and pulmonary edema.

Correct Answer: D

Rationale: The correct answer is D: Assisting with tracheostomy insertion. Subcutaneous emphysema traveling up the neck indicates potential airway compromise. Tracheostomy insertion may be necessary to secure the airway and prevent further complications. Surgery (choice A) may not address the immediate need for securing the airway. Encouraging the client to use the Incentive Spirometer (IS) (choice B) or palpating the area (choice C) would not address the urgency of the situation or provide a definitive solution to the airway compromise.

Correct Answer: B

Rationale: The correct answer is B: Leave the pimple. Pinching a pimple can lead to inflammation, scarring, and further spread of bacteria. Leaving the pimple allows it to heal naturally, reducing the risk of complications. It is important to practice gentle skincare to promote healthy skin and avoid causing damage or irritation. Other choices are incorrect as they involve actions that can harm the skin and worsen the condition.

Correct Answer: A

Rationale: The correct answer is A: The slower the pulse. As people age, their heart muscles may weaken, causing the heart to pump less efficiently, resulting in a slower pulse rate. This physiological change is a common part of the aging process. Choice B is incorrect as aging typically leads to a decrease, not an increase, in pulse rate. Choices C and D are left blank as they are irrelevant to the question.