A patient has decided to stop hemodialysis because his renal failure progresses and he wishes to spend more time with family. Palliative care will continue, and the approach will be discussed with the patient and family as needed and at change of shift. The care delivery model in this situation is termed:

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Ethics & Issues in Contemporary Nursing Questions

Question 1 of 5

A patient has decided to stop hemodialysis because his renal failure progresses and he wishes to spend more time with family. Palliative care will continue, and the approach will be discussed with the patient and family as needed and at change of shift. The care delivery model in this situation is termed:

Correct Answer: B

Rationale: The correct answer is B: patient-centered. This model focuses on meeting the individual patient's needs and preferences, involving them in decision-making, and providing care that is respectful and responsive to their values. In this scenario, the patient's decision to stop hemodialysis is respected, and palliative care is provided in alignment with his wishes. Partnerhsip (A) typically involves collaboration between healthcare providers and patients, which is not explicitly mentioned. Case management (C) focuses on coordinating services for complex cases, which is not the primary focus here. Total patient care (D) involves providing all aspects of care directly by the same nurse, which is not the main approach in this scenario.

Question 2 of 5

Each month data on admission assessments that are based on the following standard are entered: "All patients will be assessed by an RN within 2 hours of admission." The target goal for this standard is 97% compliance. Data are displayed on a graph that shows number and time of admission assessments and compliance variation limits. This pictorial representation is:

Correct Answer: B

Rationale: The correct answer is B: control chart. A control chart is used to display data over time and indicate variations within set limits, making it ideal for monitoring compliance with a standard like "All patients will be assessed by an RN within 2 hours of admission." The control chart allows for easy identification of trends, shifts, or patterns that may indicate a need for corrective action to maintain the 97% compliance goal. A: Pareto chart is used to identify the most significant factors contributing to a problem, not to monitor compliance over time. C: Deployment chart is not a standard tool in quality control or process monitoring. D: A top-down flowchart is used to depict the sequence of steps in a process, not to monitor compliance with a standard over time.

Question 3 of 5

The staff on a nursing unit notes that patient satisfaction varies from month to month. They plot the degree of patient satisfaction each month for 1 year to determine when the periods of greatest dissatisfaction are occurring. The staff uses which type of graph?

Correct Answer: A

Rationale: The correct answer is A: Time plot. A time plot is the most appropriate graph for displaying data over time to identify trends and patterns. In this scenario, plotting patient satisfaction levels monthly over a year allows the staff to analyze fluctuations and identify periods of greatest dissatisfaction accurately. Summary of other choices: B: Pareto chart - Pareto charts are used to display the frequency of occurrences in a dataset in descending order. It is not suitable for analyzing trends over time. C: Flowchart - Flowcharts are used to represent processes and workflows, not suitable for displaying time-series data. D: Cause-and-effect diagram - Cause-and-effect diagrams are used to identify and analyze potential causes of a problem, not suitable for displaying time-series data.

Question 4 of 5

The surgical team arrives in the operating room and one member states, "Everyone stop. Let's identify the patient and operative site. Now does anyone have any questions or concerns?" This process is known as:

Correct Answer: A

Rationale: The correct answer is A: time-out. A time-out is a crucial pre-operative safety practice where the surgical team pauses to verify the patient's identity, procedure, and surgical site to prevent errors. This step ensures everyone is on the same page and reduces the risk of wrong-site surgeries. Explanation: 1. Identify patient and operative site: By verifying the patient's identity and the correct surgical site, the team prevents potential mistakes. 2. Address questions or concerns: Encouraging team members to voice any uncertainties or issues promotes open communication and collaboration. 3. Safety measure: The time-out is a key component of the World Health Organization's Surgical Safety Checklist to enhance patient safety. Summary: B: A critical pathway is a predetermined sequence of steps in patient care, not specific to surgical safety. C: Special cause variation refers to statistical process control, unrelated to surgical safety. D: Lean methodology focuses on efficiency and waste reduction in processes, not directly related to pre-operative safety checks like a time

Question 5 of 5

Nurses working on an orthopedic unit use personal digital assistants (PDAs) to review medications prior to administration to reduce potential drug interactions. Software is also installed that provides video clips of common procedures performed by nurses. Nurses on this unit are best demonstrating which QSEN competencies?

Correct Answer: B

Rationale: The correct answer is B: Informatics. Nurses on the orthopedic unit are demonstrating informatics competency by using PDAs for medication review and accessing video clips for procedures. This showcases their ability to utilize technology to enhance patient care. Patient-centered care (A) focuses on individualized care, teamwork (C) emphasizes collaboration, and quality improvement (D) pertains to enhancing processes. The use of technology in this scenario aligns most closely with the informatics competency, making it the best choice.

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