As a QA nurse, which of the following can Nurse Jen adopts as a concurrent evaluation of patient's outcomes in the unit? I Direct observation of patient's condition. II Patient's interview in the unit. III Face to face interview with nursing staff. IV Nursing audit from the patient's chart.

Correct Answer: A

Rationale: As a QA nurse, Nurse Jen can adopt concurrent evaluation methods to assess patient outcomes in the unit. The most appropriate options for concurrent evaluation are Face to face interview with nursing staff (III) and Nursing audit from the patient's chart (IV).

Correct Answer: C

Rationale: When selecting participants for a qualitative research study, it is important to choose individuals who are able to articulate and reflect on the phenomenon being studied. This is crucial for gathering in-depth and rich data that can provide valuable insights for the study. Participants who can express their experiences, thoughts, and feelings clearly will allow the researcher to delve deeper into the research objectives and gain a more comprehensive understanding of the phenomenon under investigation. Selecting individuals with the ability to articulate and reflect ensures that the data collected will be meaningful and contribute significantly to the research findings. It is essential for qualitative researchers to prioritize such participants who can best meet the objectives of the study by offering detailed and insightful perspectives.

Correct Answer: A

Rationale: Patients with COPD are at increased risk for developing ventilator-induced lung injury (VILI) due to their underlying lung pathology. Using a low tidal volume strategy (6-8 ml/kg predicted body weight) has been shown to reduce the risk of VILI in these patients. Additionally, applying high positive end-expiratory pressure (PEEP) helps to recruit collapsed alveoli, improve oxygenation, and decrease the risk of barotrauma by keeping the alveoli open throughout the respiratory cycle. Therefore, the most appropriate ventilator settings to minimize the risk of VILI in a COPD patient with acute exacerbation and respiratory failure requiring mechanical ventilation would be low tidal volume and high PEEP.

Correct Answer: C

Rationale: When communicating with a patient from a different cultural background, the nurse should prioritize recognizing and respecting the patient's cultural beliefs and practices. This is essential in providing culturally competent care, fostering trust and rapport with the patient, and ultimately improving health outcomes. By acknowledging and understanding the cultural context of the patient, the nurse can adapt communication strategies, address the patient's needs effectively, and avoid misunderstandings or misinterpretations. Building a culturally sensitive approach can enhance the quality of care and strengthen the therapeutic relationship between the nurse and patient.

Correct Answer: B

Rationale: Ramsay Hunt syndrome is caused by the varicella-zoster virus affecting the geniculate ganglion, leading to a triad of symptoms known as the Hunt syndrome: facial paralysis, ear pain, and a vesicular rash in the ear or palate. The facial paralysis in Ramsay Hunt syndrome is usually peripheral, similar to Bell's palsy, but may be more severe. In addition to facial paralysis, the patient may have the inability to close the eye on the affected side (lagophthalmos) and loss of taste sensation on the anterior two-thirds of the tongue due to involvement of the chorda tympani nerve. This differentiation is important to consider in the context of our patient's presentation.

Correct Answer: A

Rationale: The nurse should inform the public that rabies can be prevented. This is an extremely important piece of information to help raise awareness about the disease and promote preventive measures such as timely vaccination of both animals and humans. Rabies is a deadly viral infection that affects the central nervous system, and prevention through vaccination is highly effective in controlling its spread. By emphasizing the preventability of rabies, the nurse can educate the public on the importance of taking proactive steps to avoid contracting the disease.

Correct Answer: C

Rationale: The initial teaching given to a patient with ALS and her family should focus on explaining the disease process, the expected course, and prognosis. Providing this information early on can help the patient and her family understand what to expect, make informed decisions about care and treatment, and prepare emotionally for the challenges ahead. It is important to establish open communication and provide support from the beginning to help the patient and her family cope with the diagnosis and navigate the journey with ALS. While referral to support groups, prevention of complications, and prevention of depression are all important aspects of care for ALS patients, understanding the disease process and prognosis is fundamental to setting realistic expectations and planning for the future.

Correct Answer: B

Rationale: Heart failure is a condition in which the heart is unable to pump enough blood to meet the body's need for oxygen and nutrients. Ineffective tissue perfusion is a relevant nursing diagnosis for a client with heart failure because the heart's inability to effectively pump blood can lead to poor perfusion of tissues and organs, resulting in inadequate oxygen and nutrient delivery to cells. This can lead to symptoms such as fatigue, dyspnea, and edema, which are common in individuals with heart failure. By addressing ineffective tissue perfusion, nurses can focus on interventions to improve cardiac output and optimize tissue perfusion, ultimately improving the client's overall condition.

Correct Answer: B

Rationale: Avascular necrosis of the femoral head, also known as osteonecrosis, is a common complication associated with hip fractures in elderly patients. It occurs when there is a loss of blood supply to the femoral head following the fracture, leading to bone tissue death. This can result in pain, limitation of motion, and potentially the collapse of the femoral head, causing further complications. Timely diagnosis and appropriate management are crucial in order to prevent further degeneration of the hip joint. Other complications such as compartment syndrome, dislocation of the hip prosthesis, and Volkmann's contracture are not typically associated with hip fractures in elderly patients.