Who should be involved in quality improvement measures?

Correct Answer: A

Rationale: Quality improvement measures are most effective when everyone within an organization is involved. This includes not only professional and management staff but also consumers or customers who are directly impacted by the products or services being provided. By involving everyone, a more comprehensive and diverse perspective can be gained, leading to better identification of areas for improvement and more successful implementation of quality improvement initiatives. Additionally, by involving all stakeholders, there is a greater buy-in and commitment to the process, increasing the likelihood of sustainable improvements being made.

Correct Answer: C

Rationale: To create personal time as a nurse with rotating shifts, it is important to prioritize personal well-being and make time for oneself. By eliminating tasks that add no value, nurses can streamline their workload and focus on essential responsibilities. This can help in reducing unnecessary stress and allowing for more personal time outside of work. Delegating work to others and filling every moment with tasks or chores may not necessarily create personal time, as it can keep nurses constantly busy and overwhelmed. Hiring someone else to do the work may not always be feasible or practical in a nursing setting, but by eliminating non-essential tasks, nurses can better manage their time and have more opportunities for personal activities and self-care.

Correct Answer: D

Rationale: Multiple myeloma is a plasma cell neoplasm characterized by the presence of abnormal monoclonal plasma cells in the bone marrow, which produce a monoclonal spike on serum protein electrophoresis. The clinical presentation of weakness, bone pain, and recurrent infections is typical of multiple myeloma. Anemia can result from bone marrow infiltration by the abnormal plasma cells, hypercalcemia is due to bone destruction and release of calcium, renal insufficiency can result from hypercalcemia and protein deposition in the kidneys, and the monoclonal spike in serum protein electrophoresis indicates the presence of a monoclonal protein. Waldenström macroglobulinemia, Hodgkin lymphoma, and chronic lymphocytic leukemia do not typically present with the classic tetrad of findings seen in multiple myeloma.

Correct Answer: B

Rationale: Identifying persons with sputum characterized as blood stained is important in case finding for pulmonary tuberculosis (PTB) in the community. Blood stained sputum, also known as hemoptysis, is a common symptom of TB. It occurs when there is bleeding in the respiratory tract, often as a result of damage to the lungs caused by tuberculosis infection. Therefore, the presence of blood in the sputum is a significant clinical finding that should alert healthcare providers, including nurses, to the possibility of TB. Early identification and diagnosis of individuals with blood stained sputum can lead to prompt treatment and the prevention of further transmission of the disease in the community.

Correct Answer: D

Rationale: In a situation where a nurse administers the wrong medication to a patient resulting in harm, both the nurse and the physician can be held liable for their respective roles in the error. The nurse is responsible for administering the incorrect medication, which is a violation of their duty to provide safe and appropriate care. However, the physician is also responsible because they failed to review the patient's documentation indicating the allergy to the medication before ordering it. As healthcare professionals, both the nurse and the physician have a duty of care to ensure patient safety, and in this case, both individuals failed in their responsibilities, leading to the harm caused to the patient. Therefore, both the nurse and the physician can be held accountable for the error.