The nurse is caring for a client on the first day of postoperative for a descending aortic aneurysm repair. Which assessment finding should the nurse prioritize reporting to the healthcare provider?

a.Serum potassium 4.8

b.Urine output 30ml/hr

c. Electrocardiogram ST Segment elevation

d.BP 130/80

 

21. A client who is admitted to the intensive care unit is manifesting signs of an acute Addisonian crisis. The nurse is observing the clients, a hemodynamic monitor, as the client becomes tachycardic and hypotensive. Which intervention is most important for the nurse to implement?

a.Access invasive lines using sterile gloves and sterile transport dressing

b.Administer all dietary supplements with meals

c. Perform passive exercises and ROM

d.Notify HCP of cardiac output less the 3.9

 

24. When assessing an adult client on a mechanical ventilator, the nurse notes that the client becomes restless has diminished to absent breath sounds on the right side and the right side of the clients chest is not expanding equally to the left side. Based on these assessment findings, which analysis should the nurse formulate?

a.The endotracheal tube has slipped into the esophagus

b.A tension pneumothorax has occurred.

c. The ventilator is malfunctioning

d.The client developed pneumonia

 

25. An adult client is transported via ambulance to the emergency department following a motorvehicle accident . On arrival the client complains of severe upper back pain. The vital signs are: Temp 98.6, HR 145 bpm, resp 26 and BP 70/40. Which change in assessment findings indicate the clients condition is deteriorating?

a.Oxygen sat 90%

b.Glascow coma score 15

c. HR 40 bpm

d.Resp 34 breaths/min

27. Following a CABG, an older client with COPD is being maintained on mechanical ventilation. Which action should the nurse implement to prevent ventilator-associated pneumonia?

a.Maintain the head of the bed at 45 degree elevation

b.Instill sterile saline in endotracheal tube before suctioning

c. Schedule q4 hour bronchodilator nebulizer treatment

d.Set FIO2 to deliver 100% oxygen concentration

 

28. The nurse assess a male client postoperatively who has an arterial line in the radial artery. Assessment findings include pallor, paresthesia, and slow capillary refill in the client’s right-hand fingers. What action should the nurse plan?

a.Elevate the clients right arm

b.Perform allen test

c. Flush the line with heparinized saline

d.Notify HCP

Note:- Please give short explanation/rational why the answer is correct

Implementation of a psychoeducational program for cancer survivors and family caregivers at a cancer support community affiliate: A pilot effectiveness study. Cancer Nursing, 39(3), 169-180. Dockham, B., Schafenacker, A., Yoon, H., Ronis, D. L., Kershaw, T., Titler, M. G., & Northouse, L. (2016).

 

1. What was the overall topic of the evidence-based practice

change?

2. Describe some of the members of the evidence-based practice

team and the types of collaborations they built to support this

study.

3. Who, if anyone, would you identify as “stakeholders” in the

evidence-based practice team?

4. Was the best available evidence retrieved? If so, which strategies

were used?

5. What was the approach for grading the quality of the individual

evidence and strength of the body of evidence?

6. Was the research evidence (existing clinical practice guidelines,

systematic reviews [including meta-analyses and/or metasyntheses],

and primary sources/individual research studies)

177

critiqued?

7. Was the research evidence synthesized? What were the evidencebased

practice change recommendations?

8. Was the evidence-based practice change written in detail?

9. How was the decision to make the evidence-based practice

change supported?

10. Is a method for evaluating the feasibility of the evidence-based

practice change identified?

11. Was the evidence-based practice change evaluated? Was it

successful?

12. What were the strategies used by the evidence-based change

team to promote the adoption of the evidence-based practice

change?

I interviewed the nurse manager of a Jacksonville Outpatient Care Clinic’s Primary Care Department. She manages the Patient Aligned Care Team (PACT). The PACT teams are designated Red Team or Blue Team. The purpose of PACT is to achieve continuity with providers and nursing staff with the goal to improve access to care. It is team-based care that provides for the veteran’s healthcare needs and coordinates care with other specialties.

The manager oversees the primary care clinics and her responsibilities include scheduling of staff, addressing problems in the clinic as they arise. Responding to physician or veteran issues, maintaining the efficient running of the clinics. She allowed me to shadow her for a day at her clinic. I was able to observe her routine and ask interview questions throughout the day. The questions asked of the manager are below:

 

• Please describe the nursing and inter-professional teams that operate in the PACT teams.

There are internal medicine physicians, 1 registered nurse, 4 licensed practical nurses, social workers, pharmacist, and dietician,

 

• Can you provide an example of a nursing practice that has been changed in the last year based on current best evidence?

 

• Please identify the impact of change within your organization and your role as leader/manager in this change process

 

• Please identify strategies used for fiscal and human resources that contribute to the organization’s ability to deliver quality cost-effective patient-centered care

 

• What do you consider your biggest challenge as a leader/manager?

 

• What do you love most about your job?

 

• Why did you choose this job?

 

• What other kinds of nursing/other job did you ever do?

 

• How would you describe your company’s culture?

 

• How would you describe your role in admission and staffing decisions?

 

• What is your leadership style?

You are a population health nurse working with congestive heart failure clients (greater than the age of 65) who receive services from your hospital. From a population health management perspective, identify services and interventions that address the health needs of this particular population. Your exploration with this particular population should include cost-effective interventions that address health promotion and illness prevention, risk management, care coordination, and disease management.