A nurse on an obstetrics-gynecology unit is planning care for four clients after receiving change of shift report. Which of the following clients should the nurse assess first?
A client who is 4 days postpartum and has mastitis
A client who had a bilateral tubal ligation 12 hr previously
A client admitted 1 hr ago for an ectopic pregnancy
A client who is a 1 day postpartum after a late term miscarriage
The Correct Answer is C
Rationale:
A. A client who is 4 days postpartum and has mastitis should be assessed, but this condition is less acute compared to the others.
B. A client who had a bilateral tubal ligation 12 hr previously requires post-operative monitoring, but this is less urgent than the client with an ectopic pregnancy.
C. A client admitted 1 hr ago for an ectopic pregnancy is the priority as this condition can be life-threatening and requires immediate assessment.
D. A client who is 1 day postpartum after a late-term miscarriage requires care, but the immediacy is less than that of the ectopic pregnancy client.
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Correct Answer is B
Explanation
Rationale
A. Teaching about low-sodium foods requires specialized knowledge and should be performed by an RN.
B. Measuring and recording intake and output can be done by an AP, as it involves routine data collection rather than clinical judgment.
C. Wound irrigation is a more complex procedure that requires clinical skills and should be performed by an RN or LPN.
D. Evaluating pain relief involves clinical assessment and judgment, which is beyond the scope of an AP.
Correct Answer is ["A","E"]
Explanation
Rationale:
A. The benchmark for glucose control is 90%, but the percentages reported are consistently below this threshold: 75.29% in Quarter 1, 85.5% in Quarter 2, and 82% in Quarter 3. Improvement is needed to meet or exceed the benchmark.
B. The benchmark is 80.2%, and the percentages are above this threshold: 75.79% in Quarter 1, 80.5% in Quarter 2, and 92% in Quarter 3. No improvement needed as the measure is above the benchmark.
C. The benchmark is 85%, and the percentages reported are: 69% in Quarter 1, 85% in Quarter 2, and 86.2% in Quarter 3. Although Quarter 1 is below the benchmark, Quarter 2 and Quarter 3 meet or exceed the benchmark. Overall, the trend shows improvement.
D. The benchmark is 100%, and the percentages reported are: 90.4% in Quarter 1, 88.2% in Quarter 2, and 92.6% in Quarter 3. Although the percentages are below the benchmark, there is a trend of improvement. However, the measure still requires further enhancement to meet the benchmark.
E. The benchmark for smoking cessation education 4 weeks prior to surgery is 75%. The percentages are below this benchmark in Quarter 1 (70.6%) and Quarter 3 (74%), although it meets the benchmark in Quarter 2 (100%). Consistent adherence to the benchmark needs to be improved.
