1.     A nurse is caring for a client newly diagnosed with pertussis. What is one(1) intervention the nurse will incorporate in the plan of care.

2.     A client threaten to leave the hospital against medical advice and the nurse notes that this is the client’s right. In addition to having the client sign an Against Medical Advice form, what is the nurse’s priority action?

3.     A client newly admitted with abdominal pain ask the nurse to explain how their blood test indicating that they are positive for helicobacter pylori has to do with their abdominal pain. How should the nurse respond?

4.     A nurse manager is preparing for a performance appraisal review for an employee who has been identified as substandard. Describe the process of conducting a performance appraisal review and when disciplinary action is necessary.

5.     A committee of nurse have been task with reviewing an increase in central line infections on their unit. Explain the process that they should follow.

6.     A nurse is preparing discharge for a client that has been diagnosed with stage 4 terminal lung cancer. The client has chosen to pursue palliative care. Describe the nurse’s responsibility regarding discharge planning.

7.     A nurse enter the room of the client that insist that they need to smoke a cigarette immediately. Explain how the nurse can use the technique of collaboration to resolve this conflict.

8.     How are benchmarks used in the evaluation of health care quality? Provide an example of using an evaluation of health care quality review.

9.     During the admission assessment a client informs the nurse that they utilize essential oils and acupuncture as part of their health routine. What is the nurse’s responsibility regarding this information?

10.  Risk for violent behavior can be identified using the epidemiological triangle’s 3 components: Hosts, Agent and Environment. Provide an example of each factor that can influence violent behavior.

11.  The nurse knows that health care beliefs can originate from different cultural practices. Define the following belief types: Biomedical, naturalistic, and magico-religious.

12.  The community health nurse is speaking to a men’s civic group about health promotion for men. The question is posed regarding how and when to properly perform testicular self-examination (TSE). What information should the nurse provide to the group?

SOLUTIONS

1. One intervention the nurse will incorporate in the plan of care for a client newly diagnosed with pertussis is administering antibiotics, such as azithromycin or erythromycin, to treat the infection and prevent transmission to others.
2. In addition to having the client sign an Against Medical Advice (AMA) form, the nurse’s priority action is to thoroughly educate the client about the risks and consequences of leaving the hospital against medical advice. This includes discussing the potential worsening of their condition, the need for continued treatment, and the potential legal ramifications of leaving without medical clearance.
3. The nurse should respond to the client’s question about the relationship between their positive test for Helicobacter pylori and their abdominal pain by explaining that H. pylori infection can cause inflammation of the stomach lining, leading to symptoms such as abdominal pain, nausea, and vomiting. The nurse can further explain that treatment for H. pylori infection may help alleviate their abdominal symptoms.
4. The process of conducting a performance appraisal review involves setting clear performance expectations, gathering feedback from multiple sources, conducting a formal evaluation of the employee’s performance, providing constructive feedback, identifying areas for improvement, and creating a plan for professional development. Disciplinary action may be necessary when an employee consistently fails to meet performance expectations despite remediation efforts, or when there are serious violations of policies or standards of conduct.
5. The committee of nurses reviewing an increase in central line infections on their unit should follow a systematic process, including:
   • Gathering data on the number and types of infections, as well as contributing factors.
   • Analyzing the data to identify patterns, trends, and potential causes of the infections.
   • Implementing evidence-based interventions to address identified issues, such as improving hand hygiene practices, enhancing central line insertion and maintenance protocols, and promoting a culture of safety.
   • Monitoring and evaluating the impact of interventions over time, and making adjustments as needed to further reduce infection rates.
6. The nurse’s responsibility regarding discharge planning for a client with stage 4 terminal lung cancer who has chosen palliative care includes:
   • Collaborating with the interdisciplinary team to ensure comprehensive and holistic care planning.
   • Providing education and support to the client and their family regarding palliative care options, symptom management, and end-of-life care.
   • Facilitating referrals to appropriate community resources, such as hospice care programs, home health services, and support groups.
   • Ensuring that the client’s preferences and goals of care are respected and incorporated into the discharge plan.
7. The nurse can use the technique of collaboration to resolve the conflict with the client who insists on smoking a cigarette immediately by:
   • Exploring the underlying reasons for the client’s desire to smoke, such as anxiety or nicotine dependence.
   • Engaging in open and nonjudgmental communication to understand the client’s perspective and concerns.
   • Collaborating with the client to develop alternative coping strategies or distractions, such as deep breathing exercises, relaxation techniques, or engaging in a preferred activity.
   • Negotiating a compromise that respects the client’s autonomy while also addressing their health needs and the hospital’s policies on smoking cessation.
8. Benchmarks are used in the evaluation of health care quality by providing a standard or reference point against which performance or outcomes can be measured. For example, a benchmark for hospital readmission rates for heart failure patients may be set at 15%, and hospitals would compare their actual readmission rates to this benchmark to assess their performance and identify areas for improvement.
9. The nurse’s responsibility regarding a client’s use of essential oils and acupuncture as part of their health routine includes:
   • Documenting the client’s use of complementary and alternative therapies in their medical record.
   • Assessing the client’s understanding of the safety and efficacy of these therapies, as well as any potential interactions with conventional treatments.
   • Providing education and guidance to the client about the risks and benefits of complementary and alternative therapies, and encouraging open communication with their healthcare providers.
   • Collaborating with other members of the healthcare team to integrate complementary and alternative therapies into the client’s overall care plan, if appropriate.
10. Examples of factors influencing violent behavior according to the epidemiological triangle include:

• Host: Individual characteristics such as impulsivity, history of violence, mental health disorders, substance abuse, and exposure to trauma or abuse.
• Agent: Factors such as access to weapons, availability of drugs or alcohol, and exposure to violent media or peers.
• Environment: Social and environmental factors such as poverty, unemployment, neighborhood violence, lack of access to education or mental health services, and social norms that condone or tolerate violence.

11. Health care beliefs can originate from different cultural practices:

• Biomedical beliefs are based on the principles of Western medicine and emphasize scientific explanations for health and illness.
• Naturalistic beliefs view health and illness as being influenced by natural forces, such as balance and harmony with nature, and may include practices such as herbal remedies or acupuncture.
• Magico-religious beliefs attribute health and illness to supernatural or spiritual causes, and may involve rituals, prayers, or charms to ward off evil spirits or promote healing.