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BCON exam 2 Questions With Complete Solutions
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BCON exam 2 Questions With Complete Solutions
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BCON exam 2 Questions With Complete Solutions4. A nurse manager is evaluating patient outcomes on the
hospital unit. The nurse manager discovers that the re-admission
rate of hospitalized patients is very high on this unit. The nurse
manager desires improved coordination of care and
accountability for cost-effective quality care. The nursing care
delivery model best suited to these needs is
a. Total patient care.
b. Primary nursing.
c. Team nursing.
d. Case management. Correct Answer ANS: D
What is unique about case management is that clinicians, as
individuals or as part of a collaborative group, oversee the
management of patient groups with specific case types and
usually are held accountable for some standard of cost
management and quality. Case management is a care approach
that coordinates and links health care services to patients and
families while streamlining costs. In the team nursing care
model, the RN assumes the role of group or team leader and
leads a team made up of other RNs, licensed vocational nurses,
and nurse assistants or technicians. Total patient care involves
an RN being responsible for all aspects of care for one or more
patients. Primary nursing places RNs at the bedside more,
assuming responsibility for a caseload of patients over time.
This model, however, does not require an all-RN staff as is
required for total patient care.
A charge nurse should instruct a new nurse taking care of a
patient with hypercholesterolemia to make which of these
lifestyle modifications?
,a. High-protein, high-fat diet
b. Decreased walking frequency from three times to two times a
week
c. Discontinuation of antihypertensive medications
d. Smoking cessation Correct Answer ANS: D
The only appropriate lifestyle modification among these options
is smoking cessation. Hypercholesterolemia can be caused by a
high-fat diet; therefore, a high-fat diet should be avoided.
Exercise is usually recommended, not contraindicated. The
patient should continue blood pressure medications. In this
question, the nurse is using the aspect of evaluation in clinical
care coordination.
A goal for a patient with a diagnosis of Ineffective coping is to
demonstrate effective coping skills. Which of these patient
behaviors indicates that interventions performed to meet this
outcome have been successful?
a. States he feels better after talking with his family and friends
b. Continues to consume several alcoholic beverages a day
c. Dislikes the support group meetings
d. Spends most of the day in bed Correct Answer ANS: A
Evaluative data that show signs of effective coping will help the
nurse determine whether the patient has met the outcome.
Talking to family and friends is the only positive option. The
other patient behavior choices indicate unsuccessful progress
toward meeting the patient's goal.
A hospital's wound nurse consultant made a recommendation for
nurses on the unit to continue the patient's dressing changes as
previously ordered. The nurses on the unit should incorporate
this recommendation into the patient's plan of care by
,a. Assuming that the wound nurse will perform all dressing
changes.
b. Requesting that the physician look at the wound herself.
c. Including dressing change instructions and frequency in the
plan of care.
d. Encouraging the patient to perform the dressing changes.
Correct Answer ANS: C
The wound nurse clearly recommends that nurses on the unit,
not the patient, should continue dressing changes. The nurses
should not make a wrong assumption that the wound nurse is
doing all the dressing changes. The recommendation states for
the nurses to do the dressing changes. If the nurses feel strongly
about obtaining another opinion, then the physician should be
contacted. No evidence in the question suggests that the patient
needs a second opinion.
A new graduate nurse is not sure what the heart sound is that she
is listening to on a patient. To avoid diagnostic error, what
should the nurse do?
a. Assign the nursing diagnosis of Decreased cardiac output.
b. Ask the patient if he has a history of cardiac problems before
assigning the diagnosis of Decisional conflict.
c. Check the previous shift's assessment and document what was
noted on the last shift.
d. Ask a more experienced nurse to listen also. Correct Answer
ANS: D
The potential diagnostic error here is an error in data collection.
If a new nurse is not comfortable with his/her assessment
technique, he or she should ask another nurse to validate the
findings. Diagnosing before validating assessment findings leads
to the potential for error. Assessment data are not sufficient to
, assign the diagnoses Decreased cardiac output and Decisional
conflict. Every nurse needs to perform his or her own
assessment. A patient's status can change very rapidly. A nurse
who copies the previous shift's assessment is not practicing
according to standards of practice and is violating the code of
ethics.
A new nurse expresses frustration at not being to complete all
interventions for a group of patients in a timely manner. The
nurse leaves the rounds report sheets at the nurse's station when
caring for patients and reports having to go back and forth
between rooms several times looking for equipment and
supplies. This nurse could benefit from practicing better _____
skills.
a. Clinical decision-making
b. Organizational
c. Evaluation
d. Interpersonal communication Correct Answer ANS: B
The clinical care coordination skill this nurse needs to improve
on is organization. This nurse needs to keep the patient report
sheets in hand to anticipate what equipment and supplies a
patient is going to need. Then the nurse may not have to leave
the room so often; this will save time. The nurse in this example
does not voice concern about decision-making skills, evaluation
skills, or communication skills.
A new nurse states that she is confused about using evaluative
measures when caring for patients and asks the charge nurse for
examples and an explanation. Which of the following is the
most accurate response from the charge nurse?
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