NACE Management of Care 5 — Questions and Answers
Question 1: A PN is supervising a UAP who reports that a patient's blood pressure is 88/52 mmHg. What is the nurse's best initial action?
- Ask the UAP to recheck the blood pressure in 15 minutes
- Instruct the UAP to place the patient in Trendelenburg position immediately
- Go to the patient's bedside immediately to perform an assessment (Correct answer)
- Call the physician with the reported value right away
Correct answer: Go to the patient's bedside immediately to perform an assessment
The nurse must personally assess the patient to verify the finding and determine clinical status before notifying the physician or intervening.
Question 2: Which of the following best describes the concept of 'continuity of care' in nursing practice?
- Assigning the same nurse to a patient every shift to build rapport
- Coordinating and communicating patient care across all providers and settings to ensure seamless transitions (Correct answer)
- Ensuring all nursing documentation is completed before the end of each shift
- Limiting the number of care providers involved in a patient's treatment plan
Correct answer: Coordinating and communicating patient care across all providers and settings to ensure seamless transitions
Continuity of care involves coordinating information and services across providers and settings so patient care remains consistent and uninterrupted.
Question 3: A nurse is caring for a terminally ill patient who has a valid DNR order. The patient goes into cardiac arrest. The patient's adult son demands that the nurse 'do everything.' What is the appropriate nursing response?
- Initiate CPR to honor the family's wishes
- Explain to the son that the patient's documented wishes and DNR order will be followed (Correct answer)
- Call the physician to cancel the DNR order before taking any action
- Defer to the son's request since he is the next of kin
Correct answer: Explain to the son that the patient's documented wishes and DNR order will be followed
A valid DNR order reflects the patient's autonomous decision and must be honored; the nurse should compassionately explain this to the family.
Question 4: When triaging four patients in the emergency department, which patient requires the highest priority of care?
- A 45-year-old with a laceration on the forearm requiring sutures
- A 60-year-old with chest pain radiating to the left arm and diaphoresis (Correct answer)
- A 28-year-old with an ankle sprain and mild swelling
- A 72-year-old with a urinary tract infection and low-grade fever
Correct answer: A 60-year-old with chest pain radiating to the left arm and diaphoresis
Chest pain with radiation to the left arm and diaphoresis are classic signs of a myocardial infarction, a life-threatening emergency requiring immediate intervention.
Question 5: A nurse working the night shift notices a pattern of medication errors occurring on the unit over the past month. What is the most appropriate action?
- Bring the concern to the nurse manager and submit a formal quality improvement report (Correct answer)
- Speak only to the nurses involved about being more careful
- Avoid reporting to prevent staff from getting in trouble
- Report individual nurses directly to the state board of nursing
Correct answer: Bring the concern to the nurse manager and submit a formal quality improvement report
Identifying a pattern of errors requires a systems-level response; the nurse should escalate to management and engage the quality improvement process.
Question 6: A patient with limited English proficiency needs to sign a consent form for a procedure. Which action by the nurse is most appropriate?
- Have the patient's bilingual family member interpret the consent form
- Use a professional medical interpreter to explain the consent form to the patient (Correct answer)
- Obtain consent from the next of kin since the patient cannot fully understand
- Proceed with the procedure using simple words and gestures to explain
Correct answer: Use a professional medical interpreter to explain the consent form to the patient
A professional medical interpreter must be used to ensure accurate communication and protect the patient's right to informed consent.
Question 7: Which behavior by a nurse best demonstrates professional accountability?
- Blaming a medication error on the pharmacy that dispensed the wrong dose
- Acknowledging an error, completing an incident report, and implementing corrective measures (Correct answer)
- Asking a colleague to co-sign the incident report to share responsibility
- Only reporting errors that resulted in patient harm
Correct answer: Acknowledging an error, completing an incident report, and implementing corrective measures
Professional accountability means accepting responsibility for one's actions, transparently reporting errors, and taking steps to prevent recurrence.
NACE Management of Care 5
A PN is supervising a UAP who reports that a patient's blood pressure is 88/52 mmHg.
What is the nurse's best initial action?