Title: ASN 210 Week 5 Pre-Quiz (Remotely Proctored)
Course: 16SP-ASN-210-GH1A1-ADV NUR THROUGH LIFESPAN I > Section: Week 5

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Q: A cardiac nurse wants to know about the best practices to prevent pneumonia after open-heart surgery. In what order do the steps of the evidence-based practice (EBP) process take place?<br>1.   Asking “burning” clinical questions<br>2.   Making recommendations for practice improvement<br>3.   Implementing accepted recommendations<br>4.   Finding the very best evidence to try to answer those questions<br>5.   Evaluating outcomes<br>6.   Critically appraising and synthesizing the relevant evidence
- 5, 1, 4, 6, 3, 2
- 1, 5, 4, 3, 2, 6
- 1, 4, 6, 2, 3, 5
- 5, 2, 1, 4, 6, 3
A: 1, 4, 6, 2, 3, 5
If right: The process of EBP is systematic and includes the following steps: (1) asking “burning” clinical questions; (2) finding the very best evidence to try to answer those questions; (3) critically appraising and synthesizing the relevant evidence; (4) making recommendations for practice improvement; (5) implementing accepted recommendations; and (6) evaluating outcomes.
If wrong: The process of EBP is systematic and includes the following steps: (1) asking “burning” clinical questions; (2) finding the very best evidence to try to answer those questions; (3) critically appraising and synthesizing the relevant evidence; (4) making recommendations for practice improvement; (5) implementing accepted recommendations; and (6) evaluating outcomes.

Q: A health care facility is implementing a new evidence-based nursing protocol. Which action is necessary to ensure successful implementation?
- Develop evaluation processes to validate the protocol.
- Ask for recommendations from senior nursing administration.
- Assess cost-effectiveness of the evidence-based protocol.
- Attain support from nurses who are implementing the protocol.
A: Attain support from nurses who are implementing the protocol.
If right: Complete buy-in from the people who will be involved in implementing the new protocol is essential to the success of implementation.
If wrong: Complete buy-in from the people who will be involved in implementing the new protocol is essential to the success of implementation.

Q: A client is typed and crossmatched for a unit of blood. Which statement by the nurse indicates a need for further genetic education?
- “Blood type is formed from three gene alleles: A, B, and O.”
- “Each blood type allele is inherited from the mother or the father.”
- “If the client’s blood type is AB, then the client is homozygous for that trait.”
- “If the client has a dominant and a recessive blood type allele, only the dominant will be expressed.”
A: “If the client’s blood type is AB, then the client is homozygous for that trait.”
If right: There are three possible gene alleles: A, B, and O. Blood type is determined by only two of the three specific gene alleles. The blood type OO is homozygous in contrast to the blood type AB, which is heterozygous. In the blood type AO, the gene allele A is dominant and will be expressed as blood type A. It is true that each blood type allele is inherited from the mother or the father.
If wrong: There are three possible gene alleles: A, B, and O. Blood type is determined by only two of the three specific gene alleles. The blood type OO is homozygous in contrast to the blood type AB, which is heterozygous. In the blood type AO, the gene allele A is dominant and will be expressed as blood type A. It is true that each blood type allele is inherited from the mother or the father.

Q: A client who tests positive for a mutation in the <i>BRCA1</i> gene allele asks a nurse to be present when she discloses this information to her adult daughter. How should the nurse respond?
- “I will request a genetic counselor who is more qualified to be present for this conversation.”
- “The test results can be confusing; I will help you interpret them for your daughter.”
- “Are you sure you want to share this information with your daughter, who may not test positive for this gene mutation?”
- “This conversation may be difficult for both of you; I will be there to provide support.”
A: “This conversation may be difficult for both of you; I will be there to provide support.”
If right: A nurse should provide emotional support while the client tells her daughter the information she has learned about the test results. The nurse should not interpret the results or counsel the client or her daughter. The nurse should refer the client for counseling or support, if necessary.
If wrong: A nurse should provide emotional support while the client tells her daughter the information she has learned about the test results. The nurse should not interpret the results or counsel the client or her daughter. The nurse should refer the client for counseling or support, if necessary.

Q: A client has received an opioid analgesic for pain. The nurse assesses that the client has a Pasero Scale score of 3 and a respiratory rate of 7 shallow breaths/min. The client’s oxygen saturation is 87%. What action should the nurse perform first?
- Apply oxygen at 4 L/min.
- Attempt to arouse the client.
- Give naloxone (Narcan).
- Notify the Rapid Response Team.
A: Attempt to arouse the client.
If right: The Pasero Opioid-Induced Sedation Scale is used to assess for unwanted opioid-associated sedation. A Pasero Scale score of 3 is unacceptable but is managed by trying to arouse the client in order to take deep breaths and staying with the client until he or she is more alert. Administering oxygen will not help if the client’s respiratory rate is 7 breaths/min. Giving naloxone and calling for a Rapid Response Team would be appropriate for a higher Pasero Scale score.
If wrong: The Pasero Opioid-Induced Sedation Scale is used to assess for unwanted opioid-associated sedation. A Pasero Scale score of 3 is unacceptable but is managed by trying to arouse the client in order to take deep breaths and staying with the client until he or she is more alert. Administering oxygen will not help if the client’s respiratory rate is 7 breaths/min. Giving naloxone and calling for a Rapid Response Team would be appropriate for a higher Pasero Scale score.