Level: Foundational
Difficulty: Easy
Subtopic: Levels of evidence
NCLEX: The nurse reviewing a unit quality dashboard is being evaluated for evidence-based practice and levels of evidenc…
Statistics or evidence-based practice Management of Care
Case Study
The nurse reviewing a unit quality dashboard is being evaluated for evidence-based practice and levels of evidence. Assessment data include fall rates increased from 2.1 to 4.8 per 1,000 patient days after a process change. Which assessment approach should the nurse use first?
Question
A. Begin invasive procedures before any focused assessment.
B. Use only the chart from admission without current data.
C. Screen for instability, then perform a focused assessment related to the presenting concern.
D. Defer assessment until all medications are administered.
B. Use only the chart from admission without current data.
C. Screen for instability, then perform a focused assessment related to the presenting concern.
D. Defer assessment until all medications are administered.
Rationale
Correct answer: C. Screen for instability, then perform a focused assessment related to the presenting concern.
Rationale: Assessment begins with stability screening and focused data collection before invasive or delayed actions.
Hint: Apply ABCs, client stability, and NCSBN clinical judgment steps before choosing an intervention.
Rationale: Assessment begins with stability screening and focused data collection before invasive or delayed actions.
Hint: Apply ABCs, client stability, and NCSBN clinical judgment steps before choosing an intervention.