Nursing Elites

1. Which medication might the healthcare provider prescribe if the client expresses discomfort with being in the enclosed space of a CT scanner?

• A. Valium (diazepam)
• B. Clozaril (clozapine)
• C. Catapres (clonidine)
• D. Lasix (furosemide)

Correct answer: A

Rationale: Valium (diazepam) is a sedative that might be prescribed to help a client who feels uncomfortable in the confined space of a CT scanner. Diazepam can help reduce anxiety and promote relaxation, making the scanning process more tolerable. Clozaril (clozapine), Catapres (clonidine), and Lasix (furosemide) are not sedatives and wouldn't be appropriate for alleviating discomfort related to being in an enclosed space. Clozaril is an antipsychotic used to treat schizophrenia, Catapres is a blood pressure medication, and Lasix is a diuretic used to treat fluid retention, so they are not indicated for this situation.

2. The nurse notices that a family is waiting at the nursing station desk for its loved one to be brought to the unit for admission during a change-of-shift report. The nurse should:

• A. request that the family wait for its loved one in the client's room and wait to resume the report until the family has left the desk area.
• B. request that a nursing assistant bring coffee for the family while it waits at the desk and continue with the report.
• C. request that the family have a seat in the station rather than stand while awaiting its loved one.
• D. request that the family wait for its loved one in the Emergency Department waiting room.

Correct answer: A

Rationale: To protect the privacy of clients and the confidentiality of the information shared in a change-of-shift report, the family should be asked to wait in the client's room. This ensures that sensitive information is not overheard. The report should be resumed only after the family has left the desk area to maintain confidentiality. Choice B is incorrect as bringing coffee does not address the issue of maintaining confidentiality. Choice C is incorrect as standing or sitting in the station does not prevent the family from overhearing confidential information. Choice D is incorrect as the Emergency Department waiting room is not the appropriate setting for waiting during a unit admission.

3. Which of the following scenarios are considered violations of HIPAA laws?

• A. Discussing discharge plans with a client in a multi-bed recovery room with the curtain drawn around the client's bed.
• B. Looking up the medical information of a friend without permission.
• C. Checking on your spouse's medical record because you are listed as her power of attorney.
• D. Avoiding conversations about clients while in line in the cafeteria with a mutual caregiver of that client.

Correct answer: C

Rationale: Scenarios B and C are considered violations of HIPAA laws. Looking up the medical information of a friend who is not in your care, even with permission, is a violation of HIPAA as the friend is not your patient. Checking on your spouse's medical record, even as a power of attorney, is a violation unless it is directly related to caregiving decisions. Discussing discharge plans with a client in a multi-bed recovery room with the curtain drawn around the client's bed is not a violation of HIPAA. This scenario is considered an 'incidental disclosure' and is not a breach of HIPAA privacy rules. Avoiding conversations about clients while in line in the cafeteria with a mutual caregiver of that client is actually a good practice as it maintains client confidentiality.

4. The nurse acts as an advocate for the nursing profession by performing all of the following activities except:

• A. encouraging political involvement by nurses with their legislators.
• B. acting as a first-aid provider for a children's athletic team.
• C. precepting newly licensed nurses in the work situation.
• D. encouraging as many persons to become nurses as possible.

Correct answer: D

Rationale: The nurse acts as an advocate for the nursing profession by encouraging appropriate persons to become nurses, by being a positive role model and mentor, and by communicating the needs of nurses in the most professional manner possible to those making the laws. Encouraging as many persons as possible to become nurses may not align with the advocacy role, as the focus should be on quality rather than quantity. Choices A, B, and C are activities that align with being an advocate for the nursing profession by promoting political involvement, providing first aid, and precepting newly licensed nurses, respectively.

5. All of the following interventions should be performed when fetal heart monitoring indicates fetal distress except:

• A. Increase maternal fluids.
• B. Administer oxygen.
• C. Decrease maternal fluids.
• D. Turn the mother.

Correct answer: C

Rationale: When fetal heart monitoring indicates fetal distress, interventions are aimed at improving oxygenation to the fetus. Increasing maternal fluids helps improve placental perfusion and oxygen delivery to the fetus. Administering oxygen also aids in increasing oxygen supply to the fetus. Turning the mother can help relieve pressure on the vena cava, optimizing blood flow to the placenta. Therefore, decreasing maternal fluids would not be performed as it can further compromise placental perfusion and fetal oxygenation, making it the exception. Decreasing maternal fluids could potentially exacerbate fetal distress by reducing oxygen delivery and nutrient supply to the fetus, which is contrary to the goal of managing fetal distress.

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