Nursing Elites

1. A charge nurse is discussing HIPAA with a newly licensed nurse. Which action should the charge nurse include in the teaching as an example of a HIPAA violation?

• A. Faxing a patient’s discharge summary to the pharmacy.
• B. Emailing the patient’s positive hepatitis results from an unencrypted server.
• C. Discussing the patient’s care plan during bedside rounds.
• D. Placing the patient’s chart in a secure location at the nurse’s station.

Correct answer: B

Rationale: Emailing patient information from an unencrypted server violates HIPAA because it exposes sensitive health information to potential breaches. Choice A is not a violation as long as the fax is sent to the correct recipient. Choice C is not a violation if the discussion is done discreetly and within an appropriate setting. Choice D is a recommended practice to ensure patient information is kept secure.

2. A nurse in the emergency department is caring for a patient who has extensive partial and full-thickness burns of the head, neck, and chest. While planning the patient’s care, the nurse should identify which of the following risks as the priority for assessment and intervention?

• A. Infection
• B. Airway obstruction
• C. Fluid imbalance
• D. Pain management

Correct answer: B

Rationale: When a patient has extensive burns involving the head, neck, and chest, the priority concern is airway obstruction. The proximity of the burns to the airway can lead to swelling and compromise the patient's ability to breathe. In this situation, ensuring a clear airway and adequate oxygenation takes precedence over other risks such as infection, fluid imbalance, or pain management. While these are also important considerations in burn care, the immediate threat to the patient's life from airway compromise makes it the priority for assessment and intervention.

3. A nurse in an urgent-care clinic is collecting admission history from a client who is 16 weeks gestation and has bacterial vaginosis. The nurse should recognize that which of the following clinical findings are associated with this infection?

• A. Frequency and dysuria
• B. Profuse milky white discharge
• C. Hematuria
• D. Low-grade fever

Correct answer: B

Rationale: Bacterial vaginosis often presents with a profuse, milky white discharge and a characteristic fishy odor, without significant inflammation, hematuria, or fever. Choice A, frequency, and dysuria are more indicative of a urinary tract infection. Choice C, hematuria, is associated with conditions like urinary tract infections or kidney problems. Choice D, low-grade fever, is not a typical symptom of bacterial vaginosis.

4. A nurse is caring for a client prescribed metoprolol. Which of the following should the nurse monitor for as an adverse effect of this medication?

• A. Bradycardia
• B. Hypotension
• C. Tachycardia
• D. Hyperglycemia

Correct answer: B

Rationale: The correct answer is B: Hypotension. Metoprolol, a beta-blocker, can lead to a decrease in blood pressure, resulting in hypotension. Monitoring blood pressure regularly is essential to detect and manage this adverse effect. Choices A, C, and D are incorrect because metoprolol typically does not cause bradycardia, tachycardia, or hyperglycemia as its primary adverse effects.

5. A client tells the nurse that she suspects she is pregnant because she is able to feel the baby move. The nurse knows that this is a:

• A. Presumptive sign of pregnancy
• B. Probable sign of pregnancy
• C. Positive sign of pregnancy
• D. Possible sign of pregnancy

Correct answer: A

Rationale: The correct answer is A: Presumptive sign of pregnancy. Quickening, or the sensation of fetal movement, is considered a presumptive sign of pregnancy. It is not definitive because other conditions, such as gas or intestinal movement, can mimic the feeling of fetal movement. Choice B, Probable sign of pregnancy, refers to signs that make the nurse reasonably certain that a woman is pregnant, such as a positive pregnancy test. Choice C, Positive sign of pregnancy, includes signs like hearing fetal heart tones or visualizing the fetus on ultrasound, which definitively confirm pregnancy. Choice D, Possible sign of pregnancy, is a vague term and does not specifically relate to any pregnancy sign.

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