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 client receiving chemotherapy is experiencing neutropenia. Which of the following should the nurse include in this client's education?

• A. Track oral temperature weekly
• B. Gardening is a good form of mild exercise
• C. Avoid crowded events
• D. Eat plenty of fresh fruits and vegetables

Correct answer: C

Rationale: Clients with neutropenia have a weakened immune system, making them susceptible to infections. Avoiding crowded events helps reduce the risk of exposure to pathogens, thereby minimizing the chance of infections. Tracking oral temperature is important for detecting fever early, which is a sign of infection and requires immediate medical attention. While gardening can be a good form of exercise, clients with neutropenia should avoid it due to the risk of exposure to bacteria and fungi present in soil. Eating fresh fruits and vegetables is generally encouraged for overall health but may carry a risk of bacterial contamination, which could be harmful to a client with neutropenia.

3. When caring for a client with a sealed radiation implant, which action should be included in the plan of care?

• A. Remove dirty linens after double bagging them
• B. Wear a dosimeter film badge while in the client’s room
• C. Limit visitors to 1 hour per day
• D. Ensure family members remain at least 3 feet from the client

Correct answer: B

Rationale: The correct answer is to wear a dosimeter film badge while in the client's room. This is crucial for monitoring radiation exposure levels when caring for a client with a sealed radiation implant. Option A is incorrect as removing dirty linens after double bagging them is not directly related to radiation safety. Option C is incorrect as there is no specific guideline to limit visitors to 1 hour per day for clients with sealed radiation implants. Option D is incorrect as the distance of family members from the client is not a primary safety measure when dealing with sealed radiation implants.

4. A client newly diagnosed with osteoporosis is being taught by a nurse about preventing complications. Which food should the nurse recommend?

• A. Fried chicken
• B. Whole milk
• C. Oatmeal
• D. Bacon

Correct answer: C

Rationale: Oatmeal is an excellent recommendation for clients with osteoporosis due to its richness in fiber and nutrients, making it a heart-healthy and bone-friendly choice. Fried chicken (Choice A) is high in unhealthy fats and lacks the nutrients needed for bone health. Whole milk (Choice B) contains calcium but can be high in saturated fats, which may not be the best choice for individuals with osteoporosis. Bacon (Choice D) is high in saturated fats and sodium, which can have negative effects on bone health and overall well-being.

5. A nurse is assessing a client who has a femur fracture and is in skeletal traction. Which of the following findings should the nurse report to the provider?

• A. Clear fluid drainage from the pin sites
• B. Client reporting intermittent muscle spasms
• C. Client reporting severe pain despite receiving analgesics
• D. The traction weights are hanging freely

Correct answer: C

Rationale: The correct answer is C. Severe pain that is not relieved by analgesics may indicate neurovascular compromise or other complications and requires immediate attention by the provider. Choices A, B, and D are incorrect because clear fluid drainage from the pin sites is expected in skeletal traction, intermittent muscle spasms are common in this situation, and traction weights hanging freely indicate proper traction alignment.

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