a nurse is assessing a client who has meningitis which of the following findings should the nurse report to the provider immediately
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Leadership and Management HESI Test Bank

1. A nurse is assessing a client who has meningitis. Which of the following findings should the nurse report to the provider immediately?

Correct answer: C

Rationale: The correct answer is C: Decreased level of consciousness. In a client with meningitis, a decreased level of consciousness is a critical finding that should be reported immediately. This could indicate increased intracranial pressure or neurological deterioration, requiring prompt intervention. Choices A, B, and D are important in the assessment of meningitis but are not as immediately concerning as a decreased level of consciousness. A generalized rash over the trunk can be seen in meningococcal meningitis, an increased temperature is expected due to the inflammatory response, and photophobia is a common symptom due to meningeal irritation.

2. Which of the following most accurately describes a current concern in health care today?

Correct answer: D

Rationale: Gun violence has become a growing public health concern due to the increasing rates of injury and death caused by the misuse of firearms. Choice A is incorrect because health care-associated infections are not limited to health-care settings and continue to increase. Choice B is inaccurate as preventable deaths from the opioid crisis have not led to a rise in life expectancy in the United States. Choice C is incorrect as medication errors have not been completely eliminated despite the use of electronic medication administration records.

3. What is a major concern about the health-care system in the United States?

Correct answer: B

Rationale: The major concern about the health-care system in the United States is the quality of care provided. While disease prevention and collaborative care are important aspects, the primary focus of concern is ensuring that the care delivered meets high standards in terms of effectiveness, safety, and patient outcomes. Reduction in hospital-acquired drug-resistant infections, although relevant, is not the primary concern when evaluating the overall quality of healthcare services.

4. A nurse in the emergency department is performing triage for a group of clients who were in a train crash. Which of the following clients should the nurse tag as emergent?

Correct answer: C

Rationale: In a triage situation, an asymmetrical thorax suggests a potentially life-threatening condition such as a pneumothorax or hemothorax, requiring immediate attention. This client should be tagged as emergent. Periorbital ecchymosis and deep-partial thickness burns, while concerning, may not indicate an immediate life-threatening situation. An open fracture of the femur, although serious, can be prioritized after addressing emergent cases.

5. Which of the following healthcare providers can legally have access to all, or part, of a patient's medical record because they have a 'need to know'? Select one that does not apply.

Correct answer: B

Rationale: Student nurses, licensed practical nurses, the Vice President for nursing investigating a fall, and quality assurance nurses have a 'need to know' basis to access patient records. Registered nurses who are not directly involved in the care of a patient do not have a legitimate reason or 'need to know' to access that patient's medical records, making choice B the correct answer. The Vice President for nursing investigating a specific incident and licensed practical nurses directly involved in a patient's care have legitimate reasons to access the medical records, ensuring continuity and quality of care.

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