Nursing Elites

1. A healthcare professional is supervising the logrolling of a patient. To which patient is the healthcare professional most likely providing care?

• A. A patient with neck surgery
• B. A patient with hypostatic pneumonia
• C. A patient with a total knee replacement
• D. A patient with a stage IV pressure ulcer

Correct answer: A

Rationale: Logrolling is a technique used to move a patient as a single unit to prevent twisting or bending of the spine. Patients who have undergone neck surgery require special care to ensure the spinal column remains in straight alignment to prevent further injury. Therefore, the correct answer is a patient with neck surgery. Choice B, a patient with hypostatic pneumonia, does not require logrolling, as it is a condition affecting the lungs, not the spine. Choice C, a patient with a total knee replacement, does not typically necessitate logrolling, as the procedure focuses on the knee joint, not the spine. Choice D, a patient with a stage IV pressure ulcer, requires wound care but does not necessarily involve logrolling unless the ulcer is located in a critical area that requires special handling.

2. The healthcare provider is assessing a client with a history of congestive heart failure. Which assessment finding would be most concerning?

• A. Shortness of breath on exertion
• B. Weight gain of 2 pounds in a week
• C. Orthopnea
• D. Crackles in the lungs

Correct answer: D

Rationale: Crackles in the lungs are concerning because they indicate pulmonary congestion, a serious complication of congestive heart failure. The presence of crackles suggests fluid accumulation in the lungs, requiring immediate attention to prevent respiratory distress and worsening heart failure. While shortness of breath on exertion, weight gain, and orthopnea are common signs and symptoms of heart failure, crackles specifically point to acute pulmonary edema or worsening congestion, making them the most concerning finding in this scenario.

3. A nurse manager is overseeing the care on a unit. Which of the following should the nurse manager identify as a violation of HIPAA guidelines?

• A. A nurse who is caring for a client reviews the client's medical chart with the nursing student who is working with the nurse.
• B. A nurse asks a nurse from another unit to assist with her documentation.
• C. A nurse who is caring for a client returns a call to the client's durable power of attorney for health care designee to discuss the client's care.
• D. A nurse discusses a client's status with the physical therapist who is caring for the client at the bedside.

Correct answer: B

Rationale: The correct answer is B. HIPAA guidelines specify that only healthcare professionals directly involved in a patient's care should access their medical information. Asking a nurse from another unit to assist with documentation involves sharing patient information with someone not directly caring for the patient, which violates HIPAA guidelines. Choices A, C, and D involve individuals directly involved in the client's care, making them appropriate actions in line with HIPAA regulations. Choice A involves educating a nursing student under the supervision of the nurse, which is permissible. Choice C involves communicating with the client's designated healthcare decision-maker, which is also allowed under HIPAA. Choice D involves discussing the client's status with another healthcare professional directly involved in the client's care, which is within HIPAA guidelines.

4. A client is being taught about the use of an incentive spirometer. Which statement by the client indicates effective teaching?

• A. I will use the spirometer every hour while awake.
• B. I will blow into the spirometer as hard as I can.
• C. I should feel dizzy when using the spirometer.
• D. I will only use the spirometer if I feel short of breath.

Correct answer: A

Rationale: The correct answer is A because using the spirometer every hour while awake is an effective way to prevent respiratory complications. This frequency helps in maintaining lung function and preventing atelectasis. Choice B is incorrect because blowing too hard into the spirometer can lead to hyperventilation and dizziness, making choice C also incorrect. Choice D is wrong as waiting to use the spirometer only when feeling short of breath may not provide optimal lung expansion and can lead to respiratory issues.

5. A visitor comes to the nursing station and tells the nurse that a client and his relative had a fight, and that the client is now lying unconscious on the floor. What is the most important action the LPN/LVN needs to take?

• A. Ask the client if he is okay.
• B. Call security from the room.
• C. Find out if there is anyone else in the room.
• D. Ask security to make sure the room is safe.

Correct answer: D

Rationale: The most critical action for the LPN/LVN to take in this situation is to ask security to ensure the room is safe. This step is crucial to prevent any further harm to the unconscious client or others. While it is important to assess the client's condition, ensuring safety takes precedence. Calling security from the room may expose the LPN/LVN to potential danger without confirming the safety of the environment first. Finding out if anyone else is in the room can wait until safety is established to avoid unnecessary risks.

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