Nursing Elites

1. A nurse working the 7 a.m. to 3 p.m. shift is reviewing the records of the assigned clients. Which client should the nurse assess first?

• A. A client scheduled for hemodialysis at 10 a.m.
• B. A client scheduled for contrast computed tomography (CT) at noon.
• C. A client scheduled for a nuclear scanning procedure at 10 a.m.
• D. A client scheduled for hydrotherapy for the treatment of a burn injury at 10:30 a.m.

Correct answer: A

Rationale: The correct answer is the client scheduled for hemodialysis at 10 a.m. This client needs immediate assessment before the procedure, which may take up to 5 hours. The nurse should ensure the client is physically and emotionally prepared, check for fluid overload by assessing weight and lung sounds, review vital signs, and laboratory test results. The other clients described in the options have needs that are not as urgent. The client scheduled for a nuclear scanning procedure at 10 a.m. may require information reinforcement and increased fluid intake before the procedure. The client scheduled for hydrotherapy for the treatment of a burn injury at 10:30 a.m. may need pain medication administered 30 minutes prior to the therapy. The client scheduled for a contrast CT at noon may need procedure information reinforcement and a special contrast preparation just before the procedure.

2. Which of the following provides the framework for confidentiality and the client's right to privacy?

• A. Health Insurance Portability and Accountability Act
• B. CDC Surveillance Programs
• C. American Nurses Association Code of Ethics
• D. Durable Power of Attorney for Health Care

Correct answer: A

Rationale: The correct answer is the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is the federal statute that outlines client confidentiality and the client's right to privacy. It establishes national standards to protect individuals' medical records and personal health information. The American Nurses Association Code of Ethics emphasizes principles of nursing ethics but does not serve as a legal framework for confidentiality and privacy. CDC Surveillance Programs focus on disease surveillance and control at a public health level and are not directly related to individual client privacy. The durable power of attorney for health care pertains to granting legal decision-making authority to another individual in healthcare matters, rather than addressing confidentiality and privacy rights.

3. While on the wound care team, the nurse notices that a fellow nurse opens extra colloid dressings that are often thrown away when they are not needed. What should the nurse do?

• A. Do nothing, as it is not impacting client care.
• B. Discuss with the colleague the concern about wasting supplies.
• C. Tell the charge nurse to stop ordering these dressings.
• D. Remove the colloid dressings from the shelf so that the nurse will find other supplies to use.

Correct answer: B

Rationale: The correct answer is to discuss with the colleague the concern about wasting supplies. By addressing this issue, the nurse can promote cost-effective care within the unit. While it may not directly impact client care, the wastage of supplies affects the unit's supply cost, making choice A incorrect. Choice C is incorrect as it assumes the charge nurse is solely responsible for the ordering process and overlooks the opportunity for direct communication between colleagues. Choice D is incorrect as it involves taking matters into one's own hands rather than addressing the issue through communication and collaboration.

4. The nurse on the 3-11 shift is assessing the chart of a client with an abdominal aneurysm scheduled for surgery in the morning and finds that the consent form has been signed, but the client is unclear about the surgery and possible complications. Which is the most appropriate action?

• A. Call the surgeon and ask them to see the client to clarify the information
• B. Explain the procedure and complications to the client
• C. Check the physician's progress notes to see if understanding has been documented
• D. Check with the client's family to see if they understand the procedure fully

Correct answer: A

Rationale: The most appropriate action in this scenario is to call the surgeon and ask them to see the client to clarify the information. It is the responsibility of the physician to explain and clarify the procedure to the client, ensuring informed consent. Answer B is incorrect as nurses should not provide detailed medical explanations beyond their scope of practice. Answer C is incorrect as the physician's notes may not capture the client's current understanding accurately. Answer D is incorrect because the client's own understanding, not the family's, is crucial for informed decision-making regarding the surgery.

5. In which of the following conditions might increased cortisol levels be found?

• A. Cushing's syndrome
• B. Addison's disease
• C. Renal failure
• D. Congestive heart failure

Correct answer: A

Rationale: Cushing's syndrome is characterized by increased cortisol levels due to the overproduction of cortisol by the adrenal glands. This excess cortisol can lead to various symptoms and complications. Addison's disease is associated with decreased cortisol levels as it results from adrenal insufficiency, making it an incorrect choice in this context. Renal failure and congestive heart failure are not typically linked to abnormal cortisol levels, further indicating that they are not the conditions where increased cortisol levels are found.

Similar Questions