Nursing Elites

1. All of the following clients are in need of an emergency assessment except:

• A. a bleeding client who has an injury from falling debris.
• B. an unresponsive client.
• C. a client with an old injury.
• D. a pregnant woman with imminent delivery.

Correct answer: C

Rationale: The correct answer is 'a client with an old injury.' Emergency assessments are required for immediate and life-threatening situations. Clients A, B, and D are in need of emergency assessments due to their critical conditions. Choice C, a client with an old injury, does not require an emergency assessment as it is not an acute or life-threatening situation. While the client with an old injury may still need medical attention, it does not necessitate an emergency assessment as the condition is not currently life-threatening or in need of immediate intervention.

2. Which of the following lab values is associated with a decreased risk of cardiovascular disease?

• A. high HDL cholesterol
• B. low HDL cholesterol
• C. low total cholesterol
• D. low triglycerides

Correct answer: A

Rationale: The correct answer is high HDL cholesterol. High HDL cholesterol levels are associated with a decreased risk of cardiovascular disease because HDL helps remove LDL cholesterol from the arteries, reducing plaque buildup. Low HDL cholesterol (choice B) is actually associated with an increased risk of cardiovascular disease. Low total cholesterol (choice C) or low triglycerides (choice D) are not indicators of a decreased risk of cardiovascular disease; in fact, extremely low total cholesterol levels may indicate other health issues.

3. 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.

4. The nurse notices that a family is waiting at the nursing station desk for its loved one to be brought to the unit for admission during a change-of-shift report. The nurse should:

• A. request that the family wait for its loved one in the client's room and wait to resume the report until the family has left the desk area.
• B. request that a nursing assistant bring coffee for the family while it waits at the desk and continue with the report.
• C. request that the family have a seat in the station rather than stand while awaiting its loved one.
• D. request that the family wait for its loved one in the Emergency Department waiting room.

Correct answer: A

Rationale: To protect the privacy of clients and the confidentiality of the information shared in a change-of-shift report, the family should be asked to wait in the client's room. This ensures that sensitive information is not overheard. The report should be resumed only after the family has left the desk area to maintain confidentiality. Choice B is incorrect as bringing coffee does not address the issue of maintaining confidentiality. Choice C is incorrect as standing or sitting in the station does not prevent the family from overhearing confidential information. Choice D is incorrect as the Emergency Department waiting room is not the appropriate setting for waiting during a unit admission.

5. Which action by the nurse represents the ethical principle of benevolence?

• A. The nurse administers an immunization to a child even though it may cause discomfort
• B. The nurse follows a plan of care designed to relieve pain in a client with cancer
• C. The nurse provides equal amounts of care to all assigned clients on the basis of illness acuity
• D. The nurse upholds a client's decision to refuse chemotherapy for lung cancer

Correct answer: A

Rationale: Benevolence is taking action to help others. In this scenario, administering an immunization to a child, even though it may cause discomfort, aligns with the principle of benevolence as the benefits of protection from disease outweigh the temporary discomfort. Fidelity refers to keeping promises made to clients, families, and other healthcare professionals. Autonomy is a person's independence, and respecting autonomy means agreeing to respect an individual's right to determine their course of action. Justice refers to fairness and equity, including the fair allocation of resources, such as nursing care for all clients. Choice B is incorrect as it pertains more to the ethical principle of beneficence rather than benevolence, which focuses on doing good for others without an expectation of something in return. Choices C and D are incorrect as they do not directly align with the principle of benevolence.

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